Diabetes Flashcards
Types of rapid acting insulin
Aspart (Novolog)
Glulisine (Apidra)
Lispro (Humalog)
Types of short acting insulin
Regular
Types of long acting insulin
Glargine (Lantus)
Detemir (Levemir)
What is the onset time of rapid acting?
5-15 mins
What is the onset time of short acting?
30-60 mins
What is the onset time of NPH?
2-4 hrs
What is the onset time of Glargine (Lantus) and Detemir (Levemir)?
2-4 hrs
What is the peak time of rapid acting?
30-90 mins
What is the peak time of short acting?
2-3 hrs
What is the peak time of NPH?
8hrs
What is the peak time of Glargine (Lantus) and Detemir (Levemir)?
No peak
What is the effective duration time of rapid acting?
Less than 5 hrs
What is the effective duration time of short acting?
6-8 hrs
What is the effective duration time of NPH?
10-16 hrs
What is the effective duration time of long acting insulin?
20-24 hrs
S/S of Type 1 diabetes:
Polyuria Polyphagia (appetite) Polydipsia (thirst) Unexplained weight loss Dehydration Fatigue
S/S of Type 2 diabetes:
Fatigue
Recurrent infections
Prolonged wound healing
Visual changes
What is the targeted HbA1C level for someone with diabetes?
6.5-7%
What are the two type of complications?
Acute
Chronic
What is the an acute complication for Type 1?
DKA
What is the acute complication of Type 2?
HHS
Hyperglycemic Hyperosmolar Syndrome
S/S of HHS
Coma Confusion Convulsions Dry mouth, dry tongue Fever Increased thirst Increased urination (at the beginning of the syndrome) Lethargy Nausea Weakness Weight loss Abdominal distension
What is the treatment for HHS?
Aggressive rehydration
Monitoring and replacement of electrolytes
Correction of hyperglycemia with insulin (addition of glucose to IVF when blood sugar reaches 250)
*Potassium should be corrected (if needed) before insulin
What will hyperglycemia, hypertension, and hyperlipidemia cause when presented together?
Impaired sensation/perception
Nervous system dysfunction
Impaired perfusion
Impaired oxygenation
What is macrovasuclar disease?
Disease of large and medium sized blood vessels
What is microvascular disease?
Specific to diabetes
Result from thickening of vessel membranes in capillaries and arterioles
Microvascular disease is in response to what?
Chronic hyperglycemia
What are the areas most noticeably affected by microvascular disease?
Eyes (retinopathy) (blindness)
Kidneys (nephropathy) (kidney failure)
Skin (dermopathy)
What is critical for preventing or delaying small vessel disease?
Tight glucose control BP management ACE inhibitors (used even when not hypertensive) (prevent nephropathy) Angiotensin II receptor antagonists Yearly screening (eye and urine)
What are characteristics of diabetic neuropathy?
Loss of sensation
Abnormal sensations
Pain
Paresthesias
What can diabetic neuropathy affect in the autonomic nervous system?
Gastroparesis Delayed gastric emptying Cardiovascular abnormalities Sexual function Neurogenic bladder
What are key educational considerations?
Control your glucose, BP, and cholesterol
Early treatment of foot, eye, kidney, and heart problems
No
Smoking
Education about diabetes, nutrition, and exercise
What is a common long term complication of diabetes affecting 50%?
Peripheral neuropathy
Peripheral neuropathy affects what?
Functioning sensory, motor, and autonomic nerve fibers
What is the most common form of peripheral nerve dysfunction and the form most closely associated with ulcer aetiology ?
Sensory neuropathy
What are some chronic complications of diabetes?
Retinopathy Nephropathy Cardiac failure Neuropathy Amputation
What is a main difference between DKA and HHS?
Speed of symptom development
DKA is faster than HHS
In people with Type 1 diabetes, DKA can be precipitated by what?
Infection such as UTI or respiratory
Insulin errors and omissions
MI
Diarrhea and vomiting (Illness)
DKA is a result of what?
And increases the production of what counter-regulatory hormones?
Relative or absolute lack of insulin
Glucagon
Catecholamines
Cortisol
Growth hormone
What are some examples of food that contains 15g?
Apple 1 slice of bread Bran cereals 1/2 cup Cookie, fat free, 2 small Cupcake no frosting Ice cream (light) 1/2 cup Milk 8oz Orange juice 1/2 cup Potato Rice 1/3 cup Saltine crackers (6) Sugar/honey 1 Tsp Yogurt, fat free, with sugar substitute 1 cup
Type of intermediate acting insulin ?
NPH