Details Title: 135 - diabetes Description: diabetes Total Flash Cards: 53 Created: 02/12/2009 08:15:33		New Users: To study from this flashcard set, or to create your own your own study flash cards, REGISTER HERE. Existing Users: CLICK HERE. Additional Health Care Flashcards
Cards in this set: Term factors of type 1 diabetes Definition comprises 5-10% of all cases -peak incidence of puberty -men and women are equally effected - more prevelant in non-hispanic whites -autoimmune destruction of the beta cells Term S&S of type 1 DM Definition polyuria, polydipsia, polyphagia, weight loss(H2O loss with protein and fat breakdown), malaise and fatigue Term factors of type 2 DM Definition BMI > 27, insulin resistance, abnormal lipid panel, increaed abdominal circumference, inactive lifestyle, family history, **more frequent in AA, hispanics, pacific islanders, asains, and native americans Term S&S of type 2 DM Definition slow onset of symptoms, polyuria, polydipsia, weight loss(not common), hypergycemia, fatigue, blurred vision, parethesias, skin infections, impaired healing of wounds Term DM is a chronic disease T or F? Definition TRUE Term fasting plasma glucose... Definition diabetes: >126 pre DM: 100-126 normal: under 100 Term casual plasma glucose... Definition DM: more than 200 Term can you have damage done during a pre DM state? Definition FUCK YA Term How much healthcare dollas where spent in 2007? Definition 174 billion!! Term Diabetes control and complications trial did what? Definition showed that a metabolic control of type 1 DM makes a difference Term if your A1C going down by 1%, then your chance of complications goes down by ____% Definition 35 Term ABC's of DM Definition A: A1C, should be under 7% B: blood pressure, under 130/80 C: cholesterol, under 200 Term management goals of DM Definition normalize ABC's, body weight (loose 5-7%), prevent or delay complications, avoid acute complications, strive for qbest quality of life. Term if your A1C is 6%, then your BG over the past couple months have been... Definition 126 Term glycosolated hemoglobin: A1C Definition -measures glucose bound to RBC's (they live for 2-3 months) -average BG over 203 months -what it to be <7% -should be checked at least 2 times a year Term Beta cells: Definition INSULIN: facilitates the movement of glucose across cell membrane Term Alpha cells: Definition GLUCAGON: stimulates breakdown of glycogen in the liver, the formation of arbs in the liver, and the breakdown of lipids in both the liver and apidose tissue. Term Delta cells: Definition SOMATOSTATIN: neurotransmitter that inhibits the production of both insulin and glucagon Term actions of insulin: Definition PROMOTES: entry of glucose into cells, glycogen storage, fat storage, and protein storage INHIBITS: gluxose synthesis, breakdoqwn of glycogen, fat and protein Term when you eat, you have two phases of insulin release, what are they and where do they come from? Definition Phase 1: 1-2 minutes of ingested good and completed within 10 minutes, this is stored insulin Phase 2: release of preformed and newly synthesized insulin, begins 5-10 minutes of ingestion and continue as long as beta cells are stimulated Term global approach to diabetes includes Definition medical nutrition, medications, physical activity, and psychosocial considerations Term nutritional therapy and goals Definition -provide enough calories, achieve BGM goals, good lipid levels, -meal plans are on an individualized approach...duh -some good approached include: exchange list, plate method, and carb counting Term ___% of carbs are broken down into glucose Definition 100 Term CARBS: Definition 10-65% of your calories should come from carbs primary source of energy for the body two types: simple and complex ***1 carb choice = 15 GARNS IF CHO!!!! (skim milk, 1/2 cup of juice o soda, 1 slice of bread) Term recommended amount of exercise that i dont achieve per week... Definition FITT: frequency: 3-7 times a week Intensity: light to hard Type: aerobic, resistance, and flexibitly training Time: 20-60 minutes Term type 2 DM benefits of exercise: Definition -improves glucose tranport - increases insulin sensitivity for a peroid of 8-48 hours -acutely reduces BS -promotes weight loss Term benefits of type 1 DM from exercise: Definition -improves glucose untake -enhances insulin sensitivity Term psychosocial considerations : Definition stress, asess adjustment and copig skills, uses of appropriate interpersonal skills, address different leanring styles, consider needs of individual, assist with behaboir chanfe, consider financial support/resources Term T or F: the earlier you start insulin therapy, the more it helps you in the long run with less complications... Definition TRUE Term Bolus insulins: Definition prevents post-prandial hyperglycemia! rapid (15 minutes of meal) and short acting (w/ in 30 minutes prior to mean) Term basal insulins Definition Prevens hyperglycemia from not eating -take at same time each day -includes intermediate and long acting Term rapid acting: humalog, novolog Definition O: w/in 15 minutes P: 1 hour D: 3 1/2 - 4 hours Term short acting: regular Definition O: 1/2 - 1 hour D: 2 - 4 hours P: 6 - 8 hours Term intermediate: NPH Definition O: 2-4 hours D:6-10 hours P: 10-16 hours Term Long acting: lantus Definition O: 2 P: peakless D: 24 hours Term place where the best absorption occurs? Definition abdomen, arm, Term Facts about IV insulin therapy... Definition -reduces fluctuations in BG -infused with REGULAR insulin -flow rate based on BG -discard 1st 50 mls of insulin, saline mix -half like is 5-10 minutes Term if your BG is under 70, what do you do? Definition 15 grams of CHO and check BG in 15 minutes Term insulin secretagogues includes what groups? Definition sulfonylureas, meglitinides, D-phenylalanine **these help stimulate release of insulin from pancreas Term types of oral antidiabetic agents Definition insuline secretagogues, insuline sensitizers, alpha-glucosidase inhibitors, and combintions Term insulin sensitizers includes: Definition thiazolidinediones and biguanides **helps the body use insulin better Term secretagogues: sulfonylureas... Definition EX: amaryl and glucotrol (RECHECK) -primary site of action if the pancreas, which helps stimulates insulin release -also decreases hepatic glucose production, increases number of insulin receptor sites sensitivity, and may improve insulin receptor defects -S/E: HYPOGLYCEMIA! -drugs that decrease action: Ca channel blockers, oral contraceptives, steroids, thiazise diuretics -drugs the intensify action: NSAIDS, sulfonamide abx, ranitidine, cimetidine, and beta blockers Term secretagogues: meglitinides / D-phenylalaines Definition EX: prandin and starlix site of action: pancreas actions: stimulates panreatic release of insulin, rapidly absorbed from GI tract, metabolized by liver, excreted primarily in feces, may be used in renal insufficiency S/E: hypoglycemia. Term sensitizers: biguanides Definition EX: METAFORMIN sites of action: liver, intestines, adipose tissue, and muscle cells Primary actions: reduces hepatic glucose production -decreases intestinal absorption, increases peripheral glucose uptake and utilization, does not stimulate beta cell or insulin production, does not cause hypoglycemia when monotherapy Benefits: weightloss,increased HDL, improved LDL and triglycerides S/E: GI upset (gass, cramping diarrhea) , start low go slow Term Cautions for metaformin: Definition contradictions: -renal impairment = Cr >1.5 in men and >1.4 in women -any threat to renal perfusion (surgery, infection, foot ulcer) -CHF -acidosis -severe acute illnesses -contradicted in contrast dyes Term sensitizers: thiazolidinediones Definition EX: Actos and Avandia Sites of action: muscle, adipose tissue, and liver main action: improve peripheral insulin resistance in skeletal muscle -also reduces excessive hepatic glucose production -does not stimulate insulin secretion - does not cause hypoglycemia when used alone S/E: fluid retention = CHF Contradictions: liver disease, increases ALT, class 3 or 4 heart failllure Term alpha-glucosidase inhibitors: Definition EX: precose/glyset Site of action: intestines -delays indgestion of ingested carbs, results ina smaller rise in post prandioal glucose levels, to be taken with first bite of food at meals!, DOES NOT CAUSE HYPOGLYCEMIA! S/E: GI upset, Contradictions: inflammatory bowel disese, colonic ulceration, Cr >2.0, or cirrhosis Term byetta... Definition for type 2 DM, used as adjunct therapy with oral agents, lowers postmeal and fasting glucose levels ACTIONS: stimulates insuline secretion only if BG us elevated and helps restore first phase insulin response -this is a fixed dose SQ injection Term Symlin....new med for DM Definition -used in conjuction with insulin in type 1 and 2 DM -helps lower post meal elevation and reduces weight -used at mealtime for pats who failed to achieve desiredglucose control despite optimal inculin therapy Term S&S of hypoglycemia....like we dont know this already Definition cold sweats, hunger, shakiness, weakness, grouchiness, confusion, slurred speech, change in LOC Term glucagon pen: Definition stimulates hepatic glucose release, injected when patient is nonresponsive, requires a prescription!, esponse in 15 minutes, may cause N/V, give carb once pt has responded **tell patient to always wear DM emergancy band! Term acute complictions of hyperglycemia and the causes... Definition DKA, HHS, and pre-during-post surgery Causes: infection, TPN, steroid therapy, dawm phenomenon, and somogyi phenomenon. Term acute complictions of hyperglycemia and the causes... Definition DKA, HHS, and pre-during-post surgery Causes: infection, TPN, steroid therapy, dawm phenomenon, and somogyi phenomenon.