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Diabetes
Chapter 67 Diabetes
| Question | Answer |
|---|---|
| Type I | autoimmune, does not produce insulin, usually younger than 30 |
| Signs of Type I | 3 Polys (thirst, increase urine, increase hunger), weight loss, fatigue, rapid onset |
| Type II | insulin resistant, adult onset, obesity |
| Signs of Type II | 3 Polys, obesity, gradual onset, insulin resistance |
| Hypoglycemia | Cool, Clammy, diaphoreses, aniety, irritablility, conusfion, hunger, SEIZURES |
| Hyperglucemia | Hot, Dry, N/V, Kussmal respirations, Fruity Breath |
| Oral Antidiabetics | Use for type II can be used with insulin Avoid ETOH disulfiruam like reation |
| Biguanides | Metforman: monitor renal function; lactic acidosis |
| Thiazolidiones | Use additional form of birth control |
| Hyperglycemia | leads to Polyuria, Polydipsia, Polyhagia |
| Dehydration leads to | hemoconcentration, hypovolumia, hyperviscosity, hypoperfusion, hypoxia |
| Acute Complications of DM | DKA=caused by lack of insulin and ketonesHHS=caused by insulin deficiency and profound dehydration |
| Macrovascular | CVS=MIAlbuminuria=presence of albumin in the urineCVD=stroke |
| Microvascular | NPDR=growth of retnial blood vessal dont grow backPDR=growth of blood vessels:but vessels are fraigle and bleed easlyNephropathy=decreaase kidney function;reanal failureNeuropathy=destruction of nervesED |
| Type II-Metabolic Syndrome | Abd obesity, hyperglycemia, hypertension, dislipidema |
| Type II | More common in older adults, esp AA and Mexican Americans, |
| Lab Test | FPG-perfered in non pregnant adults/two seperate tests greater than 126OGTT-most sensitive test-HBA1C-shows avg blood glucose w/in 120 days. Not affected by eating. Want to be around 7 |
| Urine Test | Moderate/High ketones indicates a severe lack of insulin |
| Sulfonylurea Agents | used with pts with some pan beta cell function-side effects include wight gain and hypoglycemia |
| Lispro Insulin | rapid acting insulin |
| Short Acting | Humulin R- 0.5 onset 2-4hr peak-5-7 hours lasts |
| Long Acting Insulin | Lantus 2-4hr onset and lasts 24 hr |
| Comlications of Insulin Therapy | LipoatrophyLipohypertrophyDawn PhenomenonSomogyi Phenonmenon |
| Problem with Type I diabetes | hypoglycemic unawareness: pts no longer have the warning sypmtoms of impending hypoglycemnia that should prompt to take action |
| Treatment for hypoglycemia | Glucotrol,15-15-15 |
Created by:
Kribat
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