Define and Compare and Contrast

Type 1 vs. Type 2 Diabetes

(cause, onset, insulin, age of onset, pathophysiology)

Type 1:  cause:  beta cell of pancrase don't function

              Insulin dependant:  

              Onset between 5-30

              Body does not produce insulin

Type 2:  receptors in cell become imune to insulin

                 because of over use with exccessive

                 intake of foods; 

              Onset in late adulthood, 

              body produces insulin but cell receptors 

                       do not respond.

Primary secondary, tertiary prevention of DM

Primary:  Identify risks and eliminate them-change diet, exercise etc.

Secondary:  early identification and treatment.  Test blood sugar, test urine

Tertiary-  treat patient to minimize impact of disease-   teach patient what to eat and when to take insulin

Impaire glucose fasting is  ____________

126 mg/dl

Impaired glucose 2hrs post-prandial_____?

>140mg%-199mg% 

Normal HIAC goal for non-diabetics  ___?

< 6

indicator of good compliance for a diabetic is < 7

Sign/Symptons of Type 1 DM?

• polyuria
• polydispsia
• ployphagia
• weight loss
• fatique
• blurred vision
• infections
• acute onset

Signs/Symptons of Type 2 DM?

• polyuria
• polydipsia
• fatique
• inefections
• poor healing
• overweight
• vision
• blood sugar not as high as type 1
• gradual onset

Drug:

Novolog

• rapid acting
• 10-15 min onset
• Peak 45-90 min.
• duration 3-4 hours

Humalog

• also insuling lispro
• onset- 10-15min
• peak 45-90 min
• duration 3-4 hours

insulin regular

(humulin R)

• onset 30-60 min
• peak 2-3 hours
• duration 3-8 hours

NPH 

(Insulin isophane suspension)

•  onset- 1-3 hours
• peak 6-12 hours
• duration 20 hours

Most likely to be hypoglycemic at peak aprox. 8 hours

Lantus

insulin glargine

• onset 1-3 hours
• peak NONE
• duration 24 hours

 Most serious side effect of Glucophage?

Most common side effect of Glucophage?

Renal Failure

Hypoglycemia

exanatide (Byetta)

 Class:  Incretin mimetic

acton; lowers postprandial blood glucose

SE: nause; Weigh loss

made from salvia of helo monster

Signs and Symptons of Hypoglycemia?

Anrenergic- pallor, diaphoresis, tachycardia

Neuroglycopenic- HA, mental confusion, circumoral aresthesia, diplopia, coma

Pathology of macrovascualr disease?

• accelerated cariovascular deterioration
• Accelerated atherosclerosis- occlusions of small arteries and arterioles of lower extremities cause gangrenous changes

lipid pane s/b

Low density lipids < 100

high densit lipids >45

Triglycerides < 150

BP 130/80 or less

Antihypertensives- ace inhbitors are best to protect kidney function