28.1 Introduction to Diabetes
2 min read•june 18, 2024
Diabetes is a chronic condition affecting how your body processes . There are two main types: Type 1, an autoimmune disorder, and Type 2, characterized by . Both types lead to high blood sugar levels, causing various symptoms.
Diagnosis involves blood tests like fasting glucose, oral glucose tolerance, and A1C. Understanding the causes, symptoms, and diagnostic methods is crucial for managing diabetes effectively and preventing complications. Early detection and proper treatment can significantly improve quality of life.
Overview of Diabetes
Type 1 vs Type 2 diabetes mechanisms
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- Autoimmune disorder destroys -producing beta cells in the resulting in little or no insulin production
- Patients require exogenous insulin (injections or pump) to manage blood glucose levels
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- Characterized by insulin resistance where cells become less responsive to insulin leading to
- Pancreas may produce insufficient insulin to overcome resistance
- Often associated with obesity, sedentary lifestyle, and genetic factors
- Managed with lifestyle changes (diet, exercise), oral medications (), and sometimes insulin
Common signs and symptoms of diabetes
- increased urination due to excess glucose in the blood being excreted by the kidneys
- increased thirst caused by fluid loss from frequent urination
- increased hunger resulting from inability of cells to utilize glucose effectively
- Unexplained weight loss due to breakdown of fat and muscle tissue for energy
- Fatigue and weakness caused by inefficient glucose utilization by cells
- Blurred vision as high blood glucose can cause fluid shifts in the eye affecting lens shape
- Slow-healing wounds or frequent infections (UTIs, yeast infections) as elevated blood glucose impairs immune function and wound healing
Causes and Diagnosis of Diabetes
Causes of diabetes and diagnostic tests
- Causes of diabetes
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- Genetic predisposition and environmental triggers like viral infections
- of pancreatic beta cells
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- Combination of genetic and lifestyle factors
- Obesity, physical inactivity, and unhealthy diet contribute to insulin resistance and/or decreased insulin production
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- Diagnostic tests for diabetes
- (FPG) test measures blood glucose after an 8-hour fast, diabetes diagnosed at FPG ≥ 126 mg/dL (7.0 mmol/L)
- (OGTT) measures blood glucose before and 2 hours after consuming a 75g glucose drink, diabetes diagnosed at 2-hour post-load glucose ≥ 200 mg/dL (11.1 mmol/L)
- (A1C) test reflects average blood glucose over the past 2-3 months, diabetes diagnosed at A1C ≥ 6.5% (48 mmol/mol)
- Random plasma glucose test measures blood glucose at any time of day, diabetes diagnosed at random glucose ≥ 200 mg/dL (11.1 mmol/L) with classic symptoms (, , unexplained weight loss)
Key Terms to Review (57)
African descent: African descent refers to individuals whose ancestry traces back to the African continent. It is significant in pharmacology due to genetic variations that can influence drug metabolism and disease prevalence.
Alaska Native: Alaska Native refers to the indigenous peoples of Alaska, including various tribes and ethnic groups. They have unique cultural practices and may face distinct health challenges, particularly in managing chronic conditions like diabetes.
American Indian: American Indian refers to the indigenous peoples of the Americas, particularly those living in what is now the United States. This term encompasses a diverse group of tribes and cultures with distinct histories and traditions.
Asian American: Asian American refers to individuals in the United States with origins in the countries of East Asia, Southeast Asia, or South Asia. In healthcare, recognizing cultural influences on health practices and beliefs is crucial for providing effective patient care.
Autoimmune Destruction: Autoimmune destruction refers to the process in which the body's own immune system mistakenly attacks and damages its own healthy cells, tissues, or organs. This aberrant immune response can lead to the development of various autoimmune disorders.
Basal insulin dosing: Basal insulin dosing involves the administration of long-acting insulin to maintain blood glucose levels within a target range during fasting periods, typically over 24 hours. It is essential for managing diabetes mellitus, particularly Type 1 diabetes.
Beta Cell Function: Beta cell function refers to the ability of the pancreatic beta cells to produce and secrete insulin, the hormone responsible for regulating blood glucose levels. These specialized cells play a crucial role in maintaining glucose homeostasis within the body.
Black: Black is a term often used to describe the absence of color or light. In medical contexts, it can refer to certain labels or warnings related to drug safety and adverse effects.
Carbohydrates: Carbohydrates are essential macronutrients that provide energy for the body by being broken down into glucose. They play a crucial role in managing blood sugar levels, especially important for individuals with diabetes.
Comorbidity Tests: Comorbidity Tests are medical tests conducted to identify additional diseases or conditions that coexist with a primary disease, such as diabetes. These tests help in tailoring comprehensive treatment plans for patients.
Diabetes Mellitus: Diabetes mellitus is a chronic metabolic disorder characterized by the body's inability to properly regulate blood glucose levels. It arises from either the pancreas's failure to produce sufficient insulin, a hormone that regulates blood sugar, or the body's inability to effectively utilize the insulin produced.
Diabetic Ketoacidosis: Diabetic ketoacidosis (DKA) is a serious complication of diabetes that occurs when the body produces high levels of blood acids called ketones. This happens when the body is unable to use glucose for energy, and instead breaks down fat for fuel, resulting in a buildup of ketones in the bloodstream.
Diabetic Neuropathy: Diabetic neuropathy is a type of nerve damage that can occur in people with diabetes. It is a complication of diabetes that results in damage to the nerves, leading to various symptoms and complications. This condition is closely linked to the management of blood sugar levels in individuals with diabetes.
Fasting blood glucose: Fasting blood glucose is the level of glucose in a person's blood after they have not eaten for at least 8 hours. It is commonly used to diagnose and monitor diabetes.
Fasting Plasma Glucose: Fasting plasma glucose is a blood test that measures the concentration of glucose in the blood after a period of not eating or drinking (fasting) for at least 8 hours. It is a key diagnostic tool used to screen for and monitor diabetes and prediabetes.
Gestational diabetes: Gestational diabetes is a form of diabetes that develops during pregnancy and usually disappears after giving birth. It occurs when the body cannot produce enough insulin to meet the extra needs of pregnancy.
Gestational Diabetes: Gestational diabetes is a form of diabetes that develops during pregnancy in women who did not have diabetes prior to their pregnancy. It occurs when the body is unable to produce enough insulin to meet the increased insulin demands during pregnancy, leading to elevated blood glucose levels.
Glucagon: Glucagon is a hormone produced by the pancreas that plays a crucial role in maintaining blood glucose homeostasis. It is the counterpart to insulin, acting to increase blood glucose levels when they drop too low. Glucagon's functions are closely tied to the topics of maintaining homeostasis, diabetes management, and the gastrointestinal system.
Glucose: Glucose is a simple sugar that serves as the primary source of energy for the body's cells. It is a monosaccharide that is absorbed from the digestive system and transported through the bloodstream to be utilized by various tissues and organs.
Glucose Metabolism: Glucose metabolism is the set of biochemical processes that cells use to convert the energy stored in glucose molecules into a form that can be used by the body. It is a crucial aspect of cellular respiration and energy production within the human body.
Glyburide/metformin: Glyburide/metformin is a combination oral antidiabetic drug that contains glyburide, a sulfonylurea, and metformin, a biguanide. It is used to improve blood glucose control in adults with type 2 diabetes.
Glycated Hemoglobin: Glycated hemoglobin, also known as hemoglobin A1c (HbA1c), is a form of hemoglobin that has glucose molecules attached to it. It serves as a marker for average blood glucose levels over a 2-3 month period, providing valuable insights into the management of diabetes.
Glycemic Control: Glycemic control refers to the regulation of blood glucose levels within a normal or target range. It is a critical aspect of diabetes management and is essential for preventing or delaying the development of diabetes-related complications.
Glycosuria: Glycosuria is the presence of glucose in the urine, which occurs when the kidneys are unable to reabsorb all of the filtered glucose from the bloodstream. This condition is often associated with diabetes mellitus, where high blood glucose levels overwhelm the kidneys' capacity to reabsorb glucose, leading to its excretion in the urine.
HbA1c: HbA1c, also known as glycated hemoglobin, is a measure of the average blood glucose level over the past 2-3 months. It provides an indication of how well diabetes is being managed and can help guide treatment decisions.
Hispanic: Hispanic refers to people, cultures, or countries related to Spain or Spanish-speaking countries in Latin America. It is an ethnic category that encompasses a diverse range of backgrounds.
Hyperglycemia: Hyperglycemia refers to an abnormally high level of glucose in the bloodstream. It is a key feature in the pathophysiology of various medical conditions, particularly diabetes mellitus, and can have significant implications for fluid and electrolyte balance, inflammatory processes, and overall health.
Hypoglycemia: Hypoglycemia is a condition characterized by abnormally low levels of blood glucose. It commonly occurs as a side effect of diabetes treatment, particularly insulin or certain oral medications.
Insulin: Insulin is a hormone produced by the pancreas that regulates blood sugar levels by facilitating the uptake and utilization of glucose by cells throughout the body. It plays a crucial role in maintaining homeostasis, managing electrolyte balance, and supporting various physiological processes, making it an essential consideration in drug administration, documentation, and the treatment of conditions like diabetes and weight management.
Insulin Deficiency: Insulin deficiency refers to the inability of the body to produce or effectively utilize the hormone insulin, which is critical for regulating blood sugar levels. This condition is a hallmark of diabetes mellitus and can lead to hyperglycemia and various associated complications if left untreated.
Insulin Pump: An insulin pump is a small, portable medical device that delivers precise doses of insulin to individuals with diabetes. It is designed to mimic the way a healthy pancreas produces and regulates insulin, providing a more natural and flexible approach to insulin management compared to traditional insulin injections.
Insulin Resistance: Insulin resistance is a condition in which the body's cells become less responsive to the hormone insulin, leading to impaired glucose metabolism and an increased risk of developing type 2 diabetes. This term is crucial in understanding the pathophysiology and management of various endocrine and metabolic disorders.
Insulin Sensitivity: Insulin sensitivity refers to the body's ability to effectively utilize insulin, the hormone responsible for regulating blood sugar levels. It is a measure of how responsive the body's cells are to the presence of insulin, which is crucial for maintaining glucose homeostasis and overall metabolic health.
Islets of Langerhans: The islets of Langerhans are clusters of specialized endocrine cells within the pancreas that produce hormones crucial for regulating blood sugar levels and maintaining overall metabolic homeostasis.
Juvenile-Onset Diabetes: Juvenile-onset diabetes, also known as type 1 diabetes, is an autoimmune disorder in which the body's immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. This leads to an inability to produce insulin, the hormone responsible for regulating blood sugar levels. Typically diagnosed in childhood or adolescence, this form of diabetes requires lifelong insulin therapy and careful management of diet and exercise to maintain proper blood glucose control.
Ketoacidosis: Ketoacidosis is a serious complication of diabetes that occurs when your body produces high levels of blood acids called ketones. It develops when the body starts breaking down fats at an accelerated rate due to insufficient insulin.
Latino/Latina: Latino/Latina refers to individuals in the United States who have cultural ties to Latin America. This includes people from Mexico, Central and South America, and the Spanish-speaking Caribbean.
Metformin: Metformin is an oral antidiabetic medication used primarily in the treatment of type 2 diabetes. It works by reducing hepatic glucose production and increasing peripheral glucose uptake, thereby improving insulin sensitivity and glycemic control.
National Diabetes Prevention Program: The National Diabetes Prevention Program (NDPP) is a CDC-led initiative aimed at reducing the incidence of Type 2 diabetes through evidence-based lifestyle interventions. It focuses on promoting healthy behaviors to prevent or delay the onset of diabetes.
Nocturia: Nocturia is the medical term for the need to wake up and urinate one or more times during the night. It is a common condition that can have various underlying causes, including diabetes, diuretic medication use, and age-related changes in the urinary system.
Oral Glucose Tolerance Test: The oral glucose tolerance test (OGTT) is a diagnostic procedure used to assess an individual's ability to metabolize glucose. It involves measuring blood glucose levels before and after the ingestion of a standardized glucose solution, providing information about glucose regulation and the potential presence of diabetes or prediabetes.
Pancreas: The pancreas is a vital organ located behind the stomach that plays a crucial role in the body's metabolism and digestion. It is responsible for producing hormones that regulate blood sugar levels and enzymes that aid in the breakdown of food.
Polydipsia: Polydipsia is a condition characterized by excessive thirst and an increased intake of fluids. It is often associated with diseases such as diabetes mellitus.
Polydipsia: Polydipsia is an abnormally increased thirst and excessive drinking of fluids, often associated with diabetes mellitus and other medical conditions. It is a key symptom that can help identify and manage these underlying health issues.
Polyphagia: Polyphagia is excessive hunger or increased appetite, often a symptom of uncontrolled diabetes. It occurs because the body is unable to utilize glucose properly.
Polyphagia: Polyphagia is a medical term that refers to excessive or abnormal hunger, often associated with certain medical conditions such as diabetes. It is characterized by an increased appetite and the frequent desire to eat more than usual.
Polyuria: Polyuria is the excessive production and passage of urine, often seen in patients with uncontrolled diabetes. It occurs when high blood glucose levels cause the kidneys to excrete large amounts of water.
Polyuria: Polyuria is the medical term for excessive or abnormally large production and passage of urine. It is a common symptom associated with various medical conditions, particularly those related to disorders in fluid and electrolyte balance or impaired glucose regulation.
Prediabetes: Prediabetes is a condition characterized by blood sugar levels that are higher than normal but not yet high enough to be classified as type 2 diabetes. It is a critical warning sign and an opportunity for intervention to prevent the progression to diabetes.
Prediabetes: Prediabetes is a condition where a person's blood glucose levels are higher than normal, but not high enough to be diagnosed as type 2 diabetes. It is a precursor to the development of full-blown diabetes and serves as a warning sign that action needs to be taken to prevent the progression to the disease.
Random blood glucose: Random blood glucose measures the concentration of glucose in the blood at any given time, regardless of when you last ate. It is used to screen for and diagnose diabetes or monitor glucose levels in diabetic patients.
Type 1 diabetes: Type 1 diabetes is a chronic condition where the pancreas produces little to no insulin due to autoimmune destruction of insulin-producing beta cells. It requires lifelong management with insulin therapy.
Type 1 Diabetes: Type 1 diabetes is an autoimmune disorder in which the body's immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas, resulting in the inability to produce insulin, a hormone essential for regulating blood sugar levels.
Type 2 diabetes: Type 2 diabetes is a chronic condition characterized by insulin resistance and impaired insulin secretion. It leads to elevated blood glucose levels and can result in serious health complications if not managed properly.
Type 2 Diabetes: Type 2 diabetes is a chronic metabolic disorder characterized by the body's inability to effectively use insulin, a hormone that regulates blood sugar levels. This leads to high blood glucose levels and can result in a range of health complications if left untreated.
U.S. Food and Drug Administration: The U.S. Food and Drug Administration (FDA) is a federal agency responsible for protecting public health by ensuring the safety, efficacy, and security of drugs, biological products, and medical devices. It also oversees the nation's food supply, cosmetics, and products that emit radiation.
White clients: White clients are individuals of Caucasian descent who may exhibit unique responses to pharmacological treatments due to genetic, environmental, and cultural factors. Understanding these differences is crucial for personalized patient care in nursing.