1. Jessica johnson, pharm. D.
Diabetes
Jessica johnson, pharm. D.

2. Etiology (causes) Type 1 Diabetes Type 2 Diabetes Gestational Diabetes
Formerly called Juvenile Diabetes
Due to destruction of pancreatic beta cells, which are responsible for creating insulin
Produce NO insulin; therefore sometimes referred to as “insulin dependent”
Type 2 Diabetes
Formerly called Adult-Onset Diabetes
Cells through-out body have decreased sensitivity to insulin
Still produce insulin, but cells are resistant to the insulin
Gestational Diabetes
Occurs during pregnancy
Usually tested between weeks 24-28

3. Risk factors (type 2 only)
Age > 45
Overweight
Physical inactivity
Family history (1st degree relatives)
Certain ethnic groups (African American, Latino, Native American, Asian)
History of gestational diabetes or macrosomia (baby > 9 lbs at delivery)
Hypertension and High Cholesterol

4. Signs and symptoms Three P’s Lethargy and weakness Labs
Polyphagia (excessive hunger)
Polydipsia (excessive thirst)
Polyuria (excessive urination)
Lethargy and weakness
Labs
Fasting glucose > 126 mg/dL
2 hour post-prandial glucose (PPG) > 200 mg/dL
Glucosuria
A1c > 6.3%

5. Monitoring SMBG A1C Self-monitored blood glucose
Absolutely necessary for good control
A1C
Measured every 3 months
Gives an average for the blood glucose level over the last 3 months
Goal < 6.5% (< 7% in individuals who have a high risk associated with hypoglycemia, usually children and elderly)

6. Complications Acute Chronic Diabetic Ketoacidosis Hypoglycemia
Increased risk of heart attack, stroke
Decreased healing of wounds (can lead to amputation)
Chronic kidney disease
Retinopathy, glaucoma, blindness
Neuropathy (nerve pain)

7. Non-Pharmacologic Treatment
Diet
Limit carbohydrate intake
Increase fiber intake
Exercise
At least 30 minutes per day most days of the week
Routine examinations
Eyes
Feet
Kidneys

8. Health care providers Endocrinologists Nurses Pharmacists
Nutritionists/Dieticians