Adult Health Diabetes Quick Review Flashcards
What 5 steps are involved in escalating treatment of type 2 Diabetes?
1) Implement Diet and exercise therapy
2) Initiate therapy with one oral hypoglycemic
3) Treat with two oral hypoglycemics.
4) Treat with three oral hypoglycemics or with one oral hypoglycemic plus insulin
5) Treat with insulin alone.
What does the oral hypoglycemic Sulfonylureas do?
Increases insulin secretion by beta cells of the pancreas.
Can cause weight gain and hypoglycemia.
What are the types of oral hypoglycemic available?
1) sulfonylureas
2) Metformin thiazolidinediones
3) Alpha-glucosidase inhibitors
4) Meglitinides (glinides)
5) Biguanides
6) Dipeptidyl peptidase-4 (DPP-4) inhibitors
How do Meglitinides work?
Increases insulin secretion by beta cells of the pancreas.
Can cause hypoglycemia if not taken with food.
How do Biguanides work?
Reduces hepatic glucose production while increasing insulin action on muscle glucose uptake.
Can cause GI side effects and lactic acidosis.
Withheld before diagnostic tests involving contrast dye.
How do Thiazolidinediones work?
Increases cellular response to insulin by decreasing insulin resistance.
Use cautiously in clients with HF.
How do Alpha-glucosidase inhibitors work?
Delay carbohydrate digestion.
Do not need insulin with this. Can cause GI side effects.
What are some rapid-acting insulin examples?
Insulin Lispro
Insulin aspart
Insulin glulisine
What are the onset, peak, clear or cloudy, injection time and duration of rapid-acting insulin?
Onset: 10 to 15 minutes
Clear
Peak: 30 minutes to 1 hour
Duration: 3-5 hours
Injected 0-15 minutes before meal
What are the onset, peak, clear or cloudy, injection time and duration of short-acting (regular) insulin?
Onset: 30-60 minutes
Clear
Peak: 2-5 hours
Injected 30-45 mins before meal
Duration: 5-8 hours
What are the onset, peak, clear or cloudy, injection time and duration of intermediate-acting insulin?
Onset: 1.5-4 hours
Cloudy
Peak: 4-12 hours
Duration: 12-18 hours
Injected BID (breakfast and dinner)
What are the onset, peak, clear or cloudy, injection time and duration of Long-acting insulin?
Onset: 1-4 hours
No Peak
Clear ( do not mix)
Duration: 24+ hours. Continuous and steady
Injected once a day (Bedtime or Morning)
Purpose of an Insulin Pump?
To provide continuous glycemic control with insulin and to simulate normal pancreatic function.
It works by delivering a basal rate of regular insulin all day and patients can get more insulin depending on how much carbohydrates they consumed.
