glucose control Flashcards
how do you diagnose diabetes
fasting BS 126 or greater
random BS >200
whats a normal A1C
4-6%
ADA recommends
<7-8%
the insulin receptor is a ____ receptor
phospho related
what does insulin bring into the cell
amino acids, phos, K, mg
insulin receptor number is ___ related to the plasma concentration of insulin
inversely
T/F Insulin can regulate the population of receptors
TRUE
T/F Liver disease prolongs the elimination half time more than renal disease
FALST - Renal disease prolongs more
Basal rate of insulin secretion by the panaceas is ___unit/hr. and the total daily secretion of insulin is approx ___units/day
1, 40
T/F insulin response to glucose is greater for oral ingestion than for IV infusion
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
what is the longest acting insulin that we have that lasts up to 42h
Degludec (Tresiba)
it is a lot of insulin molecules put together that slowly break apart.
what type of insulin is the most similar to the regular insulin that we make naturally?
Regular
regular has an onset of ___min, a peak of ___hr, a duration of ____
30, 2-4, 6-8
rapid acting insulins have an onset of ___ min
15
humulin 70/30 - which number is int acting and which number is short acting
the larger number is int acting
only ___ insulin may be given IV or thru a pump
regular
what is the body’s compensatory action to hypoglycemia?
release of EPI causing diaphoresis, tachycardia, htn.
what is the somogyi effect?
rebound hyperglycemia - d/t the compounded ANS effects + external glucose source
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.
TRUE
Chronic ___ admin may lead to the development of antibodies to ___
NPH, protamine.
what is the optimal BG range for surgery
80-180
what is the optimal BG for total joints
<150
non-tight control give __ to ___ the dose of int or long acting insulin . and what dose of short acting
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
tight control what would you do
iv insulin infusion
maint w D5/electrolyts
measure BG q1-2h
T/F IV boluses of regular insulin can create dangerous swings of glucose levels.
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
If a patient has an insulin pump, what do you do?
- 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
