University:
MacEwan University
Course:
HEED 110 | Introduction to Personal Health and Well-Being
Academic year:

2023
Views:

464

Pages:

3
Author:

Arthur M.

Chapter 20: Diabetes Overview of Diabetes Mellitus In the United States 0.3% of people 20 years old have diabetes Leading cause of death, contributes to development of chronic disease Severe disorder of immune, metabolic function Can't produce insulin or can't use it well Defective insulin production, insulin resistance, production in the liver Hyperglycemia Excess sugar in blood glucose Travel to damage blood vessels and nerves Current Diagnosis Criteria Fasting plasma glucose: 126 mg/dL After an hour: 200 mg/dL Types of Diabetes Mellitus Type 1, Type 2, Pancreas damage or disease interfere with insulin function Children, adolescents at risk factors Gestational may lead to diabetes in children Type 1 Diabetes Usually in children or teens Caused by autoimmune destruction of pancreatic cells Type 2 Diabetes Most common type (90-95%) Insulin resistance (cells don't respond) Higher prevalence in obese, inactive adults Often diagnosed after 40 years old Acute Complications of Type 1 Diabetic Ketoacidosis - most severe in Type 1 Ketones: >300 mg/dL Symptoms: Polyuria, polydipsia, polyphagia Nausea, vomiting, abdominal pain Weakness, fatigue Kussmaul respirations (deep and rapid) Fruity breath odor Mental status changes: lethargy, coma Acute Complications in Type 2 Diabetes Hyperosmolar Hyperglycemic State Hyperglycemia, hyperosmolarity in the absence of significant ketonemia Develops over days or weeks Symptoms: Extreme hyperglycemia (>600 mg/dL) Dehydration Mental status changes Acute Complications of Diabetes Mellitus Hypoglycemia (low blood glucose) Treatment: immediate administration of carbohydrates Chronic Complications Diabetic Neuropathy Symptoms: numbness, tingling, pain, burning in hands, feet, legs; muscle weakness; difficulty with balance and coordination Treatments for DM Lifestyle Modifications: diet, exercise, weight loss Oral Medications: Sulfonylureas, meglitinides, biguanides, alpha-glucosidase inhibitors, thiazolidinediones, DPP-4 inhibitors, GLP-1 receptor agonists Insulin: Basal insulin, rapid-acting insulin, premixed insulin Monitoring: blood glucose monitoring, A1C monitoring, weight management Other: diabetes education, foot care, eye exams, blood pressure control, kidney function monitoring, smoking cessation, vaccination Evaluating Treatments Monitoring glycemic control Assessing hypoglycemia risk Considering patient preferences Evaluating comorbidities Monitoring cost and access Nutrition Therapy Micronutrient Intake Consistent Carb Intake Avoid fruits, urine grains, legumes, milk Low sugar Artificial sweeteners are safe Dietary Fat Aim for 2-3 tbsp of oil or nuts Sources: fish oil, flax seed, or kale Protein: Similar to general population Alcohol 1 drink for women, 2 for men *gestational should avoid Alk Micronutrients Supplements not recommended Body weight in type 2 Meal Planning Strategies Carbohydrate Counting Track between meals Food lists for diabetes: consistent nutrient and energy density Less flexible than carb counting Insulin Therapy Required by people w/ 312