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Unit #1

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Term
Definition
Diabetes   A complex disorder that affects carbohydrate, protein, and fat embolism  
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Diabetes Mellitus   A of diseases characterized by hyperglycemia and abnormalities in fat, carbohydrate, and protein metabolism that lead to microvascular, macrovascular,and neuropathic complications.  
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Type 1   insulin-dependent, is present in 5% to 10% of the diabetic population. , complete lack of endogenous insulin production, needs exogenous insulin  
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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)  
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Type 2   Most common 90% of all cases, caused by insulin deficiency, insulin resistance, and increased glucose production by the liver,  
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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  
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Diabetes Mellitus   Elevated fasting blood glucose (<126 mg/dL), A1c >6.5,  
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DM signs and symptoms   Polyuria, Polydipisia,Polyphagia, frequent infections, unexplained wt. loss ketoacidosis, irritability  
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Major Long-Term Complications of DM   Macrovascular and Microvascular  
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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  
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Microvascular (Capillary Damage)   Retinopathy, Neuropathy, Nephropathy, those that arise from destruction of capillaries in the eyes, kidneys, and peripheral tissues.  
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type 2 diabetes treatment   Lifestyle changes, wt. loss, improved dietary habits, smoking cessation, reduced ETOH consumption, regular exercise, oral drug therapy, and insulin  
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type 1 diabetes treatment   Insulin therapy  
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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.  
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Antidiabetic Drugs   Insulin and Oral hypoglycemic drugs  
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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  
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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  
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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  
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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  
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Long acting Insulin   Glargine, detemir , clear colorless, referred to as basal insulin, Onset 1.1 hrs, No Peak, Duration up to 24 hrs  
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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)  
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Oral Antidiabetic Drug ( Mechanism of Action    
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