Diabetes Flashcards
______ is made from the alpha cells (counterregulatory hormone)
glucagon
____ is made by the beta cells
insulin
insulin is not needed for the ______ or ______
brain or liver
Destruction of beta cells by the immune system (80-90% of cells destroyed)
type 1 DM
what are the 3 P’s?
o Polyuria
o Polydipsia
o Polyphagia
Insulin is present but there is cellular resistance to it
type 2 DM
what are risk factors for type 2 DM?
Obesity is a major risk factor
o Also, family history, HTN, sedentary lifestyle
o Metabolic syndrome
what is metabolic syndrome?
Elevated LDL’s
Blood pressure
The placenta blocks the action of the mother’s insulin
gestational diabetes
in gestational diabetes, mother may need up to ____ the amount of insulin by the third trimester
3 times
babies from mother with gestational DM are usually delievered by? why?
-by C-section due to the babies’ weight
-Baby puts on extra weight due to the extra sugar from the mom being given to the baby
diabetes insipidus is caused by?
o Brain tumors
o Infections
o CBA’s
o Pituitary surgery
o Renal or organ failure
*ADH insufficiency (produced by the hypothalamus)
o Hypernatremia!
Why do we change injection sites of insulin?
to prevent lipodystrophy
* Tissues become hardened
* Medication absorption is affected/hindered
what are some rapid acting insulins?
- lispro (Humalog)
- aspart (Novolog)
- glulisine (Apridra)
what is a short-acting insulin example?
- Regular (Humulin R, Novolin R)
what is an intermediate acting insulin example?
- NPH (Humulin-N, Novolin N
what are some long-acting insulin example?
- glargine (Lantus/Toujeo)
- detemir (Levemir)
what is the Somogyi Effect
hypoglycemia during late evening
insulin causes counter-regulatory response
hyperglycemia in early morning
what is the Dawn Phenomenon
Abnormal early morning increase in blood glucose
Surge of hormones early morning as bedtime insulin is wearing off
Results in increased fasting glucose
what are some other treatments for DM other than insulin and meds?
Stem cell treatments
Islet cell transplants
Gene therapy (beta cells with interleukin 10)
Pancreas transplants
what is considered hypoglycemia?
<70
what are s/sx of hypoglycemia?
Confusion
Irritability
Diaphoresis
Tremors
Hunger
Rapid pulse
Hypotension
Sweating
Anxiety
Weakness
Visual disturbances
some long term complications of hypoglycemia:
Hypertension
Hyperlipidemia
Blindness
End-stage kidney disease
Amputations
Neuropathy
Macrovascular
macrovascular complications from hypoglycemia?
- ATH
- CAD
- HTN
- Stroke
- PVD
microvascular complications from hypoglycemia?
- Diabetic retinopathy
- Diabetic nephropathy
- Diabetic neuropathy
o Foot ulcers/amputations - Mood alterations
- Infection
how many times a day should a patient check their blood sugar?
3-4 times
what electrolyte imbalance would you exspect from a patient with HHNKS or DKA?
potassium
what are ketones?
a by-product of fat metabolism
-commonly seen in starvation
what does insulin do?
promotes glucose transport from the bloodstream to the cell
what are some conterregulatory hormones to insulin?
glucagon
epinephrine
growth hormone
cortisol
what insulins should not be mixed with othrs?
insulin glargine (lantus)
insulin detemir (levemir)
what BS level do the kidneys start to pour glucose out in the urine?
180
what to do when a diabetic pt is going into surgery?
- stop oral diabetic pills
- stop sq insulin
- dextrose may be needed (NPO)
not DC of metformin can cause what?
lactic acidosis
when a pt is unconscious how should you treat?
im injection of glucagon
admin D50
what causes HHNKS?
dehydration secondary to an illness in a type 2 diabetic
what causes DKA?
lack of insulin and ketosis
how do we treat HHNKS?
hydration
insulin
correct electrolyte imbalances
how do we treat DKA?
airway managment
fluid replacment
insulin replacment
elcetrolyte replacment
sodium bicarb?
what are the sick day guidelines?
-increase frequency of BS checks
-check urine for ketones
-drink plenty of fluids
-watch for s/sx of dehydration
