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13 Cards in this Set
- Front
- Back
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Diabetes Mellitus
Define |
metab dz resulting from breakdown in the body's ability to either produce and or utilize insulin, resulting in inappropriate hyperglycemia
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Diabetes Mellitus
Type 1 patho |
-previously known as insulin dependent or juvenile diabetes
-most common in adolescents but may occur in adulthood |
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Diabetes Mellitus
Type 1 patho (3 things different from DM2) |
1. strongly associated with presence of human leukocyte antigens (HLA-DR3, DR4)
2. islet cells antibodies found in approx 90% of pt within 1st yr of dx 3. Ketone dvp usually occurs |
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Diabetes Mellitus
Type 1 signs and symptoms |
1. polyuria
2. polydipsia 3. polyphagia 4. nocturnal enuresis 5. weight loss 6. weakness, fatigue 7. others |
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Diabetes Mellitus
Type 1 Laboratory/Diagnostics |
1. random plasma glucose >200 mg/DL with polyruia, polydipsia, and weight loss
2. serum fasting (at least 8 hr) blood sugar > 126 mg/Dl on 2 separate occasions |
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Diabetes Mellitus
Type 1 Laboratory/Diagnostics (continue) |
-ketoneia, ketonuria or both
-BUN/Creatinine elevated (dehydrated) -oral glucose intolerance test> 200 mg/Dl 2 hours post prandial, rarely used HGB A1c: gives indication of glycemia control for the past 2 to 3 months; normal = 5.5 to 7% -imparied glucose tolerance test: FBC>100 and <125 |
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Diabetes Mellitus
Type 1 Management Step 1 |
treatment plans for all diabetics must be highly individualized
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Diabetes Mellitus
Type 1 Management Analyze Baseline Studies |
analyze baseline studies
a. age of onset b. obesity c. cardacic risk factors d. presence of ketones e. diagnostic markers f. cholesterol, triglycerides, ECG g. renal studies, as needed h. baseline physical exam noting peripheral pulses, neurolgic function, eye and foot exams |
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Diabetes Mellitus
Type 1 Management Dietary teaching: consult dietician |
a. total carbohydrate itnake 55-60% total caloric intake
b. fats 20 to 30% total c. Fiber 14g/1000 calories d. protein 10-20% total calories |
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Diabetes Mellitus
Type 1 Management If patient present with Ketones, |
then insulin tx is likely warranted...
a. the general rule of them is to begin with 0.5 u/kg/day giving 2/4 of the dose in the morning and the remaining 1/3 in the evening |
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Diabetes Mellitus
Type 1 Management Insulin Administration |
a. conventional split dose mixtures
b. morning dose of insuline is 2/3 NPH and 1/3 regular c. evening dose is 1/2 NPH and 1/2 regular |
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Diabetes Mellitus
Type 1 Management Intensive Therapy |
reduce or omit the p.m dose and add a portion at bedtime
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Diabetes Mellitus
Type 1 Management Insulin Analogs |
1. Aspart (Novolog)
2. glargine (lantus): prolonged duration 3. Lispro (humalog): rapid onsent |
