Diabetes Type 2
Ways to prevent Type 2 Diabetes 1 2 3 = PST Primary = Prevention Secondary = Screening Tertiary = Treatment
1 2 3 = PST Primary = Prevention Secondary = Screening Tertiary = Treatment
Alcohol Intake No more than ___drink per day for women and ___ drinks per day for men Consume with food to reduce the risk of hypoglycemia Carbohydrates with alcohol (mixed drinks) may raise blood glucose
1, 2
Fasting blood glucose (FBG) that is equal to or greater than ______ mg/dL on two or more measurements is the current standard.
126
Fat Intake Minimize trans fat Eat low saturated fat Dietary cholesterol less than ______mg/day At least two servings of fish per week (polyunsaturated fatty acids)
200
A BMI over 25 is considered overweight and over ____ is considered obese
30
A conditioned characterized by numbness and tingling, pain, or weakness in the extremities caused by damage to the peripheral nerves.
Peripheral neuropathy
Which factors put an individual with type 2 diabetes at high risk for hyperosmolar hyperglycemic syndrome (HHS)? Select all that apply. Legally blind Recent myocardial infarction Blood urea nitrogen (BUN) 7 mg/dL 77 years old Has influenza
Recent myocardia Infarction 77 years old Has influenza
The acronym TIRED helps clients recognize the signs of hypoglycemia. T - tachycardia and tremors I - irritability R - restless E - excessive hunger D - diaphoresis (sweating)
The acronym TIRED helps clients recognize the signs of hypoglycemia. T - tachycardia and tremors I - irritability R - restless E - excessive hunger D - diaphoresis (sweating)
Which statement best describes insulin resistance?
There is insulin in the blood, but insulin receptors do not respond to it.
the pancreas produces insulin, the insulin receptors and glucose transporters work as expected, providing the cells with glucose for energy and the blood glucose level is normal.
This is a person without diabetes
does not produce insulin to open the glucose transporter, leaving the cells without glucose for energy and the blood with hyperglycemia.
Type 1 Diabetes
Because the pancreas produces low levels of insulin as blood glucose levels rise, the cells get some glucose, but not enough. Known as insulin resistance, excess glucose remains in the blood, causing it to rise.
Type 2 Diabetes
insulin is produced by the pancreas and enters the blood. When the insulin reaches the cells, it fails to connect with the insulin receptor and the glucose transporter fails to open. This leaves the cells without glucose for energy and the blood with hyperglycemia.
Type 2 Diabetes
An older adult who is 5'4'' tall and weighs 248.6 pounds has a wound on the left lower leg that has not healed in two weeks. Regarding the type of diabetes mellitus, this person is most likely to have
Type 2 diabetes
In _______insulin production is low and what is produced is not used properly, leading to high levels of glucose in the blood
Type 2 diabetes
The 3Ps does not always show up in _______. but can be a sign of clinical manifestations
Type 2 diabetes
frequent urination increased thirst extreme hunger tingling and numbness in hands and feet darker patches on the skin slow healing sores sexual disorders itching and fungal infections extreme fatigue
Type 2 diabetes
used to be known as adult-onset diabetes and is more common than type 1 diabetes mellitus, accounting for 90-95% of all diagnosed clients
Type 2 diabetes
plays a role in reducing inflammation, reducing insulin resistance, and protecting the beta cells against destruction. Therefore, deficiency contributes to both diabetes mellitus type 1 and type 2 (
Vitamin D
Which clinical manifestations of diabetes mellitus are unique to type 2 diabetes? Select all that apply. Weight gain Dark patches in skin folds Polyuria Frequent fungal infections Polydipsia
Weight gain Dark patches in the skin Frequent fungal infection
a disorder in which the pancreas secretes inadequate amounts of insulin and/or the body has developed a resistance to the insulin that is secreted
Diabetes Type 2
_______s a serious chronic multisystem health problem throughout the world.
Diabetes mellitus
Which behaviors will help maintain a healthy blood glucose level? Select all that apply. Sedentary lifestyle Exercise Regular Exams Medication Moderate amount of Red Wine Smoking
Exercise Regular Exams Medication
Although polyuria and polydipsia are not always present in clients with type 2 diabetes, they are often seen due to the fluid lost due to hyperglycemic diuresis (water lost as glucose is eliminated through the kidneys).
Although polyuria and polydipsia are not always present in clients with type 2 diabetes, they are often seen due to the fluid lost due to hyperglycemic diuresis (water lost as glucose is eliminated through the kidneys).
__________also referred to as glycosylated hemoglobin, is used to monitor the long-term control of diabetes. While a value greater than 6.5% confirms diabetes, a value of less than 7% demonstrates good glycemic control.
Hemoglobin A1C (HbA1C)
Which information best indicates that an individual living with type 2 diabetes has not achieved good glucose control of their diabetes mellitus over time?
Hemoglobin A1C 9%
______ is required for glucose to enter cells and be used as energy.
Insulin
What is given to treat Hyperosmolar Hyperglycemis Syndrome?
Insulin IV fluids Replace electrolytes
Is when the cells in the muscles, fat, and liver, do not respond well to insulin and cannot easily take up glucose from the blood.
Insulin Resistance
Beta bells in the pancreas become fatigue and begin to fail
Insulin production is decreased
In a person with insulin resistance, the insulin fails to connect with the __________ and the glucose transporters fail to ______. This leaves the cell without glucose for energy and the blood with hyperglycemia
Insulin receptor open
a condition in which the body tissues do not respond to the action of insulin. Insulin receptors are unresponsive or insufficient in number Hyperglycemia
Insulin resistance
_________________ in an attempt to correct hyperglycemia. Hyperinsulinemia and hyperglycemia
Insulin resistance causes the pancreas to produce more insulin
Which statement about medications used to treat type 2 diabetes is correct?
Many medications increase the effect of insulin on the cells.
Hyperosmolar hyperglycemia syndrome (HHS) is an _____, life-threatening complication of type 2 diabetes.
acute
Total Carbohydrate Intake Should include primarily ______ carbohydrates (grains, legumes, vegetables) and some simple carbohydrates (fruits, low-fat milk) Fiber intake 25 - 30 g/day Use nonnutritive sweeteners as needed Limit sugar-filled beverages (regular soda, fruit juice)
complex
90% to 95% have
diabetes mellitus type 2
Ways to prevent type 2 diabetes:
doing light-to-moderate exercise for at least 150 minutes a week, including daily activity maintaining a healthful, balanced diet reducing simple sugars, excess sugars, and fats in food monitoring carbohydrate intake eating smaller meals throughout the day rather than three large meals losing 5 to 7 percent of total body weight monitoring or treating blood glucose levels eliminating stress to reduce levels of cortisol (a hormone that increases blood glucose levels) staying hydrated increasing fiber intake
ethnicity New diabetes cases were higher among non-Hispanic Blacks. People of Hispanic origin had higher rates than non-Hispanic Asians and non-Hispanic Whites
ethnicity New diabetes cases were higher among non-Hispanic Blacks. People of Hispanic origin had higher rates than non-Hispanic Asians and non-Hispanic Whites
Normally, glucose is absorbed into the bloodstream and the pancreas releases insulin in response. The _____ lowers the level of glucose in the blood stream.
insulin
Because the pancreas produces low levels of insulin as blood glucose levels rise, the cells get some glucose, but not enough. Known as _________, excess glucose remains in the blood, causing it to rise.
insulin resistance
There are 5 main factors that contribute to type 2 diabetes
1. Insulin resistance 2. Insulin resistance causes the pancreas to produce more insulin 3. Insulin production is decreased 4. Glucose is not appropriately produced by the liver 5. Cytokines causes chronic inflammation
The disorder is more common in adults over age _____ but can develop at any age .This is increasingly diagnosed in younger clients due to childhood obesity, a significant contributing risk factor.
45
for type 2 diabetes age is greater than ___
45 years
about __% of total fat lies under the skin
90%
Glucose released haphazardly in a manner that does not mean the body's need
Glucose is not appropriately produced by the liver
Contributes to insulin resistance
Cytokines produced by the adipose tissue
In someone with _________, insulin from the pancreas can not adequately keep blood sugar low. This means blood sugar levels remain ____ in the blood stream.
Diabetes type 2 High
High blood glucose damages the small blood vessels in the eye, damaging eyesight.
Diabetic Retinopathy
What are long term complications of type 2 diabetes?
Diabetic Retinopathy Peripheral Neuropathy Diabetic foot
With decreased blood flow (peripheral vascular disease) and feeling (peripheral neuropathy), the feet are prone to injury and sores that will not heal.
Diabetic foot
What are the risk factors for type 2 diabetes? Select that all apply. Diet high in simple carbohydrates Insulin resistance Recent viral infection Metabolic syndrome Inactivity
Diet high in simple carbohydrates Insulin resistance Metabolic Syndrome Inactivity
A person at risk for type 2 diabetes who wants to avoid the disease should follow which dietary practices? Select all that apply. Eat fish at least two times per week. Increase daily fiber intake. Limit saturated fat to 15% of caloric intake. Decrease intake of complex carbohydrates. Skipping meals will aid in weight reduction.
Eat Fish at least two times per week Increase daily fiber intake
____that is equal to or greater than 126 mg/dL on two or more measurements is the current standard.
Fasting blood glucose (FBG)
Which laboratory test would be used to determine if Rita does have diabetes mellitus?
Fasting blood glucose test
is characterized by three classic symptoms: polyuria, polyphagia, and polydipsia. In addition, the client will experience fatigue, headaches, blurred vision, nausea, and abdominal cramps.
Hyperglycemia
occurs when there is insufficient insulin. Its onset is more gradual
Hyperglycemia
Acute illness of undiagnosed type 2 diabetes are often the cause of ______
Hyperosmolar hyperglycemia syndrome
In older clients, this syndrome can be triggered by an inability to replace fluids or increasing cognition problems
Hyperosmolar hyperglycemia syndrome
What is more common with type 2 diabetes who are older than 60 years?
Hyperosmolar hyperglycemia syndrome
is an acute, life-threatening complication of type 2 diabetes
Hyperosmolar hyperglycemia syndrome
An older adult living with type 2 diabetes mellitus has pneumonia. For which complication is this person at highest risk?
Hyperosmolar hyperglycemia syndrome (HHS)
blood glucose less than 70 mg/dL, is characterized by cold, clammy skin, numbness in fingers/toes, tachycardia, headaches, tremors, dizziness, slurred speech, and blurred vision. Hypoglycemia can ultimately lead to seizures and coma if not corrected.
Hypoglycemia
occurs when there is too much insulin working in the body. Its onset is rapid
Hypoglycemia
Since these manifestations of Hyperosmolar Hyperglycemia Syndrome may resemble a stroke, measuring _____ is critical for correct diagnosis and treatment.
blood glucose
Hyperosmolar hyperglycemia syndrome (HHS) is___ common than diabetic ketoacidosis (DKA) and is more common in clients with type 2 diabetes who are older than 60 years.
less
What is critical to do for diagnosing and treating Hyperosmolar Hyperglycemia Syndrome?
measuring blood glucose
Insulin resistance is when cells in the muscles, fat, and liver do not respond well to insulin and cannot easily take up glucose from the blood. As a result, the pancreas makes ______ insulin to help glucose enter the cells. If the pancreas can make enough insulin to overcome the cells' weak response to insulin, blood glucose levels will stay in the healthy range.
more
Protein Intake Individualize goals based on needs High-protein diets are ____ recommended for weight loss
not
Whatis causing more children to have type 2 diabetes?
obesity
Once a person has been identified as having symptoms consistent with type 2 diabetes, ____________is used to confirm the diagnosis.
serum glucose testing
Because the body produces insulin, the symptoms of Hyperosmolar hyperglycemia syndrome develop ______, taking days or weeks to develop. These symptoms include: high blood sugar level (over ___ mg/dL) confusion, hallucinations, drowsiness, or passing out dry mouth and extreme thirst that may eventually get better frequent urination fever over 100.4°F blurred vision or loss of vision weakness or paralysis that may be worse on one side of the body
slowly 600
Since these manifestations of Hyperosmolar Hyperglycemia Syndrome may resemble a _____, measuring blood glucose is critical for correct diagnosis and treatment.
stroke
