Honeymoon phase honeymoon educate that it may happen

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Unformatted text preview: Depression Case 1: Special Concerns for College Students College • • • • • Independence Dining hall food Alcohol – lowers blood sugar Roommate aware of diabetes, glucagon Airline travel – prescription labels Case 1 Case • Discharged after teaching complete on – Glargine and Humalog – 0.7 units/kg/day • 3 weeks after diagnosis blood sugars weeks begin going low begin • What is going on? Honeymoon Phase Honeymoon • • • • • • Educate that it may happen Diabetes is not cured! Occurs within first 3 months of diagnosis Insulin requirements <0.5 units/kg/day Lasts weeks to up to 2 years Resolution of glucotoxicity, recovery of Resolution residual β-cell function Case 1 Case • Blood glucoses continue to be so low that Blood pt takes himself off all insulin pt • Normal blood glucoses for 5 months off Normal insulin insulin • Blood glucoses begin to rise • Homesickness • Depression Long Term Complications Long • • • • Retinopathy Nephropathy Neuropathy Cardiovascular disease • Prevention by optimal glucose control Diabetes Control and Complications Trial Complications Conventional Therapy • 1-2 injections/day • Mean A1c 9% Intensive Therapy • ≥3 injections/day • Mean A1c 7% • 1983-1993, early termination given results 1983-1993, • Intensive therapy delays onset and progression Intensive of long-term complications in type 1 diabetes of Diabetes Control and Complications Trial Complications • Intensive therapy reduced risk by: – – – – 76% for retinopathy 54% for nephropathy 69% for neuropathy 41% for macrovascular disease • Adverse events – Hypoglycemia – Weight gain Case 1 – Follow-up visit Case • • • • Home from college on break Insulin requirement 0.5 units/kg/day Physical exam Monitoring for complications Physical Exam Physical • • • • • • • Height, weight, BP Pubertal progression Thyroid Abdomen Shot sites - lipohypertrophy Feet Medical alert tag Necrobiosis Lipodica Ne...
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This note was uploaded on 12/24/2011 for the course STEP 1 taught by Professor Dr.aslam during the Fall '11 term at Montgomery College.

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