Term
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Definition
fuel option for muscle, adipose tissue, liver;
ONLY fuel source for BRAIN |
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Term
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Definition
| storage molecule for excess glucose |
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Term
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Definition
breakdown of glycogen into glucose;
occurs during low blood glucose levels;
liver can release glucose into blood stream |
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Term
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Definition
production of glucose from new sources;
occurs in liver |
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Term
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Definition
increases glucose uptake in cells;
decreases fat & glycogen breakdown;
increases protein synthesis, decreases protein breakdown;
decreased gluconeogenesis;
increased TG synthesis;
increased FA transport into adipose tissue;
secretion regulated by blood glucose (positive feedback) |
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Term
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Definition
maintains blood glucose between meals;
increased glycogenolysis in liver;
increased gluconeogenesis in liver;
High levels:
breaks down adipose tissue;
- increased blood flow to tissues;
secretion regulated by blood glucose (negative feedback) |
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Term
| epinephrine & norepinephrine |
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Definition
catecholamine released in times of stress;
decreased insulin release from pancreas;
promotes glycogenolysis;
increased lipolysis; |
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Term
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Definition
increased protein synthesis;
increased FA mobilization from adipose tissue;
decrease cellular uptake & use of glucose --> increased BG;
release inhibited by insulin, increased by exercise; |
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Term
| glucocorticoid hormones (cortisol) |
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Definition
released in response to stress;
increased gluconeogenesis;
moderately decreases tissue use of glucose |
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Term
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Definition
| insulin, lack of food, increased exercise, excess EtOH, excess DM meds, decreased liver or kidney fcn |
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Term
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Definition
| excess food, illness, stress, counter-regulatory hormones, insufficient DM meds, other medications (antibiotics) |
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Term
| Sugar Intake Increases BG |
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Definition
carbs cause change in 1 hr;
proteins & fats cause change in 3-4 hrs;
Eating late at night may raise early morning BG |
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Term
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Definition
decreases BG with longer fasting periods;
Recommend: 6 SMALL meals/snacks daily; |
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Term
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Definition
maintains BG levels, prevents hypoglycemia;
used instead of adjusting insulin levels;
may lead to HYPERglycemia if not careful |
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Term
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Definition
may increase or decrease BG;
rapid use of available insulin & glucose at 20x normal rate;
short burts: decrease BG;
extended length: increases BG;
MONITOR BG!!! |
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Term
| Additional Benefits of Exercise in DM pts |
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Definition
reduces body weight;
improves BP and lipids;
reduced risk of cardiovascular diseases |
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Term
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Definition
moderate amounts in controlled DM pts WILL NOT affect BG;
< or = 1 drink/day for women;
< or = 2 drinks/day for men;
Recommend: ingest with other Carbs to prevent overnight hypoglycemic for those on insulin or secretagogues;
Co-consumption w/ Carbs may raise BG |
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Term
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Definition
release of catecholamines (mainly Epi);
decreased insulin release;
stimulates conversion of muscle & liver glycogen to glucose --> glycogenolysis |
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Term
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Definition
decreased caloric intake;
decreased insulin sensitivity;
"stress" can raise BG |
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Term
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Definition
| corticosteroids, diuretics (thiazide & loop), protease inhibitors, anti-hyperlipidemics (niacin), antipsychotics, anticonvulsants |
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Term
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Definition
| antidiabetics, antimalarial, antibiotics |
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Term
| Meds that mask hypoglycemia |
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Definition
| non-selective beta-blockers (propranolol, carvedilol, nadolol) |
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Term
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Definition
Non-DM:
Pre - 80-90 mg/dl
Post - <140 mg/dl;
DM:
elevated BG >126 mg/dl |
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Term
| Self-Monitoring BGs (SMBG) |
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Definition
Recommended for ALL pts w/ DM;
Mutiple daily injections: >= 3x/day;
Once daily insulin, oral meds, Nutrition controlled: 1x/day or less;
When:
Before meals (FBG) - marker of basal blood sugar;
After meals (Postprandial - PPG) - 2 hrs after meals - marker of food metabolism & absorption & mealtime med control;
Bedtime - prevent nocturnal hypoglycemia
Exercise - before & after |
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Term
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Definition
BG < 70 mg/dL
Shaking, sweating, hunger, tachycardia, anxious, irritable, impaired vision, weakness/fatigue, HA, dizziness, difficulty problem solving, changes in emotional behavior
, seizures & coma if severe (<30 mg/dL) |
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Term
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Definition
| late/skipped meals, increased activity, too much DM meds, EtOH and/or drug consumption, reduced liver or kidney fcn |
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Term
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Definition
low BG without Sx;
more likely to occur in:
very elderly, concurrent nonselective beta-blockers, longstanding DM, frequent hypoglycemia |
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Term
| Treatment of HypOglycemia in Conscious Pts |
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Definition
give 15 g fast-acting CHOs;
wait 15 min then test BG:
- if BG <60, give another 15 g CHOs, repeat until BG >60, then give meal or snack;
- if BG >60, give additional snack or meal if next meal is >1 hr away; |
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Term
| Treatment of Hypoglycemia in Unresponsive Pt (neuroglycemic) |
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Definition
Inject Glucagon:
- Adults (>=20 kg): 1 mg SC
- Children (<20 kg): 0.5 mg SC;
Repeat dose q20 min until effective;
When alert, offer oral snack;
N/V are major ADRs;
Notify HCP |
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Term
| Hypoglycemia OVER-treatment |
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Definition
eat more food at meals;
skip DM meds;
use more CHO at sx than necessary;
occurs most commonly in pts w/ previous bad experience |
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Term
| Prevention of Hypoglycemic Events |
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Definition
keep meals/meds/exercise consistent;
SMBG regularly;
may raise BG goals if frequent, severe, or unaware; |
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Term
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Definition
BG >140 mg/dL
S/Sx:
extreme thirst, extreme hunger, frequent urination, dry skin, blurred vision, drowsiness, decreased healing |
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Term
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Definition
| food, stress, glucagon, infection, acute illness, insufficient DM meds, other meds |
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Term
| Counseling Points for Hypo/hyperglycemia |
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Definition
keep SMBG/diet log;
always carry some glucose;
pts on insulin should have glucagon kit, teach close friends/relatives how to use it;
keep meals/snacks regular;
regular SMBG |
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Term
| Counseling Points for Hypo/hyperglycemia |
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Definition
keep SMBG/diet log;
always carry some glucose;
pts on insulin should have glucagon kit, teach close friends/relatives how to use it;
keep meals/snacks regular;
regular SMBG |
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