diabetestalk.net

A Common Complication Of Long-term Diabetes Is Quizlet

Pathophysiology Chapter 25 Short-term Complications Of Diabetes

Pathophysiology Chapter 25 Short-term Complications Of Diabetes

Sort Which of the following scenarios may result in hypoglycemia? Select all that apply. Excess insulin Recent carbohydrate ingestion Insufficient insulin Increased physical activity Insufficient carbohydrate intake ... Which of the following statements about the Somogyi effect and dawn phenomenon are correct? Select all that apply. Both the Somogyi effect and dawn phenomenon are associated with morning hyperglycemia. Nocturnal hypoglycemia occurs in the Somogyi effect, but not the dawn phenomenon. Morning hypoglycemia occurs in both the Somogyi effect and dawn phenomenon. Growth hormone elevation at night contributes to the dawn phenomenon. In the Somogyi effect and dawn phenomenon, blood glucose levels spike after mid-day. Submit ... Hyperglycemia may result in which of the following? Select all that apply. Increased serum osmolarity Decreased kidney filtration of glucose Decreased urination Shift of intracellular fluid into extracellular fluid Suppression of thirst mechanism ... Elevated ketone formation ______________________. results from carbohydrate metabolism. may reduce the respiratory rate. occurs more commonly in type 2 diabetics. occurs when lipolysis is suppressed. may cause a decrease is serum pH. ... A nurse is caring for a patient with type 2 diabetes. During a follow-up visit, the nurse finds that the patient has developed hyperosmolar hyperglycemia syndrome. Which symptoms in the patient support the nurse's conclusion? Select all that apply. Dizziness Mild hyperglycemia Kussmaul's respirations Ketoacidosis Serum hyperosmolarity ... Dawn Phenomenon Morning hypoglycemia Growth hormone peaks in the evening Limited endogenous insulin is present Normal to high blood glucose level between 2:00 a.m. and 4:00 a.m. Nocturnal hypoglycemia Growth hormone peaks in Continue reading >>

2.3 Diabetic Complications

2.3 Diabetic Complications

Glaucoma is when the pressure pinches the blood vessels that carry blood to the retina and optic nerve. Vision is lost. Cataracts interferes with vision, the solution is to remove the lens of the eye. Retinopathy changes in the blood vessels of retina. Results in pain and loss of vision. a condition caused by the damage to blood vessels in the brain. It can cause loss of speaking, thinking and memory. Having diabetes increases your risk of a stroke by 1.5 times. When blood vessels in the leg narrowed or blocked by fatty deposits and blood flow to your feet and legs decreases. If you have diabetes you are most likely to have PAD, a heart attack, or a stroke. Causes diabetic nerve damage, skin changes, calluses, foot ulcers, poor circulation and amputation. Lessens ability to feel pain your skin becomes excessively dry or cracks. High Glucose levels associated with diabetes cause damage to small blood vessels in the inner ear, the same way diabetes damages the eyes and kidneys. High levels of blood sugar make the kidneys filter to much blood. After many years of this, they start to leak and useful protein is lost in the urine. Sends information from the central nervous system to the rest of the body. Damages a peripheral nerves, causes weakness, numbness and pain, (usually in hands and feet). Is when your body were reacting as if it were under attack. People with diabetes their body does not have a preparation called flight-or-fight response because this stores a lost of energy glucose and fat. But, for diabetics it does not respond because insulin does not allow it to let anything extra in so it piles. Can lead to diabetic coma or death. When your cell does not receive required glucose it needs for energy, your body begins to burn fat for energy, which produces Ketones. Continue reading >>

Module 1 Long-term Complications Of Diabetes

Module 1 Long-term Complications Of Diabetes

Sort Long-Term Complications of Diabetes Microvascular Disease • Retinopathy with potential loss of vision • Nephropathy leading to renal failure Neuropathic Syndromes • Peripheral sensorimotor neuropathy • Autonomic neuropathy, including: — Constipation — Diabetic diarrhea — Gastroparesis — Gustatory sweating (i.e., sweating soon after ingesting food) — Neurogenic bladder — Orthostatic hypotension — Sexual dysfunction Macrovascular Disease • Accelerated coronary atherosclerosis • Accelerated cerebrovascular atherosclerosis • Accelerated peripheral vascular disease Mixed Vascular and Neuropathic Diseases • Foot ulcers • Leg ulcers Diabetic retinopathy and nephropathy are associated with thickening of capillary basement membranes in the retina and kidneys due to the accumulation of cross-linked advanced glycation end products. Changes in the basement membranes in the retina lead to microaneurysms and increased vascular permeability; changes in the kidney lead to persistent urine albumin excretion of 30-299 mg/24 hours (formerly described as "microalbuminuria"). In both areas, the pathologic process culminates in irreversible occlusion of the vascular lumina. Diabetic neuropathy is considered a microvascular complication of diabetes, although the exact mechanism by which nerve damage occurs is unclear. The mechanism of damage has been suggested to result from polyol accumulation, injury from advanced glycation end products, and oxidative stress. Peripheral neuropathy in diabetes may take several different forms, including sensory, focal/multifocal, and autonomic neuropathies. Foot ulceration or injury, often resulting from diabetic neuropathy, has been linked to the great majority of lower-limb amputations. Diabetic retinopathy is categoriz Continue reading >>

Diabetes Mellitus Flashcards | Quizlet

Diabetes Mellitus Flashcards | Quizlet

Islets of Langerhans in the pancreas secrete glucagon and insulin Their job is to keep tight control of the blood sugar levels Our bodies need glucose and oxygen for our primary energy source, so relatively constant levels of both need to be maintained throughout the day Release of hormones into the blood controlled by the negative feedback system Alpha cells - glucagon (raises BS by breaking down glycogen) Beta cells - insulin (decrease BS by moving the sugar back into cell) Delta cells - somatostatin (prohibiting production of glucagon and insulin) 3) Insulin facilitates movement of sugar into the cells 5) Insulin is no longer secreted by the pancreas... NEGATIVE FEEDBACK 6) Any extra glucose not taken into the cell is stored in the liver as glycogen 1) Your blood sugar drops...sugar going elsewhere 2) Your pancreas stops secreting insulin... 4) Glucagon signals the liver to break down the stored glycogen into glucose 5) The liver releases glucose into the blood 7) The pancreas stops secreting glucagon...NEGATIVE FEEDBACK! How Pancreas Knows When to Secrete Insulin Glucose in the blood after a meal is controlled by the emptying rate of the stomach and delivery of nutrients to the small intestines Incretin hormones secreted in response to the presence of food in the stomach, increase insulin secretion, inhibit glucagon secretion and slow the rate of gastric emptying thereby preventing hyperglycemia Maintained through the action of insulin and glucagon All body tissues and organs require a constant supply of glucose Not all tissues require insulin for glucose uptake The brain, the liver, the intestines and the renal tubules DO NOT require insulin. Skeletal muscle and adipose tissue DO require insulin for glucose movement into the cells Includes a group of hormones that Continue reading >>

Pathophysiology Chapter 25 Long-term Complications Of Diabetes

Pathophysiology Chapter 25 Long-term Complications Of Diabetes

Place the following sequence of events in the proper order. Decreased T cell activity and increased microorganism growth causes infection of the wound. Hyperglycemia causes demyelination of peripheral nerves. Development of infection in wound prolongs healing of the wound, resulting in further damage. Decreased pain sensation results in blister being formed on foot without person being aware. Blister forms into a wound, as blood supply to wounded area is compromised. George has been managing his diabetes for 20 years. His recent check-up revealed the following: He has had bouts of alternating constipation and diarrhea. He complains of being too hot when he goes outdoors in the summer and admits he is sweating less. He has been treated for urinary tract infections twice in the past year. Drag and drop the complication related to George's symptoms and illnesses. Hyperglycemia can injure the capillaries of the glomeruli of the kidneys. One of the initial signs of this damage is the presence of albumin in the urine. Eventually, so much damage occurs to the glomeruli that proteins may also begin to appear in the urine. The damage and resulting changes to the glomerulus lead to renal dysfunction. Renal dysfunction is a source of hypertension, which further damages the glomeruli. This damage then continues in a cyclical manner. Chronic hyperglycemia may cause ____________________. Select all that apply. both microvascular and macrovascular angiopathy damage to peripheral, but not autonomic nervous system damage to both peripheral and autonomic nervous systems both microvascular and macrovascular angiopathy damage to both peripheral and autonomic nervous systems Which conditions may be caused by chronic hyperglycemia? Select all that apply. Continue reading >>

Long Term Complications Of Diabetes

Long Term Complications Of Diabetes

Sort how do microvascular complications occur? how long do they take to develop, when do they normally present? Most cells are able to reduce glucose transport in response to extracellular hyperglycaemia Retinal endothelial cells Mesangial cells of glomerulus Schwann cells and peripheral nerve cells many years to develop Rare before 5 years of type 1DM May be detected at presentation of type 2 what are the 3 clinical stages of retinopathy? -Non-proliferative Background Pre-proliferative -Proliferative -Macular Oedema Sight threatening Non sight threatening give some associated symptoms of autonomic neuropathy? 5 Gastroparesis (disease of the muscles of the stomach or the nerves controlling the muscles that causes the muscles to stop working. Gastroparesis results in inadequate grinding of food by the stomach, and poor emptying of food from the stomach into the intestine.) Postural hypotension Erectile dysfunction Gustatory sweating (Symptoms of profuse head and neck diaphoresis with eating ) Diarrhoea disecribe the link between diabetes and foot problems? Diabetes is the commonest cause of non-traumatic lower limb amputation PVD Neuropathy Imapaired leucocyte function claw-foot, callus (soft tissues necrose and liquefy), neuropathic ulcer (risk of bone infection) charcot foot (swollen foot due to high blood flow, loss and destruction of joint s in foot, mid part of foot begins to prolapse down, fracture to bones in foot) Continue reading >>

Diabetes Mellitus Flashcards | Quizlet

Diabetes Mellitus Flashcards | Quizlet

Acidosis seen in Type I Diabetes resulting from the breakdown of fat. Ketoacidosis especially prevalent. Acetone is produce and the breath has a sweet, fruity odor. Dry, flushed skin, Kussmaul's respiration, Anorexia, nausea and vomiting, abdominal pain, CNS depression, fruity breath odor, eventual coma (treated with insulin). Respirations that indicated the respiratory system trying to correct acidosis by raising the blood pH Tachycardia and palpitations, diaphoresis with pale, clammy skin, tremors, headache and dizziness, anxiety and irritability, poor judgement, hunger, fatigue, confusion, seizures and coma. This is a problem of both insulin resistance and a reduction of insulin secretion. Most common type of diabetes. Known as non-insulin dependent diabetes. Diagnosed Often known as MODY, it is type II diabetes that is likely genetic and affects those younger thank 25. Diabetes that is considered type II, and presents itself during pregnancy. May or may not go away after pregnancy. Genetic and environmental factors contribute to the development. Obesity is a significant risk factor. Family history, being older than 30, and being Native American, black, or Hispanic are also risk factors. 3 P's may be present. Most are insidious and nonspecific - most clinical manifestations are related to long-term complications, such as visual changes, changes in kidney function, coronary artery disease, peripheral vascular disease, neuropathy and recurrent infections. Diet, exercise, oral hypoglycemic agents, and insulin This is glycosalated hemoglobin. Numbers of this rises with poorly controlled hemoglobin. Tracking the levels of this is used to assess effectiveness of therapy. The goal is usually 7% or less A percentage of Hemoglobin A 1C in the blood that indicated nondiabetic Continue reading >>

Diabetes Mngmt And Long Term Complications

Diabetes Mngmt And Long Term Complications

Describe the chronic complications of diabetes and their relationship to hyperglycemia -Microvascular- retinopathy, nephropathy, neuropathy -Macrovascular- cardiovascular disease (MI, CVA, PVD) Understand the impact on the health care system and society of diabetic management and complications Know eye screening recommendations for diabetic patients Know risk factors for development or progression of diabetic retinopathy and briefly review treatment options Review the pathophysiology of diabetic nephropathy and neuropathy Define diabetic nephropathy, its incidence, screening and treatment options Differentiate between the different types of diabetic neuropathy Know the incidence and morbidity associated with diabetic neuropathy Outline the diagnostic tools associated with diabetic neuropathy Describe a treatment plan for diabetic neuropathy Understand the risk reduction of chronic complications with glycemic control Know the incidence of CVD in diabetics and preventative measures for adverse CVD associated adverse outcomes Be familiar with the medications used to treat diabetes including their mechanism of action, impact on A1c, impact on weight, precautions and common side effects Outline a treatment plan for both type 1 and type 2 diabetics -particularly if have good glycemic control MCC of new blindness in adults ages 20-74 Permeability, leakage and accumulation of intraretinal fluid May occur at any stage of retinopathy and is the leading cause of vision loss in type 2 pts what are the ophthalmology screening recommendations for diabetics? First exam: w/in 5 yrs after dx (once pt 10 yrs or older) F/u: Yearly if retinopathy present, every 2 yrs if not F/u: Yearly if retinopathy present, every 2 yrs if not PREG - retinopathy can worsen, but not develop during -Need p Continue reading >>

Long Term Complications Of Dm

Long Term Complications Of Dm

what are the two 'other' complications of DM leading cause for kidney failure in adults accounts for 50% of nontrauma amputations in the US T/F the majority of diabetics are affected by neuropathy T/F the majority of DM patients are affected by nephropathy what is the most common measurement used to associate with risk of complication T/F some patients have complications of DM type II at the time of diagnosis two parameters that lead to increased microvascular complications in DM type 2 what is the most convenient measure of blood glucose over a 3 month period what is the main event that leads to the microvascular complications in DM type 2 what molecule is decreased in the endothelial cells in response to hyperglycemia what are the four (4) pathways that are activated during long standing hyperglycemia why is it that type 1 diabetes mellitus that are taking insulin are at increased risk for developing hypoglycemia secondary to too much insulin uptake decreased glucagon as well (alpha cell dysfunction) T/F an episode of hypoglycemia increases future episodes of hypoglycemia why is it that patients with DM type 1 are at increased risk of severe hypoglycemia other than their counterregulatory hormone imbalance decreased awareness due to blunted CNS neurotransmitter release (they don't get the symptoms of hypoglycemia, therefore are unaware of their low blood glucose, dont eat something, continued hypoglycemia) Continue reading >>

Diabetes

Diabetes

What is diabetes? Diabetes is disease that causes the body to either not produce insulin or not react properly to the insulin. There are two types of diabetes: Type 1 diabetes is when the body simply does not produce insulin. This type develops in teens and is less common than Type 2. When you have Type 1 diabetes, your immune system turns on the pancreas, causing it not to produce insulin. This causes blood sugar levels to get too high. People with Type 1 take insulin injections to help regulate their blood glucose levels. Type 2 diabetes is when the cells in the body do not react properly with the insulin being produced. The signal to the GLUT4 is never sent from the receptors, so the cells don't allow glucose to enter. Insulin injections can sometimes help people with Type 2, however they usually can only watch what they eat and be careful to exercise a certain amount. How is glucose tolerance testing used to diagnose diabetes? The GTT is usually administered after an abnormal urine test. Doctors use glucose tolerance testing to monitor the amount of glucose in the patient's blood at a given moment in time and to see if their body reacts properly in response to the glucose. If the glucose levels rise drastically and don't fall back down this indicates that there is a high chance that the patient has diabetes. The insulin test can determine the difference between Type 1 and Type 2 diabetes; if the levels of insulin in the blood are high, the patient has Type 2 diabetes, and if there is no insulin in the blood the patient has Type 1. How does the development of Type 1 and Type 2 diabetes relate to how the body produces and uses insulin? In type one diabetes the persons immune system attacks the pancreas causing it to shut down insulin production, leaving the person wit Continue reading >>

Feb 27- Long Term Complications Of Diabetes

Feb 27- Long Term Complications Of Diabetes

Causes atherosclerosis: CVA, MI, Peripheral vascular dz Non-vascular long term diabetic complications Increased risk for infections (UTI). Dyslipidemia (CV disease). Eye: Cataracts, glaucoma (blindness) Cells which do not require insulin for glucose uptake (all but muscle and adipose). Especially those unable to regulate glucose uptake. Endothelial cells (vascular), Neurons, Schwann, and mesangial (renal) cells. Pathologic mechanism: Increase in IC Glucose Overloads cells glc metabolic pathways - dysregulation of mitochondrial ETC. Increases free radicals (ROS) creating OXIDATIVE STRESS. Leads to 1. damage cell's proteins/lipids/DNA 2. Incite formation of signaling molecules (inappropriately) 3. glycosylates proteins. How does the increase of ROS cuase the shunting of glc into ancillary pathwyas? Increased ROS inhibits a glycolytic enzyme, creating a rate limiting step. Pathways include Polyol, hexosamine, PKC, and AGE pathway. Occurs at the glc level. Aldose reductase is first enzyme in pathway (target for drug therapy). Depletes glutathione, an important antioxidant. This increases oxidative stress At G6P level. N-acetylglucosamine glycosylates serine and threonine on many proteins. This pathway changes the proteins function. Examples: Increased TGF A or B - Increased ECM (collagen). Increased PAI-1 (decreased fibrinolysis). Inhibits NO synthetase (vasoconstriction, increased atherogenic effects). At F6P level. PKC has many effects on gene expression: vasoconstriction (Increased endothelin, decreased NO), increased vascular permeability and angiogenesis (increase VEGF), increase ECM (TGF B), Increase PAI-1 (decreased fibrinolysis -> vascular occlusion). Increase NF-KB (increase pro-inflammatory gene expression) At Glyceraldehyde 3P level. Advanced glycosylation end p Continue reading >>

Long-term Complications Of Diabetes Mellitus

Long-term Complications Of Diabetes Mellitus

Sort Interventions for occlusive peripheral arterial disease Good BS control- medication compliance Protect feet from heat and cold Foot care: Wash daily in warm water, dry well, inspect feet daily (use mirror to √ bottoms) Keep skin soft; gently smooth corns & calluses Trim toenails straight- emery board to edges Wear closed toe well-fitting shoes & socks - avoid any irritation of foot No smoking (causes vasospasm) Check DP and PT pulses; examine feet daily Reduction of risk factors for Macroangiopathies Medical nutrition therapy & exercise Reduces obesity, HTN & hyperlipidemia Obesity increases insulin resistance BP control - meds and lifestyle changes Tight BS control ↓triglyceride concentrations ↓ complications No smoking Management of Retinopathy Annual eye exam Laser photocoagulation Destroys ischemic areas of the retina that produce growth factors that encourage neovascularization This prevents further visual loss - reduces the rate of progression to blindness Done as outpatient- can return to normal ADL Control BS levels Control hypertension Cessation of smoking Continue reading >>

Diabetes Flashcards | Quizlet

Diabetes Flashcards | Quizlet

The primary organ involved in the disease process of type 1 mellitus is the Factors that seem to play a role in the development of type 2 diabetes mellitus are Acidosis, underweight, and rapid onset are characteristics of Which of the following describes characteristics of type 2 diabetes Other symptoms that may present in patients with diabetes includes Uncontrolled diabetes is related to the abnormal metabolism of The largest portion of islet cells are the B cells that synthesize The hormone considered to act in a manner opposite to insulin is Which of the following functions is not associated with the hormone insulin mobilizes liver glycogen to yield glucose The accumulation of glucose in the blood is called Ketones are a by-product of the metablosim of If diabetes is suspected, the patient should be given which of the following tests? Three common long-term complications of diabetes affect the cells of the It is recommended that about 60% of the kilocalories in the diabetic diet come from Increasing the fiber content of diabetic diet tends to A commonly used nonnutritive sweetener would include A high intake of saturated fats is associated with Type 2 diabetes usually appears after the age of A food label on a can of applesauce says, one serving contains 20 gms of sugar.This is equal to how many teaspoons A diabetic child is playing tennis and starts to feel shaky and lightheaded, what is the first thing that should be done Which of the following tests will reflect the level of blood glucose over the predecing 3 month period What are the 3 primary symptoms of diabetes mellitus Continue reading >>

Final- Diabetes (chapter 20)

Final- Diabetes (chapter 20)

Polyphagia- Excessive appetite or food intake Blurred vision- eye tissue exposed to hyperosmolar fluid Increased infections- weakened immune response and decreased blood circulation Constant tiredness- altered energy metabolism, dehydration, or other effects It is primarily based on plasma glucose levels. When taken at random times of the day (non-fasting) if there is 200 mg/dL or higher, and classic symptoms, then diagnoses with diabetes. If fasting glucose is greater than 126 mg/dL (after at least 8 hours of fasting) you are diagnosed. If your plasma glucose measure after 2 hours of 75 gram glucose load is 200 mg/dL or higher you are diagnosed. This is usually caused by an autoimmune destruction of the pancreatic beta cells, which produce and secrete insulin, so insulin must be supplied by injections. (NEED INSULIN THERAPY). Inherited or environmental. And commonly occurs in children or adolescents. What is usually the first sign of type 1 diabetes? Ketosis- build up of acid due to ketone bodies This is often asymptomatic. Some insulin is produced but your body resist insulin and beta cells get exhausted. Becoming increasingly prevalent in children. What increases the risk of type 2 diabetes? What are acute complications of diabetes? Insulin deficiencies can cause significant disturbances in energy metabolism, and severe hyperglycemia can lead to dehydration and electrolyte imbalances. Treated diabetes, hypoglycemia is a possible complication of inappropriate disease management. Examples are ketoacidosis, hypoglycemia, and hyperosmolar hyperglycemic state This is a sever lack of insulin. This includes Ketosis ( acetone breath- fruity breath), acidosis ( hyperventilation- trying to get rid of carbon dioxide), and hyperglycemia (polyuria -sig fluid loss lowering blood Continue reading >>

2.2.3 Complications Of Diabetes

2.2.3 Complications Of Diabetes

140/90 is a high BP, can only find out BP by going to the doctor, can lead to eye, heart, kidney problems callouses (high pressure points), poor circulation (can't fight infection), skin in this area changes (becomes dry, cracks, peels), can cause neuropathy, numbness high blood sugar -> chemical changes -> stomach lining causes malfunctions and cannot empty contents of stomach --> bacterial infection, vomiting, constipation, can lead to gastroporesis high blood glucose causes the loss of fluid, makes this area dry, cracked, and itchy. This leads to bacterial infections, hair follicile infections, nail infections, ring worm, jock itch, athletes' foot three classes: autonomic, peripheral, and cranial. Caused by high blood pressure which damages blood fibers, and is the most common complication among diabetics affects the bladder, intestines, genitals, nerves, can cause UTI's affects the feet; muscles weaken; feet tingle/become numb/ get very cold or hot, burning pains, ulcers which heal very slowly causes a weakened spine, hard to walk, damages blood vessels excess glucose is filtered which causes capilary leakage; proteins seep and go into bloodstream and bladder, these get damaged and results in this disease, excess filtering hardening of arteries; fatty substancs form on sides of arteries; thickens arteries; inhibits blood flow/circulation. can change the leg/toe color, makes a person cold, and can make the toes and legs sore affects the brain; high blood pressure wears down blood vessels, shuts off oxygen ot the brain, inhibits walking, speaking, etc. bc it damages nerves and blood vessels and blocks the arteries Continue reading >>

More in diabetes