Term
| factors of type 1 diabetes |
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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 |
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Term
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Definition
| polyuria, polydipsia, polyphagia, weight loss(H2O loss with protein and fat breakdown), malaise and fatigue |
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Term
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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 |
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Term
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Definition
| slow onset of symptoms, polyuria, polydipsia, weight loss(not common), hypergycemia, fatigue, blurred vision, parethesias, skin infections, impaired healing of wounds |
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Term
| DM is a chronic disease T or F? |
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Definition
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Term
| fasting plasma glucose... |
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Definition
diabetes: >126
pre DM: 100-126
normal: under 100 |
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Term
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Definition
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Term
| can you have damage done during a pre DM state? |
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Definition
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Term
| How much healthcare dollas where spent in 2007? |
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Definition
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Term
| Diabetes control and complications trial did what? |
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Definition
| showed that a metabolic control of type 1 DM makes a difference |
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Term
| if your A1C going down by 1%, then your chance of complications goes down by ____% |
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Definition
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Term
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Definition
A: A1C, should be under 7%
B: blood pressure, under 130/80
C: cholesterol, under 200 |
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Term
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Definition
| normalize ABC's, body weight (loose 5-7%), prevent or delay complications, avoid acute complications, strive for qbest quality of life. |
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Term
| if your A1C is 6%, then your BG over the past couple months have been... |
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Definition
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Term
| glycosolated hemoglobin: A1C |
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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 |
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Term
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Definition
| INSULIN: facilitates the movement of glucose across cell membrane |
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Term
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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. |
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Term
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Definition
| SOMATOSTATIN: neurotransmitter that inhibits the production of both insulin and glucagon |
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Term
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Definition
PROMOTES: entry of glucose into cells, glycogen storage, fat storage, and protein storage
INHIBITS: gluxose synthesis, breakdoqwn of glycogen, fat and protein |
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Term
| when you eat, you have two phases of insulin release, what are they and where do they come from? |
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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 |
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Term
| global approach to diabetes includes |
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Definition
| medical nutrition, medications, physical activity, and psychosocial considerations |
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Term
| nutritional therapy and goals |
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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 |
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Term
| ___% of carbs are broken down into glucose |
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Definition
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Term
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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) |
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Term
| recommended amount of exercise that i dont achieve per week... |
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Definition
FITT:
frequency: 3-7 times a week
Intensity: light to hard
Type: aerobic, resistance, and flexibitly training
Time: 20-60 minutes |
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Term
| type 2 DM benefits of exercise: |
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Definition
-improves glucose tranport
- increases insulin sensitivity for a peroid of 8-48 hours
-acutely reduces BS
-promotes weight loss |
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Term
| benefits of type 1 DM from exercise: |
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Definition
-improves glucose untake
-enhances insulin sensitivity |
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Term
| psychosocial considerations : |
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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 |
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Term
| T or F: the earlier you start insulin therapy, the more it helps you in the long run with less complications... |
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Definition
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Term
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Definition
prevents post-prandial hyperglycemia!
rapid (15 minutes of meal) and short acting (w/ in 30 minutes prior to mean) |
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Term
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Definition
Prevens hyperglycemia from not eating
-take at same time each day
-includes intermediate and long acting |
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Term
rapid acting:
humalog, novolog |
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Definition
O: w/in 15 minutes
P: 1 hour
D: 3 1/2 - 4 hours |
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Term
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Definition
O: 1/2 - 1 hour
D: 2 - 4 hours
P: 6 - 8 hours |
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Term
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Definition
O: 2-4 hours
D:6-10 hours
P: 10-16 hours |
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Term
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Definition
O: 2
P: peakless
D: 24 hours |
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Term
| place where the best absorption occurs? |
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Definition
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Term
| Facts about IV insulin therapy... |
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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 |
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Term
| if your BG is under 70, what do you do? |
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Definition
| 15 grams of CHO and check BG in 15 minutes |
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Term
| insulin secretagogues includes what groups? |
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Definition
sulfonylureas, meglitinides, D-phenylalanine
**these help stimulate release of insulin from pancreas |
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Term
| types of oral antidiabetic agents |
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Definition
| insuline secretagogues, insuline sensitizers, alpha-glucosidase inhibitors, and combintions |
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Term
| insulin sensitizers includes: |
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Definition
thiazolidinediones and biguanides
**helps the body use insulin better |
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Term
| secretagogues: sulfonylureas... |
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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 |
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Term
| secretagogues: meglitinides / D-phenylalaines |
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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. |
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Term
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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 |
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Term
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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 |
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Term
| sensitizers: thiazolidinediones |
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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 |
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Term
| alpha-glucosidase inhibitors: |
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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 |
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Term
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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 |
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Term
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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 |
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Term
| S&S of hypoglycemia....like we dont know this already |
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Definition
| cold sweats, hunger, shakiness, weakness, grouchiness, confusion, slurred speech, change in LOC |
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Term
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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! |
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Term
| acute complictions of hyperglycemia and the causes... |
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Definition
DKA, HHS, and pre-during-post surgery
Causes: infection, TPN, steroid therapy, dawm phenomenon, and somogyi phenomenon. |
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Term
| acute complictions of hyperglycemia and the causes... |
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Definition
DKA, HHS, and pre-during-post surgery
Causes: infection, TPN, steroid therapy, dawm phenomenon, and somogyi phenomenon. |
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