diabetis 1,2, gestational
DM 1
DIABETES MELLITUS TYPE I/ JUVENILE DIABETES/ INSULIN-DEPENDENT DIABETES MELLITUS(IDDM)
MANIFESTATION OF DM1
(W 3P)
POLYURIA, POLYDIPSIA, POLYPHAGIA, WEIGHT LOSS
MANAGEMENT FOR DM1
HORMONE REPLACEMENT THERAPY: INSULIN
COMPLICATION OF DM1
(DK and kussmaul RNN)
Diabetic ketoacidosis(DKA): fruity scent/ acetone breath, kussmaul breathing, retinopathy, nephropathy, neuropathy
DM 2
diabetes mellitus type II/ non-insulin dependent diabetes mellitus (NIDDM)
DM2 PATHOGENESIS
(B.I)
beta cell exhaustion/not enough insulin, Insulin resistance
DM1 pathogenesis
Autoimmune disease: low insulin/does not produce insulin
manifestation of dm2
(wappp)
weight loss, acanthosis nigrican, polyuria, polydipsia, polyphagia
DM2 and GDM management
lifestyle modification, oral hypoglycemic agent: metformin, hormone replacement therapy: insulin
complication of DM2
Hyperglycemia hyperosmolar nonketotic syndrome(HHNS), retinopathy, nephropathy, neuropathy
GDM
gestational diabetes mellitus
GDM PATHOGENESIS
insulin resistance due to progesterone, human placental lactogen, estrogen
manifestation of GDM
(APPP)
acanthosis nigricans, polyuria, polydipsia, polyphagia
complication of GDM
macrosomia
GDM may resolved post-pregnancy or may lead to DM TYPE 2
hyperglycemia
hot and dry skin, sugar is high
hypoglycemia
cold and clammy skin needs candy(simple carbohydrates)
tumor like or dimpling due to repeated insulin injection on the same site
lipodystrophy
hypoglycemia at 2-3 am, Hyperglycemia at 7 am
somogyi effect
5-6 am pre-breakfast hyperglycemia
Dawn phenomenon
insulin risk
(HDLS)
hypoglycemia, dawan phenomenon, lipodystrophy, somogyi effect
oral hypoglycemic agent
(BTS SAD)
Biguanides: metformin, thiazolidinediones: pioglitazone, sulfonylureas:glibenclamide, glimepiride, SGLT2 inhibitors: dapagliflozin and canagliflozin, alpha-glucosidase inhibitors: acarbose, DPP-4 inhibitor: Sitagliptin and linagliptin
Normal RBS
80-100 mg/dL
RBS OF DM
200 mg/dL and above
NORMAL FBS
70-100 mg/dL
FBS OF DM
126 mg/dL and above
NORMAL postprandial blood sugar( 2 hours after meal)
90-140 mg/dL
NORMAL glycosylated hemoglobin or HbA1c(average glucose in the hemoglobin previous three months, hence fasting is not needed)
5.7%
Postprandial blood sugar of DM
200 mg/dL and above
ABNORMAL glycosylated hemoglobin or HbA1c(average glucose in the hemoglobin previous three months, hence fasting is not needed) OF DM
6.5% AND ABOVE
NORMAL glucose tolerance test( 8 hrs fasting for FBS and urine sample, drink 100 g glucose solution, then blood glucose and urine will be tested after 2-3 hours)
90-140 mg/dL
ABNORMAL glucose tolerance test( 8 hrs fasting for FBS and urine sample, drink 100 g glucose solution, then blood glucose and urine will be tested after 2-3 hours) OF DM
200 mg/dL AND ABOVE
normal urine specific gravity
1.005 to 1.030
normal uriene osmolality
300 to 900 mOsm/kg
10 pathognomonic signs
(HAHA GAGE BE)
Hyperthyroidism: exopthalmos(bulging eyes), asthma: wheezing on expiration, hepatitis: icteric sclera, acute cholecystitis: Murphy sign, guillainbarre syndrome: ascending muscle weakness, atrial flutter: flutter waver, gout: tophi, enteric fever: rose spots in abdomen, Bulimia nervosa: chipmunk face, emphysema: barrel chest
10 ANTIDOTE
METHANOL: ETHANOL, OPOID: NALOXONE, HEPARIN: PROTAMINE SULFATE, INSULIN: GLUCOSE, WARFARIN: VITAMIN K, ISONIAZID: PYRODOXINE, DIGOXIN: DIGIFAB, MAGNESIUM SULFATE: CALCIUM BICARBONATE, BETA BLOCKER: GLUCAGON
10 LAWS
EO 51: MILK CODE
EO 209(1987):FAMILY CODE OF THE PHILIPPINES
PD 48: MATERNITY LEAVE BENIFIT
PD 442(1974): LABOR CODE OF THE PHILIPPINES
PD 491(1974): NUTRITION ACT
PD 603(1974): CHILD AND YOUTH WELFARE CODE
PD 856(1975): SANITATION CODE OF THE PHILIPPINES
RA 6675(1988): GENERIC ACT
RA 9173(2002): PHILIPPINE NURSING ACT
RA 11223(2019): UNIVERSAL HEALTH CARE ACT