chapter 66 good Flashcards
What structures in the body is diabetes most likely to affect
eyes
heart
kidneys
feet
at what blood glucose would it be contraindicated to administer insulin
do not administer insulin if BG is less than 4 mmol/L
how often do you rotate injection sites
every week
what are the rapid acting insulins
Aspart
Lispro
Glulisine
What is the onset peak and duration of rapid acting insulins
-Onset: less than 15 min
-Peak 0.5-1 hr
-duration: 3-4 hours
when is the best time to take rapid acting insulins
while eating
What are adverse effects of insulin therapy
-Irritation at injection site
-Lipodystrophy
-Weight gain
what are SERIOUS adverse effects of insulin therapy
-hypoglycemia
-Rebound Hyperglycemia
-hypokalemia
what is the only biguanide medication
Metformin
how do biguanides help control type 2 diabetes
-Decrease glucose production by liver
-increase insulin sensitivity
-Increase glucose transportation to cells
How long do biguanides take to reach therapeutic levels
6-12 weeks
if a type 2 diabetic was going to have a procedure with contrast dye what would you need to make sure of before the procedure
make sure they stop taking their biguanides/metformin for 48 hrs before and after procedure
what are contraindications of biguanides
-Heart failure
-hypoxemia/lactic acidosis
How do sulfonylureas help control type 2 diabetes
-stimulate insulin release from the pancreas
-increase sensitivity to insulin
-decrease prolonged hypoglycemia
What type of medication will usually end in “-ide”
Sulfonylureas
(remember surfing tIDES)
what are considerations for sulfonylureas
-it is a sulfa drug so watch for sulf and thiazide allergy
-discontinue 1 month before getting pregnant and cant take while breastfeeding
what type of medication will usually end in
“-glinide”
Meglitinides
what are considerations for all oral antidiabetic agents
-watch liver function
-second gen sulfonylureas have fewer drug to drug interactions
how do meglitinides help regulate type 2 diabetes
increase insulin production (watch for hypoglycemia if pt misses meal or something)
what type of insulin is never mixed with another insulin
Lantus
what is a contraindication for glitazones
Severe heart failure
when is the best time to take short acting insulin
30 min before meal
what is the short acting insulin
regular insulin
what type of insulin would be used for gestational diabetes
regular insulin since it is a natural hormone
what are signs and symptoms of hypoglycemia
cold and clammy need some candy
-and sympathetic signs since when blood sugar is low SNS is activated
what are signs and symptoms of hyperglycemia
Think the three P’s
-Polyuria
-polydipsia (increased thirst)
-polyphagia
-N/V
