http:medweb'bham'ac'ukeasdecpreventionwhat_is_the_hba1c'htm

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http//medweb.bham.ac.uk/easdec/prevention/what_is
_the_hba1c.htm
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A 1 change in HbA1c corresponds to a 30 mg/dL
change in mean blood glucose.
http//diabetes.bio-rad.com/images/cardback.jpg
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The greater the HbA1c value, the higher the risk
of developing eye problems, kidney problems, and
nerve related disorders.
http//diabetes.bio-rad.com/images/graph.gif
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• Glomerular Capillary Membrane
• (three layers)
• capillary endothelial layer
• a. fenestrations
• basement membrane
• a. determines the permeability of the
  glomerular-capillary membrane
• single-celled capsular epithelial layer
• a. podocytes

Porth Fig. 32-5
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Porth Fig. 43.11
Microalbuminemia is the first sign of diabetic
kidney disease. Everyone with diabetes who is
between 12 and 70 years of age should be tested
for microalbuminuria at least once per year.
Risk for Microalbuminemia
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What is the normal value for plasma K? 3.5
5.0 mEq/L
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What would be the expected hydration status in a
patient with severe DKA? Hydration status
________dehydrated______________________________

• What are three specific signs/symptoms that
  reflect this status?
• Extreme thirst
• Dry mouth
• Loss of skin turgor
• Sunken eyes

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What would be the expected mental status in a
patient with severe DKA, and why?Decreased
level of consciousnessAcetoacetate, but not
beta-hydroxybutyric acid, in high concentration
in DKA produces impaired consciousness and
decreased cerebral oxygen utilization. A close
correlation has been found between plasma
osmolarity and altered mental status. Cellular
dehydration or volume loss has been proposed as
the main mechanism. The electrical activity of
the reticular formation is affected by altered
osmolarity. The abrupt development of plasma
hyperosmolarity may be the main contributing
factor, rather than hyperglycemia since patients
with longstanding severe hyperglycemia,
hyponatremia, and renal impairment do not show
mental impairment.
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What would be the expected respiratory status in
a patient with severe DKA, and why?Kussmaul's
breathingAbnormally large tidal volume with
normal, or perhaps even slowed rate.
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