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Sydney Borden

on 10 March 2014

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Transcript of Diabetes

What is Diabetes?
Diabetes Mellitus is the name for a group of chronic diseases that involves insulin production within the pancreas. This term can be divided into two categories in which the person has high blood glucose levels resulting from insulin production being inadequate or the body's cells do not respond properly to insulin.
The Pancreas and its Hormones
The Important Role of Insulin and Glucagon in Maintaining Homeostasis
Type 1 Diabetes
A disease in which the
produces little to no
due to the body's own immune system
the insulin-producing cells of the pancreas. You are born with this disease.
Type 2 Diabetes
disease in which the
produces little to no insulin and/or the
body loses the ability
to respond normally to insulin. The body becomes insulin
The Pancreas acts as a
-producing endocrine gland. Focusing in on Diabetes, the pancreas contain islets (called the Islets of Langerhans) that produce cells that make
to control the amount of glucose (
) in the blood vessels.
Insulin- A
that is needed to transport
to the cells which
the blood sugar levels in the blood stream.
Glucagon- A hormone that has the opposite effect of
; it increases the
levels in blood by
stimulating the liver to break down glycogen (stored glucose) to be released into the blood as glucose
temporarily paralyzing the muscles from allowing glucose to enter its cells

What is Glucose?
Glucose is a
simple sugar
that provides
to all of the cells in your body. Your cells take in glucose from the blood and break it down for energy. Glucose comes from the
food that you eat
Symptoms: Headache, sweating, shakiness, pale and moist skin, mental confusion, loss of coordination, weakness, dizziness, rapid pulse, shallow breathing, seizure, extreme hunger, fatigue, blurred vision, inability to concentrate, loss of consciousness.

Keep the blood sugar levels close to normal
Need to work with a health care team to maintain a balance between medication, blood sugar monitoring, and exercise.

Symptoms: Frequent urination, excessive thirst, fatigue, very dry skin, sores that are slow to heal, more infections than usual, tingling and numbness in hands, dehydration, unexplained weight loss, extreme hunger, sudden vision change.
These symptoms develop gradually and may not appear until years later after the onset of diabetes, although some patients may be asymptomatic.
Maintaining Diabetes
Reasons for Medication
To improve insulin release and decrease insulin resistance by:
the pancreas to produce and release more insulin
Inhibiting the production and release of
from the liver
Blocking the action of stomach enzymes that break down carbohydrates
Improving the sensitivity of cells to insulin
Insulin Therapy
Type 1:
People diagnosed with type 1 diabetes usually start with
injections of insulin per day of two different types of insulin and generally progress to three or four injections per day of insulin of different types. The types of insulin used depend on their
blood glucose
Most people with type 2 diabetes may need
injection per day without any diabetes pills. Some may need a single injection of insulin in the evening (at supper or bedtime) along with diabetes pills. Sometimes diabetes pills stop working, and people with type 2 diabetes will start with
injections per day of two different types of insulin. They may progress to
three or four
injections of insulin per day.
Type 2:
Special Considerations:
Insulin is required for people with type 1 diabetes and sometimes necessary for people with type 2 diabetes.
Syringe is the most common form of insulin delivery, but there are other options, including insulin pens and pumps.
Insulin should be injected in the same general area of the body for consistency, but not the exact same place.
Insulin delivery should be timed with meals to effectively process the glucose entering your system.
Insulin shots work fastest when given in the abdomen. Insulin arrives in the blood a little more slowly from the upper arms and even more slowly from the thighs and buttocks.
Insulin Pens
Some insulin pens contain a cartridge of insulin that is inserted into the pen and some are pre-filled with insulin and discarded after all the insulin has been used. The insulin dose is dialed on the pen, and the insulin is injected through a
, much like using a syringe.
Insulin Pumps
Insulin pumps are
small computerized devices
that deliver insulin in two ways:

In a steady measured and continuous dose (the "basal" insulin)
As a surge ("bolus") dose, at your direction, around mealtime.

Doses are delivered through a
flexible plastic tube
called a catheter. With the aid of a small needle, the
is inserted through the skin into the fatty tissue and is taped in place.

This delivery system most closely mimics the body's normal release of insulin.
Insulin shots are most effective when you take them
before you eat
so that insulin goes to work when glucose from your food starts to enter your blood.
Gestational Diabetes
People with pre-diabetes have glucose levels that are
higher than normal but not enough yet to indicate
Used to be called borderline diabetes
If you have pre-diabetes, the chance of developing Type 2 is likely as well as other health problems associated with diabetes.
With pre-diabetes, you are at a
higher risk of heart disease and stroke than someone who does not have pre-diabetes.
To determine if you have pre-diabetes, your doctor can perform one of three different blood tests – the fasting plasma glucose (FPG) test, the oral glucose tolerance test (OGTT) or the Hemoglobin A1C (or average blood sugar) test.
Although most people with pre-diabetes have
no symptoms at all
, symptoms of diabetes may include unusual thirst, a frequent need to urinate, blurred vision, or extreme fatigue.
Gestational diabetes is a condition characterized by high blood sugar (glucose) levels that is first recognized during
. The condition occurs in approximately
of all pregnancies.
If you have Gestational diabetes you most likely will not have any symptoms.
Pregnancy causes most women to
more often and to feel more
, so having these symptoms does not always mean that a woman has diabetes.
When a woman is pregnant,
are secreted that makes it hard for
to do its job-controlling blood sugar.
Urine Checks
Monitoring Blood
Sugar Levels
Blood glucose monitoring is the main tool you have to check your diabetes control. This check tells you your blood glucose level at any one time. In order to check your glucose levels in your blood you must use a glucometer.
1. After washing your hands, insert a test strip into your meter.
2. Use your lancing device on the side of your fingertip to get a drop of blood.
3. Touch and hold the edge of the test strip to the drop of blood, and wait for the result.
4. Your blood glucose level will appear on the meter's display.

Glood glucose targets are individualized based on:

duration of diabetes
age/life expectancy
hypoglycemia unawareness
individual patient considerations.

Urine checks for glucose are not as accurate as blood glucose checks and should only be used when blood testing is impossible.
Ketone is a chemical produced when there is a shortage of insulin in the blood and the body breaks down body fat for energy. Ketones in the urine is a sign that your body is using fat for energy instead of using glucose because not enough insulin is available to use glucose for energy.
- Meaning low blood sugar, occurs when the blood sugar levels drop below 70mg
- This can be caused by eating too little or by eating too infrequently , by too much physical activity without eating or too much insulin
1. If conscious & can swallow, check blood sugar with blood sugar meter
2. If blood sugars are low, provide sugar immediately
3. Treat with 15 grams of carbohydrates (3-4 glucose tablets, ½ cup of juice,1/2 cup of diet soda)
4. Wait 15 minutes to check blood sugar again
5. Repeat the process until he/she feels better of the blood sugar has increased

1. If conscious & cannot swallow, check blood sugars with meter
2. If low provide 15 grams of sugar
3. Since the patient cannot swallow, apply gloves, jam, syrup, and instant glucose can be rubbed between the teeth and cheeks, so it can be absorbed without the risk of chocking

1. if unconscious & , nothing should be given by mouth because they are unconscious & unable to swallow
2. A glucagon injection should be administrated immediately by someone that is certified to perform this action.

Meaning high blood sugar, this occurs when the blood sugar rises and stays above the normal level (120mg before meals and 180mg after meals)

1. Call 911 or take to the hospital if he or she is breathing rapidly or unresponsive
2. If able, check blood sugar
3. If not treat with carb containing foods ( ½ cup of fruit juice, 3-4 glucose tablets)

When exercising, the body needs extra energy (in the form of glucose) for the exercising muscles. With continued moderate exercising your muscles take up glucose at up to 20 times the normal rate. This decreases the amount of glucose in your blood stream which helps with hyperglycemia.
Diabetes in Athletics
People with diabetes have to take extra care to make sure that their food is balanced with insulin and oral medications (if they take them).
A healthy diet is a way of eating that that reduces risk for complications such as heart disease and stroke. Healthy eating includes eating a wide variety of foods including:

- Vegetables
- Whole grains
- Fruits
- Non-fat dairy products
- Beans
- Lean meats
- Poultry
- Fish
Normally, after the woman has the child, the diabetes goes away. However, they are at a
higher risk of developing diabetes later on.
Having gestational diabetes increases a woman’s future chances of developing diabetes by 35-60 percent.
Many people with diabetes are afraid to exercise because they fear low blood sugar levels (hypoglycemia).
Blood glucose levels should be closely monitored before exercise.
Do not start exercise with low blood sugars (below 70). Have a snack first.
A carbohydrate-based meal or snack is recommended one to three hours before exercising.
Always carry some form of carbohydrates with you, such as hard candy, dried fruits (raisins), fresh fruits, granola bars or crackers.
Be sure to let your coach and/or other teammates know that you are diabetic and what the signs/symptoms of hypoglycemia are so that they can help you if this should occur.
If you are on insulin, be sure to talk to your doctor about adjusting your dosage for exercise. Most of the time, having a snack before exercise will suffice.
Plan to snack during the activity if it lasts longer than one hour.
Simple vs. Complex Carbs
Eating too many carbohydrates can make your blood sugar levels too high.
Simple Carbs
include things that would be found in your icecream bowl such as candy, syrup, fruit, and even milk.
Simple carbohydrates are mainly simple sugars and they raise blood sugar much faster and usually higher than complex carbs.
Complex carbohydrates are basically starches that contain fiber. Foods like brown rice, whole grains, oatmeal, whole wheat pasta and high fiber cereals are complex carbs. They take longer to digest, so blood sugar levels don't rise as fast.
Simple or Complex?
Further Complications
These pills work best when used with meal planning and exercise. This way you have three therapies working together to lower your blood glucose levels.

Diabetes pills don't work for everyone. Although most people find that their blood glucose levels go down when they begin taking pills, their blood glucose levels may not go near the normal range.

Diabetes pills sometimes stop working after a few months or years. The cause is often unknown.

Diababetic patients should be checked up reguarly for complions within their kidneys, cardiaovascualr system, and extremities.
The most common condition that diabetics get in their eyes is called Diabetic Retinopathy. It occurs when the retina is damaged by the detirition of the blood vessel that supplies it the blood it needs.

The fluid glaucoma builds up in the eye which causes increased pressure and can damage the optic nerve.

Cataracts can often happen as well. A cataract is clouding around the lens of the eye which causes fuzzy vision.
Diabetics usually have poor circulation problems. People who suffer from this disease the blood vessels going to the extremities harden and narrow. When a person with diabetes gets any kind of trauma to any of the extremities, it makes it harder for it to heal due to the fact that the circulation is poor in that certain area.
Exercise is good for poor circulation. It stimulates blood flow in the legs and feet. Walk in sturdy, good-fitting, comfortable shoes, but don't walk when you have open sores.
Some people feel pain in their calves when they are walking. This condition is called
intermittent claudication (
is pain that goes into the muscles of the leg due to poor circulation).
The kidneys in some diabetics usually result in a disease called Nephropathy. Diabetics high glucose levels can mess up the normal process of the kidneys. High levels of glucose in the blood makes the kidney filter too much blood. After having nephropathy for a long period of time the kidneys may start to leak, and useful protein is lost in the urine. The kidneys eventually lose their filtering ability.
The most common heart disease in diabetes is coronary heart disease.
Coronary Heart Disease
This a disease in which a waxy substance called plaque (plak) builds up inside the coronary arteries.
This disease usually results in a heart attack or stroke.
Mouths of a person suffering from diabetes have a higher risk receiving periodontal disease which is often times called periodontist. Periodontist are infections that are both to the gums and bones. The blood vessel often change within the person who suffers from diabetes, so the efficiency of the flow of the nutrients and removal of waste from the bodies tissues loses its ability and may become impaired. When it does this it can cause the gums and the bones to come more susceptible to infection.

and I
work together to maintain
throughout the body. When the blood sugar is too high, normally,
insulin is released from the pancreas to take the glucose out of the bloodstream
and insert it in other parts of the body (muscles, other organs).

When the blood sugar is too low in the bloodstream,
glucagon is released to pull glucose out of the liver to put back into the bloodstream
in order to create
. This glucose is stored in the liver as glycogen. Blood glucose is low between meals and during exercise.

Diabetic Coma
Extremely high blood sugar (glucose) levels
Extreme lack of water (dehydration)
Decreased consciousness
This condition is usually seen in people with type 2 diabetes.
May be brought on by:

Other illness such as heart attack or stroke
Medications that lower glucose tolerance or increase fluid loss (in people who are losing or not getting enough fluid)
Normally, the kidneys try to make up for high glucose levels in the blood by allowing the extra glucose to leave the body in the urine. If you do not drink enough fluids, or you drink fluids that contain sugar, the kidneys can no longer get rid of the extra glucose. Glucose levels in the blood can become very high as a result. The blood then becomes much more concentrated than normal which is called hyperosmolarity.
A diabetic coma is a life-threatening diabetes complication that causes unconsciousness.

If you have diabetes, dangerously high blood sugar (hyperglycemia) or dangerously low blood sugar (hypoglycemia) can lead to a diabetic coma.
Diabetic Shock
Diabetic Shock is a serious case of hypoglycemia. It is also called insulin reaction.
This may also be caused by not having to much nutrients in your system.
If the diabetic goes untreated then it can lead to diabetic coma.
- Irritability
- Loss of coordination
- Loss of consciousness
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