Diabetes

Question 1

What are the signs and symptoms of type 1 diabetes?

Answer 1

• polyuria (⬆️voiding)
• polyphagia (⬆️hunger)
• polydispsia (⬆️ thirst)
• weight loss
• nocturia

Question 2

What is hemoglobin A1C ? Include normal ranges with and without diabetes

Answer 2

Hemoglobin A1C: the average blood glucose level of the last 3 months
Normal range : 6% or less
Goal for diabetes: 6.5-7% above = not well controlled diabetes

Question 3

How to maintain glycemic control while exercising?

Answer 3

• take blood glucose levels before exercising
• take a snack 30/60min of 10-15g of complex carbs and proteins before exercise
• take a snack of simple carbs every 30minutes if exercising for a long period of time

Question 4

What type of Insulin is used in the subcutaneous insulin pump? Give the rationale.

Answer 4

Rapid acting insulin like Lispro (Humalog)
Rationale: rapid acting taken continuously to maintain blood levels in the normal ranges that mimics the pancreas action of insulin in the body.

Question 5

Treatment for type 1 diabetes?

Answer 5

• Intensive insulin regimen or subcut insulin pump
• regular meals and snacks
• exercise (maintain weight for metabolism)

Question 6

Treatment for type 2 diabetes?

Answer 6

• Weight reduction (if obesity present) and maintenance
• physical activity
• healthy diet —> regular meals and snacks (consistent carbs)
• might need oral antihyperglycemics and insulin if lifestyle changes aren’t enough

Question 7

Which type of insulin can be given IV?

How often do you need to monitor the blood glucose?

Answer 7

Humilin R which can sometimes be added to TPN bags

Need to monitor blood glucose q1h

Question 8

What are the Signs and symptoms of hyperglycaemia (high blood glucose levels) ?

Answer 8

• extreme thirst
• dry mouth
• polyuria
• drowsiness
• blood glucose above 14

Question 9

What are the signs and symptoms of hypoglycaemia (low blood glucose)?

Answer 9

• sweating
• trembling
• dizziness
• headache
• hunger
• mood changes
• fatigue
• blurred vision
• paleness
• uncoordinated movement
• altered level of consciousness
• blood glucose levels lower than 4mmol/L

Question 10

How to counteract hypoglycaemia with a conscious person?

Answer 10

• administer 15g of quick acting carbs (dextrose tabs)
• 175 mL of orange juice if not contraindicated

Reassess after 15min:

If blood sugar is above 4mmol/L :
- take normal meal or snack with 15g of carbs and protein

If not : readminister dextrose tabs

Question 11

What insulins can be mixed in the same syringe and in what order?

Answer 11

NPH and regular/rapid acting insulin can be mixed in the same syringe.
- draw Humalog (Rapid acting) & then NPH (clear before cloudy)