glucose control

Question 1

how do you diagnose diabetes

Answer 1

fasting BS 126 or greater

random BS >200

Question 2

whats a normal A1C

Answer 2

4-6%

Question 3

ADA recommends

Answer 3

<7-8%

Question 4

the insulin receptor is a ____ receptor

Answer 4

phospho related

Question 5

what does insulin bring into the cell

Answer 5

amino acids, phos, K, mg

Question 6

insulin receptor number is ___ related to the plasma concentration of insulin

Answer 6

inversely

Question 7

T/F Insulin can regulate the population of receptors

Answer 7

TRUE

Question 8

T/F Liver disease prolongs the elimination half time more than renal disease

Answer 8

FALST - Renal disease prolongs more

Question 9

Basal rate of insulin secretion by the panaceas is ___unit/hr. and the total daily secretion of insulin is approx ___units/day

Answer 9

1, 40

Question 10

T/F insulin response to glucose is greater for oral ingestion than for IV infusion

Answer 10

TRUE - because you get that extra effect from the glucagon-like peptide that is released from the gut in response to the glucose. it has extra CNS effects that you bypass when you give it injectable

Question 11

what is the longest acting insulin that we have that lasts up to 42h

Answer 11

Degludec (Tresiba)

it is a lot of insulin molecules put together that slowly break apart.

Question 12

what type of insulin is the most similar to the regular insulin that we make naturally?

Answer 12

Regular

Question 13

regular has an onset of ___min, a peak of ___hr, a duration of ____

Answer 13

30, 2-4, 6-8

Question 14

rapid acting insulins have an onset of ___ min

Answer 14

15

Question 15

humulin 70/30 - which number is int acting and which number is short acting

Answer 15

the larger number is int acting

Question 16

only ___ insulin may be given IV or thru a pump

Answer 16

regular

Question 17

what is the body’s compensatory action to hypoglycemia?

Answer 17

release of EPI causing diaphoresis, tachycardia, htn.

Question 18

what is the somogyi effect?

Answer 18

rebound hyperglycemia - d/t the compounded ANS effects + external glucose source

Question 19

T/F Use of human insulin has eliminated the problem of systemic allergic reactions that could be associated with animal preparations, however local allergic reactions (red hardened areas) can develop due to non-insulin materials in the preparation.

Answer 19

TRUE

Question 20

Chronic ___ admin may lead to the development of antibodies to ___

Answer 20

NPH, protamine.

Question 21

what is the optimal BG range for surgery

Answer 21

80-180

Question 22

what is the optimal BG for total joints

Answer 22

<150

Question 23

non-tight control give __ to ___ the dose of int or long acting insulin . and what dose of short acting

Answer 23

1/4 to 1/2 of int or long acting insulin (the last dose prior to procedure)

short acting/rapid acting as needed - give 1unit regular for every 50-60

Question 24

tight control what would you do

Answer 24

iv insulin infusion
maint w D5/electrolyts
measure BG q1-2h

Question 25

T/F IV boluses of regular insulin can create dangerous swings of glucose levels.

Answer 25

TRUE.

Regular insulin has a t1/2 of 4-5min with a biological T1/2 of 15-20min resulting in short, but high levels of inslin

Question 26

If a patient has an insulin pump, what do you do?

Answer 26

• prior to surgery they can have clear liquids with or without sugar
• maintain basal rate and turn off pre-praindial boluses.
• measure BG q1
• know the typical bolus for the patient to decrease BG 50mg/dl