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DIABETES (SIGNS/SYMPTOMS (3 P's (IMPORTANT CONCEPT), dizziness,…

- - - - hormones
        
        diagnosed around puberty
        
        increased hormones may precipitate the destruction
      - viruses
        
        could activate gene in which the pancreas attacks itself
    - - islet cell antibodies (ICAs)
        
        responsible for destroying Beta cells
        
        indicates possibility of T1D instead of T2
      - HLAs
        
        show predisposition
    - - insulin is the treatment
        
        pt HAS to get insulin b/c body DOESN'T produce it!!!!
        
        CANNOT BE GIVEN PO!!!! INJECTION, SUBCUT
  - - - obesity
      - diet
      - lifestyle
    - - insulin levels may be high, low, or normal
      - do not display ICAs because T2D doesnt destroy cells
      - HLAs
        
        ANTIGEN VS ANTIBODIES
    - - diet and lifestyle FIRST!
      - dont have to be on meds. or insulin if managed well
  - - - type 2 diabetes
      - PVD, hypertension
    - - apple or pear
      - abdominal circumference (@ the belly button)over 40 in men over 35 in women
    - - 6.5 - 7
    - - HDL in normal range (under 50?)
      - cholesterol is very important - too high is bad
  - - - @ 26-28 weeks
        
        if mom has high blood sugar, baby has high blood sugar
        
        baby's body increases production of insulin and when theyre born they have high blood sugar
        
        baby will be large at birth
        
        mom is at risk for dehydration
        
        increased risk for infection
        
        risk for c-section
        
        increased risk for DVT
    - - diet/lifestyle
      - insulin if diet/lifestyle doesnt work
        
        insulin is for safety of the baby
      - baby glucose will be checked often, every time they eat to prevent HYPOglycemia
  - - - LISTEN TO RECORDING FOR EXAMPLE
- - - - gastroparesis
        
        neuropathy where GI tract slows down - constipation
  - - - if you know what they're going home with, you can educate them on how to use it.
    - - teach instructions of how to use device
      - how to complete the testing
      - prepping the device and hands for glucose check
        
        alcohol is a sugar, after using alcohol wipe, use gauze
    - - inadequate blood amount
      - single use items only used ONCE
      - never share equip
      - NO HOME MONITORS IN HOSPITAL SETTING, use the facilities for glucose monitoring values to treat
- - - - T2DM
  - - - water dilutes the sugar/ decreasing blood sugar
      - food increases glucose levels
      - 2 fasting glucose levels over 100
    - - gestational diabetes
        
        1st test is 50 grams - over 140 considered +
        
        follow up where grams are doubled - 100 grams - over 140 +
    - - GOLD STANDARD - does the average blood glucose level for 3 months
      - will be automatically ordered when levels are HIGH
      - want to be under 7% - 7 is considered diabetes
        
        every % increases by 30 (LOOK AT THIS)
      - how is OVERALL ma
    - - bedside blood glucose - its whatever it is at that time
      - "casual diabetic" if showing symptoms of 3 P's and >200
    - - random blood glucose
        
        determines how much insulin they'll get
        
        TYPE 2 DIABETICS ONLY
      - C-peptide
        
        tells functioning of beta cells
        
        low in type 1
        
        low in type 2, pancreas isnt producing enough
      - hgb A1C
        
        until A1C is where they want it to be itll be taken q3months
      - urine ketones
        
        produced from anaerobic metabolism
        
        blood sugar will be over 180
        
        pts. sick at home will e recommended to check q4hr (every time they urinate
      - kidney function
        
        BMP/LMP
        
        UA - for protein and albumin
        
        main thing to look @ it can be a problem with chronic issues
        
        done once a year
      - lipid profile
        
        LDL, HDL, triglycerides - once a year
        
        tells cardiovascular risk