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Unit #1

Diabetes A complex disorder that affects carbohydrate, protein, and fat embolism
Diabetes Mellitus A of diseases characterized by hyperglycemia and abnormalities in fat, carbohydrate, and protein metabolism that lead to microvascular, macrovascular,and neuropathic complications.
Type 1 insulin-dependent, is present in 5% to 10% of the diabetic population. , complete lack of endogenous insulin production, needs exogenous insulin
type 1 occurs more frequently in juveniles, ts caused by an autoimmune destruction of the beta cells in the pancreas The onset of this form of diabetes usually has a rapid progression symptoms (a few days to a few weeks)
Type 2 Most common 90% of all cases, caused by insulin deficiency, insulin resistance, and increased glucose production by the liver,
Gestational Diabetes Hyperglycemia develops during pregnancy, insulin may be needed, usually subsides after delivery, 30% of patients develop TYPE 2 DM within 5-10 years
Diabetes Mellitus Elevated fasting blood glucose (<126 mg/dL), A1c >6.5,
DM signs and symptoms Polyuria, Polydipisia,Polyphagia, frequent infections, unexplained wt. loss ketoacidosis, irritability
Major Long-Term Complications of DM Macrovascular and Microvascular
Macrovascular (Atherosclerotic Plaque) Coronary arteries, Cerebral arteries, Peripheral arteries Stroke, MI, and peripheral vascular disease account for 75%to 80% of mortality in patients with diabetes
Microvascular (Capillary Damage) Retinopathy, Neuropathy, Nephropathy, those that arise from destruction of capillaries in the eyes, kidneys, and peripheral tissues.
type 2 diabetes treatment Lifestyle changes, wt. loss, improved dietary habits, smoking cessation, reduced ETOH consumption, regular exercise, oral drug therapy, and insulin
type 1 diabetes treatment Insulin therapy
Screening for DM Fasting plasma glucose (FPG) levels > or equal to 100 mg/dL but< 126 mg/dL may indicate prediabetes, Impaired glucose tolerance test (oral glucose challenge), Screening recommended every 3 yrs. for all patients 45 yrs and older.
Antidiabetic Drugs Insulin and Oral hypoglycemic drugs
Insulin functions as a substitute for endogenous hormones, effects are the same as normal endogenous insulin, Restores diabetic patients ability to: metabolize carbohydrates, fats, and proteins, Stores glucose in the liver, Convert glycogen to fat stores
Rapid acting insulin Most rapid onset of action (5 to 15 minutes) shorter duration, patient must eat a meal after injection, insulin lispro-give Subcut, similar action to endogenous insulin, insulin aspart-may be given subcut or IV, Insulin glulisine-may be give IV for uncont
Short acting Insulin regular insulin(Humulin R), onset 30-60 minutes, Peak 2.5-5 hrs, duration 5-10 hrs, may be given Subcut, IV, IM
Intermediate acting Insulin NPH Isophane insulin suspension , cloudy apperance,slower onset and more prolongeed in duration than endogenous insulin Onset 1-2 hrs, Peak 4-12 hrs, Duration 16-28 hrs
Long acting Insulin Glargine, detemir , clear colorless, referred to as basal insulin, Onset 1.1 hrs, No Peak, Duration up to 24 hrs
Oral Antidiabetic Drug (Metformin) Mechanism of Action Decrease production of glucose by liver, decrease intestinal absorption of glucose, increase uptake of glucose by tissues, Does not increase insulin secreetion from pancreas (does not cause hypoglycemia)
Oral Antidiabetic Drug ( Mechanism of Action
Created by: cwalker75



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