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Med Surg Exam 1 > Diabetes > Flashcards

Diabetes Flashcards

1
Q

Diabetes most prevalent in what groups

A

African americans

Alaska native

Hispanic

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2
Q

Normal glucose

A

74-106mg/dL

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3
Q

Type 1vs 1b

A

1 is autoimmune

1b is idiopathic

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4
Q

LADA

A

Latent autoimmune diabetes in adults

strongly inherited, over 35 years old.

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5
Q

Type 2 DM

A 
Insulin resistance
3 Os 
-Older
-Overweight
-Obese

Decrease in insulin production

Insulin receptors unresponsive, insufficient in # or both

Altered production of adipokines

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6
Q

Metabolic syndrome

A 
Abdominal Obesity
Hyperglycemia
Hypertension
High triglycerides
Low HDL
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7
Q

Diagnostic tests for DM

A

A1C 6.5% or higher

Fasting plasma glucose at 126mg/dL orhigher on 2 separate occasions

2 hour OGTT (Oral Glucose Tolerance Test) 200mg/dL or higher

Random plasma glucose 200+

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8
Q

DM2 symptoms

A

Increased thirst

Increased urination

Fatigue

Blurry vision

Slow to heal

Inc. hunger

Numbness in extremities

Weight loss

Frequent yeast infections

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9
Q

Rapid acting insulin

A

Lispro (Humalog)

Aspart (NovoLog)

Glulisine (Apidra)

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10
Q

Rapid acting insulin pharmacokinetics

A

Onset: 15 min
Peak 60-90min
Duration: 3-4 hr

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11
Q

Short acting insulin

A

Regular insulin

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12
Q

Short acting insulin pharmacokinetics

A

onset: 30min-1hr
Peak 2-3 hr
Duration: 3-6hr

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13
Q

Intermediate acting insulin

A

NPH or Lente

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14
Q

Intermediate acting insulin pharmacokinetics

A

Onset: 2-4hr
Peak: 4-10hr
Duration: 10-16hr

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15
Q

Long acting insulin

A

Glargine (Lantus)

Detemir (Levemir)

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16
Q

Long acting insulin pharmacokinetics

A

Onset: 1-2hr
Peak: none-flat
Duration: 24+hours

17
Q

Mealtime (prandial) insulin

A

Rapid acting: Lispro (humalog), Aspart (NovoLog), glulisine (Apidra)

Short acting: Regular insulin

18
Q

Which insulin do you not mix with other insulins

A

Long acting: Glargine (Lantus), detemir (Levemir), degludec (Tresiba)

19
Q

Combination therapy

A

Intermediate (NPH) in same syringe as short or rapid.

harder to control

20
Q

fastest to slowest insulin absorption sites

A

Abdomen
Arm
Thigh
Butt

21
Q

When to recap insulin syringe

A

NEVER

22
Q

Dawn phenomenon

A

Increase in cortisol and GH lead to lower insulin

This leads to higher blood sugar

23
Q

Somogyi effect

A

Go hypoglycemic overnight

Varies individually

24
Q

How to differentiate dawn from somogyi

A

Check blood sugar in middle of night- Normal or high=dawn

Low=Somoygi

25
Q

How to avoid exercise induced hypoglycemia

A

Reduce insulin dose on days of exercise

Consume carbs after exercise

Avoid exercise late at night

Protein/complex carbs pre workout or after period of hypoglycemia and simple sugar ingestion.

26
Q

Hypoglycemia manifestations

A

Cool/clammy

Diaphoretic (sweating)

Neuro/confusion

Fatigue-> unconsciousness

27
Q

What to give hypoglycemic people

A

Unconscious: D50, glucagon

Conscious: Juice, candy, glucose tab (when more alert eat protein and complex carbs)

28
Q

DKA

A

Diabetic Ketoacidosis

Mostly seen in type 1
Glucose 300+
Manifestations:

Vomiting
Stomach pain
Tachycardia
Dry mouth
Fruity breath
  • Deep rapid breathing (Kussmaul, compensation for metabolic acidosis)
  • Urine Ketones
29
Q

How to manage DKA

A

IV fluids

Insulin gtt

electrolyte replacement

fix triggering factor

30
Q

HHNS

A

Hyperosmolar Hyperglycemic Nonketotic Syndrome

Caused mostly by illness or infection

Seen in mostly type 2

You make insulin, but not enough to stop hyperglycemia

Extremely high glucose levels (600+)–>Hyperosmotic (super concentrated blood)—>Water pulled to concentration, dehydrating body

Happens gradually

Presents with: Severe dehydration, Super concentrated blood, neurological changes (dehydration), normal blood pH

How to fix: Insulin and FLUIDS

31
Q

Difference between DKA and HHS

A

HHNS has

  • No metabolic acidosis
  • No Kussmaul
  • No ketones
  • Super high blood glucose
32
Q

How to manage HHNS

A

Get serum and urine labs

Give fluids, electrolytes, and insulin

Med Surg Exam 1 (8 decks)

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