Blood Glucose Agents - General Flashcards
Pancreas
- Plays a major role in glucose regulation
- Endocrine gland: produces hormones in the islets of Langerhans
- Exocrine gland: releases sodium bicarbonate and pancreatic enzymes directly into the common bile duct to be released in the small intestine
Insulin
- Hormone produced by beta cells of the islets of Langerhans
- Released into circulation when levels of glucose rise around the cells
- Stimulate glycogen synthesis
- Released after meals, causing blood glucose levels to fall
Glucagon
- Released from alpha cells into islets of Langerhans in response to low blood glucose
- Causes immediate mobilization of stored glycogen and raises blood glucose
Adipocytes
-Secrete adiponectin, which increases insulin sensitivity, decreases release of glucose from liver, and protects blood vessels from inflammation
Endocannabinoid receptors
-keep the body in a state of emergency gain to prepare for stressful situations
SNS role
-decreases insulin release, increases release of stored glucose
Corticosteriods
-decrease insulin sensitivity, increase glucose release
Growth hormone
-decreases insulin sensitivity
Hyperglycemia
-increased blood sugar
Glycosuria
-sugar spilled into the urine
Polyphagia
-increased hunger
Polydipsia
-increased thirst
Lipolysis
-fat breakdown
Ketosis
-ketones cannot be removed effectively
Acidosis
-liver cannot remove all the waste products
Disorders associated with diabetes
- Atherosclerosis
- Retinopathy
- Neuropathies
- Nephropathy
Type 1 Diabetes Mellitus
- Insulin dependent
- Usually rapid onset, seen in younger people
- Connected to many cases to viral destruction of the beta cells of the pancreas
Type 2 Diabetes Mellitus
- Non insulin dependent
- Usually occurs in mature adults
- Slow and progressive onset
S/S of hyperglycemia
- Fatigue
- Lethargy
- Irritation
- Glycosuria
- Polyuria
- Polydipsia
- Polyphagia
- Itchy skin
S/S of impending dangerous hyperglycemia
- Fruity breath
- Dehydration
- Kussmaul’s respirations (Slow, deep)
- Loss of orientation and coma
Hypoglycemia
- Low blood glucose <70 mg/dL
- Initial response is PNS followed by SNS
S/S of hypoglycemia
- Shakiness
- Dizziness
- Sweating
- Hunger
- Tachycardia
- Inability to concentrate
- Confusion
- Irritability or moodiness
Considerations for children
- Monitor closely for hyper and hypoglycemia
- Insulin often needs to be diluted
- Two nurse check for insulin
- Challenging to treat in teens
- Metformin is the only PO drug approved
Considerations for adults
- Emphasized diet and exercise
- Caution about OTC, herbal, and alternative therapies
- Insulin is best choice for pregnancy and lactation
Considerations for older adults
- Underlying problems complicate diabetic therapy
- Dietary deficiencies lead to fluctuations in glucose
- Renal and hepatic impairment may make oral agents not feasible
- Emphasize diet, exercise, and foot care
- More likely to experience organ damage