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46 Cards in this Set
- Front
- Back
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DKA clinical features or signs
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Hyperglycemia Dehydration Acidosis
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A group of diseases characterized by hyperglycemia due to defects in
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Insulin Secretion Insulin Action or Both
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DM affects ____ million people
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21 million people in US
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Functions of Insulin
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Transport & Metabolizes glucose for energy
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Function of Insulin to stimulate storage
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glucose in the liver & muscle as glycogen
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Function of Insulin it accelerates transport of _______ ______ into the cell
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amino acids
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The Hispanic Population is _______ disposed to DM
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genetically.
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Classifications of DM
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Type 1 & Type 2 Pre DM, Gestational
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Type 1 DM
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Beta Cells destroyed by autoimmune process requires insulin, Onset is acute before age 30. 5-10% of DM are Type 1.
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Name the three P’s associated with DM
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Polyuria Polydypsia Polyphagia
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Oral hypoglycemic agents are used with this type of DM
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Type 2
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True or False Type 1 DM is treated first with diet and exercise?
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False
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Fasting Blood Sugar
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Normal <100 Pre DM 100 -125 Full DM 126>
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Two Hour PC Blood Sugar
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Normal <140 Pre DM >140 Full DM >200
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Good Blood Sugar Regiment
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3 days a wk = 1 fasting (morning) 1 (3) after each meal B/L/D total 4!
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The renal threshold for glucose is
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180 to 200 mg/dl
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Meal Planning DM Carbohydrates
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50-60% emphasize whole grain
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Meal Planning DM Fats
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20 -30%
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Fiber impact Blood Sugar Up or Down
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Down
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True or False, Exercise at Peak Insulin Release times
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False
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Good Time to Exercise if DM
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After Breakfast or After Dinner
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Exogenous Insulin PT should do what before exercise?
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Snack 15 g carbohydrate snack
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What category is insulin is rapid acting?
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Humalog
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Major side effect with Oral DM Meds for Type 2 Pt
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hypoglycemia
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Alpha cells produce
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Glucagon
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Beta Cells produce
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Insulin
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Delta Cells produce
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Somatostain
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Insulin Waning TX
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Incr. evening dose of humalog N or lantus
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Define Insulin Waning
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Progressive rise in blood glucose from bedtime to morning
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Define Dawn Phenomenon
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Relatively normal blood glucose until about 3 am, levels rise
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Dawn Phenomenon TX
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Change time of injection evening humalog N
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Somogyi Effect TX
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Decrease eveing dose of intermediate acting insulin or increase bed time snack
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Define Somogyi Effect
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Normal or elevated blood glucose at bedtime a decrease 2-3to hypoglycemic
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Rule of 15
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15g of fast acting, concentrated carbohydrates, Re Test 15min, Tx if <70, 15g & 15 min. Then provide protein snack to maintain.
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DM PT is unconscious
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Glucagon 1mg SQ or IM (1ml per minute)
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Hypoglycemia S/S
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HA, Confusion, Memory lapses, slurred speech, double vision, sweating, tremors, tachycardia, palpations, nervousness, hunger.
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DKA
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Diabetic Ketoacidosis
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HHNS
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Hyperglycemic hyperosmolar nonketotic syndrome AKA coma
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Ketoacidosis reflects low what levels
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bicarbonate and low ph & low PCO2
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TX of DKA
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Rehydration ,IV continuous insulin of regular insulin, Reverse acidosis and restore fluid & electrolyte balance
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TX of HHNS
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Rehydration*Insulin administration*Monitor F&E status
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Long Term DM Complications
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Macro, Micro & Neuropathic changes and complications
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Macrovascular (DM)
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CAD PVD
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Microvascular (DM)
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Retionpathy, nephropathy
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Neuropathic (DM) S/E
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ED, Dec. Circulation, HTN, PE, DVT
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Keys to DM Foot Care
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White Cotton Socks, Closed toed shoes, No Lotion for Toes, Check shoes b4 putting on. No Bathroom Surgery, No Bare Feet Ever!
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