Diabetes

Endocrine and

Metabolic Disorders

Types of Diabetes Type 1- Insulin deficient, juvenile diabetes

Types of Diabetes Type 2- insulin resistance; adult onset;

Types of Diabetes Gestational diabetes- BMI >30, history of GDM

Diagnosis of DiabetesA1C- measures your average blood glucose for the past 2

to 3 months.

Diagnosis of Diabetes Fasting Plasma Glucose (FPG)

Diagnosis of Diabetes Oral Glucose Tolerance Test (also called the OGTT)

Diagnosis of Diabetes Random (also called Casual) Plasma Glucose Test

Blood glucose of greater than or equal to

200 mg/dl

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.

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

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

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

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

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

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

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.

Complications of uncontrolled

diabetes Diabetic ketoacidosis (DKA)- hyperglycemia

Signs

nausea and vomiting

stomach pain

dehydration

fruity breath odor

rapid breathing

Treatment

Insulin, rehydration

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

Complications of uncontrolled

diabetes Long Term

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

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