diabetes Flashcards
combo insulin therapy
1 to 2 injections short or rapid-acting mixed with intermediate insulin
Mealtime and basal coverage without having to give 2 separate injections
Basal Bolus plan for insulin
most closely mimics normal insulin production (multiple injections with self-monitoring), rapid and SA before meals and intermediate or long-acting insulin once or twice a day
inhaled insulin
onset, peak, and duratino
onset 12-15 minutes
with a peak at 60 minutes
Duration 2.5-3 hr
long-acting insulin
onset, peak, duration, when it administers
over 24 hours steady and continuous release
onset 0.8-4 hr with lack peak
Duration 16-24 hr
intermmediate acting
onset, duration, peak
onset 1.5 - 4 hr
the peak between 4-12 hr
Duration 12-18 hr
Short-acting insulin
onset, peak, duration, and when to take it
30-60 minutes onset
peak 2-5 hr
Duration 5-8 hours
In relation to meals within 30-45 minutes of meal
rapid-acting insulin
onset, peak, duration, when to take it
closely mimic insulin in relation to meals
onset 10-30 minutes
peak 30 min- 3 hours
Duration 3-5 hours
In relation to meals within 15 minutes of a meal
Types of insulin (5 types)
Rapid-acting short-acting intermediate-acting long-acting inhaled insulin
barriers to effective diabetes management
Barriers: feeling of inadequacy about own ability, unwillingness to make behavioral changes, ineffective coping skills, and cognitive deficits
home management of diabetes
nutritional therapy exercise glucose monitoring hygiene education
Lifestyle choices associated with diabetes
Lack exercise/Sedentary lifestyle
Obesity/excess weight
Improper nutrition
Functions of A1C, what it is, and normal ranges
Reflects average blood sugar level for the past 2-3 months
Percentage of hemoglobin proteins in blood coated with sugar, glycosylated hemoglobin
An increase in A1C reflects elevated blood glucose
Normal range 5.7% and lower
importance if cheeking feet
Check feet ➡ loss of sensation ➡ diabetic foot ulcers ➡ possible amputation
High risk for foot ulceration and lower extremity amputations
What are the 2 conditions primarily related to death related to diabetes?
heart disease and stroke
sensory vs. autonomic neuropathy
Sensory neuropathy: distal symmetric polyneuropathy afters hands and/or feet bilaterally (loss of sensation, abnormal sens, pain, or paresthesias)
Autonomic neuropathy: can affect nearly all body systems and lead to hypoglycemia unawareness (bowel incontinence, diarrhea, and urinary retention)
retinopathy (non proliferative vs proliferative)
Nonproliferative Retinopathy: most common parietal occlusion of small blood vessel in the retina causes microaneurysms to develop in capillary walls
Leak fluid ➡ retinal edema and hard exudate or intraretinal hemorrhages
Proliferative retinopathy: server and involves the retina and vitreous, retinal capillaries occluded and body compensates by forming new blood vessels to supply retina without blood
New vessels fragile and hemorrhage easily, light prevented from reaching retina as vessela breaks and bleed into vitreous cavity
Retinal detachment possible
microvascular complications (what happens and types)
result from thickening of the vessel membranes in capillaries and arterioles in response to conditions of hyperglycemia ➡ retinopathy, nephropathy, and neuropathy
microvascular complications (what happens)
disease of large and medium sized blood vessels that occur with greater frequency ➡ CVD and peripheral vascular disease
Long term effects of diabetes: Angiopathy (what is it and causes)
damage to blood vessels
High glucose concentrations (chronic hyperglycemia)
preventing hypoglycemia
take prescribed dose of med at proper time, accurately administer insulin, non insulin, injectables, OA, ingest al recommended foods at proper time, provide adequate food intake needed for calories or exercise, be able to recognize and know symptoms and treat them immediately, carry simple carbohydrates, educate family and caregiver about symptoms and treatment, check blood glucose as ordered, wear medic alert identification
preventing hyperglycemia
take prescribed dose of medication at proper time, accurately administer insulin, non insulin, injectables, OA, maintain diet, adhere to sick-day rules when ill, check blood for glucose as ordered, wear diabetic identification
hypoglycemia treatment
Drink or eat 15g of quick acting carbohydrates (4-6 oz regular soda, 8-10 lifesavers, 1 tbsp honey, 4 tsp jelly, 4-6 oz orange juice, commercial dextrose products)
Wait 15 min and check glucose again
If blood glucose is still 70 have patient repeat treatment of 15g carbohydrates
Once level is table the ext meals is more than 1 hr away give patient additional food of longer acting combo of carb plus protein or fat
Immedicalt notify health care provider or emergency services if patient outside hospital of symptoms do not subside after two or three administration of quick acting carbs
If patient becomes unconscious: subcutaneous or IM injec of 1mg glucagon, IV administration of 25-50 ml 50% glucose
hypoglycemia causes
alcohol intake without food, too little food (delyade, omitted, inadequate intake), too much diabetic meds, too much exercise without adequate food intake, diabete medication or food taken at wrong time, loss of weight without change in med, use of beta-adrenergic blockers which may interfere with recognition of symptoms
hypoglycemia manifestations
lose blood glucose (,70 mg/dL), cold clammy skin, numbness of fingers, toes, and mouth, rapid heartbeat, emotional changes, headache, nervousness, tremors, faintness, dizziness, unsteady gait, slurred speech, hunger, changes in vision, seizures, coma
possible unresponsiveness, jittery, and hungry
