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Stable glucose range
70-120
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What is the average daily secretion of insulin a day
0.6units/kg
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Impaired glucose tolerance or impaired fasting glucose aka
Pre-diabetes
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Prediabetics
IGT:
- Fasting glucose higher than normal
- (>100mg/dl, but <126 mg/dl)
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Prediabetics
IFG
- 2 hour plasma glucose higher than normal
- between 140-199 mg/dl
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Risk factors diabetes
- Race- american indian, african americans, eskimos
- Age - 65+
- Obesity
- Family History
certian meds - hypertension
- stress
- inactivity
- pregnancy
- high cholesterol
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Main symptoms of diabetes
- Polyuria
- Polyphagia
- Polydispsia
- Weight gain
- kussmaul breating (hyperventilation)
- blurred vision
- smell of acetone
- N&V
- Abdominal pain
- Glycosuria
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Criteria for diagnosis
Classic symptoms of diabetes and...
Blood sugar >
or
Fasting blood glucose >
or
2hr plasma glucose> ___ during OGTT testing using glucose load 75G
- Blood sugar >200mg/dl random
- FBG >126
- OGTT > 200
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Rebound effect in which an overdose of insulin causes hypoglycemia
Usually during hours of sleep
Counter regulatory hormones released
Rebound hyperglycemia and ketosis occur
Somogyi effect
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Characterized by hyperglycemia present on awakening in the morning
due to relase of counter regulatory hormone in predawn hours
growth hormone/ cortisol possible factors
Dawn Phenomenon
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Medical management of diabetes mellitus
- nsulin if unresponsive to diet therapy and oral agents
- increase activity
- decrease hypertension adn lipid levels and prevent heart attacks and strokes
- Diet therapy (5-6 TIMES a day)
- Stress management
- Blood glucose monitoring before, after meals, or at night
-
Main things that are complications of diabetes
- Vision- retinopathy
- Heart- arthersclerosis--> cardiomyopathy
- Kidneys- nephropathy
-
Signs and symptoms of hypoglycemia
- Shaky, tachycardia
- Coll and clammy skin, dizzy
- Anxious, weakness
- Headache
- Hungrey
- Blurred vision
- Irritable, nervous
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S&S of hyperglycemia
- Polyphagia
- Headache, weakness
- polydispsia
- polyuria
- dry hot skin
- N&V
- Blurry Vision
- Kusmahls breathing
- Dehydration
- Fruity Breath
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If severe hypoglycemia what do you administer
D50%- IV glucose
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What amount do you want for carbs a day
-
-
saturated fat
Less that 7%
-
HHNK
bg-
most prodominant in type
what does it do?
- BG->800
- Serum osmolarity >350
- Mostly in type 2
- No kussmauls
- Severe dehydration and electroylte changes (Low K, Na)
- Hypotension, acute renal failure, hyperviscosity
- seizures, coma, death
-
Hyperglycemia: glucose usually >300mg/dl
Ketonemia: total serum ketones >3
Acidosis: blood ph <7.3 or HCO3->15
rapid unpredicatable onset
Diabetic ketoacidosis
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clinical symptoms of diabetic ketoacidosis
- polyuria
- N&V
- SOB
- Fever
- Polydipsia
- Abdominal pain
- CNS depression
- Infection
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Diabetes complications heart
- coronary artery disease
- HTN
- Poor circulation to legs and feet
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Complications of eyes\
vision loss, glacoma, retinopathy
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complications for kidneys
- renal insufficiency
- and failure
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Complication brain/nerves
- Stroke
- Chronic pain
- neropathy
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