Diabetes

Editor's Notes

• #3 when the body loses the ability to make insulin or can only make a very small amount of insulin. Type 1 diabetes is usually caused by an autoimmune process, and your body’s immune system mistakenly destroys the insulin-producing cells. About 10% of individuals with diabetes have type 1 diabetes.
• #4 few things can be happening with this px They may have the “run away liver” is that the px liver is continue to produce sugar. Even eating breakfast. Lunch, dinner during those times, the liver still decides to produce sugar where as for the healthy person who don’t have diabetes the liver typically produce sugar in their blood stream at times when sugar levels were low. The “pooped out pancreas” which means that the patient has a functioning pancreas but a tired pancreas and results to not producing enough insulin to keep up Insulin resistance- a px has enough insulin in the blood stream but the insulin coupled with the sugar is not getting into the cells and so its staying in the blood stream and being passed in the urine
• #5 When you have gestational diabetes, your pancreas works overtime to produce insulin, but the insulin does not lower your blood glucose levels. Although insulin does not cross the placenta, glucose and other nutrients do. So extra blood glucose goes through the placenta, giving the baby high blood glucose levels. This causes the baby's pancreas to make extra insulin to get rid of the blood glucose. Since the baby is getting more energy than it needs to grow and develop, the extra energy is stored as fat. This can lead to macrosomia, or a "fat" baby. Babies with macrosomia face health problems of their own, including damage to their shoulders during birth. Because of the extra insulin made by the baby's pancreas, newborns may have very low blood glucose levels at birth and are also at higher risk for breathing problems. Babies with excess insulin become children who are at risk for obesity and adults who are at risk for type 2 diabetes.
• #6 The advantages of being diagnosed this way are that you don't have to fast or drink anything. Diabetes is diagnosed at an A1C of greater than or equal to 6.5%
• #7 This test checks your fasting blood glucose levels. Fasting means after not having anything to eat or drink (except water) for at least 8 hours before the test. This test is usually done first thing in the morning, before breakfast. Diabetes is diagnosed at fasting blood glucose of greater than or equal to 126 mg/dl -
• #9 This test is a blood check at any time of the day when you have severe diabetes symptoms. Diabetes is diagnosed at blood glucose of greater than or equal to 200 mg/dl
• #11 Maintain Blood glucose level Consistent carbohydrate intake Monitor Blood glucose Planned exercise- reduction of insulin dosage to prevent hypoglycemia Endurance Athletes: 120-180 mg/dl is guideline during activity (thletes should drink noncarbohydrate fluids when blood glucose levels exceed the renal glucose threshold (180 mg/ dL, or 10 mmol/L), which may lead to increased urination, fluid loss, and dehydration.)
• #12 GI of a food reflects the rate of digestion & absorption
• #13 1 slice of bread (weighing 1 ounce)1/4 large bagel1/2 hamburger bun, hot-dog bun, pita bread, English muffin1/3 cup rice, pasta, millet, couscous1/2 cup beans (pinto, kidney, garbanzo, lentils)1/2 cup starchy vegetable (potato, corn, peas, sweet potato, yam) 1/2 cup oatmeal, kasha, grits, bulgur 1 small tortilla (flour or corn, 6 inch size) 6 saltine crackers3 graham cracker squares3 cups popcorn
• #14 1 small apple, orange, peach, pear, or nectarine (1/2 if large fruit) 1 small banana (1/2 of average banana)1/2 grapefruit1/2 cup unsweetened applesauce 3/4 cup fresh pineapple chunks, blueberries, or blackberries 17 grapes3 prunes1 1/4 cups strawberries, or watermelon 1 cup cantaloupe, honeydew, or papaya1 large kiwi2 tablespoons raisins1/2 cup orange juice, apple juice, or grapefruit juice
• #15 1 cup = 8 fluid ounces
• #16 Meglitinides, Sulfonylureas: - Pills that increase insulin release from the pancreas Metformin: Enhace insulin reaction basically it a Pills that reduce sugar production from the liver Thiazolidinediones work to lower your blood sugar by increasing the muscle, fat and liver’s sensitivity to insulin. TZDs are referred to as “insulin sensitizers” and also are blood sugar normalizing Starch blockers (Acarbose) lowers your blood sugar by delaying how quickly starch and carbohydrate (CHO) are absorbed from your intestines. Glucagon like peptide- enhance insulin secretion Pramlintide (amylin agonist)is an injected medicine for people with type 1 and type 2 diabetes that helps control blood sugar levels after eating.
• #17  The dawn phenomenon is more common than the Somogyi effect. To diagnose these phenomena, it is useful to measure plasma glucose levels for several nights between 3 a.m. and 5 a.m. or use a continuous glucose monitoring system. Although their treatment differs, the best way of preventing both the dawn phenomenon and the Somogyi effect is an optimal diabetes control with insulin therapy. All people have the “dawn phenomenon,” if they have diabetes or not. The dawn phenomenon is a surge of hormones that the body produces daily around 4:00 a.m. to 5:00 a.m. People with diabetes don't have normal insulin responses to adjust for this, and may see their fasting glucose go up. The rise in glucose is mostly because your body is making less insulin and more glucagon (a hormone that increases blood glucose) than it needs. The less insulin made by the pancreas, the more glucagon the pancreas makes as a result. Glucagon signals the liver to break down glycogen into glucose. This is why high fasting blood glucose levels are common in people with type 2. Steps that may help: Eat dinner earlier in the evening Do something active after dinner (such as going for a walk) If your fasting glucose continues to be high, your health care provider may prescribe medication.
• #18 an emergency condition in which extremely high blood glucose levels, along with a severe lack of insulin, result in the breakdown of body fat for energy and an accumulation of ketones in the blood and urine. Signs of DKA are nausea and vomiting, stomach pain, fruity breath odor and rapid breathing. Untreated DKA can lead to coma and death.
• #19 As the term implies, low blood sugar, or hypoglycemia, occurs when your brain and body are not getting enough sugar. For most people whose blood sugar is kept in the near normal range, less than 70 mg/dl can be considered low, or hypoglycemic. Treatment Take at least ½ cup fruit juice, or 3 glucose tablets, or approximately 15 grams of glucose or sugar if your blood sugar is low. You will need more glucose if the blood sugar is very low
• #20 Vision loss or blindness Kidney damage or failure Nerve pain and damage Heart and blood vessel disease High blood pressure Dental problems Hand problems Foot problems
• #21 Is absorbed quickly from your fat tissue (subcutaneous) into the bloodstream. Is used to control the blood sugar during meals and snacks and to correct high blood sugars
• #22 Intermediate-acting insulin: Is absorbed more slowly, and lasts longer Is used to control the blood sugar overnight, while fasting and between meals