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Patient Centered Care 2 > Glucose Regulation > Flashcards

Glucose Regulation Flashcards

1
Q

What causes T1DM

A

Destruction of beta cells of the islets of Langerhans which are the cells that make insulin.

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2
Q

What’s the difference between basal and bolis beta cells?

A

Basal cells gmaintain Blood glucose while we are not eating, and bolus cells regulate blood glucose in response to food. (They are also increased 10 mins before eating)

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3
Q

What’s the difference between Type 1 DM and T2DM?

A

Type 1 is insulin dependent and type 2 is insulin resistant

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4
Q

What ethnic group is more at risk for undiagnosed diabetes and why?

A

Native Americans because they live on their own reservation so they do not always have access to important health care.

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5
Q

DM is the leading cause for what following things in the US?

A
  1. New cases of blindness
  2. End stage kidney disease. Requiring dialysis or kidney transplant
  3. Lower extremity amputation
  4. ER visits for hypoglycemia and hyperglycemia
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6
Q

What is an early sign for diabetes?

A

Increased thirst

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7
Q

What are the symptoms of hyperglycemia

A
  1. Feeling hungry
  2. Blurry vision
  3. Frequent urination
  4. High blood sugar
  5. Tingling limbs
  6. Feeling thirsty
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8
Q

What are some atypical presentation of hyperglycemia in the elderly?

A
  1. A sense of not feeling oneself
  2. Electrolyte imbalance and dehydration
  3. Incontinence
  4. Appetite loss (due to depression, GI disease, of drug side effects)
  5. Fatigue and gradual profound loss
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9
Q

Signs and symptoms of hypoglycemia

A
  1. Sleepiness
  2. Sweating
  3. Pallor
  4. Lack of coordination
  5. Irritability
  6. Hunger
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10
Q

What are some causes of hypoglycemia reactions

A

Too much insulin, too little food, increase exercise without food.

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11
Q

What are some home management interventions for hypoglycemia?

A

10-15 carbs, recheck BG in 15 min and repeat. Eat a small carb and protein snack if next meal is more than an hour away

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12
Q

What are some moderate hypoglycemia (<40) home management interventions?

A

15-30 carbs plus low-fat milk or cheese after 10-15 min. Recheck BG in 15 min. Pop that is not diet will give you about 15 grams of carbs

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13
Q

What are some interventions for for severe hypoglycemia (<20) (unconscious)

A

Glucagon 1 mg IM or Sub Q, administer a second dose in 10 min if remains unconscious, notify the provider and transport to ER. Conscious pt give a small meal if not nauseated

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14
Q

How does someone get diagnosed with diabetes?

A

1, hemoglobin A1C is greater than of equal to 6.5%

  1. Fasting blood glucose is greater than or equal to 126 mg/dL
  2. 2- hour plasma glucose is greater than of equal to 200 mg/dL in the 75 g OGTT
  3. Signs and symptoms of hyperglycemia and random plasma glucose greater than or equal to 200 mg/mL
  4. In the absence of hyperglycemia, confirmed by repeat testing
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15
Q

What are the diagnostic tests to test for diagnostic?

A
  1. Fasting blood glucose
  2. No calorie intake for 8 hours
  3. Oral glucose tolerance test
  4. Glycosylaged hemoglobin
  5. C-peptide
  6. Urine tests
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16
Q

What is the ratio of carbs to insulin?

A

For every 15 g of carbs there’s 1 unit of insulin

17
Q

What is the timing of insulin to exercise that is recommended for diabetics?

A

No exercisewithin 1 hour of insulin injection or at the peak time of insulin action.

18
Q

When should pt’s eat snack when they exercise?

A

They should eat small snacks before, during, and after exercise. During vigorous exercise they should eat 15-30 grams of carbs every 30-60 min of exercise

19
Q

What are the different types of insulin?

A
  1. Rapid: Humalog or novolog
  2. Short: humbling R or Novolin R
  3. Intermittent: NPH, Novolin N, or humbling N
  4. Lente: Novolin L, Humulin L, insulin detector
  5. 24 hour: insulin glargine (lantus)
  6. 48 hour: insulin degludec (tresiba)
  7. Weekly: dulagutide (trulicty)
20
Q

hypoglycemic reaction

A

tremors, nervousness, profuse perspiration

21
Q

SSA DM nail care

A

after bathing, trim straight, wear closed-toe shoes

22
Q

diabetic teaching injury prevention further teaching needed

A

break in shoes wearing all-day

23
Q

Hgb a1c 8/9%

A

report to dr.

24
Q

insulin short or rapid-acting

A

make sure meal at the bedside

25
Q

If someone plays sports and they have DM what should they do?

A

eat before they play

26
Q

before giving insulin, what is needed to verify

A

2 pairs of eyes

27
Q

how often should foot exams be performed?

A

every month

28
Q

coexisting problems get worse more rapidly

A

periodontal disease

29
Q

How long can insulin sit out for?

A

after opening for 28 days

30
Q

metformin and high a1c

A

ask about current diet and what meds they’re on

Patient Centered Care 2 (26 decks)

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