Pattern management powerpoint part 2 Flashcards
What is pattern management?
Applying results of home blood glucose
monitoring to drug therapy management
Recognizing _____/_____ that occur in
patterns.
Recommending appropriate drug therapy to
address the patterns of highs and lows
seen.
Follow-up on results for changes made
high/lows
Advantages of Meter Download Packages
Quickly put data in a format beneficial for pattern
management
Provide graphic representation of _______
Gives a “picture” of their blood sugars
Provide other support and tools directly to PWD
Provide value added service to establish relationship
with PWD
Track/store data for measuring _________
Individual patients over time
Can assist you to compile data for ________ patients to determine impact of clinical service
trends
outcomes
multiple
So many numbers…
…where to start?
Look for most dangerous FIRST–>”_______”
Patterns – which has most above goal
– Breakfast
– Lunch
– Dinner
– Bedtime
Reflective of previous meal or med dose
The Lows
Documentation of BS
State _______ of BS at specific time
State number of BS that are above target
State the target – in what part of note?_________
Example:
Before breakfast 104-182, 6/11 <130
Before breakfast 104-182, 5/11 >130
range
objective
Documentation of BS
O: am fasting 63-134, 13/28 <130
after breakfast 154-219, 7/19 >180
A: About half of blood sugars before
breakfast are in range and about half are
in range after breakfast…..
____________ – Low Blood Glucose
Hypoglycemia
__________- is defined as a blood glucose
that is lower than normal.
Blood glucose less than 70 mg/dL
Hypoglycemia
Hypoglycemia
Everyone is unique –two people may have the
same low blood glucose level but experience
very different symptoms
Every episode is unique
Symptoms vary from episode to episode
Symptoms may begin at different glucose levels on
different occasions
Hypoglycemia - Signs and Symptoms
_________/trembling
Weakness
__________/light-headed
Sleepiness
Trouble concentrating
Headache
Nervous feeling
_______ speech
_______, clammy skin
Intense hunger
________ “skips a beat”
Blurred vision
Nausea/queasiness
_______ in hands/feet/lips
shaking/trembling
dizziness
slurred
sweaty
Heart
Tingling
Hypoglycemia - Nocturnal
More than half of all episodes of hypoglycemia
occur during the night – and you may sleep
through it
Common Symptoms
Nightmares
____________
________thrashing (observed by a bed partner)
Bed partner _____________ you from sleep
Unexplained ___________ upon waking
night sweats
seizures
cannot arouse
headache
Risk Factors for Hypoglycemia
Intensive insulin regimen (_______ daily doses)
____________ glycemic goal
________ doses of insulins
Insulins with ___________ and duration
Diabetes medications that cause _________ (e.g.
sulfonylureas-glipizide, glimepiride, glyburide;
meglitinides-repaglinide, nateglinide)
Advanced _______
Decreased ________ intake in comparison to insulin dose
Erratic meal schedule or missed meal(s)
Exercise
History of hypoglycemia
Alcohol intake
Renal dysfunction (decreased insulin clearance)
Hepatic dysfunction (decreased gluconeogenesis)
Having type 1 diabetes
Error in insulin administration (injecting ________ dose,
waiting >15 minutes to eat after injecting rapid-acting
insulin)
multiple
aggressive
Higher
longer peaks
hypoglycemia
age
carbohydrate
incorrect
Hypoglycemia – Rule of 15
Treat with _______carb, wait 15 minutes, recheck BS, retreat if needed.
Seek help if severe or not responding to treatment
15 gram
