Term
| What are the complications of diabetes? |
|
Definition
- Sixth leading cause of death in U.S> (2002)
- Associated with significant complications
- About 73% of adults with diabetes in the U.S. have a BP greater than 130/80
- Have a greater risk for periodontal disease (2x greater)
- Gingivitis and caries rate increases |
|
|
Term
|
Definition
Diabetes Mellitus
(the word diabetes is Greek for "passing through urine" and mellitus is Latin for "honey")
- disease marked by high levels of blood glucose resulting from defect in insulin production, action, or both
- is a syndrome of disordered metabolism usually due to a combination of hereditary and environmental causes, resulting in abnormally high sugar levels (hyperglycemia). Blood glucose levels are controlled by the hormone insulin made in the beta cells of the pancreas
- Diabetes develops due to a diminished production of insulin (in type 1) or resistance to its effects (in type 2 and gestational). Both lead to to hyperglycemia, which largely causes the acute signs of diabetes:
excessive urine production, resulting in compensatory thirst and increased fluid intake, blurred vision, unexplained weight loss, lethargy, and changes in energy metabolism.
- The term "type 1 diabetes" has universally replaced several former terms, including childhood-onset diabetes, juvenile diabetes, and insulin dependent diabetes (IDDM). Likewise,the term "type 2 diabetes" has replaced several former terms, including adult onset diabetes, obesity related diabetes, and non-insulin dependent diabetes (NIDDM) |
|
|
Term
|
Definition
- Most important factor in regulation of blood glucose level
- Synthesized in beta cells of pancreas
- Rapidly secreted into blood in response to elevations in blood sugar levels |
|
|
Term
|
Definition
- Major fuel and energy source for all body cells
- The brains only "fuel" |
|
|
Term
| Why is insulin important and Why is it important to cells? |
|
Definition
- Promotes uptake of glucose into the body's cells
- Without insulin the cell membranes of many cells are impermeable to glucose
- Is a signal to the body that it has been fed well and maintains glucose homeostasis |
|
|
Term
|
Definition
| Diabetic Ketoacidosis (DKA) is a life-threatening complication in patients with diabetes mellitus. Near complete deficiency of insulin and eevated levels of certain stress hormones increase the chance of a DKA episode. DKA is more common among Type I Diabetics, but may occur in Type II Diabetics, particularly during periods of increased physiologic , such as during an infection. Patients with new, undiagnosed Type I diabetes frequently present to hospitals with DKA. DKA can also occur in a known diabetic who fails to take prescribed insulin, or indiabetics who fall sick due toillnesses such as pneumonia or a kidney infection. DKA as a major cause of death in Type I diabetics before insulin injections were available; untreated DKA has a high mortality rate. |
|
|
Term
| What is the function of Glucose and why is it so important? |
|
Definition
- Major fuel and energy source for all body cells
- Brains only fuel
- Body's homeostatic mechanisms try and maintain blood glucose levels at 50-150mg/dl
- levels above 180, glucose "spills" into urine resulting in loss of energy and water.
-Large molecular size; glucose in urine through osmosis carries with it large volumes of H2O as well as electrolytes
- Levels that are to high/low produce varying degrees of central nervous system dysfunction |
|
|
Term
| What are the differences between a Type I diabetic and a Type II diabetic? |
|
Definition
Type I
- Failure to produce endogenous insulin
- Dependent on exogenous insulin to sustain life
- Usually arises in childhood or puberty ( used to be called juvenile or insulin dependent diabetes)
- predisposing factors can include: genetics, environmental, and autoimmune factors
Type II
- Body does not produce enough insulin
- Controlled by diet or medication
- Maturity onset diabetes |
|
|
Term
| What are the differences between a Type I diabetic and a Type II diabetic? |
|
Definition
Type I
- Failure to produce endogenous insulin
- Dependent on exogenous insulin to sustain life
- Usually arises in childhood or puberty ( used to be called juvenile or insulin dependent diabetes)
- predisposing factors can include: genetics, environmental, and autoimmune factors
Type II
- Body does not produce enough insulin
- Controlled by diet or medication
- Maturity onset diabetes |
|
|
Term
Define hyperglycemia.
Include signs, symptoms,and how to manage a hyperglycemic emergency. |
|
Definition
*High Blood Sugar*>250 mg/dL
- too little insulin (can't use glocose for food
- can progress into a diabetic ketoacidosis/ diabetic coma
Signs and Symptoms
-normal to low BP
-Dry, warm skin
-Rapid, weak pulse
-ltered level of consciousness
-Pt. exhibits increased thirst and urination
- Dehydration occurs
- Breath has fruity acetone odor (excess sugar)
- Waste products are ketones
- Ketones build up in blood and are toxic (acidic) to brain cells=ketoacidosis=loss of consciousness=coma
-Body metabolizes proteins and fat for fuel
Hyperglycemic Emergency
-Pt. needs insulin
-management of hyperglycemic pt.
- conscious
- stop dental tx
- place pt. in comfortable position
- Have pt.administer own insulin if available (insulin is not in emergency kit)
If pt. dteriorates, summon EMS
- Unconscious
- Stop dental treatment
- Supine position
- Administer basic life support as needed
- Summon EMS
- Administer basic life support as needed
- Summon EMS
- Vitals
- If diagnosis is in doubt administer glucose paste
- if available IV infusion of 5 % dextrose and water or normal saline may be started
- Administer O2
- Transport to hospital |
|
|
Term
Define Hypoglycemia.
Signs, symptoms, and how to manage a hypoglycemic emergency. |
|
Definition
*Low Blood Sugar*<50mg/dL
- Can develop rapidly
- Pt. can loose consciousness within minutes after insulin administration (oral meds casue slower symptoms)
- Dental treatment poses potential threats to diabetic pts. due to:
- More stress, increased chance of
missing meals (due to length of
appointment, long lasting
anesthesia, dental tmt. causing
difficulty eating.)
- "insulin" shock due to:excessive
exercise before meals, increasing
insulin dosage, omission or delay
of meal.
Signs and Symptoms
- Perspiration
- Confusion
- Anxious
- Lethargic
- Low BP
- Increased pulse
- Hunger/ nausea
- Headache
- Shakiness
- Normal or depressed respirations
_ Diaphoresis (cold and clammy)
- Dizziness
- Difficulty speaking
- Inability to concentrate
- Blurred vision
Management of Hypoglycemia
- conscious
- recognize hypoglycemia
- Stop treatment
- Comfortable position
- BLS as needed
- Give oral carbohydrate (o.j., candy, frosting)
- Permit pt. to recover and discharge (can take up to one hour)
- If pt. is unresponsive to oral carbohydrates then:
* Summon EMS
* Administer 50 mL of 50% dextrose IV or 1mg Glucogon IM
Unconcious
- Stop treatment
- Supine position
- Administer BLS as needed
- Summon EMS
- Monitor vitals
- Administer oral carbohydrate (glucose paste)
- Administer 50% dextrose IV or 1 mg glucogan IM (if available)
*Severe Hypo can develop tonic/clonic seizures* |
|
|
Term
|
Definition
-Hypo more likely to become serious quickly
- Hyper will more likely occur slowly over time, pt.will feel poorly and likely not be in dental office
- When in doubt, treat emergencies like hypoglycemia to avoid more serious results |
|
|
Term
| What is the link between heart disease, stroke, and diabetes? |
|
Definition
|
|
