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SD- Hospital > Diabetes Lecture > Flashcards

Diabetes Lecture Flashcards

1
Q

90% of DM patients are type….

A

2

(10% type 1)

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2
Q
  1. avoid hypoglycemia
  2. avoid severe hyperglycemia
  3. assess pt education needs and address gaps in knowledge or accesss to resources
A

goals of in patient DM management

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3
Q

glucose levels under ___ are associated with highest incidence of complications (ie arrhythmias, delirium, aspiration events, falls)

A

<70

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4
Q

arrhythmias
delirium
aspiration events
falls

can all be seen with glucose levels….

A

under 70

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5
Q

hypoglycemia is most often seen with…

1.
2.
3.

A
  1. sulfonylureas
  2. sliding scale
  3. intensive insulin therapy (seen in critical care)
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6
Q

for a non critical, hospitalized patient…

pre-meal glucose target=?

A

<140

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7
Q

For non critical, hospitalized patients…

Fasting glucose should be no lower than….

A

90

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8
Q

For non critical, hospitalized patients….

average random glucose should be..?

A

<180

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9
Q

What should hospitalized pts do about their sulfonylureas?

A

Hold them! for any chance of poor PO intake

(these can cause hypoglycemia)

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10
Q

How should you tx hypoglycemia in-patient?

A

prevent it!!

*for asymptomatic or mildly symptomatic who can take PO safely:

  • glucose tabs/gel
  • juice or milk
  • snack or full meal
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11
Q

one amp of D50
follow this with PO intake if safe

A

used to tx hypoglycemia

(prevents recurrent hypoglycemia)

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12
Q

the ADA and AACE recommend a blood glucose of below what to avoid severe hyperglycemia

A

<180

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13
Q

*increased risk of infection
*volume depletion (dehydration) from osmotic diuresis
*caloric and protein loss

A

associated with hyperglycemia (blood glucose >180)

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14
Q

True or False…

hyperglycemia causes immune system and neutrophil function decrease

(increasing risk of infection)

A

True

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15
Q

True or false…

hyperglycemia causes volume depletion (dehydration) from osmostic diuresis

*causing renal failure and severe electrolyte disturbances

A
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16
Q

______ causes caloric and protein loss, which leads to poor healing/rehabilitation and edema

A

hyperglycemia

17
Q

What type of diet should a diabetic pt be on?

A

ADA

18
Q

Lactic acidosis is associated with radiocontrast studies and what diabetic med?

A

Metformin

19
Q

TZDs are associated with _____ dysfunction

A

ventricular

20
Q

Which insulins are usually used for the sliding scale?

A

Aspart
Lispro

21
Q

for sliding scale…

blood sugar of 200-250

how many units of insulin?

A

1 unit

22
Q

for sliding scale….

blood sugar of 251-300

how many units of insulin are given?

A

2 units

23
Q

for sliding scale…

blood sugar of 301-350

how many units of insulin?

A

3 units

24
Q

for sliding scale….

blood sugar of 351-400

how many units?

A

4 units

25
Q

for sliding scale…

a blood sugar >400

A

call the doctor

26
Q

what 3 types of insulin should hospitalized pts be on?

A

basal insulin
+
scheduled short acting
+
sliding scale

27
Q

Lantus
Detemir

…what type of insulin?

A

basal bolus (long acting)

peak = 12 hours

28
Q

calculate total daily insulin requirements (0.5-1.0 units/kg)

*how do you split this between basal and short acting?

A

50% basal insulin given in 1 dose at night

50% in short acting insulin (divided into 3 doses before 3 meals)

29
Q

ex… if pt weights 100 kg and you give them 0.5 unit.kg

how many units do you give for basal insulin? how many units for short acting?

A

25 units in long acting/basal (lantus)

25 units in short acting (aspart or lispro)…aka ~8 units given TID

30
Q

True or False…

You adjust scheduled insulin to meet the <180 average glucose goal

A

true

31
Q

True or False…

You adjust your long acting insulin using the fasting AM glucose to now lower than 90 goal

A

True

32
Q
  • Insurance
  • Pharmaceutical access
  • Equipment (test strips, glucometer, auto injector, etc)
  • Sustainability (pt self management, facility employee competencies)
A

Educational and logistical barriers

*case managers, discharge planners, social workers help with these

33
Q

Must ensure these pts have steady source of insulin going into their body (even NPO)

*keep the pump going and let them manage themselves if capable

*DKA can settle in fast and have fatal consequences

A

DM type 1

SD- Hospital (10 decks)

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