Summary
Samenvatting DH jaar 3
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In deze samenvatting staat alle lesstof voor de DH toets van jaar 3. Dit zijn aantekeningen uit de les en literatuur. Vooral kinderdiëtetiek is uitgebreid beschreven.
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Week 1Diabetes is a disorder of carbohydrate metabolism. For glucose to enter the cells, insulin
must be present. This is produced by the pancreas. In people with dIabetes, the pancreas
produces little or no insulin or the cells do not respond appropriately to insulin. As a result,
glucose builds up in the blood, causing hyperglycemia. The kidneys are taxed beyond their
capacity to reabsorb glucose, and the excess spills into the urine, where it can be detected.
Unable to use glucose, cells turn to other energy sources: fat -> ketose en acidose and
protein -> muscle breakdown and weakness
Overtime hyperglycemia increases the risk of high blood pressure, heart disease and kidney
disease. It also leads to damage of tissues, especially the eyes, kidneys, nerves and blood
vessels.
Types of diabetes mellitus:
- Type 1: usually diagnosed in children and young adults. the body fails to produce
insulin.
- excessive thirst
- frequent urination
- rapid weight loss
- blurred vision
- Type 2: either the body doesn’t produce enough insulin or the cells ignore the insulin.
Obesity and genetic factors play a role.
- fatigue
- nausea
- frequent urination
- unusual thirst
- weight loss
- blurred vision
- frequent infections
- slow healing of wounds
- Gestational: occurs in a pregnant woman who has never had diabetes, but who
develops hyperglycemia during pregnancy. Occurs more in african americans, native
americans and hispanic americans, obese women, and women with a family history
of diabetes.
- Pre-diabetes: blood glucose levels are higher than normal, but not high enough to
diagnose diabetes. Unless they take steps toward prevention, such as dietary
changes, weight loss, regular exercise, many will develop type 2 diabetes within 10
years.
Hypoglycemia
Excess insulin results in low blood sugar or hypoglycemia. Too much glucose enters cells,
lowering blood glucose levels too far.
- nervousness
- irritability
, - hunger
- headache
- shainess
- rapid heartbeat
- weakness
Caused by overdose of insulin or vigorous exercise. Reactive hyperglycemia occurs about
one hour after eating carbohydrate-rich food. Fasting hypoglycemia occurs because the
body produces too much insulin even when no food is eaten.
Risk factors for DM
Modifiable Non modifiable
Physical activity 45+ years of age
CVD or other vascular disease Family history
Overweight, obese or high waist Ethnicity
circumgerence
Blood pressure >140/90 mm Hg Gestational diabetes
Triglycerides >250 mg/dl Delivery of heavy baby
HDL <35 mg/dl Treatment for depression
Prediabetes: fasting glucose 100-125 mg/dl
Sleep apnea
Insulin resistance syndrome
Management of diabetes
- healthy eating
- physical activity
- insulin delivery
- weight loss
exercise increases the sensitivity of body cells to insulin.
, Glucose wordt nuchter en 2 uur na maaltijd geprikt
Hypoglycemie:
- flauwte
- trillen
- hoofdpijn
Glucose omhoog:
- Koorts
- Stress
- Voeding
- Medicatie
Glucose omlaag:
- Vasten
Metformine: zorgt dat je gevoeliger wordt voor insuline
Retinopathie
Diabetische retinopathie wordt veroorzaakt door afwijkende of lekkende bloedvaatjes. De
netvlies wordt aangetast. Hierdoor ontstaat slechtziendheid of zelfs blindheid. Regelmatige
controle is belangrijk.
Neuropathie
Diabetische zenuwschade komt veel voor, maar wordt lang niet altijd herkend. Naar
schatting krijgt de helft van de mensen met diabetes er ooit mee te maken. Ongeveer 1 op
de 5 mensen met diabetes ontwikkelt pijnlijke klachten.
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