Diabetes Flashcards
Autoimmune & insulin dependent
Type I DM
Insulin resistance w/ insulin deficiency
Type II DM
Glucose intolerance w/ pregnancy
Gestational diabetes
Polyuria
excess urine production and frequency
Polyphagia
excessive hunger and eating
Polydipsia
excessive thirst
Metabolic syndrome (Syndrome X)
obesity, sedentary lifestyle, HTN, elevated lipid & triglyceride levels, CV disease
Normal range of blood glucose values
70-110
Triangle of diabetic management
exercise, diet, and medication
Rotating insulin injection sites prevents
lipodystrophy
Complications of DM
cardiovascular & cerebrovascular disease, diabetic retinopathy, diabetic neuropathy, diabetic nephropathy, sexual dysfunction
Subq injections - angle and sites
Inject at a 45- or 90-degree angle into fatty tissue overlying the triceps muscle, abdomen, upper back, or thighs
Lispro, aspart, & glulisine
Insulin
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
Regular- Humulin R & Novolin R
Insulin
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
Isophane (NPH)
Insulin
Intermediate acting
Onset 1-2 hr
Peak 4-8 hr
Duration 10-18 hr
Inject subq, mix (cloudy)
Do not mix w/glargine
Determir (Levemir)
Insulin
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
Glargine (Lantus)
Insulin
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
Patient education points for insulin
-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
What oral hypoglycemic must be discontinued 48 hours prior to any contrast studies due to increased risk of kidney damage?
Glucophage (metformin)
Proper foot care for diabetic patients
-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
Do not exercise within 1 hr or near time of peak insulin action.
True or False
True
What is the sick-day rule for diabetics?
Notify provider if ill due to metabolism changes
-skin is cool, clammy, sweaty
-anxious, nervous, irritable, confused
-weakness, blurred vision, hunger, tachy
-glucose <70 mg/dL
-negative for ketones
hypoglycemia
-skin is warm, dry, vasodilated
-dehydration
-Kussmaul respirations, fruity breath
-N/V, orthostatic hypotension, poor skin turgor
-glucose >250 mg/dL
-positive for ketones
hyperglycemia
Hyperglycemia in the morning due to the nighttime release of adrenal hormones (growth hormones)
Dawn phenomenon
Nocturnal hypoglycemia followed by hyperglycemia in the morning. Corrected with bedtime snack.
Somogyi phenomenon
