Diabetes 2
Terms
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- Hyperinsulinemia
- Excessive blood insulin levels
- Hypoglycemia
- Occurs when too much insulin or too little glucose is present.
- Hyperglycemia
- High blood sugar levels
- Honeymoon phase
- Temporary remission in Type I diabetes when beta cells produce insulin again. May last up to one year. May need little to no insulin. May need to be monitored.
- Glucagon
- Maintains blood gluose levels. Secreted from alpha cells
- Gastroparesis
- Paralysis of the stomach cased by damage to the nerves in the autonomic nervous system.
- Somatostatin
- Secreted from delta cells in the pancrease, gut & brain. Inhibits the release & action of glucogen & insulin from the pancreas.
- Euglycemia
- A normal concentration of glucose in the blood
- Glycogenesis
- The formation of glycogen from glucose
- Polydipsia
- Excessive thirst
- Polyphagia
- Excessive hunger
- Glycogenolysis
- The conversion of glycogen to glucose
- Ketones
- A waste product of fat metabolism
- Neuropathy
- Damage to the nerves from diabetes. The leading cause of foot ulcers, wounds & amputations.
- Retinopathy
- Damage to the reina from diabetes. The leading cause of blindness.
- Somogyi Effect (Rebound Hypoglycemia)
- A swing to high levels of glucose from low levels. Usually occurs during the morning from release of stress hormones, epinephrine, cortisol & glycogen.
- Nephropathy
- Damage to the kidneys from diabetes. The leading cause of kidney failure
- Dawn Phenomenon
- A nighttime release of growth hormone that causes blood glycose elevations at about 5-6 am. Treated by providing an intermediate acting dose at 10 pm
- Sulfonylureas
- Cause pancreas to make more insulin
- Biguanides
- Reduces the amount of flucophage glucose that is made by the liver & helps body better use insulin.
- Alpha-Glucosidase Inhibitors
- helps keep blood sugar in target cell range after a meal
- Kussmaul Respiration's
- Increased rate & depth in an attempt to excrete more carbon dioxide & acid.
- Macrovascular Disease
- Cornoary dises, cerebrovascular problems & peripheral vascular disease.
- Microvascular Disease
- Complications in retina of eye, nephron of kidney & neurons of the body
- DKA - Uncontrolled Hyperglycemia
- Over time it creates a buildup in the blood of acidic waste products called ketones.
- FBS
- Finger Blood Glucose
- SMBG
- Self monitored blood glucose. Checking your level frequently
- FPG
- Fasting Plasma Glucose - fasting before having blood drawn
- ESRD
- End Stage Renal Disease
- HbA1c - Glycosylated Hemoglobin
- A test that measures how high your BS has been over the last 90 days - the lifespan of the RBC's.
- OGTT
- Oral Glucose Tolerance Test - drawing blood for a fasting plasma blood glucose test, drink sweet drink, then draw again 2 hrs later to check blood glucose level.
- Where is Glucagin produced?
- In the pancreas
- What is Diabetes?
- A group of disorders categorized by a glucose intolerance. A disease that is caused by an imbalnace between insulin supply & demand. Person has insufficient or ineffective insulin.
- What are symptoms of Hyperglycemia?
- Polyuria, polydipsia, polyphagia
- Metabolic Acidosis
- When ketones accumulate in the blood when glucose isn't available
- Hemoconcentration
- Increase of blood concentration
- Hypovolemia
- Decrease in blood volume
- Hyperviscosity
- Thick concentrated blood
- Hypoperfusion
- Decrease in circulation
- Hypoxia
- Not enough )2 to cells. These cells are unable to metabolize cells efficiently, Kreb cycle is blockes & you have lactic acid build up which sets stage for more acidosis.
- Clinical manifestations as disease progresses:
- slow wound healing, parasthesias (unusual sensations in extremities), thrush, vaginal infections, peripheral vascular disease which effects primarily the feet, blurry vision, frequent UTI's
- What does insulin do?
- It lowers blood glucose by facilitating the uptake & utilization of muscles & fat cells. It decreases the release of glucose from liver.
- Tissue Hypertrophy (lipohypertrophy)
- Is a thickening of SQ tissue, soft & lumpy and is prevented by rotating injection sites.
- Adrenergic S/S
- weak, palpitations & sweating
- How do you manage Diabetes?
-
1. frequent self monitoring of glucose.
2. check for ketones & HGBA1c.
3. carefull meal planning
4. exercise - walking
5. insulin regimine - onset, peak, duration
6. check eyesight - 3 Complications of Diabetes
-
1. Hypoglycemic Reaction
2. Diabetic Ketoacidosis
3. HHNKS - Hyperglycemic Hyperosmolar Nonketonic syndrome - HHNS - Hyperglycemic-hyperosmolar nonketotic syndrome
- Associated with insulin deficiency, profound dehydration, adn the absence of ketosis
- Albuminuria
- The presence of albumin in the urine
- Hyperlipidemia
- Excessive blood levels of cholesterol & other fats.
- Microalbuminuria
- Presence of very small amounts of albumin in the urine.
- Proteinuria
- Protein in the urine
- Type 1 Diabetes
- Is an autoimmune disorder in which beta-cell destruction in the pancreas occurs.
- Type 2 Diabetes
- The presence of antibodies in the bloodClients with type 2 have a reduction in the ability of most cells to respond to insulin (insulin resistance)
- What ethnic groups have an increased risk of developing type 2 diabetes?
- African Americans, Hispanics, Native Americans.
- Oral Glucose Tolerance Test
- The most sensitive test for the diagnosis of diabetes, although it is not routinely used, except in diagnosis of gestational diabetes.
- What is the normal range for adults for a Fasting Blood glucose test?
-
< 110 mg/dl (6.1 mmol/L)
Levels > 126 mg/dL (7.0 mmol/L) obtained on at least two occasions are diagnostic of diabetes, even in older adults. - What is the normal range for adults for a Glucose Tolerance Test (2-hour post load result)
-
< 140 mg/dl (7.8 mmol/l)
Levels >140 mg/dL (7.8 mmol/L0 and < 200 mg/dL (11.1 mmol/L) indicate impared glucose tolerance.
Levels > 200 mg/dl (11.1 mmol/L) indicate provisional diagnosis of diabetes. - What is the normal range for adults for a Glycosylated hemoglobin (hemoglobin A1c test)
-
4% - 6%.
Levels over 8% indicate poor diabetic control with need for adherence to regimen or changes in therapy. - Symptoms of Hypoglycemia
-
Headache
confusion
slurred speech
behavior changes
coma
warm
weak
faint
dizzy
blurred vision