Ch.40 Flashcards
Formerly known as insulin-dependent diabetes mellitus or IDDM
Type 1
Formerly knows as non-insulin-dependent diabetes mellitus or NIDDM
Type 2
DM is a chronic disorder characterized either by insufficient insulin production by the __ cells of the ___ or by __ __ to insulin
Beta
Pancreas
Cellular resistance
SATA
Those with tpr 1 do not produce enough insulin and therefore must have __ ___ to survive. Type one usually has a __ onset, occurs before age __, produces more __ symptoms __ than type 2, and more ___ to control
Insulin supplementation
Rapid
20
Severe
Swifter
Difficult
Control of type 1 is particularly difficult because of the lack of __
Insulin production by the pancreas
Those with type 2 are affected with by decreased production of __ by the __ cells of the ___ or by decreased sensitivity of the __ cells to insulin, making the cells __
Insulin
Beta
Pancreas
Body
Insulin resistant
SATA
Risk factors for type 2 DM
Obesity
Older age
Family history of diabetes
History of gestational diabetes
Impaired glucose intolerance
Minimal or no physical activity
Race/ethnicity (African American, Hispanic/latino Americans, native Americans, & some Asian Americans)
When insulin first begins to act in the body
Onset
When the insulin is exerting maximum action
Peak
The length of time the insulin remains in effect
Duration
Has a slower and more even release into the bloodstream; therefore, it does not have a “peak action”
Peakless
Glargine
Selected drugs that decrease the effect (more insulin may be required)
Contraceptives
Oral corticosteroids
Nicotine
Drugs that increase the effect (less insulin may be required)
Beta blocking drugs
Salicylates
Insulin most common for gestational diabetes
GLP-1s (glucagon like peptide 1 agonists)
Contraindicated in clients with a personal or family history of thyroid (medullary) or other endocrine cancers.
GLP-1s
This drug should not be used to treat type 1
GLP-1s
Improve insulin sensitivity in muscle and fat cells
Thiazolidinediones (TZDs)
Prevent the after meal surge in blood glucose by delaying the digestion absorption of carbs in the intestine
Acarbose (Precose)
Miglitol (Glyset)
Appear to lower blood glucose by stimulating the beta cells of the pancreas to release insulin
Sulfonylureas
The most commonly used sulfonylureas
Glimepiride
Glipizide
Glyburide
Sulfonylureas may have an increased ___ effect when administered with anticoagulants, NSAIDs, salicylates or sulfonamides
Hypoglycemic
The best way to monitor long term glycemic control and response to treatment is with __ levels measured at __ intervals
HbA1c
3 month
Insulin requirements may change when the client experiences any form of __ with any __ particularly illnesses resulting in __ and __
Stress
Illness
Nausea & vomiting
__ is the only insulin prep given IV
Regular insulin
