Term
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Definition
| Chronic multisystem disease related to abnormal insulin production, impaired insulin utilization, or both |
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Term
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Definition
| Abnormal insulin production, insulin dependent, progressive destruction of pancreatic beta cells by body's own T cells, often occurs before 30 years of age, antibodies cause a reduction of 80-90% of normal beta cell fx before manifestation occurs |
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Term
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Definition
| Hx of recent, sudden wt loss, polydipsia, polyuria, polyphagia |
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Term
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Definition
| Most prevalent type, over 90% of pts with diabetes, usually occurs in pts over 35, 80-80% of pts are overweight |
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Term
| Three major metabolic abnormalities in Type 2 Diabetes |
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Definition
| 1. Insulin resistant; 2. Pancreas inability to produce insulin; 3. Inappropriate glucose production from liver |
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Term
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Definition
| Elevated insulin levels along with insulin resistance, increased triglycerides and LDL's, decreased HDL's, HTN--need at least three of those conditions for metabolic syndrome |
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Term
| Risk Factors for Metabolic Syndrome |
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Definition
| Central obesity, sedentary lifestyle, urbanization, certain ethnicities |
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Term
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Definition
| Develops during pregnancy, detected 24-28 weeks of gestation, glucose levels back to normal 6 weeks postpartum, if able to maintain pre-pregnancy wt then DM 2 will be unlikely |
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Term
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Definition
Comes from another medical condition; Cushing syndrome, hyperthyroidism, pancreatitis, parenteral nutrition, cystic fibrosis, hematochromatosis
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Term
| Clinical Manifestations--Type 1 |
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Definition
| Polyuria, polyphagia, polydipsia, wt loss, weakness, fatigue |
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Term
| Clinical Manifestations--Type 2 |
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Definition
| Unspecific symptoms, fatigue, recurrent infections, recurrent vaginal yeast infections, prolonged wound healing, visual changes |
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Term
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Definition
| Fasting plasma glucose, random or casual plasma glucose, two hour OGTT, HbA1C now approved |
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Term
| Fasting Plasma Glucose or Impaired Fasting Glucose |
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Definition
>126 mg/dl=diabetes; >100-<125=pre-diabetes; <100=non-diabetic
Need to have more than one test to diagnose |
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Term
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Definition
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Term
| Two Hour OGTT or Impaired Glucose Tolerance |
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Definition
| >200=diabetes; <200->140=pre-diabetes; <140=non-diabetic |
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Term
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Definition
Normal = 4-6%
Increased risk = 5.7-6.4%
Diabetes = >6.5% |
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Term
| Rapid Acting Insulin--Bolus |
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Definition
Onset 15 min; Peak 60-90 min; duration 3-4 hours
Lispro (Humalog), Aspart (Novalog), Glulisine (Apidra)
All clear insulin |
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Term
| Short-Acting Insulin--Bolus |
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Definition
Regular
Onset 30 min- 1 hr
Peak 2-3 hrs
Duration 3-6 hrs
All clear
Humulin N, Novolin N, ReliOn N |
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Term
| Intermediate Acting Insulin |
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Definition
NPH or Lente (Humulin N, Novolin N, ReliOn N)
All cloudy
Onset 2-4 hrs
Peak 4-10 hrs
Duration 10-16 hrs
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Term
| Long Acting Insulin--Basal |
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Definition
Glargine (Lantus), Detemir (Levemir)
All clear
Onset 1-2 hrs
Peak no pronounced peak
Duration 24+ hrs |
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Term
Problems with Insulin Therapy
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Definition
| Hypoglycemia, allergic reactions, lipodystrophy, Somogyi effect, dawn phenomenon |
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Term
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Definition
Exubera
Rapid acting, dry powder unhaled through mouth into lungs
Not recommended for patents with asthma, bronchitis, emphysema
1 mg=3 units 3 mg-8 units |
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Term
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Definition
| Works on three defects caused by type 2 diabetes; insulin resistance, decreased insulin production, increased glucose production |
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Term
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Definition
| Stimulates insulin production from pancreas, decreases liver glucose production, augments glucose uptake in tissues, delays reabsorption of glucose in gi tract |
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Term
| Sulfonylureas--Glyburide, Glimepride(Amaryl), Glipizide(Glucotrol) |
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Definition
Increases insulin production in pancreas
Hypoglycemia is most common SE (alcohol increases risk)
Can cause wt gain
may cause heart disease is insulin is increased for a long period of time |
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Term
| Biguanides--Metformin (Glucophage) |
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Definition
Reduce glucose production by liver, enhance insulin sensitivity at tissues, improve glucose transport into cells, does not promote wt gain, may be given for pre-diabetes
SE: nausea, diarrhea, metallic taste, intestinal gas
Decrease in Vitamin B12 can occur
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Term
| a-Glucosidase Inhibitor--Acarbose (Precose) |
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Definition
"Starch Blocker", slows down absorption of carbohydrates in small intestine, given only with food
SE: intestinal symptoms (gas, discomfort, diarrhea) can lessen SE by eating higher carb food |
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Term
| Thiazolidinediones--Pioglitazone (Actos), Rosiglitazone (Avandia) |
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Definition
Most effective in those with insulin resistance, improves insulin sensitivity, transport, and utilization at the target tissues
SE: weight gain, muscle pain, mild anemia, headaches, retention of fluid in the body that may lead to heart failure, URI and sinusitis
Takes up to 3 mos to work
Avandia is on BAD LIST for CHF and weight gain need to be on continuous liver tests |
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Term
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Definition
Pramlintide (symlin)
Amylin is a hormone secreted by beta cells of pancreas, normally co-secreted with insulin, symlin is indicated for type 1 and type 2 diabetics, slow gastric emptying, slows glucagon secretion, delays glucose output from liver, increases satiety, SC thigh or abdomen...NOT ARM
SE: Nausea |
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Term
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Definition
Synthetic peptide, stimulates release of insulin from beta cells, subcutaneous injection, suppressess glucagon secretion
Only used in type 2 diabetes, cannot be used with insulin
SE: Nausea and diarrhea, when taken with a sulfonylureas may cause hypoglycemia |
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Term
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Definition
| Cornerstone of care for diabetes, most challenging for many people, recommended that diabetes nurse educator and registered dietician with diabetes experience be members of team |
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Term
| Nutrition Therapy-Type 1 Diabetes |
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Definition
| Meal plan based on individual's usual food intake and is balanced with insulin and exercise patterns, insulin regimen managed day to day |
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Term
| Nutritional Therapy--Type 2 Diabetes |
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Definition
| Emphasis based on achieving glucose, lipid, an blood pressure goals, calorie reduction |
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Term
| Nutritional Therapy--Plate method |
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Definition
| Half filled w/ veggies, quarter filled with protein, quarter filled w/ carbs |
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