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16 Cards in this Set
- Front
- Back
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Diabetes Mellitus
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*Metabolic disorders characterized by:
Elevated blood glucose Disordered insulin metabolism *May have: Impaired insulin secretion Cells that do not respond to insulin normally Results in hyperglycemia |
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Symptoms of Diabetes Mellitus
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*Classic symptoms:
Glycosuria Polydipsia Polyuria Polyphagia *Other: Blurred vision Increased infections Loss of weight Constant fatigue |
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Diagnosis of Diabetes
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*Non-fasting plasma glucose 200 mg/dL > & classic symptoms
*Fasting glucose level 126 mg/dL> *Plasma glucose 2 hours after a 75 gm glucose load = 200 mg/dL> |
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Type 1 Diabetes
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*5-10% of cases
*Autoimmune destruction of beta cells *May be inherited or environmental *Need insulin therapy *Usually occurs in childhood or adolescence *Ketosis may be the first sign |
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Type 2 Diabetes
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*Often asymptomatic
*Some insulin is produced *Insulin resistance & relative insulin deficiency *Beta cells get exhausted *Risk increases with: Obesity Age Decreased physical activity Genetics Prevalence is increasing in children |
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Acute Complications of Diabetes
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*Disturbances in energy metabolism
*Fluid & electrolyte imbalances *Hyper & hypoglycemia |
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Ketoacidosis
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*With Type 1 Diabetes
*Ketosis (acetone breath) *Acidosis (hyperventilation) *Hyperglycemia (polyuria) *Causes: Missed insulin, illness or infection, alcohol abuse, physiological stressors |
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Hypoglycemia
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*With Type 1 Diabetes
*Inappropriate management *Excessive insulin or antidiabetic drugs *Prolonged exercise *Skipped/delayed meals *Alcohol without food |
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Hyperosmolar Hyperglycemic State
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*With Type 2 Diabetes
*Fluid losses *Blood volume depletion *Electrolyte imbalances *Glucose rises to >600-1000 mg/dL |
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Chronic Complications of Diabetes
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*Large blood vessels
Accelerated athrosclerosis Impaired circulation Foot ulcers *Small blood vessels Retinopathy Nephropathy *Nerve damage *Pain & burning *Numbness & tingling *Loss of sensation *Delayed stomach emptying *Sexual dysfunction *Constipation |
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Treatment (Both Types)
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*Type 1
Insulin therapy *Type 2 Diet therapy Exercise Oral medications or insulin Requires lifelong treatment |
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Treatment Goals
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*Desirable blood glucose levels
*Healthy blood lipid concentrations *Control blood pressure *Manage weight |
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Body Weight Concerns
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*Type 1
Newly diagnosed are thin Usually gain weight with insulin therapy *Type 2 Newly diagnosed usually overweight Worsens insulin resistance Weight loss is beneficial |
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Nutrient Recommendations
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*Carbohydrates:
High fiber, whole grain *Fiber Same as general population *Sugar: Minimize foods & drink with added sugars *Protein: 15-20% of kcalories *Fat Saturated fat <7% total kcalories Cholesterol <200 mg/day 2 or more fish servings/week *Alcohol Use with food *Micronutrients Same as general population |
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Insulin Therapy & Hypoglycemia
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*Most common complication
*Need immediate intake of glucose or CHO food *15-20 grams *Relieves in about 15 minutes |
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Gestational Diabetes
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*Risk factors:
Family history of diabetes Obesity Certain ethnic groups Delivered babies weighing over 9 pounds *May need to restrict carbohydrates to 40-45% total kcalories *Space carbohydrates throughout the day *Regular aerobic activity *May need insulin |
