Diabetes Mellitus Flashcards
1
Q
Diagnosis of Diabetes
A
- excessive plasma glucose is diagnostic of diabetes
- tests include fasting plasma glucose (FPG), casual plasma glucose, and oral glucose tolerance test (OGTT)
2
Q
Diabetes Treatment
A
- primary goal is to prevent long term complications
- tight control of blood glucose level is important
- it is also important to control blood pressure and blood lipids
3
Q
Insulin
A
- promotes the use of glucose by body cells, and stores glucose as glycogen in muscles
- used to reduce blood glucose levels
4
Q
Interactions of Insulin
A
- increased hypoglycemia with aspirin, anticoagulants, alcohol, oral hypoglycemics, BBs, TCAs, MAOIs, and tetracyclines
- Decreased hypoglycemia with thiazides, glucocorticoids, oral conctraceptives, thyroid drugs, and smoking
5
Q
Side effects of insulin
A
- Hypoglycemia (includes headache, dizziness, confusion, slurred speech, nervousness, anxiety, agitation, tremors, incoordination, sweating, tachycardia, and seizures)
- Hyperglycemia (includes extreme thirst, dry mucous membrane, poor skin turgor, polyuria, fruity breath, fatigue, tachycardia, and kussmaul respirations)
6
Q
Types of insulin
A
- Fast acting (lispro, aspart, and gluisine)
- Short duration (Humulin R, Novolin R)
- Intermidiate Duration ( NPH, levemir)
- long duration (glargine)
7
Q
Administration of Insulin
A
- subcutaneous infection
- subcutaneous infusion (insulin pumps)
- IV
8
Q
Administration of Insulin: Nursing Interventions
A
- monitor vital signs and glucose levels
- instruct patient to report hyper/hypoglycemia
- encourage compliance with diet, insulin, exercise
- advise client to wear medic-alert tag
- teach client how to check blood glucose
- teach client how to administer insulin
9
Q
Complications of Insulin Treatment
A
- hypoglycemia
- lipohypertrophy
- allergic reactions
- hypokalemia
- drug interaction with hypoglycemic agents, hyperglycemic agents, and beta blockers
10
Q
Oral Hypoglycemics
A
- biguanides
- Sulfonylureas
- Thiazolidinediones
- Meglitinides
- Alpha glucosidase inhibitors
- incretin mimetic
- amylin mimetic
- combination products
11
Q
Biguanides
A
- increases glucose absorption from the intestine and decreases glucose production in the liver, & also improves insulin sensitivity in the peripheral tissues
12
Q
Metaformin (glucophage)
A
- biguanide
- does not affect beta cells of pancreas, increase release of insulin, or cause hypoglycemia
- side effects include anorexia, abd gas or pain, headache, nervousness
- adverse efffect is lactic acidosis
- liver function tests before starting and periodically for at least 1 yr
13
Q
Sulfonylureas
A
- blocks ATP-regulated K channels causing depolarization that results in Ca influx and insulin release from pancreatic β-cells
= 2nd generation prescribed more often than first
- 2nd generation include Glipizide (administer 30 min before meals), glipizide XR (extended action), Glyburide (use caution with elderly and renal failure), and glimepriride (lower side effect profile, use with elderly)
- side effects include weight gain and hypoglycemia
14
Q
Thiazolidinediones
A
- resensitize the body to its own insulin & decrease insulin resistance in the periphery & liver, which results in glucose processing in the body
- examples include Pioglitazone (actos) and Rosiglitazone (Avandia)
- potent agonists for receptors in adipose tissue, skeletal muscle, and the liver
- side effects include edema, HA, myalgia, and URI
- must do liver function tests before starting and 2 months a year
15
Q
Meglitinides
A
- stimulates beta cells of pancreas to produce insulin
- improves insulin secretion in response to increased glucose levels by regulating ATP sensitive K+ channels
- example includes Repaglindine (prandin)
- shorter acting and excreted faster than sulfonylureas
- side effects are similar to sulfonylureas
