Diabetes Mellitus

Question 1

How does the body regulate glucose?

Answer 1

Glucagon increases blood glucose by converting glycogen to glucose
Insulin decreases blood glucose by transporting glucose into the cells and converting glucose to glycogen in the liver

Question 2

What is the difference between type 1 and type 2 diabetes?

Answer 2

type 1 early in life; insulin-producing cells are destroyed
type 2 later in life; cells are insulin-resistant

Question 3

3 P’s of uncontrolled diabetes?

Answer 3

polyphagia = hunger
polyuria = pee lot
Polydipsia = thirsty

Question 4

What is Metformin prescribed for and how does it work?

Answer 4

1st line treatment for type 2 diabetes
1. reduces glucose production
2. decreases glucose absorption in gut,
3. increases insulin sensitivity in cells

Question 5

What are some high-yield concepts for taking Metformin?

Answer 5

1. GI problems: decreased appetite, N/D, abdominal bloating and flatulence ( could carefully titrate dosage, use ER, or taking with meal can help)
2. Reduces absorption of Vitamin b12 and B9 which can cause peripheral neuropathy and anemia
3. Lactic acidosis: early signs include hyperventilation, muscle pain, extreme fatigue
4. Contraindicated with client has renal impairment

Question 6

What are examples of sulfonylureas for management of type 2 diabetes and how do they work?

Answer 6

Glimepiride
Glipizide (most commonly prescribed)
MOA: stimulates pancreas to release more insulin which decreases blood glucose

Question 7

What are some high yield concepts for taking sulfonylureas?

Answer 7

1. Hypoglycemia ( sweating, rapid HR, shaking, hunger, fatigue)
2. weight gain
3. alcohol interaction

Question 8

What is a drug with the suffix “-gliptin” used for and what are some concerns when taking this medication?

Answer 8

Sitagliptin used as add-on medication for type 2
Runny nose, sore throat, pancreatitis

Question 9

What is Empagliflozin? What is it prescribed for and what are some precautions taking it?

Answer 9

1. Empagliflozin is used for management of type 2 diabetes and can also reduce risk of death for patients with heart failure
2. Short half-life. Should be taken before breakfast
3. Dehydration
4. Increased genital and urinary tract infections (fungal like yeast)

Question 10

This drug has the suffix “glutide” which is a noninjectable insulin medication. What are some of its high yield concepts when taking this drug?

Answer 10

Dulaglutide is a subcutaneous medication for type 2 diabetes
1. GI effects = Nausea, weight loss, higher doses can cause kidney failure
2. Pancreatitis = severe intolerable abdominal pain. Patient should stop meds can contact HCP

Question 11

What are examples of rapid, short, and long-acting insulins

Answer 11

Rapid:
1. insulin aspart
2. insulin lispro
Short:
3. insulin regular
Intermediate:
4. NPH insulin
Long:
5. Insulin glargine

Question 12

What are some high-yield concepts when taking insulin?

Answer 12

1. hypoglycemia = it is important to understand the set, peak, and duration. Blood glucose should be greater than 70
2. Weight gain with prolonged use
3. unopened insulin should be kept in refrigerator. Opened can be kept at room temperature for 4 weeks

Question 13

What are administration precautions when insulin?

Answer 13

1. Correct syringe (U-100 syringe with U-100 insulin)
2. Don’t shake suspensions but gently roll
3. Rotate injection sites to avoid lipodystrophy (loss fat in one area) or lipohypertrophy (fatty masses)
4. Double check with another nurse