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49 Cards in this Set
- Front
- Back
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Diabetes is more prevalent at what age group
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60 years and older
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Which gender is more likely to have diabetes 20 years or older
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Males
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Which race is more likely to have diabetes?
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Non-hispanic Blacks
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Which race is least likely to have diabetes?
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non-hispanic whites
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Diabetes is a chronic metabolic disorder characterised by:
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insulin resistance
insufficient insulin secretion one or both |
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Diabetes is associated with abnormalities in the metabolism of:
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carbohydrates, fat, and protein
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Where is insulin secreted and what is its purpose in the body
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B-cells in pancreas, decreases glucose levels, inhibits glucagon secretion
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Processes involved in the development of diabetes
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Autoimmune B-cell destruction of the pancreas
impaired insulin secretion increased glucose production by liver abnormalities which result in resistance to the action of insulin |
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What is Pre-diabetes?
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Increased risk for DM, associated w/ an increased risk for CVD
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What fasting glucose indicates pre-diabetes?
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100-125 mg/dL
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What are risk factors for gestational diabetes?
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Family history
GDM hx high-risk ethnic group overweight prior baby >9lbs |
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What causes Type 1 diabetes?
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Autoimmune destruction of pancreatic B-cells
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Type of diabetes known as "juvenile-onset diabetes" or "insulin-dependent diabetes"
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Type 1
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Diabetes characterized by absolute insulin deficiency
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Type 1
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Requires outside insulin for survival
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Type 1
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Only represents 5-10% of all diabetes mellitus cases
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Type1
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Results from a combination of insulin secretion defects and insulin resistance in muscle, liver and adiocyte tissues
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Type 2
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Risk factors for Type 2 diabetes
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Older age
family hx ethnicity overweight or obese physical inactivity |
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Diabetes primary characterized by insulin resistance
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Type 2
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Type 2 diabetes
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Insulin resistance, sufficient amount of insulin is produced but the body is unable to utilize it properly
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Accounts for 90-95% of diabetes mellitus cases
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Type 2
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ADA recommends screening for Type 2:
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every 3 years for adults > 45 y/o or in younger with risk factors.
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Type with rapid onset of disease
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Type 1
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Type commonly associated with a family history
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Type 2
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Symptoms of Diabetes
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Frequent urination
extreme hunger excessive thirst blurry vision weight loss fatigue |
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ADA diagnostic criteria for diabetes
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fasting glucose (FPG) >126 mg/dL -OR- sx of hyperglycemia AND casual glucose >200 -OR- 2 hour glucose >200 during an oral glucose tolerance test (OGTT)
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Tow major types of diabetic complications
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microvascular, macrovascular
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Microvascular complications
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neuropathy (peripheral & autonomic)
nephropathy retinopathy |
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macrovascular complications
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coronary artery disease
cerebrovascular disease peripheral vascular disease |
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most common cause consequence of peripheral neuropathy
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diabetic foot ulcers
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Intensive insulin therapy slows the progression of microvascular complications in what type of diabetes
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type 1
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symptoms of hyperglycemia
3P's |
polyuria
polydipsia (thirst) polyphagia (hunger) fatigue dry skin nausea blurry vision |
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Potential causes of hyperglycemia
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Too little insulin or diabetic medications
Too much food illness |
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How often do Type 1 diabetics self monitor glucose?
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3-4x/day
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How often do Type 2 diabetics self monitor glucose?
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4x/wk (variable)
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Good times blood glucose should be tested:
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fasting AM
Prior to meals 2 hours after meals Before bedtime 3am |
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Hemoglobin A1c
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represents avg. blood glucose for past 2-3 mos
used as a goal for treatment, not diagnosis obtained by venipuncture |
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Normal values for Hemoglobin A1c
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Between 4-6%
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Formerly known as "adult-onset diabetes" or "non-insulin dependent diabetes"
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Type 2 diabetes
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Treatment goals of HbA1c
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< 7.0%
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Treatment goals for fasting glucose
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70-130 mg/dL
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Treatment goals for peak postprandial plasma glucose
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<180 mg/dL
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Treatment goal for LDL
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<100 mg/dL
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Treatment goal for LDL with over CVD
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<180 mg/dL
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Treatment goal for HDL
men & women |
>40 mg/dL men
>50 mg/dL women |
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Blood pressure treatment goal
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< 130/80
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Diabetic Oral Medications
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Insulin secretagogues
insulin sensitizers Alpha - Glucosidase Inhibitors Dipeptidyl Peptidase IV (DPP-4) Inhibitor Combination Products |
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Two types of Insulin secretagogues
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Sulfonylureas
Meglitinides |
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Sulfonylureas MOA vs. Meglitinides MOA
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Suflonyrlureas increase insulin secretion
Meglitinides stimulate insulin release to reduce postprandial hyperglycemia |
