Diabetes/Hyperglycemia

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NRS 339L: Hyperglycemia
Cindy Clair & Sara Scaggs
Northern Kentucky University

1. Type 1 Diabetes: Formerly known as juvenile onset diabetes or insulin-dependent diabetes. Type 1 diabetes is an immune-mediated disease. The body’s own T cells attack and destroy pancreatic beta (B) cells, which are the source of insulin. In addition, autoantibodies to the islet cells cause a reduction of 80-90% of normal B cell function before hyperglycemia and other manifestations occur. (Mosby, 2011) Risk Factors: Genetic predisposition & exposure to a virus may contribute to the pathogenesis of Type 1 DM. Type 2 Diabetes: Formerly known as adult-onset diabetes & non-insulin dependent diabetes. Type 2 DM accounts for 90% of diabetic patients and is also being seen in children with the increased rate of obesity. In Type 2 diabetes, the pancreas usually continues to produce some endogenous (self-made) insulin. The insulin that is produced is either insufficient for the needs of the body or is poorly utilized by the tissues, or both. The presence of insulin is used as the differentiating factor of Type 1 and Type 2 DM. (Mosby, 2011) Risk Factors: Obesity (specifically abdominal and visceral adiposity) and genetic mutations that lead to insulin resistance. Insulin Use: Rapid-acting insulin begins working approximately 5 minutes after injection, peaks at about 1 hour, and continues to work for another 2-4 hours. Rapid-acting insulins include lispro, aspart, and glulisine. Rapid-acting insulin is used when. Regular of short-acting insulin (human insulin) usually reaches the bloodstream within 30 minutes after injection, it peaks from 2-3 hours after injection, and works on the body for another 3-6 hours. Regular insulin is used when. Intermediate-acting insulin (human insulin) usually reaches the bloodstream 6-20 hours after the injection; it is effective for 20-24 hours. Glargine and detemir are long-acting insulins and tend to lower glucose levels evenly over a 24 hour period. Long acting insulin is used when Tips for insulin use: Inject insulin at room temperature, make sure no air bubbles remain in the syringe before injection, allow topical alcohol to dry before injection, keep muscles relaxed when injecting, penetrate skin quickly, and don’t change direction of the needle during insertion or withdrawal. Carbohydrates, Proteins, and Fats in the body as they relate to glucose regulation:

When carbs are eaten and digested, they are converted to glucose and enter the bloodstream where they significantly raise blood-glucose levels. Depending on the glycemic index of the carb-containing food, the blood glucose level can spike causing hyperglycemia. Our body responds by producing and releasing a large amount of insulin and shortly after, the individual will feel hungry again.

Animal-based protein, such as meat, do not effect blood sugar levels because it does not contain carbohydrates. However, added breading or batter to meat would affect blood glucose levels. All nonmeat protein sources contain carbohydrates, which will cause your blood glucose level to rise. These high-protein foods include beans, peas, legumes, lentils, eggs, hummus, falafel, nuts, peanut/almond butter, tofu, edamame, soy milk, veggie burgers, & meatless chicken tenders. Protein sources such as skinless chicken & turkey, fish, and lean beef are low in calories and saturated fat and can help patients manage their weight and heart health.

Hours after a high-fat meal is consumed, the fat begins to digest and the level of fat in the bloodstream (triglycerides) rises. When the liver is insulin resistant, it produces and secretes more glucose than usual, the blood glucose rises steadily as the livers glucose output goes up. 2. Diabetes Miletus Diagnosis:

Labs: Fasting blood glucose, oral glucose tolerance test (OGTT), random blood glucose, islet cell antibody test (for Type 1 DM). Subjective Symptoms: polydipsia,...
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