Pharm: Module 10 Flashcards
what are the three types of diabetes
diabetes mellitus, gestational diabetes, diabetes insipidus
what type of disease is type 1 diabetes
diabetes mellitus
autoimmune disease
what is wrong in a type 1 diabetes patient
pancreas is not functioning
over 80% of pancreatic cells are destroyed
body destroyed them so pancreas can no longer produce insulin
what does a normally functioning pancreas do
secretes insulin in response to blood glucose levels
three common symptoms of type 1 diabetes
polyuria, polydipsia, polyphagia
how does insulin work
attaches to cell and provides glucose entry into the cell
what is the brain’s primary source of energy
glucose
what happens in a type 1 patient
glucose builds up in blood and cannot enter cells
what occurs when BG reaches 180-200
glucose will spill over into urine
polyuria due to hypertonic environment
particle induced diuresis
what leads to polydipsia
excessive urination stimulates urge to drink
why do type 1 often lose weight
body burns off fat since it is not getting glucose in cells (patient will look tired)
what can occur due to untreated type 1
hypovolemic shock or DKA(diabetic ketonic acidosis if BG is over 500)
what is occurring if there are ketones in urine
body is burning fat for energy (acid)
what type of diabetes takes pills
type 2
what occurs in a type 2 diabetes patient
excessive glucose destroys vascular base(membrane)
causes circulation issues and increased risk for infection as bacteria like to grow in sugary envrionments
how do you know the damage has already occurred in a type 2 diabetic
when visual and erectile issues occur
diabetic neruoprophy
is the pancreas working in a type 2 diabetic
yes, but cells are insulin resistant (cells don’t respond to it)
do type 2 experience weight loss like type 1
no, because they have insulin
describe a typical type 2 patient
older, overweight
diagnosed by accident
blood sugar is very high but NOT ketones
what can type 2 lead to
blindness, kidney disease due to extremely vascular system (sugar kills vascular)
do type 2 tend to end up in DKA
no
hypoglycemic BG level and severe
<70 mg/dL
severe: <50 mg/dL
euglycemic BG level
70-140 mg/dL (normal)
hyperglycemic BG level and severe
> 140 mg/dL
severe: >180 mg/dL
symptoms of hypoglycemia
decreased cognition, tremors, diaphoresis, weakness, hunger, headache, irritability, seizure
symptoms of hyperglycemic
polyuria, polydipsia, dehydration, fatigue, fruity breath, weight loss, hunger, poor wound healing
normal fasting BG
70-99
a fasting BG of what indicates diabetes
> 200
what is a hemoglobin AC
glucose control over 3 hours
indicates what % of RBC has glucose
most accurate pic of diabetic control
what hemoglobin AC is normal and what is diabetic
normal is < 6%
diabetic is >7%
what is the only insulin that can be given IV
regular
what meds can cross placenta
oral meds
what crosses placenta
glucose but NOT insulin
what it lipodystrophy
atrophy of tissues
can occur if 1 site is not used up before moving to next
what kills people relating to diabetes
the CONSEQUENCES of diabetes not actual diabetes
when should a diabetic eat
when insulin is at peak
when there is the greatest risk for hypoglycemia
peak
how long it will exert therapeutic response
duration
what is the rapid acting insulin
Lispiro
when can you give rapid acting
only wen food is on tray in front of client
when does a rapid acting peak occur
within 30 min
what is short acting insulin also called
regular insulin
what is the peak for regular insulin
30-60 min
when do you give an IV of regular insulin
when patient comes in DKA (hypoglycemic and hypokalemic)
what is D5W
dextrose and water
what types of insulin is given in bolus
rapid and regular
what is the peak of NPH
60-120 min
describe NPH
intermediate insulin
cloudy
mimics normal pancreatic function
what is the name of long acting
Lantus
how is long acting given
basal dosing, steady long dose (1x a time)
when is the long acting peak
no peak
what maintains BG level
sliding scale
what drugs increase BG
steroids (glucocorticoids)
Albuterol and epinephrine
what drugs decrease BG
Beta Blockers(block body's response to natural epinephrine) TCA (antidepressant)
describe how insulin pumps work
basal dose of regular insulin
at meal time a bolus is given
what can also spike BG
illness and stress
describe hypoglycemia
low BG
given injection of glucose (glucagon) if extremely low
what is the 15:15 rule
give 15 g of simple carb then check in another 15 min
once stable give complex carb (peanut butter)
