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30 Cards in this Set

  • Front
  • Back
Pancreatic Hormones
insulin and glucagon
Secretion of insulin and glucagon
is controlled by the body's blood glucose levels
Insulin - secretion
secreted by beta cells in the pancreas called the islets of langerhans
Insulin - promotes
the transport of blood glucose into cells and the storage of glucose in the liver
Glucose is
energy or fuel for cells
Insulin - inhibits
glyconeogenesis (formation of new glucose from fatty acids and amino acids) and glycogenolysis (breakdown of glycogen into glucose) in the liver
secreted by the alpha cells in the islets of langerhans
Glucagon promotes
glycogenolysis (breakdown of glycogen into glucose) - increases blood glucose levels
Insulin - works
insulin secretion or administration is a decrease in blood glucose levels
Blood Glucose levels
normal - 70-100 mg/dl
above 110mg-dl insulin secretion increases
below 70 mg/dl glucagon secretion increases
Prevention of Hyperglycemia

Prevention of Hypoglycemia
Proper secretion of insulin

Proper secretion of glucagon
Diabetes Mellitus
destroyed pancreatic beta cells
caused by genetic and enviromental factors which cause an anti-immune response
results in decreased insulin production and resultant hyperglycemia
involves insulin resistance at the cellular level
Diabetes Mellitus disease
Chronic, systemic disease characterized by metabolic and vascular abnormalities- if caused by weight gain can sometimes be controlled by weight loss
Diabetes Mellitus - Type I
Juvenile, early onset, insulin dependent diabetes - must have insulin admin. Usually before age 20 - has sudden onset, 10% of all diabetics have type I
Diabetes Mellitus - Type 2
Adult onset, non-insulin dependent - patients usually overweight or obese, over 40 yrs old and have gradual onset of symptions - pancreas still produces some insulin, may be controlled with diet and oral agents, 90% of all diabetics
Human source of insulin
E.coli insulin is genetically altered (Humulin)
Facts about Insulin
Insulin is not effective when taken orally because it is destroyed in GI tract
metabolized in the liver, kidneys and muscle tissue
usually given SQ by injection or insulin pump
Concentrations of Insulin
almost always U-100 syringe
100 units per mil
use a syringe that corresponds to the vial concentration
Storage of Insulin
refrigerate unopened vials
can store opened vials at room temp. Only Lispro must be used in 28 days, rest of meds can go to expiration date
Types of Insulin
Regular - Humulin R or Novolin R
Rapid acting- lispro (Humalog)
Intermediate Acting (NPH) - Novolin N or Humulin N
Long acting Insulin - insulin zinc
Long acting - Lantus (insulin glargine)
Inhaled Insulin
Insulin Mixtures
rapid acting, Humulin R or Novolin R - onset- 30 min. to 1 hr - Peak 2 to 4 hrs -
Duration - 5 to 7 hrs -
meant to cover 1 meal
Only regular insulin can be given IV
only regular insulin used in hyperglycemic emergencies (DKA)
Sliding Scale
0-200= 0 units
201-250 = 2 units
251-300 = 4 units
over 300 = call
b4 admin. insulin ask whether the patient will be eating their next meal
Questions to ask before administring insulin
When is their next meal?
Are they NPO for a test?
Are they complaining of nausea?
Rapid acting lispro (Humalog)
most similar to physiologic insulin secretion after a meal and causes less hypoglycemia - most rapid acting - onset 15 min. - peak 30-90 min - duration 5 hrs
patients must eat within 15 min of lispro administration - works fast so be careful giving this med.
NPH - intermediate acting (longer acting)
Novolin N and Humulin N - onset 1-2 hrs - peak 8-12 hrs - duration 18-24 hrs
Will be CLOUDY looking
Long acting Insulin Zinc
Insulin Zinc - not popular drug - onset 4-8 hrs = peak 10-30 hrs - duration 36 or more hours
Long-acting Insulin glargine
Lantus - -short-acting with long acting effect -
forms microprecipitates subcutaneously and has sustained release actions
DO NOT GIVE with other insulins - Usually admin. SQ at bedtime- begins working 1 hrs and last for 24 hrs - NO PEAKING because sustained release
Inhaled Insulin
only used with adults and cannot have lung disorders - adm. 10 min prior to the meal - onset 15 min - peak 30-90 min Duration 4-6 hrs - may cause hypoglycemia
Insulin Mixtures
Humulin 70/30 or Novolin 70/30 Humulin 50/50- 70 units intermediate (NPH) and 30 units of rapid-acting (R)