223 Type 1 Diabetes Flashcards
What is the most common concentration of insulin
100 units per milliliter
Describe the physiologic regimen of insulin
Basal insulin is half of the overall insulin. Can we once daily long acting or twice daily intermediate acting. Also prandial doses of rapid acting insulin 5 to 30 minutes before each meal
What is the total daily dose of insulin for most people
Between .4 and one unit per kilogram per day
What is the recommended routes of administration of insulin for hyperglycemic crisis and why
IV administration because he answered of actions within 10 to 15 minutes
Name for ways to diagnose diabetes
A random spot check with Lucas is over 200 with symptoms of hypoglycemia or hyperglycemia crisis. To hour plasma glucose of over 200. Fasting plasma glucose greater than 126, A-1 C greater than 6.5
If you’re going to change the insulin regimen and the ECC by how much did you increase
Typically should not increase by more than 10%
What is the ratio of units of insulin per drop of milligrams per deciliter of glucose?
And type one diabetic’s one unit will drop glucose by 50. And type two little dropper by 30
What is one way that you can look at an insulin bottle and know that it’s older and effective
If there is frosting on the side of the bottle
What are three things I can falsely elevated point of care glucose
Acetaminophen, ansorbic acid, And peritoneal dialysis solutions
What is considered hypoglycemia
Plasma glucose a less than 70
List the most common causes of hypoglycemia
In adequate intake a food, an accurate administration of insulin, infection, renal failure, acute coronary syndrome, and unusual Physical or mental stress.
What is hypoglycemic on awareness?
When diabetics lack neurologic counter regulatory processes That make them unaware that there are hypoglycemic.
What’s the problem beta blockers and diabetics
It can mask typical adrenergic symptoms of hypoglycemia
What is the initial preferred glucose containing dose for hypoglycemia
15 to 20 g of glucose which can be repeated after 15 minutes. In our ER we do an amp which is 25 g
Why wouldn’t you give a Coca-Cola for hypoglycemia
Because most of the sugar is fructose which does not cross the blood brain barrier and does not significantly improve blood glucose levels
When is going on useful for hypoglycemia
It is mostly useful for type one diabetic’s and people that are not glycogen depleted. Takes about 10 to 15 minutes to work
When should you to admit an insulin overdose?
We have overdosed on a long acting insulin
How often are insulin pumps changed?
Every 2 to 3 days.
What are the benefits of insulin pumps over traditional insulin regimen’s?
Average reduction hemoglobin about 2.5% and reduction hypoglycemic episodes. But they’re expensive they require well educated patients
What is the most feared complication of insulin pumps
If they stop working the answer to ketoacidosis can happen in less than one hour
What do you do if you have to do an MRI on a patient with an insulin pump?
Give the patient either rapid and salon or like acting insulin
What to do if an insulin pump patient is NPO?
Check your blood sugars every 3060 minutes do not disconnect
Common complication of insulin pump?
Cellulitis at the infusion site or lipodystrophy.
Why shouldn’t you use a patient’s insulin pump to measure their glucose in the ED?
Because those insulin pumps use interstitial glucose values which can be an accurate due to acetaminophen and others. There’s also a 10 minute time lag for change between serum glucose and interstitial glucose levels
When you suspect insulin pump failure, what did he do to check that it’s OK
I’m sure the pump is on, the reservoir is not empty, no longer indicated, the TV is not kind, and
When is the only time that you disconnected insulin pump?
We suspect that a patient has DKA, assume that there’s a problem with the pump disconnect it and start an IV insulin infusion
How to treat hypoglycemia in a patient using insulin pump?
Just like any other patient do not discontinue the pump