Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PHARM 343 > Acute Complications Diabetes > Flashcards

Acute Complications Diabetes Flashcards

1
Q

Importance of checking BG levels

A

Very little impact alone
- Has to be associated with meaningful activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

When to check BG

A
  • To avoid Hypoglycemia
  • Confirm a low if symptoms are present
  • Assess response to medication changes
  • Assess response to food
  • Changes in routine
  • During acute illness
  • During Pregnancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Blood Glucose Monitoring Recommendations
- Using insulin more than once a day

A

Check 3 times a day
- Include pre and postprandial measurements

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Blood Glucose Monitoring Recommendations
- T2DM using once a day insulin

A

Check at least once per day at variable times

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Blood Glucose Monitoring Recommendations
- T2DM not using insulin

A

Depends on type of antihyperglycemic agent, A1c levels, and risk of hypoglycemia

  • Not at A1c target = Structured CBG Checks
  • At A1c target + Not using antihyperglycemic agents with risk of hypoglycemia = Daily CBG Checks not recommended
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Blood Glucose Monitoring Recommendations
- All individuals with diabetes when A1c is not in target OR episodes of hypoglycemia

A

Check frequently to determine most effective approach to improve BG management
- Check 4 times a day (May include overnight checks)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

When to use Real Time Continuous Glucose Monitors / Intermittently Scanned Continuous Glucose Monitoring

A
  1. T1DM using basal/bolus therapy / Continuous subcutaneous insulin infusion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Benefits of Real Time Continuous Glucose Monitors / Intermittently Scanned Continuous Glucose Monitoring

A
  1. Increases time in range
  2. Reduces duration and incidence of hypoglycemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Principles of Check Smart

A

What does the numbers mean
Why did I get that number
What could I do differently next time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Controlling Insulin

A
  • More Carbs = More Blood Glucose
  • More Protein/Fat = Less Blood Glucose
  • Intense Exercise = Less Blood Glucose
  • Sports Drinks = More Blood Glucose
  • Increase Insulin = Less Blood Glucose
  • Decrease Insulin = More Blood Glucose
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Consideration of Exercise and Blood Glucose
- Before

A

Do not exercise if Blood Glucose is too low or too hight
- Low = Exercise will exacerbate it
- High = Add to uncontrolled episode

Ensure levels is between 4.0-14.0

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Consideration of Exercise and Blood Glucose
- During

A

Will fluctuate differently depending on the person and the exercise regimen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Consideration of Exercise and Blood Glucose
- After

A

Can fluctuate up to 24 hours later
- Delayed hypoglycemia 6-12 hours after exercise
–> Caused by muscle cells absorbing glucose to replenish glycogen stores

  • Make sure to check BG when changing exercise regimen
  • May have to add extra bedtime snack
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Consideration of Exercise and Blood Glucose
- Low Intensity

A

Ex. Shopping, Walking, Stretching
- Decrease Bolus Dose by 25-50%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Consideration of Exercise and Blood Glucose
- Moderate Intensity

A

Ex. Brisk walk, swimming, tennis, mowing the lawn, riding a bike
- Decrease Bolus Dose by 50-75%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Consideration of Exercise and Blood Glucose
- High Intensity

A

Ex. Competitive sports, shoveling snow, aerobics, jogging, soccer
- Decrease Bolus Dose by 75-100%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Consideration of Exercise and Blood Glucose
- Duration of Exercise

A

May have to consume a 15 gm carbohydrate every 30 mins

18
Q

Consideration of Exercise and Blood Glucose
- Timing of Exercise

A

Reduce Dose if exercise:
- Is planned and will occur within 1-2 hours after meal-time insulin

Consumes Carbohydrate Snack, repeat if needed
- Is planned and will occur 2 or more hours after meal-time insulin
- Is unplanned and occurs within 1-2 hours after meal-time insulin

19
Q

Consideration of Alcohol and Blood Glucose
- Immediate Effects

A

Some drinks like beer and coolers have carbohydrates
- Will immediately increase blood glucose

Some drinks like hard alcohol, dry wine, and light beer do not have carbohydrates
- No immediate effect

20
Q

Consideration of Alcohol and Blood Glucose
- Delayed Hypoglycemia (Cause)

A

Happens with all type of alcohol up to 24 hours post consumption
- MOA: Inhibits glucagon production by liver, means less hepatic glucose production

Increased risk of nocturnal hypoglycemia

21
Q

Consideration of Alcohol and Blood Glucose
- Delayed Hypoglycemia (Prevention)

A

Eat food while drinking and have a bedtime snack

Check blood glucose at night

Check blood glucose the next day and be aware of potential lows the next day

22
Q

Consideration of Travel and Blood Glucose
- Storage

A

Keep supplies on you as they can freeze in storage
Keep supplies cold in a refrigerator

23
Q

Consideration of Travel and Blood Glucose
- Dosing (North-South)

A

Days are same duration
- No adjustments to basal/bolus

24
Q

Consideration of Travel and Blood Glucose
- Dosing (Travel East)

A

Day is shorter –> Reduce basal dose on travel day

Within North America (3 hr time difference)
- Decrease by 1/4 to 1/3

North America to Europe (7 hr time difference)
- Decrease by 1/3 to 1/2

25
Q

Consideration of Travel and Blood Glucose
- Dosing (Travel West)

A

Day is longer –> increase bolus dose on travel day

Have an extra snack and extra bolus dose once you arrive at location

26
Q

Consideration of Travel and Blood Glucose
- Dosing (Time Zones)

A

Switch to new time zone (mealtimes and waking hours) ASAP after arrival

27
Q

Consideration of Driving and Blood Glucose
- Checking

A

If Blood Glucose is less than 4 mmol/L
- Treat hypoglycemia (Successful treatment if BG is greater than 5 mmol/L)
- Wait 40 minutes before driving

If Blood Glucose is 4-5 mmol/L
- Consume carbohydrate before driving

Check Blood Glucose every 4 hours

28
Q

Consideration of Fasting and Blood Glucose
- Concerns who?

A

People with Type 1 Diabetes

People with Type 2 Diabetes on Insulin or on an antihyperglycemic agent associated with hypoglycemia

29
Q

Consideration of Fasting and Blood Glucose
- Actions

A

Adults with Type 1 or Type 2 Diabetes requires an assessment 1 to 2 months before fasting
- Allows a management plan for fasting

30
Q

Diabetes and Sick Day Management
- Relationship

A
  • Blood glucose can fluctuate during a common illness
  • Over the counter medication used for treating symptoms can affect glucose levels (Decongestants or sugar in syrup)
31
Q

Diabetes and Sick Day Management
- Goals

A
  • Avoid large fluctuations in blood glucose
  • Avoid dehydration
  • Avoid ketoacidosis
  • Avoid the need for urgent care
32
Q

Diabetes and Sick Day Management
- What causes Increased Glucose

A

Cortisol, Glucagon, and other hormones released
- Increased insulin resistance
- Increased hepatic glucose production

33
Q

Diabetes and Sick Day Management
- Checking

A

Check Blood Glucose 4 times per day
OR
Check Blood Glucose every 2 hours if high or continuing to rise

Check urine or blood for ketones if Blood Glucose is above 14 mmol/L

34
Q

Diabetes and Sick Day Management
- Management

A

Drink plenty of water to avoid dehydration
Drink electrolytes if there is a significant loss of fluids

If using insulin increase dose
- Blood glucose will rise even when not eating
- May need to use a correction bolus

35
Q

Diabetes and Sick Day Management
- OTCs

A

Dextrose and other carbohydrates are found in liquid cough and cold products. Try to use sugar free products or for people with diabetes products
- Small effect, but, just best to avoid

Decongestants can increase blood glucose
- Try to avoid oral products, use topical for short period of time if absolutely needed

Avoid NSAIDs (SADMANS)

36
Q

Diabetes and Sick Day Management
- SADMANS

A

Sulfonylureas
ACEi
Diuretics + Direct Renin Inhibitors
Metformin
ARB
NSAIDs
SGLT2 Inhibitors

37
Q

Diabetes and Sick Day Management
- Ketoacidosis

A

For Type 1 Diabetes

If experiencing 2 or more of these symptoms patient should seek urgent care:
- High Blood Glucose (Greater than 14)
- Moderate to high ketones in urine/blood
- Dehydration
- Anion Gap Metabolic Acidosis
- Electrolyte Imbalance
- Increased Respiratory Rate
- Acetone (Fruity) odour to breath
- Abdominal pain
- Decreased level of conciousness

38
Q

Diabetes and Sick Day Management
- Hyperosmolar Hyperglycemic State

A

Type 2 diabetes

Similar symptoms to DKA
- Frequent urination, thirst, dry mouth, dehydration, leg cramps, weakness, lethargy, unconciousness

Unlike DKA:
- Much higher blood glucose (greater than 25 mmol/L)
- Elevated serum osmolarity
- Little to no ketonuria or ketonemia

39
Q

Diabetes and Sick Day Management
- SGLT2

A

SGLT2 inhibitors can produce symptoms of DKA at blood glucose levels of 13 or above

40
Q

Diabetes and Sick Day Management
- Hyperosmolar Hyperglycemic State Treatment

A

Need IV replacement therapy

41
Q

Symptoms of DKA

A

Frequent Urination
Thirst
Dry mouth
Dehydration

Leg cramps
Weakness
Lethargy
Unconsciousness

42
Q

Diabetes and Sick Day Management
- When to seek help

A

2 or more of the following:
- Not retaining fluids (Diarrhea, vomiting)
- Gastroenteritis with fever of 38.5 or greater for 2 days or more
- Abdominal pain

  • Blood glucose is greater than 14 mmol/L and continues to climb even after therapy
  • Ketones
    –> Blood (>3mmol/L)
    –> Urine (4-16mmol/L)

PHARM 343 (35 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions