Diabetes

Question 1

Autoimmune & insulin dependent

Answer 1

Type I DM

Question 2

Insulin resistance w/ insulin deficiency

Answer 2

Type II DM

Question 3

Glucose intolerance w/ pregnancy

Answer 3

Gestational diabetes

Question 4

Polyuria

Answer 4

excess urine production and frequency

Question 5

Polyphagia

Answer 5

excessive hunger and eating

Question 6

Polydipsia

Answer 6

excessive thirst

Question 7

Metabolic syndrome (Syndrome X)

Answer 7

obesity, sedentary lifestyle, HTN, elevated lipid & triglyceride levels, CV disease

Question 8

Normal range of blood glucose values

Answer 8

70-110

Question 9

Triangle of diabetic management

Answer 9

exercise, diet, and medication

Question 10

Rotating insulin injection sites prevents

Answer 10

lipodystrophy

Question 11

Complications of DM

Answer 11

cardiovascular & cerebrovascular disease, diabetic retinopathy, diabetic neuropathy, diabetic nephropathy, sexual dysfunction

Question 12

Subq injections - angle and sites

Answer 12

Inject at a 45- or 90-degree angle into fatty tissue overlying the triceps muscle, abdomen, upper back, or thighs

Question 13

Lispro, aspart, & glulisine

Insulin

Answer 13

Rapid acting
Onset 15 min
Peak 1-2 hr
Duration 3-5 hr
Inject subq within 15 min of meal
Can mix w/NPH, draw lispro first, give immediately

Question 14

Regular- Humulin R & Novolin R

Insulin

Answer 14

Short acting
Onset 30-60min
Peak 2.5 hr
Duration 6-10 hr
Inject subq 30-60 min before meal; IV also
Can mix with NPH; do not mix w/glargine

Question 15

Isophane (NPH)

Insulin

Answer 15

Intermediate acting
Onset 1-2 hr
Peak 4-8 hr
Duration 10-18 hr
Inject subq, mix (cloudy)
Do not mix w/glargine

Question 16

Determir (Levemir)

Insulin

Answer 16

Long acting
Gradual onset
Peak 6-8 hr
Duration up to 24 hr
Inject subq 1/day or 2/day @ same time each day
Do not mix with any other insulin

Question 17

Glargine (Lantus)

Insulin

Answer 17

Long acting
Onset 1-2 hr
No peak
Duration 24 hr
Inject subq 1/day or 2/day @ same time each day
Do not mix with any other insulin

Question 18

Patient education points for insulin

Answer 18

-refrigerate insulin not in use
-may be kept at room temp. for up to 28 days to reduce injection site irritation
-do not freeze
-store prefilled syringes upright to avoid clogging
-roll prefilled syringes

Question 19

What oral hypoglycemic must be discontinued 48 hours prior to any contrast studies due to increased risk of kidney damage?

Answer 19

Glucophage (metformin)

Question 20

Proper foot care for diabetic patients

Answer 20

-inspect feet daily, esp between toes
-wash w/lukewarm water, dry thoroughly
-moisturize feet but not between toes
-clean cotton socks daily
-do not wear same shoes 2 days in a row
-check shoes for foreign objects
-trim nails straight across and smooth with emery board
-do not treat blisters, sores, or infections w/home remedies
-do not smoke or use nicotine products
-do not use very hot or very cold water, check temp with thermometer or wrist
-do not go barefoot
-do not soak feet
- do not cross legs or wear garters/tight stockings; will constrict blood flow

Question 21

Do not exercise within 1 hr or near time of peak insulin action.

True or False

Answer 21

True

Question 22

What is the sick-day rule for diabetics?

Answer 22

Notify provider if ill due to metabolism changes

Question 23

-skin is cool, clammy, sweaty
-anxious, nervous, irritable, confused
-weakness, blurred vision, hunger, tachy
-glucose <70 mg/dL
-negative for ketones

Answer 23

hypoglycemia

Question 24

-skin is warm, dry, vasodilated
-dehydration
-Kussmaul respirations, fruity breath
-N/V, orthostatic hypotension, poor skin turgor
-glucose >250 mg/dL
-positive for ketones

Answer 24

hyperglycemia

Question 25

Hyperglycemia in the morning due to the nighttime release of adrenal hormones (growth hormones)

Answer 25

Dawn phenomenon

Question 26

Nocturnal hypoglycemia followed by hyperglycemia in the morning. Corrected with bedtime snack.

Answer 26

Somogyi phenomenon