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Diabetes Mellitus

Chronic Exam #1

Beta cells produce insulin (hormone) that decreases BS
Alpha cells produce glucagon (hormone) that increases BS
Primary action of insulin active transport of glucose into muscle and adipose tissue cells to lower blood glucose
other roles of insulin regulates rate of CHO metabolism, promotes glycogen storage in the liver, inhibits fat breakdown, inhibits protein breakdown
action os glucagon raises BS by promoting conversion of glycogen to glucose
Type I Diabetes IDDM (insulin dependent) "Juvenile diabetes", total lack of insulin production (autoimmune process that destroys beta cells), onset usually younger than 30
Type II Duabetes NIDDM (non-insulin dependent) "maturity onset diabetes" inadequate production of insulin or increased cellular resistance to the body's own insulin, slower onset, tend to be obese
signs and symptoms of diabetes 3 Ps (polydipsia-excessive thirst, polyphagia-excessive hunger, polyuria-excessive urination), weight loss, fatigue, weakness, blurred vision, frequent infections
Diagnostics of Diabetes 1.Fasting Blood Sugar (FBS)- norm 70-110, diagnosis >140 on 2 different occasions2. glycosylated hemoglobin (Hgb molecules combine with glucose to form glycohemoglobin which is stored by RBCs) normal value= 4-7%
6 food groups of the exchange diet starch/bread, protein/meat, dairy/milk, fruits, vegetables, fats
distribution of calories 50-60% from carbs20-30% from fat20% from protein
Type 2 Management may be controlled with diet and exercise alone, or in combo with oral hyoglycemic agents, 20-30% require insulin during periods of stress
Type I Management require insulin therapy
typesof insulin rapid acting, short acting, intermediate acting, long acting, other
Rapid-acting insulin Humalog (lispro), clearonset- 10-15minspeak- 1hrduration- 2-4 hrs
Short acting insulin Regularonset- 1/2 hr-1hrpeak- 2-4 hrsduration- 5-7hrs
Intermediate acting insulin NPH, cloudyonset- 2-4hrspeak- 6-12 hrsduration- 18-24 hrs
Long acting insulin ultralenteonset- 6+ hrspeak- 18-24 hrsduration- 36 hrs
other types of insulin Lantus (glargine, clear, long acting, basic metabolic needs
insulin preparation for mixed dose 1. add air to cloudy vial2. add air to clear vial3. draw out clear dose4. draw out cloudy dose to reach total dose
absorption of insulin mroe rapid from abdomen, then arms, then legs
oral antidiabetic agents (types) sulfonylureas, meglitinides, biguanides, glitazones, alpha-glucosidae inhibitors
sulfonylureas Glucatrol (Glipizide), Micronase (Glyburide)- stimulate beta cells to produce insulin and increase cellular receptivity
meglitinides Prandin (Repaglinide)- stimulate beta cells to produce insulin
biguanides Glucophage (Metformin)- WORK IN THE LIVER, increasw cellular receptivity to insulin and decrease hepatic production of glucose
Glitazones (Avandia) (Actos)- decrease insulin resistance by increasing receptor sensitivity (sensitizers)
alpha glucosidase inhibitors (work in intestine) (Precose)- delay digestion of complex CHO
Created by: waiddancer