Care of Pt with DM
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What ethnicity has the highest incidence of Diabetes and complications with diabetes
- Native Americans
- African Americans and Hispanics have a higher incidence of diabetes than whites
What are some Macrovascular diseases that are caused by Diabetes?
- coronary heart disease
- cerebrovascular disease
- peripheral vascular disease
What are some Microvascular diseases that are caused by Diabetes
What are the 3 theories used to describe why their are Vascular complications?
- Chronic hyperglycemia causes irreversible basement membrane thickening and organ damage.
- Glucose toxicity directly or indirectly affects functional cell integrity
- Chronic ischemia in small blood vessels causes connective tissue hypoxia and microischemia.
Definition of Diabetes Mellitus
Disorder of glucose metabolism related to absent or insufficient insulin supply and or poor utilization of the insulin available
What is the leading cause of death among pts with DM?
Why do diabetic pts have a higher risk of Cardiovascular Disease
obesity, hypertension, dyslipidemia (excessive blood levels of cholesterol and other fats), and sedentary lifestyle. Cigarette smoking and a positive family history
The presence of what in the urine indicates renal disease?
What does the ADA reccomend diabetic pts BP and LDL levels be
- BP should be less than 130/80
- LDL for pt w/o CVD be less than100mg/dL
- LDL for pt with CVD be less than 70 mg/dL
What is Nonproliferative Diabetic Retinopathy?
causes structural problems in retinal vessels, but growth of new blood vessels is not stimulated.
What is Proliferative Diabetic Retinopathy
- growth of new retinal blood vessels, also known as “neovascularization.” When retinal blood flow is poor and hypoxia develops, retinal cells secrete a “growth factor” that stimulates formation of new blood vessels in the eye.
- However these vessels are fragile and bleed easy leading to eye hemmorhages and more vision loss
Serum glucose is regulated by
the rate of emptying of the stomach and delivery of nutrients to the small intestines
What hormones oppose the effects of insulin
Glucagon, Epinephrine, Growth Hormone and Cortisol
After a meal, insulin does what?
- Stimulates storage of glucose as glycogen in liver and muscle
- Inhibits conversion of protiens to glucose
- Enhances fat cells to store triglycerides
- Increase Protien Synthesis
The incretin hormone is produced in the intestines and...
- secreted in response to food
- increases insulin, decreases glucagon, and slows rate of gastric emptying
What viral infections are associated with autoimmune response of destroying pancreatic beta cells?
Certain viral infections, such as mumps, congenital rubella, and coxsackievirus infection, appear to trigger autoimmune destruction of pancreatic beta cells
What is insulin resistance?
a reduced ability of most cells to respond to insulin, poor control of liver glucose output, and decreased beta-cell function, eventually leading to beta-cell failure.
What are the symptoms of type I diabetes
- Polyphgia- excessive hunger
- Polydipsia-excessive thirst
What is pre diabetes?
- fasting glucose above 100
- Studies have shown that people with pre-diabetes can prevent or delay the development of type 2 diabetes through changes to their lifestyle that include modest weight loss and regular exercise.
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