102 Test Ii Diabetes Insulin Facts

Front 1

Diabetes Mellitus is a group of diseases characterized by

Back 1

elevated levels of glucose in the bloold called hyperglycemia

Front 2

Insulin is produced by the pancreas controls glucose in the blood by ...

Back 2

regulating the production and storage of glucose

Front 3

2 normal sources for glucose in the body are ...

Back 3

absorption of food GI tract
formation of glucose by the liver from food substances

Front 4

what 2 things can be happening in a diabetic state

Back 4

either:
cells stop responding to insulin
pancreas stops producing insulin entirely

Front 5

so either cells stop responding to insulin OR pancreas shuts down making insulin, this leads to hyperglycemia which may result in acute metabolic complications like ...

Back 5

diabetic ketoacidosis DKA
hyperglycemic hyperosmolar nonketstic syndrome HHNS

Front 6

what are the long term effects of hyperglycemia

Back 6

coronary heart disease
cerebrovascular disease
peripheral vascular disease
kidney / eye disease
disease of the nerves

Front 7

there are different types of diabetes mellitus but the 2 we will look at are ...

Back 7

type I diabetes or insulin dependent diabets mellitus
type II diabetes non insulin dependent diabetes mellitus

Front 8

insulin dependent diabetes is
IDDM
non insulin diabetes is NIDDM
but are no longer used b/c ...

Back 8

they relate to their Tx and not their etiology

Front 9

about 5-10 % people w/ type I which insulin producing pancreatic beta cells are destoyed by an autoimmune process. so ...

Back 9

they produce little or no insulin to control their blood glucose levels. Usually happens b/f age of 30.

Front 10

what is insulin resistance

Back 10

decreased sensitivity to insulin. this happens in type II diabetes. This results in decreased insulin production

Front 11

insulin is secreted by BETA CELLS, one of four types of cells in the islets of Langerhans in the pancreas.But what is insulin in the first place

Back 11

insulin is a hormone, a storage hormone

when you eat, insulin secretion increases & moves glucose from the blood into muscle, liver, and fat cells.

Front 12

what else does insulin do?

Back 12

inhibits breakdown of stored glucose, protein, and fat. why? during fasting like b/t meals and overnight, pancrease continously releases small amts of insulin. Another pancreatic hormone called glucagon secreted by Alpha cells in the islets of Langehans is released when blood glucose levels decrease and stimulate liver to release stored glucose. SO the 2 hormones, insulin and glucogen maintain a balance of glucose by managing the release of glucose by the liver.

Front 13

whats the diffence b/t
glycogenolysis and gluconeogenesis?

Back 13

breakdown of glycogen is glycogenolysis
the breakdown of amino acids is glyconeogenesis (which produces new glucose of course)

Front 14

characterize type I diabetes quickly

Back 14

destruction of the pancreatic beta cells.

all the pathpsy is not fully understood, it is not inherited but do inherit a predisopition to it.

Front 15

so these hormones wrestle. insulin and glucagon. but insulin does ...

Back 15

inhibits glycogenolysis (breakdown of stored glucose) AND gluconeogenesis (production of new glucose from amino acids etc)

Front 16

so people w/ type I, or have no insulin, when they eat, have uncontrolled hypoglycemia. Also fat breakdown occurs. what does this do?

Back 16

increases production of ketone bodies, a byproduct of fat breakdown.

Front 17

what are the 2 problems related to type II diabetes?

Back 17

insulin resistance

impaired insulin secretion

Front 18

what is insulin resistance

Back 18

decreased tissue sensitivity to insulin

Front 19

normally, insulin binds to a cells surface and initiates series of reactions involved in ...

Back 19

glucose metabolism. (yum yum eaten up) type II has these reactions diminished, rendering insulin less effective at stimulating glucose uptake. Also less effective at regulating glucose release by the liver.

Front 20

to overcome insulin resistance and prevent buildup of glucose in blood, ...

Back 20

increased amts of insulin must be secreated to maintain the gluocose level at a normal or slightly elevated leve. BUT if beta cells cannot keep up w/ increased demand for insulin, glucose levels rise, and type II developes.

Front 21

what is the normal BG

Back 21

range 70-110

Front 22

absorption of insulin
where is it the fastest and slowest?

Back 22

fastest is abdomen and arms
slowest is thighs and hip

Front 23

you rotate sites according to there absorption wants to stay constant:
give an example

Back 23

if they give their insulin in their abdomen then we could give in the arms

Front 24

what is lypodystropy?

Back 24

scarring of the tissue, hard, decrease absorption
happens when we don't rotate sites

Front 25

Mixture:

70/30
70% NPH
and ...

Back 25

30% regular

Front 26

whats a fast acting insulin

Back 26

Humalog
Novolog
onset 10-15 min
peak 40 min - 1 hour
duration 3-6 hours
nursing considerations
pt should eat no longer than 5 - 15 minutes after injection
really have the meal in front of them
this med is absorbed the same in all sites

Front 27

name a short acting insulin

Called Regular insulin

Back 27

Novalin
Humulin R
onset: 1/2 - 1 hour
peak: 2-3 hours
duration: 4-6 hours
nursing considerations
sol s/b clear, 20-30 min prior to meal

Front 28

intermediate acting insulin
NPH
Humulin N
Novolin L or N
Iletin II
what are the 3 deals?

Back 28

onset: 2-4 hrs
peak: 6-12 hours
duration: 16-20 hours
nursing considerations
usually cloudy in apperance, can be given alone

Front 29

long acting insulin
Ultralents
whats the peak etc

Back 29

onset: 6-8 hours
peak: continous no peak
duration: 24 hours
nursing considerations
pH of 4 can not be mixed w/ other insulins' b/c it could cause a precipitate absorbed the same in all sites