Diabetes Management and Symptoms

Diabetes Management

• Oral glucose tolerance test indicates plasma glucose > 200, leading to symptoms like polyuria.
• Symptoms include polydipsia, polyphagia, weight loss, enuresis, and fatigue.
• Diabetic Ketoacidosis (DKA) is often present at diagnosis.
• Random plasma glucose > 200 requires regular monitoring.
• Children as young as 6-8 years can assist in managing blood glucose (BG) and keeping records.
• Adolescents may struggle with treatment adherence due to peer influences.
• Self-management is the ultimate goal; collaboration with dietitians, educators, and social workers is encouraged.
• Illness prompts BG and urine ketone monitoring every 3 hours; notify healthcare provider for vomiting or BG > 240 mg/dl.

Infant Feeding Readiness

• Infants show readiness with interest in solid foods and loss of extrusion reflex.
• Signs of readiness include better head control and anticipation of feeding.
• Begin with small servings, gradually increasing as swallowing improves.
• Supervise feeding; avoid hot dogs, hard veggies, candies, and peanut chunks.

Nutritional Needs by Age Group

• Toddlers: 3 meals and 2 snacks daily; serving size is 1 tbsp per year of age; 24-48 oz milk/day (low-fat after age 2).
• Preschoolers: Develop preferences and may be picky; encourage sampling of diverse foods.
• School-Age Children: Nutritional needs increase, moderate to avoid unhealthy choices; avoid using food as a reward.
• Adolescents: Require over 2000 calories daily, more if active; potential for unhealthy eating patterns.

Food Allergies and Reactions

• Food allergies are immunologic reactions, most commonly to peanuts, milk, and shellfish.
• Diagnosed through double-blind challenges or skin prick tests; avoid allergenic foods.
• Food intolerance, not IgE-mediated, causes symptoms like indigestion and flatulence.
• Allergy symptoms can include anaphylaxis and swelling of lips/mouth; rapid intervention is critical.
• Prevention strategies: exclusive breastfeeding for 4-6 months followed by gradual introduction of high-allergy foods.

Enteral and Parenteral Nutrition

• Enteral therapy utilizes feeding tubes for patients with swallowing issues or recovery needs.
• Total Parenteral Nutrition (TPN) delivers intravenous nutrition, requiring special equipment and administration.
• TPN is indicated for congenital GI malformations, brain injuries, or severe burns.

Vomiting Management

• Vomiting is common and usually self-limiting; observe for bilious vomiting indicating obstruction.
• Treatment includes identifying the cause, rehydration via oral or IV fluids, and anti-emetic medication.
• Gradually return to normal diet; monitor for electrolyte imbalances post-vomiting.

Hirschsprung Disease

• Characterized by absent ganglion cells in the bowel wall leading to obstruction; more common in males.
• Symptoms include bilious vomiting and failure to pass meconium within 24-48 hours.
• Diagnosis confirmed via abdominal X-ray and rectal biopsy; treatment involves surgical removal of the aganglionic segment.

Cleft Lip and Palate

• Caused by improper fusion of the maxillary process; cleft lip repair usually performed at 2-3 months post-birth.
• Palate repair is ideally done before 12 months; adequate folate may aid prevention.
• Post-surgical care may require the use of soft restraints to protect the incision.

Esophageal Atresia and Tracheoesophageal Fistula

• Condition involves failure of esophagus to form as a continuous structure or separate from the trachea.
• Diagnosis may occur prenatally; symptoms include excessive salivation and choking during feeding.
• Treatment includes surgical intervention to connect the esophagus and repair any fistula, with possible G-tube placement until recovery.

This quiz focuses on the management of diabetes, particularly symptoms associated with high plasma glucose levels. It explores the significance of maintaining glucose levels, the effects of diet, and exercise on insulin action. Understanding these factors is essential for effective diabetes care.