Diabetes

Question 1

HYPOglycemia Management Prioritization

Answer 1

• Watch for hypoglycemia Sxs when giving insulin for treatment!!!
  
  • If pt is “cool and clammy” ⇒ pt needs some candy (fast-acting carbs)
• Hypoglycemia Sxs:
  
  • Mild-Moderate: Shakiness, sweating, hunger, irritability, dizziness, or confusion
  • Severe: Seizures, unconsciousness, or inability to self-treat

Question 2

Laboratory Values
Hemoglobin A1C (HbA1c):

Answer 2

• HbA1c Goal for Diabetics: < 7%
• HbA1c Norm: 4 - 5.7%
• HbA1c Pre-Diabetic: 5.7 - 6.4%
• HbA1c Diabetic: > 6.5%

Question 3

Laboratory Values
Blood glucose (SMBG):

Answer 3

• Before Eating Goal for Diabetics: 70 - 130 mg/dL
• At Night Goal for Diabetics: 100 - 140 mg/dL

Question 4

Diabetes Long-Term Complications, Screenings, & Treatments for…

Answer 4

• Microvascular Diseases:
  
  • HTN
  • Nephropathy
  • Retinopathy
  • Neuropathy
  • Dyslipidemias
• Macrovascular Diseases:
  
  • Cardiovascular diseases: atherosclerosis, MI, etc.
  • CVA/Stroke

Question 5

Diabetes Treatment Goals

Answer 5

• glycemic control and monitoring with…
  
  • Diet modifications
    
    • Avoiding highly dense carbohydrates
    • Controlled carbohydrate diet
  • Physical activity
  • Drug therapy maintenance & adherence

Question 6

T1DM Patient Education Goals & Working Together to Make Comprehensive Plan for…

Answer 6

• Goals:
  
  • Prevent long-term complications
  • Control blood glucose lvls
  • Controlling BP and blood lipids
• Work together to make comprehensive plan for…
  
  • Diet: avoid highly dense carbohydrate foods ⇒ controlled carbohydrate diet
  • Self-monitoring of blood glucose and replacing insulin if needed
    
    • Goal lab values:
    • SMBG Before Eating Goal for Diabetics: 70 - 130 mg/dL
    • SMBG At Night Goal for Diabetics: 100 - 140 mg/dL
  • Exercise
  • Insulin replacement
  • Treatment adherence

Question 7

Dawn Phenomenon

Answer 7

• What: body naturally releases hormones that secretes glucose in bloodstream ⇒ resulting in high blood sugar in the morning (mainly an ↑ at 3am)
• BUT had normal blood sugar lvls overnight
• “Dawn is rising with glucose lvls”

Question 8

Somogyi Effect

Answer 8

• What: body’s SMBG drops at night (nocturnal HYPOglycemia) ⇒ body releases hormones that secretes glucose to compensate (rebound effect) ⇒ results in morning HYPERglycemia
• HAD extremely ↓ SMBG overnight (HYPOglycemic)