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Diabetes Flashcards

1
Q

Components of the Endocrine System

A

Pituitary, thyroid, parathyroid, adrenal glands, pancreas, testes, ovaries, and placenta.

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2
Q

What does the pancreas produce and secrete?

A

Insulin and glucagon

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3
Q

What does the liver do?

A

Stores glycogen, releases it when the blood sugar is low.

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4
Q

Glycogenolysis

A

Conversion of glycogen to glucose in the circulating blood

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5
Q

What is the cause of diabetes mellitus?

A

Too little insulin production by the pancreas

Result of autoimmune response destroying the beta cells in the pancreas..

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6
Q

What is hyperglycemia?

A

Elevated blood sugar related to insufficient insulin.

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7
Q

What is hypoglycemia?

A

Low blood sugar below 70

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8
Q

Who’s at greater risk for developing diabetes?

A

a. MI
b. CVA
c. kidney disease
d. lower limb amputations

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9
Q

Type 1 Diabetes

A

no production of insulin by the beta cells. requires insulin daily for life.

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10
Q

What are the 3 P’s of Type 1 Diabetes?

A

Polydipsia- Increased thirst
Polyphagia- increased appetite
Polyuria- excessive urination.

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11
Q

Polydipsia

A

Increased thirst

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12
Q

Polyphagia

A

Increased appetite

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13
Q

Polyuria

A

Excessive urination

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14
Q

Other symptoms of Type 1 Diabetes

A

Weight loss despite enough caloric intake.

Glycosuria, blurred vision,fatigue

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15
Q

What does insulin do?

A

Hormones that Lowers blood glucose levels by helping glucose move into target tissues

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16
Q

Which type of diabetes does insulin treat?

A

Type 1

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17
Q

Type 1 Diabetes Treatment Regimen

A

Very strict diet.

Controlling simple and complex carbohydrates

Home glucose testing: 2- 4 times a day

Multiple insulin injection daily.

Planned activity daily. Exercise as tolerated.

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18
Q

What is Type 2 Diabetes?

A

The pancreas still has some ability to make insulin. Not enough to meet the demands of the body daily.

Non-insulin dependent diabetes.
Occurs after 40 years of age.

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19
Q

Type 2 Diabetes Risk Factors

A 
Obesity
Older age
 family history of diabetes.
History of gestational diabetes
Race/ ethnicity.
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20
Q

Treatment for Type 2 Diabetes

A

diet. Controlling simple and complex carbohydrates.
daily exercise
Use of one or more oral antidiabetic agents
Glucose monitoring.

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21
Q

Hypoglycemia

A 
Sudden onset
Less than 70 blood sugar
CNS: Fatigue, weakness, agitation, convulsion, dizziness unconsciousness.
Resp. Normal to rapid. Shallow.
GI: hunger, nausea
Skin: pale moist diaphoretic.
Pulse: normal or uncharacteristic
Numbness, tingling of tongue and lips
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22
Q

Hyperglycemia

A 
Gradual onset
More than 200
CNS: drowsiness, dim vision.
Resp. rapid. Kussmal, resps.
GI: thirst nausea, vomiting.
Skin: dry flushed ,warm
Pulse: rapid, weak./
Acetone breath. Fruity smell
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23
Q

Gestational Diabetes

A

Type of diabetes that develops during pregnancy. 2% out of 10 pregnancies.

Diet control/or insulin may be necessary to control blood sugars.

Approximately 30% of clients who develop gestational diabetes usually develop type 2 diabetes within 10-15 years.

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24
Q

Glycemic Goal of Treatment

A

Hemoglobin A1C is the lab value used to determine an index of controlled blood sugars from 2-3 months ago
The goal is less than 7%

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25
A1C Less than 5.7
Normal
26
A1C Between 5.7 and 6.4
Prediabetic
27
A1C above 6.5
Type 2 Diabetic
28
Onset (Insulin)
when insulin first begin to act in the body.
29
Peak (Insulin)
Insulin at its highest point
30
Duration (Insulin)
The length of time the insulin remains in effect
31
What is a rapid acting insulin?
Lispro
32
Lispro Onset, Peak, and Duration
Onset-15-30 minutes Peak- 0.5-2.5 hours Duration: 3 – 6 hours.
33
What is a short acting insulin (regular)?
Humalog
34
Humalog Onset, Peak, and Duration
Onset: 0.5-1 hr. Peak: 1- 5 hours Duration: 6 – 10 hours.
35
What is an Intermediate Acting Insulin?
NPH Insulin
36
NPH Insulin Onset, Peak, and Duration
Onset 1-2 hours Peak : 6 to 14 hours Duration: 16 to 24 hours.
37
What is a long acting insulin?
Lantus or Levemir
38
Lantus & Levemir Onset, Peak, and Duration
Onset: 70 minutes Peak: none Duration.18-24 hours
39
What is insulin resistance?
develop antibodies against insulin in the body.
40
Insulin drug precautions:
renal or hepatic impairment | Pregnancy
41
Basal Bolus Insulin Therapy
Mimics the healthy pancreas. delivers long acting insulin constantly to keep the blood glucose Steady. Allows for short acting insulin bolus to be delivered when the blood glucose elevates.
42
Meal Bolus
to compensate for increased carbohydrates at each meal.
43
Correction Boluses
when blood glucose levels are high and need to be brought down to a normal range
44
Supplies needed to administer insulin:
``` Insulin (Verify) Syringe Alcohol wipe Disposable gloves Sharps container ```
45
Oral Hypoglycemics Action
Stimulate insulin release from pancreatic beta cells; decrease insulin resistance
46
Oral Hypoglycemics Uses
``` Monotherapy versus combination therapy Six classes Biguanide Alpha-glucosidase inhibitors Meglitinides Thiazolidinediones Incretins ```
47
Biguanides
Class of medications that treat Type 2 Diabetes
48
Metformin
In the Biguanides class Oral drug used for diabetic control of blood sugar. Decreases glucose production by the liver. Newly diagnosed diabetics type 2
49
When not to take metformin (Contraindicated)
If you have renal disease. As it is excreted by the kidneys. Abdominal bloating, nausea, and or diarrhea
50
Adverse Effects of Metformin
Abdominal bloating Nausea cramping Reduced vitamin 12 Metallic taste
51
Glinides (ie. Prandin)
Class of drugs that treat Type 2 Diabetes Stimulate the liver to be sensitized to circulating insulin levels, and hepatic glucose production. In type 2 diabetes the liver may not detect levels of glucose in the blood, and may release glucose into the blood stream. Prandin ( repaglinide)
52
Thiazolidinediones (Glitazones) (ie Pioglitazone(Actos) | )
Insulin - sensitizing drugs. Decrease insulin resistance by enhancing the sensitivity of insulin receptors. Stimulate glucose uptake and storage. Inhibit glucose production in the liver.
53
When not to take Thiazolidinediones
Heart failure/water retention
54
A- glucosidase inhibitors (ie precose)
Treat Type 2 Diabetes Lower blood sugar by delaying the digestion of carbohydrates in the intestine. Glucose absorption is delayed. Used in combination with other oral hypoglycemic. Abdominal discomfort, diarrhea
55
Do not take A- glucosidase inhibitors if:
IBS/Malabsorption syndrome
56
DPP-IV Inhibitor
Januvia ( sitagliptin)- Glucose absorption in the intestine is delayed. Increases beta cell production of insulin. Suppresses glucagon production in the liver. Must be taken with food. High incidence of abdominal discomfort
57
What is a Amylin Agonists Pramlintide SQ injection?
Used when glucose control fails with insulin alone. Slows gastric emptying Suppresses glucagon secretion Increases satiety( feeling of having eaten enough) Incretin Mimetic: (Trulicity) Failed glucose control with oral antidiabetics. Enhances glucose-dependent insulin secretion. Suppresses glucagon secretion.
58
Sodium glucose Cotransorter Inhibitor( SGLT2 Inhibitor)
Prevents reabsorption of glucose in the tubule of the kidney. causing glycosuria. Decreasing glucose in the blood stream. Invokana
59
Glucose Elevating Drug
Glucagon IM injection for hypoglycemia. Oral tablet forms of glucose that dissolve. IV glucose. Can be administered in the hospital
60
Teaching Strategies
Adequate balanced nutrition with adherence to diet. Keep appointment with MD. Maintain target goals for HGAIC less than 7%. Understand signs an symptomsd of hypoglycemia Hyperglycemia. Notify MD when illness occurs so meds can be adjusted.

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