Diabetes Flashcards
What are the most common forms of diabetes?
Type 1
Type 2
Gestational diabetes
Diabetes is always chronic. T or F
False
Some cases are situational and can be reversed
What can cause hyperglycemia?
Genetic disorders
Pancreatic diseases
Endocrine disorders
Medications
Infections
Immune system disorders
How is diabetes diagnosed?
When the patient has the 3 P’s, unexplained weight loss and a random or glucose tolerance test blood sugar of 200+ or fasting blood test of 126+
What are the 3 P’s of diabetes?
The common signs and symptoms of diabetes:
Polydipsia
Polyuria
Polyphagia
What is polydipsia?
excessive thirst
What is polyuria?
excessive urination
What ais polyphagia?
excessive hunger
What are the characteristics of type 1 diabetes?
Beta cells in the islets of Langerhans in the pancreas are destroyed. The body can no longer produce insulin
How is type 1 diabetes usually treated?
chronic insulin therapy through subcutaneous shots or IV pump.
What are the characteristics of type 2 diabetes?
The body becomes resistant to insulin or can’t produce enough insulin to meet body demands.
Some beta cells still have function, so some insulin is produced.
How is type 2 diabetes usually treated?
Regular exercise and diet modifications are non invasive ways to treat.
Some may take PO or subq meds or insulin
What are conditions or behaviors associated with type 2 diabetes?
Obesity
Inactivity
Genetics
When does gestational diabetes usually resolve?
Postpartum with weight loss
What are risk factors for gestational diabetes?
Obesity prior to pregnancy
How is gestational diabetes usually treated?
Diet modifications
Exercise
Sometimes subq insulin shots
Sometimes PO metformin and glyburide
What are s/s of hyperglycemia?
3 P’s of diabetes
Nausea
Fatigue
Blurred vision
What are s/s of hypOglycemia?
blood sugar < 70
Pallor
Tremors
Diaphoresis
Palpitations
Hunger
Visual disturbances
Weakness
Paresthesia
Confusion
Agitation
Coma
Death
What are the s/s diabetic ketoacidosis?
Ketones in urine
Increased RR
Fruity breath
Severe DKA blood sugar 300+
What are the s/s of hyperglycemic-hyperosmolar state?
Blood sugar > 600
Little to no ketosis
Significant dehydration
What type of diabetes more commonly gets HHS?
Type 2 diabetes
What are acute complications of diabetes?
hyper/hypoglycemia
DKA
HHS
What are macrovascular complications of diabetes?
CAD
CVA
PVD
What are microvascular complications of diabetes?
retinopathy
neuropathy
nephropathy
What are chronic complications of diabetes?
micro/macrovascular complications
infections
What are pregnant clients with type 1 diabetes at risk for?
Infant mortality
Congenital anomalies
What are pregnant clients with gestational diabetes at risk for?
big birthweight
hypoglycemia during pregnancy
hypertension associated disorders
What will happen if hyperglycemia is untreated in pregnancy?
miscarriage
neonatal mortality
What are the risk factors for diabetes?
Family hx of diabetes
African, Hispanic, Native, and Asian Americans and Pacific Islanders are at higher risk
> 45 years old
pmhx of impaired fasting glucose / glucose tolerance
HTN 140/90 +
HDL < 35
Triglyceride 250+
pmhx of gestational diabetes
Deliver infant > 9 lbs
What is glycosylated hemoglobin?
Shows the average glucose level of 2-3 months by measuring the glucose bound to hemoglobin.
What is the life span of a red blood cell?
120 days
What is the threshold for HbA1c to diagnose diabetes?
7% + for nonpregnant adults
What are the types of insulin?
Rapid
Short-acting
Intermediate
Long-acting
What are rapid insulins?
aspart
lispro
glulisine
What are short-acting insulins?
humulin
actrapid
novolin
Which insulins can be mixed?
intermediate (NPH) and short-acting (regular)
What type of insulin can be given IV?
short-acting insulin
What is considered hypoglycemia?
< 70
How do you treat hypoglycemia?
15 g glucose, check blood sugar 15 min later
What position should you put the patient in when giving glucagon injection?
On their side
what is the Dawn phenomenon?
Normal blood sugar at night and increased blood sugar in the morning d/t increase cortisol in morning
What is the Somogyi effect?
Decreased blood sugar during the night d/t large bolus of insulin before bedtime
What causes Kussmaul’s respirations?
ketone production
What is the first priority for DKA treatment?
IV hydration (NS)
What is used after first-line DKA treatment?
Insulin pump THEN D5W
When should we give D5W to patients with DKA?
When blood sugar is 200 or below
What is first priority treatment for HHNS patients?
IV hydration
What is used after first-line HHNS treatment?
electrolyte balance THEN insulin
What is the cloudy insulin?
intermediate (NPH)
What is the clear insulin?
regular Humulin
How many units should you prime the insulin pen with?
1 unit
Is fluid retained or lost in HHNS?
Lost
Are electrolytes retained or lost in HHNS?
Lost
What electrolytes are lost in HHNS?
Ca
Cl
Mg
Ph
K
Na
What are older clients at risk for when on sulfonylureas?
hypoglycemia
What is the S triangle?
Sickness, Steroids, and Stress can cause hyperglycemia
What is the sick day rule?
GIVE insulin when a patient with diabetes is sick
What are the classes of PO medications for diabetes?
biguanide
sulfonylureas
What causes polyuria in DM?
High glucose causes body to retain water in blood (increased osmolality) and kidneys try to expel the water
What are late signs of hypoglycemia?
shakiness, seizure, coma
