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57 Cards in this Set
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- Back
- 3rd side (hint)
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How much money is spent every year on a person with diabetes?
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$1,000 - $15,000 / year
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What happens to fats in an uncontrolled diabetic?
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May be broken down into ketones
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What is diabetes?
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Insufficient or defective insulin
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What are the three key players in diabetes
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Pancreas
Insulin Glucose |
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What cells produce insulin? Where are they located?
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Islets of Langerhans
Pancreas |
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What does insluin do?
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"Unlocks" insulin receptors to carry glucose into cell
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What is Type 1 diabetes?
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autoimmute beta cell destruction when little or no insulin produced
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What is Type 2 diabetes?
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impaired beta cell function
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What can be two reasons for someone to have Type 2 diabetes?
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May have to little insulin or defective insulin produced.
May have increased insulin resistance. |
With respect to pathology?
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What type of diabetes involves defect of the islets of langerhans?
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Type 1
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What are some reasons a patients may develop Type 1 diabetes?
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Genetic predisposition
viruses |
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What is the age of onset for Type 1 diabetes?
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Usually under 40
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What is the etiology of Type 2 diabetes?
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Genetic predisposition
risk factors |
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What are some risk factors for Type 2 diabetes?
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Trunk obesity
high refined sugar diet some meds may increase blood sugar |
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What are the 3 polys of diabetes?
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Polyuria - high urine output
Polydipsia - drinking lots Polyphagia - eating lots |
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What the signs of diabetes?
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Polyuria, polydipsia, polyphagia, frequent yeast infections, glucosuria, poor wound healing, complications (blurred vision, numbness, tingling in extremities)
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What is the normal fasting target for blood glucose -
Normal? Diabetic? |
4-6 mmol/L
4-7 mmol/L |
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What is the target for 2H post meal blood sugar -
Normal? Diabetic? |
5-8 mmol/L
5-10 mmol/L |
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What is the target for glycosylated hemoglobin for a diabetic patient?
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less than or equal to 7%
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What are some complications of diabetes?
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Vascular problems
CAD Stroke Retinopathy Neuropathy Hypo/Hyperglycemia Diabetic ketoacidosis HHNK Skin problems |
V, C, S, R, N, N, H, K, H, S
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What is diabetic neuropathy and why is it important?
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Not having very strong sensation in skin - may not feel effects of hypoglycemia
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Why is it important to test the function of a diabetic patient's kidneys?
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Due to diabetic nephropathy
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What is considered to be hypoglycemia?
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BS less than 4 mmol/L
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What are some (4) causes of low blood sugar?
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Too much insulin,
Not enough food, delayed meal, Excessive exercise |
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What are some (5) S&S of hypoglycemia?
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Diaphoretic and Pale
Nervous, anxious and irritable Hungry and weak Tremors, light headed Drowsy, confused |
S, NAI, HW, T, D
Trigger the sympathetic NS |
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How do you treat hypoglycemia?
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Act fast!
Give 180cc juice or 5 dextrosol tablets, glucose gel, honey into buccal cavity |
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How long after hypoglycemic episode would you re-check BS?
What is the protocol? |
Every 15 minutes until BS >4mmol/L. Need to give a protein snack if meal > 1/2 hour away.
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When would you push IV Dextrose solution?
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If BS severely low
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What would you give to patient if hypoglycemic shock?
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Glucagon subQ
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What are some (4) causes hyperglycemia?
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too much food
not enough insulin illness/stress hormonal |
F, I , S, H
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In what type of diabetes is ketoacidosis more likely to occur
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Type 1
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What causes ketoacidosis?
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Hyperglycemia triggers no insulin production whic results in fats/proteins being broken down by cells for nrg - ketone byproduct
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What are the S&S of ketoacidosis?
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Kussmaul's breathing, fruity breath, vomiting, altered LOC
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B, F, V, L
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How is ketoacidosis treated?
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IV fluids
IV Regular insulin Treat cause correct electrolyte imbalance monitor VS, I/O, BS and LOC |
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What type of diabetes tends to have Hyperosmolar hyperglycemic non-ketosis
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Type 2
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What is HHNK
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Hyperosmolar hyperglycemic non-ketosis: when there is enough insluin to prevent ketosis but not enough to prevent hyperglycemia
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What are the S&S of HHNK
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Dry skin
Extreme thirst Polyuria altered LOC |
S, T, U, L
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When should BS be monitored (3)?
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Premeals
qhs unwell |
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What is the goal of diabetes management
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Control BS, minimize c/ps
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What education should be given to a diabetic patient?
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Diet, meds, exercise, foot care, sick days, BP, BMI
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How long before meal should insulin be given?
Rapid insulin short insulin intermediate? Premixed? extended? |
15 mins
30 mins 30 mins 30 mins 1-2 x per day |
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Which insulins are cloudy?
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Intermediate and premixed
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Which insulins are clear?
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Rapid, short, extended
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Who typically gets insulin?
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Type 1 and Type 2 not controlled by oral agents
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What are some important points to watch for insulin?
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Keep away from heat/sun
watch expiry date do not freeze give pre meal do not use if have floaties |
S, E, F, F, P
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What is the onset time of:
Rapid regular intermediate long extended humulin |
10-15 mins
30 mins 1-3 hours 3-4 hours 60-90 mins 15-30 mins |
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What is glargine
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Extended long acting insulin
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What is the peak time of:
Rapid Regular Intermediate Long Extended Humulin |
60-90 mins
2-4 hrs 5-8 hrs 8-15 hrs 24 hrs 11-14 hrs |
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What is the duration of:
Rapid Regular Intermediate Long Extended Humulin |
4 hrs
5-8 hrs up to 18 hrs 22-26 hrs 24 hrs 11-14 hrs |
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what are some (4) methods of giving insulin?
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SubQ,
IV Insulin pump Insulin pen |
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When would insulin be given IV?
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DKA or HHNK
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What is sulfonylurea?
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Antihyperglycemic agent
Stimulates secretion of insulin by pancreas eg. Glyburide |
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What are meglitinides?
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Oral hypoglycemic agent
stimlulates secretion of insulin by pancreas in patients intolerant to sulfur eg. repaglinide |
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What do biguanides do?
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Facilitate insulin transport of glucose into cell
eg. Metformin |
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What does thiazolidinedione do?
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Oral antyhyperglycemic agent
Helps insulin to work better. Eg rosiglitazone, pioglitazone Considering taking off the market because of side effects |
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What do alpha glucosidase inhibitors do?
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Oral hypoglycemic agent
Delay intestinal absorption of CHO Eg. Acarbose |
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What are some cautions around using oral hypoglycemic agents?
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Check BS
Eat all meals May get hypoglycemic side effects/peak/durations may interact with other meds may require insulin as well |
B, M, H, SE, I, I
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