223 Type 1 Diabetes

Question 1

What is the most common concentration of insulin

Answer 1

100 units per milliliter

Question 2

Describe the physiologic regimen of insulin

Answer 2

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

Question 3

What is the total daily dose of insulin for most people

Answer 3

Between .4 and one unit per kilogram per day

Question 4

What is the recommended routes of administration of insulin for hyperglycemic crisis and why

Answer 4

IV administration because he answered of actions within 10 to 15 minutes

Question 5

Name for ways to diagnose diabetes

Answer 5

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

Question 6

If you’re going to change the insulin regimen and the ECC by how much did you increase

Answer 6

Typically should not increase by more than 10%

Question 7

What is the ratio of units of insulin per drop of milligrams per deciliter of glucose?

Answer 7

And type one diabetic’s one unit will drop glucose by 50. And type two little dropper by 30

Question 8

What is one way that you can look at an insulin bottle and know that it’s older and effective

Answer 8

If there is frosting on the side of the bottle

Question 9

What are three things I can falsely elevated point of care glucose

Answer 9

Acetaminophen, ansorbic acid, And peritoneal dialysis solutions

Question 10

What is considered hypoglycemia

Answer 10

Plasma glucose a less than 70

Question 11

List the most common causes of hypoglycemia

Answer 11

In adequate intake a food, an accurate administration of insulin, infection, renal failure, acute coronary syndrome, and unusual Physical or mental stress.

Question 12

What is hypoglycemic on awareness?

Answer 12

When diabetics lack neurologic counter regulatory processes That make them unaware that there are hypoglycemic.

Question 13

What’s the problem beta blockers and diabetics

Answer 13

It can mask typical adrenergic symptoms of hypoglycemia

Question 14

What is the initial preferred glucose containing dose for hypoglycemia

Answer 14

15 to 20 g of glucose which can be repeated after 15 minutes. In our ER we do an amp which is 25 g

Question 15

Why wouldn’t you give a Coca-Cola for hypoglycemia

Answer 15

Because most of the sugar is fructose which does not cross the blood brain barrier and does not significantly improve blood glucose levels

Question 16

When is going on useful for hypoglycemia

Answer 16

It is mostly useful for type one diabetic’s and people that are not glycogen depleted. Takes about 10 to 15 minutes to work

Question 17

When should you to admit an insulin overdose?

Answer 17

We have overdosed on a long acting insulin

Question 18

How often are insulin pumps changed?

Answer 18

Every 2 to 3 days.

Question 19

What are the benefits of insulin pumps over traditional insulin regimen’s?

Answer 19

Average reduction hemoglobin about 2.5% and reduction hypoglycemic episodes. But they’re expensive they require well educated patients

Question 20

What is the most feared complication of insulin pumps

Answer 20

If they stop working the answer to ketoacidosis can happen in less than one hour

Question 21

What do you do if you have to do an MRI on a patient with an insulin pump?

Answer 21

Give the patient either rapid and salon or like acting insulin

Question 22

What to do if an insulin pump patient is NPO?

Answer 22

Check your blood sugars every 3060 minutes do not disconnect

Question 23

Common complication of insulin pump?

Answer 23

Cellulitis at the infusion site or lipodystrophy.

Question 24

Why shouldn’t you use a patient’s insulin pump to measure their glucose in the ED?

Answer 24

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

Question 25

When you suspect insulin pump failure, what did he do to check that it’s OK

Answer 25

I’m sure the pump is on, the reservoir is not empty, no longer indicated, the TV is not kind, and

Question 26

When is the only time that you disconnected insulin pump?

Answer 26

We suspect that a patient has DKA, assume that there’s a problem with the pump disconnect it and start an IV insulin infusion

Question 27

How to treat hypoglycemia in a patient using insulin pump?

Answer 27

Just like any other patient do not discontinue the pump