Week 3: Diabetes Flashcards
What are the benefits of SMBG?
enables the patient to make their own decisions regarding diet, exercise, and medication management
What is the only CGMS in Canada?
The Medtronic MiniMed Paradigm REAL-Time System
What is a CGMS useful for?
- managing insulin therapy
- alert for hyper/hypoglycemic episodes
- prompt, immediate and corrective actions
How many times should type 1DM check BG?
3 times per day
How many times should type 2DM check BG?
once daily
If a diabetic is in critical, how often should their BG be checked?
every 2-4 hours
Where is a subcutaneous injection?
into the loose connective tissue under the dermis
Why is subcut absorbed much slower?
absorbed more slowly than IM injections due to the lack of blood supply
Why may a patient experience discomfort with a subcut injection?
because the subcutaneous has pain receptors
Subcut injection angle
45-90 degree
Intramuscular injection angle
90 degree + wait 10 seconds
Intradermal injection angle
5-15 degree
What are the best Subcut sites
- outer posterior aspect of upper arms
- abdomen
- anterior thighs
- upper back
- upper ventral/dorsal gluteal areas
LMWH
Low Molecular Weight Heparin
Special considerations with LMWH (3 things)
left or right of the abdomen at least 5cm away from umbilicus
do NOT expel air bubble
pinch skin
Goals of Diabetes Management:
- promote wellbeing
-reduce symptoms - prevent acute complications of hyperglycemia/hypo
- delay onset of and progression of long term complications
Fasting Blood Glucose (FBG)
no intake for at least 8 hours
FBG ranges
less than 6 or 6 = NORMAL
between 6.1-6.9 = PRE-DIABETES
7.0 or more = DIABETES
Hemoglobin A1C
average BG over 3 months previous
A1C ranges
less than 6% = NORMAL
between 6.0-6.4% = PRE-DIABETES
6.5 or greater = DIABETES
Random Plasma Glucose
less than 11.1mmol/l (without regard to meals)
NOVA machine ranges
3.3-7.0mmol/l
S&S of hypoglycemia
- BG <4
- cool clammy skin
- rapid HR
- HA, faitness, dizziness
- nervousness, tremors, shaking
- hunger
- emotional changes
- numbness of fingers, toes, mouth
- unsteady gait, slurred speech
- vision changes
- seizures, coma
Causes of hypoglycemia
- inadvertent insulin OD
- missed/inadequate meal
- unexpected exercise
- error in dosing timing
S&S of Hyperglycemia
- elevated BG (>11)
- 3 P’s
- weakness/fatigue
- blurred vision
- headache
- N/V
- abdominal cramps
- glycosuria
Causes of Hyperglycemia
- inadequate doses
- infection
- stress
- surgery
- meds
- nutritional intake variations
- enteral/parenteral
- critical illness
Goals of BGM
- to determine or monitor BG levels @ risk of hyper/hypoglycemia
- promote BG regulation
- evaluate effectiveness of insulin/OHA