Diabetes

Question 1

Exocrine glands

Answer 1

In pancreas

Has ducts

Digestive enzymes: amylase & lipase

Question 2

What does the liver do in concern with diabetes ?

Answer 2

1. Gluconeogenesis (new)
2. Glucogenolysis (breaking down)
3. Storing glucagon

Question 3

Type one diabetes versus type two

Answer 3

Type one: not enough insulin
IDDM: insulin dependent diabetes mellitus
(On insulin for life)
Type two: insulin resistance
NIDDM: non-insulin dependent diabetes mellitus

Question 4

Humalog (lispro)

Onset
Peak
Duration

Answer 4

0.25
1 hour
6-8 hours

Question 5

Regular
Humulin R

Onset
Peak
Duration

Answer 5

30-60 min
2-3 hours
8-12

Question 6

Endocrine glands

Answer 6

In Pancreas

DUCTLESS –> directly into blood

Question 7

NPH
HUMULIN N

ONSET
PEAK
DURATION

Answer 7

1-1.5 hours
6-8 hours
24 hour

Question 8

What is it important to know the peaks of the insulins?

Answer 8

The peaks are the times they’re most likely to have a hypoglycemic reaction –> time for snacks *

Question 9

Hyperglycemia side effects

Answer 9

Poly uria (increased urination) 
Polydipsia (thirsty) 
Polyphagia  (hungry)
Weight loss 
Fatigue 
Dry, itchy skin 
Poor wound healing 
Visual changes 
Change of LOC

Question 10

Hypoglycemia side effects

Answer 10

Hunger 
Pallor 
Nausea 
Tachycardia 
Fatigue 
Numbness 
Palpitations 
Confusion 
Fainting 
Change of LOC

Question 11

Four medications that increase BS

Answer 11

Diuretics
Glucocorticoids
Beta blockers
Sympathomimetic

Question 12

Teaching points for a patient on insulin

Answer 12

Use U-100 syringes with U-100 insulin 
Teach s/s of increase or decreased BS
Aware of meds that alter BS
teach patient how to test BS
change activity/diet/stress can change insulin requirements 
Assess knowledge and management 
Store opened vials at room temp. And stored ones in the fridge 
Rotate sites 
Medic alert bracelet 
Give at same time 
Diet- weight loss 
Exercise 
Keep glucose/hard candy handy 
Mixing insulins 
Assess sights

Question 13

MOA of sulfonylureas (glyburide)
-diabeta
-gipizide
Micronase

Answer 13

Indirectly enhances the production of insulin and stimulates the release from beta cells

• decreases hepatic glycogenolysis/gluconeogenesis
• –> stimulates pancreas to produce insulin

Question 14

Side effects of the sulfonylureas (glyburide)

Answer 14

Hypoglycemia & metallic taste

Question 15

Biguanide antihyperglycemics
(Glucophage)
(Metformin)

MOA

Answer 15

Works in liver to decrease glyconeogenolysis

• decreases intestinal absorption of glucose
• helps get glucose across the cell

Question 16

Side effects/teaching for biguanide antihyperglycemics

Answer 16

Diarrhea, GI: n/v, abdominal discomfort

Teach for hypoglycemia effects

1. reacts with contrast medium
   - check BUN/Creat (before & after)
2. Contraindicated in renal/hepatic disease
3. Synergistic effects with insulin/sulfonylureas