Term
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Definition
| Multi-system disease related to abnormal insulin production, impaired insulin utilization or both |
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Term
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Definition
| Native Americans, Hispanics and AA highest |
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Term
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Definition
| cause of heart disease, cerebral vascular accidents, renal failure, blindness, and non traumatic limb amputation |
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Term
| Normal Blood Glucose Range |
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Definition
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Term
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Definition
is released from the pancreatic Beta cells.
promotes transport of glucose from the bloodstream across the cell. membrane to the cytoplasm of the cell.
Impacted by Incretin hormone |
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Term
| Rise in Insulin after a meal |
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Definition
Stimulates storage of glucose as glycogen in the liver and muscle (glycogenesis)
Inhibits conversion of proteins to glucose (gluconeogenesis)
Enhances fat cells to store triglycerides
Increases protein synthesis |
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Term
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Definition
Produced in intestines
Secreted in response to the presence of food
Increases insulin, decreases glucagon, slows the rate of gastric emptying |
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Term
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Definition
Chemical: caused by meds/steroids
D |
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Term
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Definition
Failure of pancreas.
Genetic/recessive.
Can be caused by virus.
Under age of 40.
Peak age at 20 y/o.
Progressive destruction of pancreatic B cells.
Requires continuous insulin.
Diabetic Ketoacidosis |
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Term
| Type I diabetes 3 P's (Acute Onset) |
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Definition
Polydipsia-excessive thirst
Polyphagia-excessive hunger
Polyuria-increased frequency of urination |
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Term
| Prediabetes; Impaired Glucose Tolerance (IGT) or Impaired Fasting Glucose (IFG) |
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Definition
Beta cells become fatigued from overproduction
Beta cell dysfunction is mild – with slight increase in glucose
Patients with IGT are increased risk for DM II usually within 10 years |
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Term
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Definition
Fasting BS greater than 100.
prevent or delay the development of type 2 diabetes through changes to their lifestyle that include modest weight loss and regular exercise. |
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Term
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Definition
Correlated with obesity
Over the age of 35
Genetics – dominant and multifactorial (
Insulin resistance
Pancreas usually continues to form some insulin
Insulin amount is usually insufficient to meet needs of body AND/OR is poorly utilized by tissues
Results in HHNK |
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Term
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Definition
cluster of abnormalities working synergistically to greatly ↑ risk for CV disease and diabetes.
Tx: weight loss and exercise |
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Term
| Type II- nonspecific manifestations |
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Definition
Can be the 3P’s
Fatigue
Recurrent infections
Visual changes
Prolonged healing times |
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Term
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Definition
- no caloric intake for at least 8 hrs
- (>100- <126) Impaired Fasting Glucose
- Critical Values <60 mg/dl or >500 mg/dl |
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Term
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Definition
can be drawn any time;
meals, drugs, stress can cause increase.
>180 mg/dl on two occasions
>200 mg/dl with s/s hyperglycemia |
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Term
| Two hour oral glucose tolerance test (OGTT) |
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Definition
-multiple blood draws over 2 hrs after a glucose load of 75 g.
-200 mg/dl or more = diabetes->140 and <199 = pre-diabetes |
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Term
| Glycosylated Hemoglobin A1C (HbA1C) |
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Definition
Glucose attaches to Hgb and remains attached to the RBC for it’s lifespan (90 days)
Indicates overall glucose control for the previous 90 days.
Near-normal levels over time have greatly reduced risk for development of complications.
Normal range = 4 – 7%
Goal: A1C level of 6.5% or less
Conditions that effect red blood cell turnover may alter HbA1C (sickle cell anemia, hemolysis, etc) |
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Term
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Definition
Onset: 15 min
Peak: 60-90 min
Duration: 3-4 Hrs |
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Term
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Definition
Onset: 30-60min
Peak: 2-3hours
Duration: 3-6 hrs |
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Term
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Definition
Onset: 2-4 hours
Peak: 4-10 hours
Duration: 10-16 hours |
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Term
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Definition
Onset:1-2 hours
NO PEAK
Duration: 24+hrs |
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Term
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Definition
Air in NPH
Air in Regular
Draw up Regular
Draw up NPH |
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Term
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Definition
Change site every 2 to 3 days.
Check site for redness and s/s of infection. |
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Term
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Definition
Delivers insulin in fine pressurized steam through skin without needle
Peak onset etc. occur earlier
Thorough training and monitoring needed |
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Term
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Definition
rebound effect of excessive insulin usually at night
results in ↓ B.S. in middle of night as a response to ↑ insulin
Check B.S. between 2 and 4 AM
- If this AM B.S. is low …then reduce PM dose of insulin OR eat a more substantial bedtime snack |
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Term
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Definition
: hyperglycemia noted on awakening in A.M. due to release of hormones in predawn hours.
Growth hormone is possible factor
Affects majority of those with diabetes but most severe in adolescence and young adulthood
Problem: high B.S. usually after 3 AM
Treatment:
- Check B.S. between 2 and 4 AM;
- if high then increase insulin and eat bedtime snack.
- change timing of evening intermediate acting from dinnertime to bedtime |
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Term
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Definition
| Hypertrophy or atrophy of s.c. tissue due to frequent use of same injection site or an immune reaction to impurities in insulin |
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Term
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Definition
Skin: cool & clammy
Perspiration: profuse
Mental Status: anxious, nervous, irritable, mental confusion, seizures, coma
Misc: weakness, double vision, blurred vision, hunger, tachycardia, palpitations
Glucose: <70 mg/dl (or when high level falls too rapidly)
Ketones: Negative |
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Term
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Definition
Skin: Hot, dry
Dehydration: Present
Respiration: Rapid, deep; Kussmaul type; acetone to breath
Mental Status: Varies from alert to stuporous, obtunded, or frank coma
Glucose: > 250 mg/dl
Ketones: Positive |
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Term
| Diabetes Ketoacidosis (DKA) |
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Definition
Profound deficiency of insulin
Hyperglycemia (BS > 300)
Ketosis, acidosis, dehydration
Fruity odor to breath; Kussmaul respirations
Anorexia, nausea, vomiting
Lethargy, weakness, altered mental status
Lead to coma, electrolyte imbalance, death etc. |
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Term
Hypergylcemic Hyperosmolar State (HHS)
Hyperosmolar Hyperglycemic Nonketotic State (HHNK |
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Definition
Produce enough insulin to prevent DKA
Not enough insulin to prevent osmotic diuresis, hyperglycemia or ECF depletion
Increase in serum osmolarity
BS >400mg/dl
Ketones are absent
High BG produces high serum osmolarity thus producing neurological manifestations (coma, seizures etc), strokelike s/s.
*** fewer symptoms seen earlier with HHNS so BS can get quite high |
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Term
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Definition
Medical emergency
IV administration of NSS or ½ NSS
Regular insulin IV
When glucose falls < 250… add IV glucose (D5 ½)
Electrolyte replacement
Bicarbonate for DKA in pH<7.10
Treat underlying cause and complications |
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Term
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Definition
Cataracts
Retinopathy/Blindness
Infections such as Gangrene
Neuropathy
Arteriosclerosis
Myocardial Infarctions
Kidney disease
Valve Disease
Cerebral Vascular Accidents
Erectile dysfunction |
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Term
| Illness causes increased BS |
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Definition
Eat regular diabetic diet; Increase noncaloric fluids
Continue with oral agents and/or insulin
Monitor BS every 4 hrs. If > 240 check urine for ketones and report + ketones to physician |
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Term
| If Illness leads to decreased PO intake: |
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Definition
Supplement CHO food intake with CHO-containing fluids while continuing with oral agents and/or insulin
Notify physician immediately if unable to keep any food or fluids down |
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