Blood Glucose Agents - General

Question 1

Pancreas

Answer 1

• 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

Question 2

Insulin

Answer 2

• 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

Question 3

Glucagon

Answer 3

• Released from alpha cells into islets of Langerhans in response to low blood glucose
• Causes immediate mobilization of stored glycogen and raises blood glucose

Question 4

Adipocytes

Answer 4

-Secrete adiponectin, which increases insulin sensitivity, decreases release of glucose from liver, and protects blood vessels from inflammation

Question 5

Endocannabinoid receptors

Answer 5

-keep the body in a state of emergency gain to prepare for stressful situations

Question 6

SNS role

Answer 6

-decreases insulin release, increases release of stored glucose

Question 7

Corticosteriods

Answer 7

-decrease insulin sensitivity, increase glucose release

Question 8

Growth hormone

Answer 8

-decreases insulin sensitivity

Question 9

Hyperglycemia

Answer 9

-increased blood sugar

Question 10

Glycosuria

Answer 10

-sugar spilled into the urine

Question 11

Polyphagia

Answer 11

-increased hunger

Question 12

Polydipsia

Answer 12

-increased thirst

Question 13

Lipolysis

Answer 13

-fat breakdown

Question 14

Ketosis

Answer 14

-ketones cannot be removed effectively

Question 15

Acidosis

Answer 15

-liver cannot remove all the waste products

Question 16

Disorders associated with diabetes

Answer 16

• Atherosclerosis
• Retinopathy
• Neuropathies
• Nephropathy

Question 17

Type 1 Diabetes Mellitus

Answer 17

• Insulin dependent
• Usually rapid onset, seen in younger people
• Connected to many cases to viral destruction of the beta cells of the pancreas

Question 18

Type 2 Diabetes Mellitus

Answer 18

• Non insulin dependent
• Usually occurs in mature adults
• Slow and progressive onset

Question 19

S/S of hyperglycemia

Answer 19

• Fatigue
• Lethargy
• Irritation
• Glycosuria
• Polyuria
• Polydipsia
• Polyphagia
• Itchy skin

Question 20

S/S of impending dangerous hyperglycemia

Answer 20

• Fruity breath
• Dehydration
• Kussmaul’s respirations (Slow, deep)
• Loss of orientation and coma

Question 21

Hypoglycemia

Answer 21

• Low blood glucose <70 mg/dL

- Initial response is PNS followed by SNS

Question 22

S/S of hypoglycemia

Answer 22

• Shakiness
• Dizziness
• Sweating
• Hunger
• Tachycardia
• Inability to concentrate
• Confusion
• Irritability or moodiness

Question 23

Considerations for children

Answer 23

• 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

Question 24

Considerations for adults

Answer 24

• Emphasized diet and exercise
• Caution about OTC, herbal, and alternative therapies
• Insulin is best choice for pregnancy and lactation

Question 25

Considerations for older adults

Answer 25

• 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