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Undeleted > 2 Endocrine: Glucose > Flashcards

2 Endocrine: Glucose Flashcards

1
Q

type 1 diabetes

A

(formerly juvenile onset)

  • pancreas beta cell (responsible for insulin synthesis) destruction
  • SIGNIFICANT HYPERGLYCEMIA at presentation
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2
Q

insulin

A
  • hormone necessary for normal carb, protein, fat metabolism
  • directly/indirectly affects function of EVERY tissue in body

INCREASES UPTAKE OF GLUCOSE BY TISSUES

greatest effect on three tissues responsible for energy storage: LIVER, MUSCLE, ADIPOSE

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3
Q

percent of type 1 patients treated with insulin therapy

A

100%

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4
Q

percent of type 2 patients treated with insulin therapy

A

40%

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5
Q

insulin administration key points

A
  • rotate/check injection sites to prevent lipodystrophy
  • use sites patient doesn’t use
  • vial may remain at room temp for one month after opened
  • read orders carefully!
  • review chart to see when last dose was given!!
  • check if client is NPO!!!
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6
Q

mixing insulin key points

A

Name X/Y
X = NPH
Y = rapid/short acting
Regular before NPH - “clear to cloudy”

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7
Q

insulin pump

A

delivers basal rate of insulin, programmable to meet individual metabolic needs

  • mealtime bolus calculated to match caloric intake
  • A1C levels are generally lower
  • patients change infusion sets every 1-3 days
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8
Q

insulin pens

A
  • disposable needle, cartridge
  • deliver more accurate dose
  • convenience increases compliance
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9
Q

diabetic ketoacidosis

A

life threatening complication of severe insulin deficiency

  • hyperglycemia
  • water loss
  • hypokalemia
  • altered fat metabolism (production of ketones)
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10
Q

diabetic ketoacidosis treatment

A
  • normalization of K and glucose
  • replacement of fluid and sodium
  • insulin bolus: 0.1 unit/kg body weight followed by continuous infusion at 0.1 unit/kg/hr
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11
Q

hypoglycemia

A
  • complication of insulin therapy

- blood glucose < 50 mg/dl

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12
Q

initial hypoglycemia symptoms

A
  • tachycardia
  • palpitations
  • sweating
  • nervousness

P.N.T.S.

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13
Q

untreated hypoglycemia symptoms

A
  • headache
  • confusion
  • drowsiness
  • fatigue
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14
Q

severe hypoglycemia symptoms

A
  • seizure
  • coma
  • death
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15
Q

hypoglycemia causes

A
  • increased insulin absorption
  • diarrhea
  • excessive insulin
  • labor
  • vomiting
  • exercise
  • decreased food intake

I.D.E.L.V.E.D.

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16
Q

hypoglycemia treatment

A

TEST GAG REFLEX (so patient doesn’t aspirate)

  • administer 10-20g of carbs
  • severe: IV dextrose, IM glucagon
17
Q

type 2 diabetes

A

non-insulin dependent, adult onset

  • insulin resistance and/or impaired insulin secretion
  • lifestyle modifications extremely important
  • primarily treated with oral agents
  • insulin may be prescribed if not responsive to lifestyle modifications and oral meds

SIGNIFICANT HYPERGLYCEMIA at presentation

18
Q

type 2 diabetes risk factors

A
  • age > 45
  • gestational diabetes
  • central adiposity
  • family history
  • elevated cholesterol and/or triglycerides
  • hypertension
19
Q

type 2 diabetes diagnostic criteria

A
  • symptoms of DM & casual glucose > 200 mg/dl

OR

  • fasting glucose > 126 mg/dl with/without symptoms

OR

  • 2 hour glucose or >200 mg/dl after 75g oral glucose during oral glucose tolerance test
20
Q

oral hypoglycemic agents

A

ONLY USED TO TREAT TYPE 2

21
Q

sulfonylureas side effects

A
  • hypoglycemia
  • weight gain
  • hypersensitivity reactions
  • diarrhea
  • flushing, palpitations, nausea
  • beta blockers can mask the signs of hypoglycemia
  • avoid in pregnancy/breastfeeding
22
Q

metformin side effects

A
  • abdominal cramping
  • diarrhea
  • decreased appetite, absorption of B12 and folate
  • lactic acidosis
23
Q

metformin contraindications

A
  • heart failure

- renal disease

24
Q

hemoglobin a1c

A

higher level reflects poor blood sugar control, higher risk of diabetes complications

25
Q

only insulin available in U-500

A

regular insulin

26
Q

insulin that you NEVER mix

A

long acting

glargine (Lantus) and insulin detemir (Levemir)

27
Q

only insulin that can be given IV

A

regular

28
Q

glucagon

A

raises blood glucose concentration
effect opposite from insulin

  • peptide hormone, produced by pancreas alpha cells

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