Diabetes Mellitus

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Diabetes Mellitus
2012-01-30 23:38:42

MNT information of Diabetes Mellitus
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  1. BG
    Blood Glucose
  2. 2hPG
    Two-hour plama glucose
  3. IFG
    Impaired fasting glucose
  4. IGT
    Impaired glucose tolerance
  5. BGC
    Blood glucose control
  6. bgm
    Blood glucose monitoring
  7. A1c
    glycosylated hemogobin
  8. DM
    Diabetes Mellitus
  9. GDM
    Gestational Diabetes Mellitus
  10. IDDM
    Insulin-dependent diabetes mellitus
  11. CDE
    certified diabetes educator
  12. CHO
  13. FBS
    fasting blood sugar
  14. gluc
  15. Hb or Hgb
  16. GTT
    glucose tolerance test
  17. OGTT
    Oral glucose tolerance test
  18. H/O
    history of
  19. meds.
  20. p.c.
    after eating, after meals/food
  21. q.3h
    every 3 hours
  22. i.c.
    between meals
  23. a.c.
    before meals
  24. b.i.d.
    twice a day
  25. t.i.d.a.c.
    three times a day before meals
  26. which organ produces insulin?
    the pancreas
  27. Where is insulin secreted?
    into the blood
  28. Diabetes Mellitus
    a metabloic disease causing abnormally high blood glucose conentration, resulting from insuling insufficiency and/or insulin resistance
  29. Type 1 diabetes mellitus
    is a disease characterized by high blood glucose concentration due to defect of insulin secretion and it can make individuals prone to ketoacidosis.
  30. type II diabetes mellitus
    a chronic diesease condition associated with abnormaly high blood glucose concentration, resulting from various degrees of insuin and relative insulin insufficiency.
  31. Gestational diabetes mellitus
    glucose intolerance diagnosed during pregnancy
  32. How is GDM diagnosed?
    • -fasting plasma glucse > 126 mg/dL
    • or
    • -causal plasma glucose > 200 mg/dL
    • or
    • -based on an OGTT test
  33. What are blood glucose targets for the management of GDM
    • -A1c less than 6%
    • -fasting plasma glucose < 105
  34. 12 risk factors for type II diabetes mellitus
    • 1. current of past impaired fasting glucose
    • 2. history of gestational diabetes or macrosomic infant
    • 3. overweight, obesity, especially abdominal fat accumulation
    • 4. metabolic syndrome
    • 5. family history of diabetes mellitus
    • 6. aboriginal, hispanic, african, asian or south asian descent
    • 7. health problems realted with diabetes mellitus
    • 8. diet high in energy and fat, low in fiber
    • 9. lack of physical activity
    • 10. age over 40
    • 11. schizophrenia
    • 12. Polycystic ovary syndrome (PCOS)
    • 13. Acanthosis nigricans
  35. Which foods contain carbohydrates?
    Everything but meat and oils.
  36. What are diagnostic criteria for diabetes mellitus?
    • -fasting plasma glucose > 126 mg/dL
    • -casula plasma glucose > 200 mg/dL
    • -symptoms: polydipsia, polyuria, polyphagia, weight loss, fruity breath, spilling ketones into the urine.
  37. symptoms associated with hyperglycemia
    weight loss, extreme thirst, blurred vison, fatigue, frequent urination, weakness and possible coma.
  38. long-term complications of diabetes mellitus
    metabolic syndrome, hyperlipidemia, hypertension, CVD, CHD, and MI, peripheral vascular disease, retinopathy, blindness, neuropathy, nerve damage, nephropathy, erectile dysfunction, foot problems, gastroparesis, and amputation.
  39. What can cause hyperglycemia in patients with diabetes?
    • -unknown, undiagnosed/untreated DM
    • -DM not managed properly
    • -too much CHO intake or too little physical activity
    • -not enough medication
    • -illness
    • -stress
  40. Hypoglycemia
    low blood glucose concentrations (< 70 mg/dL)
  41. hypoglycemia symptoms
    headache, nausea, hunger, weakness, sweating, confusion, skaing/trembling, palpitations, anxiety, tingling, difficulty concentrating, tiredness, drowsiness, vision changes, difficulty speaking, irritability, disorientation, loss of conciousness, seizures
  42. How are mild to moderate episodes of hypoglycemia treated?
    ingest 15 grams of easily absorbed carbohydrate, such as glucose or sucrose in solution or tablets (orange juice) then wait 15 minutes, measure glycemia and repeat if blood glucose still < 70 mg/dL
  43. causes of hypoglycemia
    • -skipping or delaying a meal or snack
    • -eating a smaller meal/snack and less CHO than usual
    • -exercising more than usual
    • -taking alcohol
    • -taking too much medication
  44. Blood glucose targets
    • -fasting glucose and before meals: 90-130 mg/dL and ideally < 110
    • -peak glucose after meals: < 180 mg/dL and ideally < 140 mg/dL
  45. What are the main goals of nutrition care for clients with diabetes mellitus?
    • -provide indiviualized recommendations and guidance
    • -to assist clients with adopting a healthy lifestyle and making appropriate dietary choices
    • -ensure adequate energy and nutrition intake
    • -teach self-monitoring and self-care
    • -prevent acute and long-term complications
    • -reduce the risk of CVD
    • -tailor nutrition recommendations to the client's physiologic state and overall health status
    • -coordinate their diet eith the other components of diabetes management
  46. Basic healthy eating recommendations for clients with DM
    • -recognize food which contains CHO and control your intake of these foods
    • -eat three meals a day at regular intervals, and healthy snacks as necessary
    • -have a well balanced diet
    • -limit intake of fat
    • -limit intake of sweets
    • -drink water when thirsty
    • -select foods rich in dietary fiber
    • -eat portions of moderate size and do not overeat
    • -limit intake of alcohol and salt.
  47. What is A1c and why is it useful to measure its blood concentration?
    • -glycosylated hemoglobin
    • -as blood glucose concentration increases, glucose binds to the hemoglobin A of red blood cells. The measurement of blood A1c concentration is a reflection of the average daily blood glucose concentration in the last 3 months, with recent blood glucose concentrations having the most influence on its value. It is used to look at blood glucose monitoring and control.
  48. Target A1c
    7% or less, but ideally less than 6%.
  49. Recommendations for alcohol consumption with diabetes mellitus
    limit alcohol intake to no more than one drink per day for women and two drinks for men. Alcohol can cause hypoglycemia and can have a delayed reaction up to 14 hours after consumption. It should consumed with a meal to try and prevent hypoglycemia.
  50. what is carbohydrate counting?
    a meal-planning approach for clients with diabetes that referes to counting the grams of carbohydrate in foods that the client will eat, in order to control carbohydrate intake and inject the right amount of insulin.
  51. What are available CHO?
    Fiber is not an available CHO. So to calculate available CHO you subtract fiber from total carbohydrate.
  52. what is the glycemic index?
    The glycemic index of fod is a relative scale reflecting how much blood glucose concentration increases after the ingestion of a food, in comparison with glucose which has a value of 100.
  53. Target lipid profile concentrations
    • Total cholesterol: < 200 mg/dL
    • LDL cholesterol: < 70 mg/dL
    • HDL cholesterol: > 50 in women mg/dL and > 40 mg/dL in men
    • Triglyceride level: < 150 mg/dL
  54. Target systolic and diastolic blood pressure
    < 130 mm Hg / < 80 mm Hg
  55. How are the different types of insulin used in the management of diabetes mellitus classified?
    according to their duration of action.
  56. What types of insulin are used in the management of diabetes mellitus?
    • -Extended long-acting insulin
    • -long-acting insulin
    • - intermediate-acting insulin
    • -short-acting insulin
    • - rapid-acting insulin
    • -premixed insulin
  57. What are antihyperglycemic agents used in the management of type 2 diabetes mellitus?
    • -alpha-Glucosidase inhibitors
    • - sulfonylureas
    • -TZDs
    • -Biguanides
    • -Combination agents
  58. Recent guidelines for treatment of diabetes mellitus promote the prescription by physicians of the __________ type of insulin more often because it is a better postmeal blood glucose control and is associated with lower risk of hypoglycemia, especially over night.
  59. Where is insulin injected?
    into the subcutaneous tissue
  60. According to the latest diabetes screening recommendations, people of ___________ years and older should have a fasting plasma glucose test done every 3 years, and those at high risk every year.
  61. Blood ketone concentration should be tested in patients with Diabetes when they have a preprandial blood glucose concentration __________
    > 252 mg/dL
  62. Which of the following is a neurogenic (autonomic) symptom of hypoglycemia.
  63. What is the treatment of severe hypoglycemia in an unconcious client?
    glucagon injection
  64. The following are symptoms of type 1 diabetes mellitus except
    A.) oliguria
    B.) unexplained weight loss
    C.) blurred vision
    D.) weakness
    E.) fatigue
    A.) oliguria
    (this multiple choice question has been scrambled)
  65. The main cause of death in people with diabetes mellitus is ____________
    heart disease and stroke
  66. Inteolerance to fat and fiber in a client with diabetes mellitus may indicate the presence of ____________
  67. True or false: Sucrose loses its sweetness during heating.
  68. Which of the following foods has the lowest glycemic index?
    A. sweet potato
    B. whole wheat bread
    C. white potato
    D. rice krispies
    E. white bread
    A. sweet potato
    (this multiple choice question has been scrambled)
  69. The recommendation to treat a mild to moderate hypoglycemic episode in a conscious adult with diabetes in to take _______ g of fast-absorbed carbohydrate and test blood glucose levels __________ minutes later.
    15 ; 15
  70. True or false: Enteropathy is a long-term complications of diabetes.
  71. What is the A1c target to prevent macrovascular complications of diabetes mellitus and that corresponds to a normal A1c.
    < 6%
  72. To prevent dangerous situations from arising when people with diabetes have a hypoglycemic episode while driving, individuals must have a blood glucose concentration of at least ______.
    90 mg/dL
  73. True or false: Alcohol can cause a delayed hypoglycemic episode up to 14 hours after its consumption.
  74. True or false: A fasting blood glucose between 110 and 125 mg/dL is a diagnostic criterion for Prediabetes.
  75. True or false when referring to insulin resistance: there is decreased glucose production by the liver.
  76. True or false: Patients with type 2 diabetes are prone to ketoacidosis
  77. Which type of eating style is indicated for clients on insulin premixes?
    Rigid eating style