Download - Diabetes
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Endocrine and
Metabolic Disorders
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Types of Diabetes Type 1- Insulin deficient, juvenile diabetes
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Types of Diabetes Type 2- insulin resistance; adult onset;
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Types of Diabetes Gestational diabetes- BMI >30, history of GDM
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Diagnosis of DiabetesA1C- measures your average blood glucose for the past 2
to 3 months.
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Diagnosis of Diabetes Fasting Plasma Glucose (FPG)
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Diagnosis of Diabetes Oral Glucose Tolerance Test (also called the OGTT)
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Diagnosis of Diabetes Random (also called Casual) Plasma Glucose Test
Blood glucose of greater than or equal to
200 mg/dl
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Diagnosis of Diabetes GDM- new recommendation for OGT 24-28 weeks
1st- 50 g OGT non-fasting measure glucose 1hour after
and if its greater than 140, you have to proceed to step
2.
Step 2- different day for fasting. 100 g OGT and will
wait 3 hours. If after 3 hours the BG is greater than 140
then you’re diagnose with GDM.
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Goals for all diabetes Maintain Blood glucose level
Consistent carbohydrate intake
Monitor Blood glucose
Planned exercise
Endurance Athletes: 120-180 mg/dl is the blood glucose
range guideline during activity
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Glycemic Index GI of a food based on the blood glucose response
compared to a reference food
High GI Foods - Glucose, bread, potatoes, breakfast
cereal, sports drinks
Medium GI Foods- Sucrose, soft drinks, oats, tropical
fruits
Low GI Foods- Fructose, milk, yogurt, ice cream
lentils, pasta, nuts, apples, oranges
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Food List Starch Group (measured after cooking)
1 slice of bread
1/4 large bagel1/2 hamburger bun, hot-dog bun, pita bread, English muffin1/3 cup rice, pasta, millet, couscous1/2 cup beans
1/2 cup starchy vegetable
1/2 cup oatmeal, kasha, grits, bulgur
1 small tortilla (flour or corn, 6 inch size)
6 saltine crackers3 graham cracker squares3 cups popcorn
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Food List & Carb countingFruit Group
1 small apple, orange, peach, pear, or nectarine 1 small banana 1/2 grapefruit
1/2 cup unsweetened applesauce 3/4 cup fresh pineapple chunks, blueberries, or blackberries 17 grapes 1 cup cantaloupe, honeydew, or papaya
1 large kiwi2 tablespoons raisins1/2 cup orange juice, apple juice, or grapefruit juice
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Food List & Carb counting Milk Group
1 cup of milk
1 cup of soy milk
1 cup of buttermilk
2/3 cup of plain yogurt
2/3 cup of aspartame sweetened yogurt
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Medication Meglitinieds (Glucotrol), Sulfonylureas: Increase
insulin release from the pancreas
Metformin: Enhace insulin reaction
Thiazolidinediones- insulin sensitizers
Starch blockers (Acarbose) delaying carbohydrate
absorption
Glucagon like peptide- enhance insulin secretion
Amylin Agonist
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Dawn Phenomenon &
Somogyi effect
a surge of hormones that the body produces daily
around 4:00 a.m. to 5:00 a.m.
two phenomena of morning hyperglycaemia
Dawn phenomenon occurs when endogenous insulin
secretion decrease
Somogyi effect is present in the case of excessive
amounts of exogenous insulin.
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Complications of uncontrolled
diabetes Diabetic ketoacidosis (DKA)- hyperglycemia
Signs
nausea and vomiting
stomach pain
dehydration
fruity breath odor
rapid breathing
Treatment
Insulin, rehydration
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Complications of uncontrolled
diabetes Acute Hypoglycemia- lack of insulin
Symptoms Shaking, sweating, rapid heartbeat Change in vision Hunger Headache Sudden moodiness
Treatment 15 g CHO Check your blood sugar again after 10-15 minutes. Repeat a dose of fast-acting carbohydrates if the sugar is
still low <70 mg/dl. give another 15 g Carb
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Complications of uncontrolled
diabetes Long Term
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Types of Insulin
Fast-acting insulin
Rapid Acting Insulin Analogs
Regular Human Insulin (Insulin Aspart, insulin Lyspro, Insulin Glulisine)
ONSET PEAK DURATION
5-15 Minutes 1-2 hours 4-6 hours
ONSET PEAK DURATION
30-60 minutes 2-4 hours 6-8 hours
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Types of Insulin Intermediate-acting insulin
NPH Human Insulin, Pre-Mixed Insulin
Long-acting insulin Insulin Glargine, Insulin Detemir
ONSET PEAK DURATION
1-2 hours 4-6 hours 12 hours
ONSET PEAK DURATION
1 1/2 -2 hours No peak 24 hours