KEY TERMS DX TESTS RISK FACTORS CANCER PATHOPHYS HODGE- PODGE

High incidence among blacks, native American esp. Pima tribe, Hispanics

Type 2 DM

Caused by an autoimmune process started by a virus or chemical

Type 1 DM

Agents which increase insulin production, improve cell receptor binding, regulate hepatic glucose production, or delay CHO absorption from the small intestine

Oral antidiabetics

Can often be controlled by diet and exercise

Type 2 DM

Organs that do not depend on insulin to use glucose for energy

Brain and kidney

Acute insulin deficiency resulting in hyperglycemia and an acid state in the body caused by fat breakdown for energy resulting in (acid) ketones in the bloodstream. May result in death

DKA

Organ that attempts to rid bloodstream of excess glucose using a lot of water resulting in polydipsia and possibly dehydration

Kidney

Caused by inability of cells to utilize glucose resulting in a starvation affect

Polyphagia

Hallmark symptoms of DM type 1

Polyuria, polydipsia, polyphagia

May not be symptomatic for years until kidney involvement, retinopathy, impotence, neuropathy, gangrene occurs

DM type2

Subjective symptoms of DM

Hunger, thirst, nausea, noctyria, weakness fatigue, blurred vision, halos around lights, H/A, cold extremities, cramping in calves, decreased sensation to pain and temperature in feet, numbness and tingling in lower extremeties,early satiety, negative feelings re body

Objective symptoms of DM

Slow wound healing, furuncles, carbuncles, ulcerations, urinary tract infections, vaginal yeast infections, wt loss, muscle wasting, shiny hairless lower extremities, cold legs and feet, possibly gangrene

Normal random glucose

200mg/dl or less

Normal fasting glucose

126 mg/dl or less

Normal 2 hr post parandial glucose

mg/dl or less

Chemical resulting from the synthesis of insulin. Used to differentiate between type1 and type 2 DM

C-peptide Normals 0.5-2ng/ml

Cornerstone of care for a person with diabetes

Nutritional therapy and education

Tool used to plan diets for persons with diabetes

MyPyramid

True or false Sugar drives up glucose more than more complex CHO such as rice and potatoes

False

Continue oral intake perhaps in a liquid form, SMBG levels every 1-2 hrs, contact health care provider for BG levels above 250mg/dl for insulin adjustment

DM care during stress and illness

Lispro, peak 1-2 hrs, Aspart, peak 1- 3 hrs. Glulisine, peak 1-3 hrs. novolog mix,and Humalog mix peak 2-10 hrs.

Rapid acting insulins onset 15 min.,

Insulin that can be given IV

Regular, onset 30 min., peak 2-4 hrs.

Inject insulin where?

Between fat and muscle

U/100 syringes are marked in _____unit increments

2

Joint Commission recommendation regarding the use of U for units

Do not use U. Spell out units to avoid medication errors