LP4: Diabetes

Question 1

Diabetes is diagnosed as an A1C of greater than or equal to _____%

Answer 1

6.5%

Question 2

“normal” A1C is less than _____%

Answer 2

5.7%

Question 3

“prediabetes” A1C is ______%

Answer 3

5.7%-6.4%

Question 4

“diabetes” A1C is ______%

Answer 4

6.5% or higher

Question 5

beta cells

Answer 5

*in the Islet of Langerhans, in the pancreas
*produce insulin

Question 6

alpha cells

Answer 6

*in the Islets of Langerhans in the pancreas
*secrete glucagon in order to increase glucose levels in the blood stream

Question 7

glucagon

Answer 7

*formed in the pancreas by the alpha cells
*promotes the breakdown of glycogen to glucose in the liver
*injected IM if no IV access, but can induce vomiting (so turn patient on their side)

Question 8

glycogen

Answer 8

*stored in the liver & in muscles
*it’s the stored form of glucose
*converts to glucose in the LIVER, from free fatty acids and protein

Question 9

insulin does what inside muscle, liver and fat cells?

Answer 9

*transports and metabolizes glucose for energy
*stimulates storage of glucose in the liver and muscle (as glycogen)
*signals the liver to stop the release of glucose
*enhances storage of dietary fat in adipose tissue
*accelerates transport of amino acids into cells
*inhibits the breakdown of stored glucose, protein, and fat

Question 10

what’s gluconeogenesis?

Answer 10

The breakdown of noncarbohydrate substances, including amino acids, by the liver to form glucose after going 8-12 hours without food (as opposed to the liver producing glucose through the breakdown of glycogen)

Question 11

what’s osmotic diuresis?

Answer 11

when excess glucose is excreted in the urine, it is accompanied by excessive loss of fluids and electrolytes

Question 12

what are ketones?

Answer 12

*highly acidic substances that are formed by the conversion of free fatty acids to glucose, in the absence of insulin

Question 13

rapid acting insulins

Answer 13

lispro
aspart
glulisine

Question 14

onset, peak & duration of rapid acting insulin

Answer 14

Onset: ~15 minutes
Peak: ~1 hour
Duration: 3-5 hours

Question 15

how to use rapid acting insulin?

Answer 15

used for rapid reduction of glucose level, to treat postprandial hyperglycemia, or to prevent nocturnal hypoglycemia

Question 16

short acting insulin

Answer 16

regular, can be taken alone or in combo with longer-acting insulin

Question 17

onset, peak & duration for short acting insulin

Answer 17

Onset: 30-60 minutes
Peak: 2 hours
Duration: 5 hours

Question 18

intermediate acting insulins

Answer 18

NPH

Question 19

how to use short acting insulin?

Answer 19

usually given 15 minutes before a meal

Question 20

onset, peak & duration for intermediate acting insulin

Answer 20

Onset: 1 hour
Peak: 4-12 hours
Duration: up to 24 hours

Question 21

how to use intermediate acting insulin?

Answer 21

food should be taken around the time of onset & peak

Question 22

long-acting insulins

Answer 22

glargine determir

Question 23

onset, peak & duration of long-acting insulin

Answer 23

Onset: 3-6 hours
Peak: no peak (continuous)
Duration: 24 hours

Question 24

how to use long-acting insulin?

Answer 24

used for basal dose