Diabetes Mellitus Flashcards
What are the main molecules involved in DM and what are their functions, where are they created or stored?
Glucose - cell energy source. stored in the liver as glycogen
Insulin - helps cells take in glucose. secreted by beta cells in islets of Langerhans of the pancreas. Decreases blood sugar.
Glucagon - peptide hormone that induces gluconeogenesis from glycogen. secreted by the pancreas. Increases blood sugar.
What are the main molecules involved in DM and what are their functions, where are they created or stored?
Glucose - cell energy source. stored in the liver as glycogen
Insulin - helps cells take in glucose. secreted by beta cells in islets of Langerhans of the pancreas. Decreases blood sugar.
Glucagon - peptide hormone that induces gluconeogenesis from glycogen. secreted by the pancreas. Increases blood sugar.
What is the pathophysiology of DM type I.
The beta cells in the islets of Langerhans are unable to produce insulin, usually due to genetics or autoimmune processes. The absence of insulin causes high blood sugar. Treatment involves insulin administration.
What are the expected findings of DM Type I?
3Ps, ketonuria, weight loss
What is the pathophysiology of DM Type II?
Cells no longer respond to insulin, resulting in insulin resistance. Blood glucose increases, increasing the risk for complications and metabolic syndrome.
What are the signs and symptoms of hypoglycemia? Treatment interventions?
BS<60mg/dL, diaphoresis, clammy, confusion, lightheadedness, tremors, blurry vision, nausea
Tx: simple carbs (hard candy, fruit juice, crackers, honey) or IV D50
What happens in DKA and what are the symptoms?
Treatment interventions?
Deficient insulin results in cell starvation, which induces the burning of fats and protein for energy. Ketone levels rise and can cause acidosis.
Symptoms include N/V, excessive thirst, hyperglycemia, and Kussmaul respirations (deep rapid breathing). BS>300
Tx: two-bag method of fluid resuscitation and insulin drip
What is a hyperglycemic hyperosmolar syndrome and what are the symptoms? Treatment interventions?
Uncontrolled hyperglycemia without ketone breakdown.
Symptoms: dehydration, thirst, hyperglycemia, hypotension, tachycardia, and mental status changes. BS > 600
Tx: Isotonic fluids, then hypotonic fluids at rate of 200-250mL/hr. When BS<350, give D5NS with insulin infusion. Provide potassium replacement if K < 4.5.
What are common findings of diabetic patients?
slow wound healing
blurry vision
glycosuria
fruity acetone breath
dry, rashy skin
frequent infections
What is the diabetic diet?
45-60% complex carbs, <20% mono/polyunsaturated fats, 15-20% protein.
limit simple carbs and starches, and decrease unhealthy fats and cholesterol.
What are the guidelines for managing blood sugar during exercise?
Always check blood sugar prior to exercising. Check before, during, and after if exercising for longer periods. If lower than 100, eat a small carb snack and eat simple carbs if hypoglycemic.
If BS>250 with ketonuria, avoid exercise and notify provider.
What medications can cause hypoglycemia?
alcohol, aspirin, DM meds, MAO inhibitors
What medications can cause hyperglycemia?
HCTZ diuretics, glucocorticoids, estrogen therapy
Match the medication to the nursing consideration.
Meds: glipizide, metformin, Amaryl, Prandin, Precose, pioglitazone, Actos, glimepiride
Nursing considerations:
- take with first bite of meals
- hold for 48 hours prior to surgery
- monitor liver function
- monitor renal function
- extreme hypoglycemia
- monitor heart function
glipizide, Amaryl, glimepiride - extreme hypoglycemia
Prandin, Precose - take with first bite of meals
metformin - hold for 48 hours prior to surgery, monitor renal function
pioglitazone, Actos - monitor liver function, heart function
What values of HbA1c are considered as prediabetic, diabetic, and normal?
prediabetic: 5.7-6.4%
diabetic: >6.5%
normal: <5.6%
