Diabetes Flashcards
Type 1 diabetes characteristics
Onset < 20 years old & abrupt
Primary white
Underweight
Usually NO insulin
Type 1 diabetes signs
Polyuria (bed wetting)
Polydipsia
Polyphagia
Fatigue
Weight loss
Blurred vision
6 Therapeutic managements for type1
1) insulin therapy
2) Daily monitoring of blood glucose
- monitor A1C
3) - Meals & snacks must be eaten according to peak insulin action
- ↓ sweets and carbohydrates, ↑ dietary fiber
4) Exercise Encouraged
- extra snacks if exercise is prolonged
- Decrease insulin dose during periods of strenuous activity
5) monitor 4 Hypo/Hyperglycemia
- Somogyi effect
6) illness management
- Initial hydration should be with 0.9% saline solution.
Somogyi effect
happens when blood sugar levels fall overnight, triggering a rebound effect that causes them to rise high in the morning
when you take insulin before bed and wake up with high blood sugar levels
A person who takes insulin doesn’t eat a regular bedtime snack, and the person’s blood sugar level drops during the night. The person’s body responds to the low blood sugar by releasing hormones that raise the blood sugar level.
Scar tissue prevention
- Rotate injection sites
- Areas with scar tissue should not be used for 3 months
Steps for Injection with an Insulin Pen
- Check the expiration date and that the insulin is the correct type and strength
- Wash hands thoroughly
- Nurses should also put on gloves
- Remove the pen cap, and clean the top (rubber seal) with an alcohol swab.
- Remove the cover from the outer shield of a new needle, and firmly attach the needle to the insulin pen by twisting it.
- Remove the needle cap
- Prime the pen with 2 units of insulin.
- Turn the dial to the correct dose
- Clean the chosen injection site with alcohol, and allow the area to dry.
- Insert the needle straight into the skin. Push the button on the insulin pen until all insulin is injected.
- Count slowly to 10.
- Remove the needle from the skin.
- Check the site to see if insulin leaks out.
Criteria for diagnosis diabetes
TWO SEPARATE OCCASIONS:
1) fasting glucose > 125
2) 2hr glucose > 200 after 75g load
- glucose tolerance test
3) HbA1C > 6.5%
HYPOglycemia
Sweating Pollar Irritability Hunger Lack of coordination Sleepiness
HYPERglycemia
Dry mouth Increased thirst **Weakness Headache Blurred vision Frequent urination
Calculating an Insulin Bolus Dose for Carbohydrate (Meal Bolus)
- Use the Insulin to Carbohydrate Ratio (ICR)
Gram of carbs divided by carb ratio
=
Carb bolus
(Correction Bolus) considerations if rapid acting insulin is to be given
If rapid-acting insulin is given after a meal, check the blood glucose before the meal.
Use that blood glucose number to calculate the correction dose, and add to the meal dose. THIS COMBINED DOSE JS ROUNDED UP IR DOWN
Calculating (Correction Bolus)
Blood glucose - target= amount to correct
Amount to correct divided by correction factor = correction bolus
Insulin pump
- pre-programmed to deliver insulin in one of two ways:
- Small, continuous insulin doses (basal insulin).
- Surges of insulin near mealtimes (bolus insulin).
- While using pump patients still need to check their blood sugar levels.
- least FOUR times a day. Or they may use a continuous glucose monitor
Possible cons of using an insulin pump can include:
- Inability to hide the tubing or pump with non-patch styles.
- Higher cost than injections.
- Pumps breaking or tubing becoming disconnected
Continuous Glucose Monitoring (CGM)
Sensor has a thin, flexible filament that sits just under the skin and automatically measures glucose EVERY MINUTE
