DM Flashcards
What does diabetes increase?
Blood sugars and blood fats
Body needs help to control blood sugar (prevent high/low blood sugars) and decrease blood fats
The pancreas actions in regulating blood sugar
Releases insulin when hyperglycemic
Releases glucagon when hypoglycemic
In the healthy body, glucagon works to:
Gluconeogenesis- breaks down protein to make “new” glucose in the liver
Raise fat levels in the blood
Help the cells use fat for energy
What is the normal blood glucose level?
70-110
Brain cells need a constant supply of _______ to survive. Falling below ____ will starve the brain cells
glucose
50
Healthy pancreas secretes how much insulin?
50-60 units/day
What is toxic to beta cells?
Chronic high blood glucose levels
Rapid-acting
insulin lispro (Humalog)
insulin aspart (Novolog)
insulin glulisine (Apidra)
15-30 min
Peak .5-2.5 hr
Duration 3-6 hr
Short-acting insulin
regular insulin (Humilin R)
regular insulin (Novolin R)
ends in R
30-60 min
Peak 1-5 hr
Duration 6-10 hr
Intermediate-acting
NPH Insulin (Humulin N)
or (Novilin N)
ends in N
1-2 hr
Peak 6-14 hr
Duration 16-24 hr
Long-acting
glargine (Lantus)
detemir (Levemir)
70 min
Peak: None
Duration 24 hr
Which insulin should NOT be mixed with others?
insulin glargine - Lantus
Insulin correction dose
given only if the blood sugar (AC) before meals is above goal range
aka sliding scale
Polyuria
Excessive urination
Polydipsia
Excessive thirst
Polyphagia
Excessive hunger
Type I DM
Beta cells shut down; no insulin is produced
Type II DM
Beta cells don’t produce enough insulin and cells are insulin-resistant
Hypoglycemia may resemble
Stroke or intoxication
How does Metformin work?
Reduces hepatic glucose production
Increases insulin action on muscle glucose uptake (reduces insulin resistance)
Sulfonylureas action
stimulate beta cells to produce more insulin
side effect: may cause weight gain
Chronic blood glucose greater than 200 can cause
Neutrophils not to work
which increases risk for infection and causes poor wound healing
Sudden rise in blood sugar may be
the first sign of infection and may occur before fever
Diabetic hospitalized patients need
continuous, nonjudgmental support
HHS (Hyperosmolar Hyperglycemic Sydrome):
1. Target population
2. Blood glucose level
happens in frail, elderly patients with Type 2 DM; often seen when a client gets an infection or is taking corticosteroids
blood sugar OVER 600
When hypoglycemia is suspected or determined
[assuming the pt is able to swallow] give them 15-20g of a rapid-acting, concentrated carbohydrate (4-6oz of fruit juice, 8oz of skim milk, or 1Tbsp of honey)
Somogyi Effect
too much insulin leads to nocturnal hypoglycemia & rebound hyperglycemia
decrease insulin and/or increase HS snack
Dawn phenomenon
hyperglycemia upon waking W/O hypoglycemia
may need more insulin