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CBG Normal values
- Adult brain requires: 60-100
convert protein and lipid to glucose
converts fats to acids
converts glycogen to glucose
- released by stomach which increases insulin production from pancreas.(Beta Cells from islets of langerhans)
- Also can inhibit glucagon secreation (alpha cells from islets of langerhans)
- requires CBG monitoring
- sliding scale insulin
- bypasses incretin hormones
Which hormones increase BG
- growth hormone
High dose steroids
increases CBG. be cognizant when administering prednisone/ steroids.
beta cell destruction leading to absolute insulin dependence-resulting in hyperglycemia. W/O insulin glucose cannot enter cells-this can lead to S&S of hyperglycemia-polyphagia, polydipsia, polyuria, fatigue.
- caused by autoimmune disorders due to environmental factors/ viral pathogens
- Coxsakier virus,measles, influenzae
S&S of DM
polyuria, polydipsia, polyphagia, weight loss, lethargy, weakness, enuresis, yeast infections. WBC cannot fight infection with high amounts of BG.
- More of a metabolic disorder, disorder of carbs, fats, proteins with relative insulin deficiency. (beta cells) are slowly destroyed.
- beginning stages of disease-hyperinsulinemia eventually the pancreas cannot keep up with production and is unable to produce required amount.
- bond between RBC and hemoglobin for lifespan of RBC (120Days)
- (normal 4-6%)
- uncontrolled diabetic >8%
Insulin doesn't pass placenta but glucose does.
Glucose tolerance test
- Mainly for diagnosing gestational
- 12 hour fast
- FBS checked (blood sample)
- 300ml sugary beverage
- CBG checked intervals of 30 mins. for 2 hours.
Metabolic syndrome X
- Group of disorders which a pt. has 3 risk factors
- central obesity
- Low HDL
- High Triglycerides
- insulin resitant
Hyperglycemia affects which electrolyte the most?
Feasting blood test-after 2hours prior to a large carbohydrate meal.
- Leads to ketogenesis-ketones on the breath (alcohol/fruity smell).
- As acidosis develops excess K+ levels may develop due to body trying to buffer. H+ ions move into cells forcing K+ out into ECF. Also Kussmauls respirations.
DKA Causes and Treatment
missed insulin, undiagnosed type 1 diabetic, infection, high levels of stress(cortisol).
treatments: Fluids and insulin drip.
- Confusion-many DKA pts. can be mistaken for someone that is drunk. they will have a tachypnea (kussmaul), rapid heart rate, ketones on breath.
- Blood work may show hyperkalemia, and PH less than 7.35
HHS in Type 2
- #1 cause of HHS in diabetic pt. is INFECTION. Other causes similar to DKA.
- Higher mortality rate than DKA.
- CBG>600 Normally higher than DKA
- Similar to DKA, but unlikely to have ketones on breath.
CBG less than 70 followed by an episode of hyperglycemia
irritable, polyphagia, polyuria, tachycardia, weakness, confusion/ altered LOC, hypotension. osmotic diuresis
CBG spikes in the morning due to hormones being released while they sleep.
Acute hypoglycemia type 1 or 2
- too much insulin
- too little food
- too much exercise
what has a higher mortality? hypo or hyper glycemia
Complications of Diabetes
- peripheral neuropathy
- acanthosis nigricans
- autonomic neuropathy
- unable to take preventative action most common in type 1.
DKA-Diabetic ketone acidosis
- Dehydration-give fluids
- K+ (consider potassium supplements)
- Acidosis (prevent ketone formation give insulin consider sodium bicarb.)