how prevalent is diabetes? - Answers -40% of hospitalized pts have diabetes
-every 17 seconds someone is diagnosed
-KY ranks 8th in US
-1 in 3 people have prediabetes
-16% of pregnant women in ky have gestational diabetes
what is diabetes? - Answers chronic, complex, common disorder of metabolism, mostly glucose
pancreas
Type 1 diabetes (T1DM) - Answers autoimmune disorder
pt do not make insulin, will ALWAYS require insulin
tx: insulin injections or pump, oral meds do not work due to stomach acidity
why would weight loss occur with T1DM? - Answers the body cannot utilize glucose for energy due to a
lack of insulin, causing it to break down muscle and fat tissue for fuel instead
Type 2 diabetes (T2DM) - Answers progressive and usually related to insulin resistance and deficiency
tx: diet, activity, stress management, diabetes education, and meds
prediabetes - Answers precursor to T2DM, once diagnosed the goal is to prevent T2DM for as long as
possible.
tx: diet and activity
screening starts at 45, unless indicated
what is MODY? - Answers maturity onset diabetes of the young is an inherited mutation found later in
life.
patients are also prescribed a statin whe on metformin or other diabetes meds. Why? - Answers Lowers
"bad" LDL cholesterol levels in the blood, reducing plaque buildup in arteries
side effects: muscle aches
what is metformin? - Answers first line of defense for T2DM. works by lowering blood sugar levels by
reducing glucose produced by the liver, improving the body's sensitivity to insulin, and decreasing the
absorption of glucose from the intestines
, why is CoQ10 prescribed as well? - Answers is an antioxidant that helps with cellular energy metabolism.
how does gestational diabetes (GDM) affect mother and babies? - Answers mother: future diabetes,
higher chance of C-SECTION (larger babies), miscarriage, preterm birth
Babies: jaundice, respiratory distress syndrome, higher birth weight, prone to obesity, preterm birth,
low BS after birth, T2DM later in life
indications for screening for diabetes - Answers ->45 years, if glucose A1C are within range, testing
should occur every 3 years
-BMI > 25 (23 in asian americans) AND one: 1st degree relative with diabetes, high risk population, given
birth to >9 pound baby, hypertension, PCOS/GDM, A1C > 5.7
what is metabolic syndrome? - Answers Simultaneous presence of metabolic factors that increase risk
for developing type 2 DM and cardiovascular disease.
features include:
-waist circumference >35 (F) or >40 (M)
-Blood glucose >100 or on diabetes med
-BP > 130/85
metabolic syndrome increases the risk of stroke, CVD, and early death
diabetes diagnosis - Answers A1c >6.5%
fasting glucose >126
random glucose >200
**prediabetes A1c 5.7-6.4%
**in pregnant clients, oral glucose tolerance test >140
what is glucagon? - Answers a hormone that has balancing actions opposite those of insulin. it is
secreted from alpha cells in the pancreas when food intake is low.
during fasting blood glucose is maintained between 60-140 mg/dl
what are incretin hormones? - Answers (GLP1) Gut hormones that enhance insulin secretion and inhibit
glucagon by slowing the rate of gastric emptying
what are other hormones that increase blood glucose levels? - Answers -epinephrine, nonepinephrine,
growth hormone, and cortisol
what is the A1c goal for diabetics? - Answers less than 7%, checked twice a year