Signs Symptoms Slow progression Diabetic complications due to high glucose

Signs symptoms slow progression diabetic

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Signs & Symptoms Slow progression! Diabetic complications due to high glucose Blurred vision/Retinopathy Paresthesia / PVD Fatigue Frequent infections (e.g. Candida Albicans) Slow wound healing Polydipsia/polyuria Hyperosmolar Hyperglycemic State (HHS) Insulin supply depleting: BG > 600mg/dL- Most common in type 2 o Osmotic diuresis/extracellular fluid depletion ( very severe ); Slow progression S/S: polyuria , decreased LOC, seizures, coma , aphasia, hypotension, tachypnea Labs: Hyperglycemia ( usually > 600 mg/dl ) Hyperosmolarity ( serum osmo > 320 mOsm/l )- Cells shrivel Generally, pH > 7.35 ABSCENCE of KETONES! -High mortality viscous blood-thrombus
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Metabolic Syndrome Cluster of conditions that increases risk for heart disease, stroke, DM Three or more ( or take meds to control ) of the listed criteria below: Comparing Type I and Type II Type I -Peak age: 12-14 yrs Autoimmune/Idiopathic Destruction of beta-cells 80-90% destroyed before symptoms occur No insulin secretion! Type II -Peak age > 40 yrs Defect in insulin receptors Increased insulin resistance Beta cells compensate by increasing insulin output Hyperglycemia increases destruction of beta cells! Medical Management of Diabetes Balance - Medications , Exercise , Diet , Monitoring glucose levels Insulin available for metabolism when food digesting and absorbed Food available while insulin is acting to prevent hypoglycemic reactions Medical Management: Goals -Maintain BG levels as near normal as possible o Goal : HbA1c < 7.0% -Modify lifestyle for prevention and treatment o Obesity o Dyslipidemia o Atherosclerosis o Cardiovascular disease o Retinopathy o Nephropathy o Neuropathy
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Chronic Complications Result of end-organ disease from damage to blood vessels secondary to hyperglycemia Microvascular (small vessels)- Result from a thickening of the vessel (basement) membranes in small vessels They become thicker but less strong and more permeable! Found throughout the body Most common Eyes - retinopathy Kidneys - nephropathy Skin- dermopathy, prone to infection/injury Macrovascular (large vessels)- Disease of large and medium sized vessels Atherosclerotic plaque formation accelerated Cerebrovascular ( stroke ) Cardiovascular- hypertension & coronary artery disease ( CAD ) Peripheral vascular disease – ulcers & gangrene Treatment aimed at: Control risk factors ( obesity, smoking, hypertension, high fat intake, sedentary lifestyle ) Treatment of disorders! Diabetic Retinopathy (Microvascular) o Decreased blood flow to the retina o Ischemia develops ; collateral circulation forms o Hemorrhages & potential retina detachment o 80% of Type II have some degree of retinal disease Diabetic Nephropathy (Microvascular) Damage to small vessels of glomeruli o Hypertension o Leakage of protein into urine ( microalbuminuria ) o Progressive renal insufficiency o Most common cause of renal failure!
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