NR 601 Final EXAM WEEK 5, 6, 7 & 8

NR 601 Final EXAM WEEK 5, 6, 7 & 8 WEEK 5 Glucose metabolism disorders o Types of diabetes (prediabetes, type 1 and type 2) • Prediabetes: impaired fasting glucose, where a person’s fasting glucose is consistently elevated above the normal range, but below the level of 100 and 125 for a formal diagnosis of DM. • DM 1: metabolic disorder (autoimmune) characterized by severe insulin deficiency, result from beta cell destruction, which produces hyperglycemia due to the altered metabolism of lipids, carbs, and proteins o Immune-mediated DM (type 1A) is 90% of cases and generally referred to as type 1 DM o Idiopathic DM (type 1B) accounts for less than 10% of type I DM cases, shows no evidence out autoimmunity and has no known cause. It is a rare form of DM that is inherited and more common in people of Asian, African, or Hispanic origin o Diagnostic: does not recommend screening type 1 DM in apparently healthy individuals who have no risk factors for this disorder o Initial testing: HbA1c of 6.5% or higher, sx of polyuria, polydipsia, weight loss plus random glucose level of 200 mg/dL or higher, FBS 126 mg/dL or higher, 2hr plasma glucose of 200 mg/dL or higher during oral glucose tolerance test • DM 2: is characterized by the abnormal secretion of insulin, resistance to the action of insulin in the target tissues, and/or an inadequate response to the level of the insulin receptor o Risk factors: most common ethnicity • DM I: predisposition for acquiring this has not been identified. • DM II: sedentary lifestyle, familial hx, age 45 years and older, HLD, hx of gestational diabetes, women delivering a baby 9lb or more, obesity (BMI greater than 25), smoking, HTN, and hx of impaired fasting glucose or impaired glucose intolerance o A disproportionate number of African Americans, Latinos, Native Americans, Asian Americans and Pacific Islanders o Incidence increases with age lOMoAR cPSD| NURNN o Diagnostic criteria • Two fasting blood glucose readings with results greater than or equal to 126 mg/dL • Random blood glucose reading greater than or equal to 200 mg/dL if sx of diabetes are present • In older adults, glucose reading after 2-hr oral glucose tolerance test (OGTT) rises more rapidly than the fasting glucose • Hemoglobin A1c (Hb A1c) measurement greater than or equal to 6.5% is indicative of DM II • In the absence of unequivocal disease (sx or risk factor or hx) the same test should be repeated at least once • Screening for prediabetes and DM should be considered in all individuals who are overweight or obese, regardless of age, and for all adults aged 45 years and older