Flashcards
Type 1 & 2 Diabetes
Cards in this deck (35)
- 1Risk factors for diabetes mellitusAge > 40, 1st degree relative w/ diabetes, member of high-risk population (Aboriginal, Hispanic, South Asian, Asian, or African), history of impaired fasting glucose and/or impaired glucose tolerance presence of vascular disease, history of gestational diabetes and/or delivery of a macrocosmic infant, hypertension, dyslipidemia, overweight, abdominal obesity, polycystic ovary disease, acanthosis nigricans, schizophrenia
- 2Beta cellsOne of the 4 types of cells in the islets of Langerhans located in the pancreas
Secretes insulin - 3Alpha cellsOne of the 4 types of cells in the islets of Langerhans located in the pancreas
Secretes glucagon - 4Roles of insulin1. Transports & metabolizes glucose for energy
2. Stimulates storage of glucose in the liver & muscles (in the form of glycogen)
3. Signals the liver to stop the release of glucose
4. Enhances storage of dietary fat in adipose tissue
5. Accelerates transport of amino acids into cells
6. Inhibits breakdown of stored glucose, protein & fat - 5Ketone bodiesAcids that disturb the acid-base balance of the body when they accumulate in excessive amounts
Are produced when there is a lack of insulin and stored fat is broken down to provide a source of energy - 6The "three P's"Polyuria - increased urination
Polydipsia - increased thirst
Polyphagia - Increased appetite - 7Waist circumference measurement indicative of abdominal/visceral obesityMales - more than 102 cm
Females - more than 88 cm - 8Main nutrient in food that influences blood glucose levelsCarbohydrates
- 9LipodystrophyA localized reaction, in the form of either lipoatrophy or lipohypertrophy, occurring at the site of insulin injections
- 10LipoatrophyLoss of subcutaneous fat and appears as slight dimpling or more serious pitting of subcutaneous fat
- 11LipohypertrophyDevelopment of fibrofatty masses at the injection site, caused by repeated use of the site
- 12Insulin warningProgressive rise in blood glucose from bedtime to morning
- 13Treatment of insulin warningIncrease evening (pre-dinner or bedtime) dose of intermediate or long-acting insulin, or institute a dose of insulin before the evening meal if one is not already in use
- 14Dawn phenomenonRelatively normal blood glucose until about 3am, when the level begins to rise
- 15Treatment of dawn phenomenonChange time of injection of evening intermediate-acting insulin from dinnertime to bedtime
- 16Somogyi effectNormal or elevated blood glucose at bedtime, a decrease at 2-3am to hypoglycemic levels, and a subsequent increase caused by the production of counter regulatory hormones
- 17Treatment of somogyi effectDecrease evening (pre-dinner or bedtime) dose of intermediate-acting insulin, or increase bedtime snack
- 184 main areas for insulin injection1. Abdomen
2. Arms (posterior surface)
3. Thighs (anterior surface)
4. Hips - 193 main acute complications of diabetes1. Hypoglycemia
2. Diabetic ketoacidosis
3. Hyperglycemic hyperosmolar nonketotic syndrome - 20Hypoglycemia-Abnormally low blood glucose level
-Occurs when blood glucose falls to less than 2.7-3.3 mmol/L
-Can be caused by
1. Too much insulin or oral hypoglycemic meds
2. Too little food
3. Excessive physical activity - 21Diabetic ketoacidosis-More common in type 1 diabetes
-Results from deficiency in insulin
-Highly acidic ketones are formed resulting in acidosis
-Fruity breath present - 22Hyperglycemic hyperosmolar nonketotic syndromeMetabolic disorder of type 2 diabetes resulting from a relative insulin deficiency initiated by an intercurrent illness that raises the demand for insulin; assoc. w/ polyuria and severe dehydration
- 23Kussmaul respirations-A form of hyperventilation during DKA
-Very deep, but laboured respirations
-Represent the body's attempt to decrease the acidosis, counteracting the effect of the ketone buildup - 24Macrovascular complicationsResult from changes in the medium to large blood vessels. Blood vessel walls thicken, sclerose, and become occluded by plaque that adheres to the vessel walls. Eventually, blood flow is blocked
- 253 main macrovascular complications1. Coronary artery disease
2. Cerebrovascular disease
3. Peripheral vascular disease - 26Diabetic microvascular disease-Characterized by capillary basement membrane thickening
-Kidneys & retina most commonly effected - 27RetinopathyDeterioration of the small blood vessels that nourish the retina
- 283 stages of retinopathy1. Nonproliferative (background) retinopathy
2. Preproliferative retinopathy
3. Proliferative retinopathy - 29Nonproliferative (background) retinopathyEarly stage, asymptomatic retinopathy. Blood vessels within the retina develop micro aneurysms that leak fluid, causing swelling and forming deposits (exudates). In some cases, macular edema causes distorted vision
- 30Preproliferative retinopathyRepresents increased destruction of retinal blood vessels
- 31Proliferative retinopathyAbnormal growth of new blood vessels on the retina. New vessels rupture, bleeding into the vitreous and blocking light. Ruptured blood vessels in the vitreous form scar tissue, which can pull on and detach the retina
- 32NeuropathyA group of diseases that affect all types of nerves, including peripheral (sensorimotor), autonomic, and spinal nerves
- 33Sudomotor neuropathyA condition that refers to a decrease of absence of sweating (anhidrosis) of the extremities, with a compensatory increase in upper body sweating. Can cause dryness in feet leading to the development of foot ulcers
- 343 complications of diabetes that contribute to foot and leg infections1. Neuropathy
2. Peripheral vascular disease
3. Immunocompromise - 35Risk factors for leg & foot infectionsDuration of diabetes >10 years, 40+ years old, history of smoking, decreased peripheral pulses, decreased sensation, anatomic deformities or pressure areas (e.g. bunions, calluses, hammertoes), history of previous foot ulcers or amputation