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75 Cards in this Set
- Front
- Back
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What are some common manifestations of hypoglycemia? |
Confusion, irritability, diaphoresis, tremors, hunger, weakness, and visual disturbances. |
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What are some neurogenic (autonomic) symptoms of hypoglycemia? |
Trembling, palpitations, sweating, anxiety, hunger, and nausea |
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What are some neuroglycopenic symptoms of hypoglycemia? |
Difficulty concentrating, confusion, weakness, drowsiness, vision changes, difficulty speaking, dizziness. |
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What is hypoglycemia? |
Low blood sugar |
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What is hyperglycemia? |
High blood sugar |
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What is the cause of hypoglycemia? |
Mismatch in timing of food intake and peak actions or insulin or oral hypoglycemic agents |
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How can the balance between blood and insulin be disrupted? |
Administration of too much insulin or medication, ingestion of too little food, delaying the time of eating, and performing unusual amounts of exercise. |
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What is diabetes? |
A chronic multisystem disease related to abnormal insulin production, impairedinsulin utilization, or both |
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What causes diabetes? |
No specific cause is known but could be due to these factors: Genetic predisposition, autoimmune disorder, viral illness, environmental exposure. |
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Where is insulin produced? |
By the beta cells in the islets of Langehans of the pancreas |
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What is a stable blood glucose level? |
4 to 6 mmol/L |
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What tissues are insulin dependent? |
Skeletal muscles and adipose tissue |
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What are counter regulatory hormones and what is their purpose? |
Glucagon, epinephrine, growth hormone, and cortisol. They oppose the action of insulin and increase blood sugar levels. |
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What are the types of diabetes? |
Pre-diabetes, Type 1, Type 2, gestational diabetes |
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What are some signs and symptoms of diabetes? |
Polydispia, polyphagia, polyuria, sudden weight loss (type 1) or obesity (type 2), feeling weak or tired, wounds that won't heal, sexual problems, blurry vision, vaginal infections, numbness or tingling in hands or feet, sedentary lifestyle, high carb diet |
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What is type 1? |
Rresultof the progressive destruction of the beta cells of the pancreas; the pancreas isno longer able to produce insulin |
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Which is the most common type of diabetes? |
Type 2 |
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What is type 2? |
Resultsfrom the inability of the body to utilize insulin effectively, or the inabilityto produce enough insulin or both |
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Who typically gets diagnosed with type 1? |
People younger than 40. Occurs most frequently in younger children and individuals with lean body types |
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Which type of diabetes is always insulin dependent? |
Type 1 |
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What are the three P's? |
Polyuria, polydispia, and polyphagia |
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What is ketoacidosis? |
When you body produces high levels of blood acids called ketones. Develops when your body can't produce enough insulin. |
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What is the most prevalent type of diabetes? |
Type 2 |
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Who typically gets diagnosed with type 2? |
People over 35 who are overweight or obese |
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What particular group is of more concern for type 2? |
High school age football players |
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Who has a increased rate of type 2 on a genetic basis? |
Aboriginal, Hispanic, South Asian, Asian, or African descent |
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What are some modifiable risk factors of type 2? |
Diet, activity, weight, BMI, abdominal girth, cholesterol, smoking, excessive alcohol consumption, hypertension |
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What are some unmodifiable risk factors of type 2? |
Age, first degree relative with type 2, member of high-risk population, history of pre-diabetes, history of gestational diabetes, history of delivery of microsomic infant, history of pancreatitis. |
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What causes type 2? |
Thepancreas continues to produce some endogenous insulin. Insulin produced isinsufficient or is poorly utilized by tissues |
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What are the four major metabolic abnormalities in type 2? |
Insulin resistance, pancreas decreases ability to produce insulin, inappropriate glucose production from liver, alteration in production of hormones and adiopkines |
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When does gestational diabetes occur? |
During pregnancy |
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What are the risks of having gestational diabetes? |
C-section delivery, perinatal death, and neonatal complucations |
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When do blood sugars return to normal after gestational diabetes? |
Typically 6 weeks postpartum |
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When is gestational diabetes typically detected? |
Between 24-28 weeks |
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What are some risk factors for gestational diabetes? |
Severe obesity, family history of type 2 diabetes, history of gestational diabetes, glycosuria, PCOS, aboriginal descent. |
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What are some treatments for gestational diabetes? |
Diet modification and tight blood sugar control with insulin |
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What are the four methods to diagnose diabetes? |
FPG > 7.0mmol/L (Fasting Plasma Glucose) A1C>6.5% (in adults) 2hPG in a 75-g OGTT>11.1mmol/L (2hPG= 2 hour plasma glucose, OGTT=oral glucose tolerance test) |
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Which test is most commonly used to diagnose diabetes? |
FPG |
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What are the goals of diabetes management? |
Decrease symptoms, promote well-being, prevent acute complications, delay onset and progression of long-term complications |
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What is exogenous insulin? |
Insulin from an outside source. |
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What are the 2 types of insulin produced synthetically? |
"Human insulin" which is the first generation of insulin, and anaglogue insulin
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What forms is human insulin available in? |
Short, intermediate, long, and mixed forms. |
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What forms is analogue insulin available in? |
Rapid, long, and mixed forms. This insulin is designed to be ansorbed more rapidl, resulting in quicker onset of action |
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What is premixed insulin? |
A single vial or cartridge containing a fixed ration of insulin |
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How to store insulin? |
Do not heat/freeze. Avoid exposure to sunlight. Prefilled syringes are stable for up to 1 week when store din the refrigerator. In-use vials may be left at room temp for up to 4 weeks. |
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What is the Somogyi effect? |
Reboundeffect in which an overdose of insulin causes hypoglycemia over night, andthen counter regulatory hormones released. Following this, reboundhyperglycemia and ketosis may occur |
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What is Dawn phenomenon? |
Ischaracterized by hyperglycemia present on awakening in the morning as a resultof predawn release of counter regulatory hormones |
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What do oral agents work on with type 2? |
Insulin resistance, decreased insulin production increased hepatic glucose production |
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What are the types of oral agents? |
Sulphonylureas, meglitinides, biguanides, a-glucosidase inhibitors, thiazolidinediones, dipeptidyl peptidase-4 (DDP-4) inhibitor, amylin analogue, incretin minetic, b-adrenergic blockers, thiazide/loop diuretics |
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What is the protein allowance for diabetics? |
15-20% of energy |
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What is the fat allowance for diabetics? |
Less than 35% of energy. Saturate and trans fats limit to 7% of energy. Include foods rich in omega-3 and plant oils. |
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What is the fibre allowance for diabetics? |
25-50 g/day. Use a variety of fibre sources including soluble and insoluble forms. |
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What is the carb allowance for diabetics? |
45-60% of energy. Less than 10% of daily energy should come from sucrose. Foods containing carbs from whole grains, along with fruits , veggies, and low-fat mil, should be included as part of a healthy meal plan. High fibre sources of carbs are recommended. |
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What is the glycemic index? |
Term used to describe rise in blood glucose levels and carb-containing food is consumed. Was developed to determine the effects of blood glucose on foods. |
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How much exercise should be done each week for a diabetic? |
150 mins of moderate to vigorous intensity aerobic exercise. Include resistance exercise >2 times a week. |
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When should exercise be scheduled? |
About an hour after meals or have a small 10-15g carbs snack before exercise. Several small carb snacks can be taken every 30 ins during exercise to prevent hypoglycemia |
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Are there any natural health products proven for diabetic treatment? |
No, some actually may be harmful |
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What is the primary care focus for someone with diabetes? |
Self-care. |
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Why does the prevalence of diabetes increase with age |
Due to a reduction in B-cell function decreased insulin sensitivity and altered carb metabolism. |
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What are some mental health concerns with diabetes? |
Psychiatric disorders, particularly depression, anxiety and eating disorders. |
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What causes diabetic ketoacidosis? |
A profound deficiency of insulin. |
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How is diabetic ketoacidosis (DKA) characterized by? |
Hyperglycemia, ketosis, metabolic acidosis, dehydration |
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What type does DKA typically occur in? |
Type 1 when there is not exogenous insulin available. It is a life threatening condition. |
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What are the precipitating factors of DKA? |
Illness, infection, inadequate insulin dosage, un-diagnosed type 1, poor self-management, eglect |
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What are some signs and symptoms of DKA? |
Polyuria, polydispia, lethargy/weakness, dehydration, abdominal pain, kussmaul repirations |
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What is diabetic retinopathy? |
Ismircovascular damage to retina as a result of chronic hyperglycemia. It’s themost common cause of new cases of blindness in people 20 to 74 years |
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What are the microvascular complications? |
Resultfrom thickening of vessel membranes in capillaries and arterioles in responseto chronic hyperglycemia. Resulting conditions are specific to diabetes, unlikemarcovascular complications |
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What areas are mostly affected from microvascular complications? |
Eyes (retinopathy), kidneys (nephropathy), and skin (dermopathy) |
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What is diabetic nephropathy? |
Associatedwith damage to small blood vessels that supply the glomeruli of the kidney. Leading cause of end-stage renal disease. |
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What is diabetic sensory neuropathy? |
Nerve damage from chronically high blood glucose. Can cause atrophy of small muscles of hands and feet.
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What are some prevention methods for complications in the feet and lower extremities? |
Check feet daily for cuts, cracks, bruises, blisters, sores, infections or unusual markings. Check legs for swelling or redness, if you have pain see your doctor or foot care specialist right away. Maintain good foot hygiene. |
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What are some interventions for diabetes? |
Client focused care, implement medical regimen, advocate for client/family, integrate the interdisciplinary team |
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What members would be part of a diabetics interdisciplinary team? |
Dietician, home care, podiatry, enterostomal therapist, physiotherapy, occupational therapy, social work, pastoral care. |
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What kind of planning can be done for a diabetics care? |
Start treatment as early as possible, identify client/family goals of care, prevent worsening of complications, prevent further complications. |
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What are some things a diabetic SHOULD NOT do for foot care? |
Cut their own corns/calluses, treat own ingrown toenails, use OTC meds for corns/warts, apply heat to feet with hot water bottle/heated blanket, soak their feet, use lotion between toes, walk barefoot, wear tight socks. |
