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Chapter 51: Diabetes/ DKA
Terms in this set (47)
Which type of DM: onset acute usually before 30 y/o?
______________ in the pancreas are destroyed by an
autoimmune process in Type 1 DM
Insulin-producing beta cells
Does Type 1 DM require insulin?
What % of people with DM has Type 1?
When is Type 1 DM diagnosed?
Not until beta cells are destroyed
What results in decreased insulin production in Type 2 DM?
Decreased sensitivity to insulin (insulin resistance) and impaired beta cell
What % of people have DM2?
What is the initial tx for DM 2
diet and exercise
If diet and exercise don't cut it, what is the next step in tx for type 2
Oral hypoglycemic agents
Glucose intolerance in Type 2 DM is ________
Any degree of glucose intolerance during pregnancy
due to secretion of placental hormone
Characteristics of Gestational Diabetes
hx of gest. diabetes
family hx. of diabetes
glycosuria - predisposition
Risk Factors Type 1
early onset, familial,
possible immunologic or
environmental (viral or
Risk Factors Type 2
obesity, age, previous
identified impaired fasting
glucose or impaired glucose
≥140/90 mm Hg, HDL ≤35 mg/dL
or triglycerides ≥250 mg/dL,
history of gestational diabetes
or babies over 9 pounds
What are the 3 P's
Most common clinical manifestation of DM
, weakness, vision changes, tingling or numbness in
hands or feet, dry skin, skin lesions or wounds that are slow
to heal, recurrent infections
Why does Type 1 DM often have sudden weight loss?
The body attempts to maintain homeostasis by catabolizing fats and muscle due to the lack of glucose present in the cell.
Fasting blood glucose found in DM
126 mg/dL or more
Random glucose exceeding
Hemoglobin A-1C should be
GOAL is to Maintain Hgb A1c <7% with diabetes
the elderly typically have a ____ glucose level
higher (age related)
What percent of carbs should a typical diet contain?
What percent fat should a typical diet contain?
w/ <10% from saturated fat
How much Cholesterol is acceptable in a diet?
What percent of protein should be in diet?
How many grams of fiber per day?
What combo of foods slow absorption and glycemic response?
Starch and protein/fats
Raw foods result in a ___________ glycemic index than cooked foods
Large amounts of ETOH can be converted into fats increasing the risk for the patient to go into
"sugarfree' labels on foods are safe to eat in unlimited quantities. T or F
If they contain nutritive sweeteners, they can still provide calories equivalent to sugar-containing foods which can elevate blood sugar levels.
Exercise initially ____________ blood sugar levels
Insulin normally__________ with exercise
After exercise, the pt. could be in danger of __________
*to prevent this, eat a 15g carb snack just before exercise
What are major side effects of Oral Anti-diabetic agents?
hypoglycemia, GI issues
Acute Complications of Diabetes
-Hyperglycemic hyperosmolar syndrome (HHS)
Adrenergic symptoms of hypoglycemia
sweating, tremors, tachycardia, palpitations,
Symptoms of severe hypoglycemia
disorientation, seizures, loss of consciousness,
After initial treatment of hypoglycemia with 15g of concentrated carbs, how long do you wait to retest glucose levels?
* retreat if levels < 70 mg/dL
*provide snack after too
If pt is unconscious in hypoglycemic crisis, what do you do?
-Subcutaneous or intramuscular glucagon (1 mg)
- 25 to 50 mL of 50% dextrose solution IV
What are the 3 types of Long term complications brought on by DM?
What is a macrovascular complication?
accelerated atherosclerotic changes, coronary artery
disease, cerebrovascular disease, and peripheral vascular disease
What is a microvascular complication?
diabetic retinopathy and
What is a neuropathic complication?
peripheral neuropathy, autonomic neuropathies,
hypoglycemic unawareness, neuropathy, sexual dysfunction, and neuropathic ulcers.
What type of infections are common in adolescents that have DM
(also b/c hormones)
vaginal infections (usually yeast)
Insulin pumps are approved for ______ y/o and above
_______ y/o can give own injections
Do NOT tell kids that can't have sweets
this is considered a punishment
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