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63 Cards in this Set
- Front
- Back
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what are the manifestations of type 1 diabetes
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recent unintentional weight loss, polydipsia, polyuria, polyphagia
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what is the cause of type 2 diabetes
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insulin resistance- cells do not use insulin properly
insulin deficiency- pancreas beta cell death and dysfunction |
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what are the risk factors for type 2 diabetes
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older age, obesity, family history, gestational DM, physical inactivity, minorities
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what are the manifestations of type 2 diabetes
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fatigue, recurrent infections, prolonged wound healing, visual changes, numbness of tingling in feet, polyuria, polydipsia, polyphagia
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what is pre-diabetes
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impaired fasting glucose (100-125) and impaired glucose tolerance (140-199)
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what does the diabetes prevention program consist of
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lifestyle changes-diet, moderate intensity physical activity: walk 2.5 hours a week
medications- metformin and acarbose |
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what is the EBP
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diabetes prevention program
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what are the microvascular complications to diabetes
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retinopathy, nephropathy, neuropathy
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what is retinopathy
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microvascular damage to the retina. Leading cause of blindness
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what is retinopathy caused by
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chronic hyperglycemia
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what are the symptoms of retinopathy
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asymptomatic
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what does retinopathy increase the risk for
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retinal detachment
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what should you do to prevent retinopathy
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annual eye exam
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what is nephropathy
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damage to the kidneys
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what is the initial symptom of nephropathy
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microalbuminuria
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what should you do if you are at risk for nephropathy
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get yearly random microalbumin-creatine ratio, maintain BP less than 130/80, take ACE inhibitor
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what is neuropathy
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damage to nerves
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what is the first loss of neuropathy
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distal sensory loss first (stocking glove pattern) usually symmetrical and bilateral
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what are the symptoms of neuropathy
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sensory and motor nerve conduction slowed (absent ankle jerks), reason for repeated trauma to feet, paraesthesais, Autonomic nervous system effects- gastroparesis, orthostasis
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what are the macrovascular complications
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disease of large and medium size blood vessels that leads to atherosclerosis, peripheral vascular disease and foot ulcerations
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what are the signs of peripheral vascular disease
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decreased peripheral pulses, intermittent claudication
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what can peripheral vascular disease lead to
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infection, gangrene, and amputation
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what are foot ulcers caused by
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diabetic foot neuropathy, may be associated with charcot foot deformity
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how do you prevent foot ulcerations
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daily foot inspection
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what is the hemoglobin a1c
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reflects the average BG over the prior 3 months
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what is the estimated average glucose
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converst the A1c to the mean blood bglucose using a mathematical formula
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what is the recommended HgbA1c
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less than 7%
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what is near normal fasting blood glucose
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80-120
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what is normal post meal blood glucose
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less than 180
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when should you test capillary blood glucose
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before meals and at bedtime, 2 hours after meal on occasion, symptoms of high or low sugar, before, during and after exercise, more frequently on sick days, before driving if prone to lows
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what should your diet be with diabetes
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consistent carbohydrate meal planning, limit intake of high sugar foods, increase fiber, do not skip meals, reduce fat
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what should your total cholesterol be
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less than 200
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what should your LDLs be
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less than 100 or less than 70 in known CAD
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what should your HDLs
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greater than 50 in women greater than 40 in men
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what should your TG be
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less than 150
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what are acute complications of diabetes
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diabetic ketoacidosis, hyperosmolar hyperglycemic syndrome, hypoglycemia
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what are the manifestations of diabetic ketoacidosis
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poor skin turgor, dry mucous membranes, tachycardia, orthostatic hypotension, lethargy, weakness, abdominal pain, N/V kussmaul respirations, acetone on breath making it sweet and fruity, blood sugar greater than 300
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what is the immediate care for diabetic ketoacidosis
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IV hydration with NSS, IV insulin infusion, cardio-pulmonary support, correct electrolyte imbalance, frequent blood glucose and serum potassium
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what is the continued care for diabetic ketoacidosis
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monitor vital signs, LOC, cardiac rhythm, O2 saturation, intake and output, transition from IV to subq insulin when stable
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when should you test capillary blood glucose
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before meals and at bedtime, 2 hours after meal on occasion, symptoms of high or low sugar, before, during and after exercise, more frequently on sick days, before driving if prone to lows
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what should your diet be with diabetes
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consistent carbohydrate meal planning, limit intake of high sugar foods, increase fiber, do not skip meals, reduce fat
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what should your total cholesterol be
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less than 200
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what should your LDLs be
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less than 100 or less than 70 in known CAD
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what should your HDLs
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greater than 50 in women greater than 40 in men
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what should your TG be
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less than 150
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what are acute complications of diabetes
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diabetic ketoacidosis, hyperosmolar hyperglycemic syndrome, hypoglycemia
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what are the manifestations of diabetic ketoacidosis
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poor skin turgor, dry mucous membranes, tachycardia, orthostatic hypotension, lethargy, weakness, abdominal pain, N/V kussmaul respirations, acetone on breath making it sweet and fruity, blood sugar greater than 300
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what is the immediate care for diabetic ketoacidosis
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IV hydration with NSS, IV insulin infusion, cardio-pulmonary support, correct electrolyte imbalance, frequent blood glucose and serum potassium
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what is the continued care for diabetic ketoacidosis
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monitor vital signs, LOC, cardiac rhythm, O2 saturation, intake and output, transition from IV to subq insulin when stable
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what is the half life in IV insulin
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8-10 minutes
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what happens in hyperosmolar hyperglycemic syndrome
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patient is able to produce enough insulin to prevent DKA, but not enough to prevent severe hyperglycemia, osmotic diuresis and extraceluar fluid depletion
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what is hypoglycemia
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blood sugar less than 70
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what are the symptoms of hypoglycemis
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hunger, irritability, diaphoresis, tremors, confusion, weakness, visual disturbances tachycardia
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what can hypoglycemia lead to
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Loss of consciousness
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what is the treatment of hypoglycemia
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rule of 15: 4-6 oz of juice or regular soft drink, 8 oz of milk, prepared gels, avoid candies with fats
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what is the treatment of hypoglycemia if NPO or risk of aspiration
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1mg of glucagon or 20-50 mL of 50% dextrose IVP
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what does poor glucose control lead to
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infection, sepsis, delayed wound healing, dehydration, electrolyte imbalance, cardiac arrhythmia, organ failure, longer ICU and hospital stays, inpatient mortality
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what is the basal bolus insulin therapy
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give aspart at breakfast, lunch and dinner and glargine at bedtime
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what is nutritional insulin
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prevents a rise in glucose following meals
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what is basal insulin
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suppresses excessive glucose production and gluconeogenesis between meals and overnight
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what is correction insulin
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used to treat hyperglycemia
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what is an insulin pump
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dosage instructions are entered into the pumps small computer and the appropriate amount of insulin is then injected into the body in a calculated controlled manner
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what is the sick day management
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need for insulin continues, insulin needs may increase, need to maintain fluids, test blood glucose every 2-4 hours, test urine ketones, ingest carbohydrate containing liquids or foods, contact MD for persistent blood glucose greater than 250, fever, ketonuria, or nausea and vomiting
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