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28 Cards in this Set
- Front
- Back
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How long to rapid-acting insulins last? What is its peak? |
1. Meal to meal 2. 30-90 minutes--- peak |
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How long does regular insulin last? What is its peak? |
1. Up to 8 hours 2. 2-5 hours--- peak |
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How long does lantus act? When is its peak concentration? |
1. 24 hours 2. No peak |
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How long does NPH last? What is the peak of NPH? |
1. 18-24 hours 2. Peak--- 4-12 hours |
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What is the use of NPH and glargine? |
1. Basal glycemic control 2. Not used for mealtime control |
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What is a split-mixed regimen? |
1. NPH and regular insulin 2. Regular to cover meals, NPH to provide basal insulin |
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What is the basal-bolus insulin concept? |
1. Basal--- controls glucose production between meals and overnight 2. Bolus--- limits hyperglycemia after meals 3. Provides both acute and chronic control |
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What is the carb control on a patient with basal-bolus insulin? |
1. Fixed amount of carbs for a given amount of insulin 2. DO NOT PRESCRIBE ZERO CARBS |
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What are the advantages/drawbacks of insulin pens? |
1. Advantage-- faster and easier than syringes 2. Drawback--- inadequate mixing |
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What is the use of insulin pumps? |
1. Provide steady basal insulin
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What is the primary tx of DM? |
1. Education
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What is BIDS tx? |
1. Basal insulin added to oral agents |
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What is the use for SMBG? |
1. Test for medication dosing, particularly insulin dosing regimens |
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If daytime readings are near normal and fasting glucose is high....? |
1. Glargine is needed |
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If fasting glucose is normal, A1c is elevated, and meal-time readings are high, patient needs....? |
1. Meal-time insulin |
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If long-acting insulin is in titration to higher and higher doses with persistently elevated fasting glucose, what should you check? |
1. Middle of the night blood sugar----somogyi--- rebound |
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What are the benefits of continuous glucose monitoring? |
1. More complete glucose profile 2. Tracking of meal-related trends 3. Detection of nocturnal hypoglycemia 4. Alarms for highs and lows |
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What are the challenges associated with continuous glucose monitoring? |
1. Daily SMBG required 2. Not suited for all patients 3. Limited accuracy |
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What can be checked periodically in DM patients? |
1. Yearly retina exams 2. EKG/stress 3. Yearly microalbumin 4. A1C, lipids, renal function, glucose |
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What should be checked in every visit in DM pts? |
1. BP, weight, skin, edema 2. Foot exams 3. Med rec 4. Review self-glucose monitoring results 5. Smokers--- you need to quit |
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What is the target BP in DM? |
1. <130/80 |
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What is the goal for total cholesterol in DM? |
1. <200
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What is the goal for LDL in DM? |
1. <100 |
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What is the goal for HDL in DM? |
1. At least 40 |
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What is the goal for TAGs in DM? |
1. 150-199 |
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What are the ABCDEs of Diabetes? |
A1c<7 BP<130/80 Cholesterol, LDL<100; HDL>40, TAGS<150 Dysalbuminuria<15 Enteric-=coated aspirin--- 81-325 mg/d |
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What is the most accurate way to measure blood glucose at home? |
1. Fingerstick |
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How should you tx DM in the hospital? |
1. Get away from sliding scale |
