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Patients with this have kussmaul respirations.
Insulin is secreted by _________ cells.
Beta cells that produce insulin are located in the _______. More specifically the _________.
- Islet of Langerhans
In type 1 diabetes the beta cells are destoyed by ________.
an autoimmune process.
This type of diabetes is characterized as "insulin resistence" and impaired ______cell functioning.
Type 2 diabetes is treated in a stairstep fashion, describe it...
- Diet and exercise, then...
- Diet, exercise and oral antidiabetics, then...
- Insulin injections
What race and gender are most at risk for diabetes?
African American women
______ is an anabolic, or storage hormone.
The majority of a diabetics carb intake should come from_______ _______.
Production of new glucose form amino acid and other substrates is called-______.
Name the pancreatic hormone secreted by the alpha cells in the Islet of Langerhans.
These diagnostic findings point to _______.Blood glucose of 300-800mg/dL, decreased HCO3-0-15mEq/L and low pH- 6.8-7.3.
Human leukocyte antigen types(HLA's) and evidence of an auto immune respone is found in type___ diabetes.
Postprandial hyperglycemia happens ______ meals.
Glucosuria happens when BG levels reach ____-____, and the kidneys do not reabsorb all the filtered _____.
What is the most important "sick day" rule?
Never eliminate insulin doses when nausea, vomiting and diarrhea occurs.
Lantus and Levemir are _____ acting insulins and have an onset of ___hr and a duration of ___hours.
- long acting - basal
- 1 hour
- 24 hrs
The breakdown of stored glucose is called________.
DKA affects - ________ diabetics.
- Type 1
- Type 2 or non diabetics.
Name the 5 componets of diabetic management.
- nutritional therapy
- pharmacologic therapy
Meal plans for diabetics focus on _____, _____, and _____.
___________ acting insulin may be split into two doses/day and produces a basalar effect. It's duration is 16-20hours with a peak of 4-12 hours.
- Humulin N
- Novolin L + Novolin N
A diabetic caloric intake should include ___-___% carbohydrates, 20-30% _____ and ___-___% _____.
Short acting or Regular insulins have an onset of ____-____hr, a peak of ___-___ hrs and a duration of 4-6 hours.
- 1/2-1 hour
- 2-3 hrs
- Humalog R and Novolin R
Cholesterol intake should be limited to less than ___mg/day.
Which fiber (soluble or insoluble) is better and why?
- Solubule because it lowers glucose and lipid levels and slows gastric emptying, slowing absorption.
- at least 25g of fiber should be ingested daily
T or F
Clients with diabetes should exercise whenerver they have time and for as long as they want.
False- they should do the same exercise, at the same time everyday for the same duration.
When rehydrating a DKA patient, infuse .5-1L/hr of .9NaCl for 2-3 hrs then .45/NaCl.for a few liter/hrs, finishing up with ______ when the blood sugar reaches 300mg/dL to prevent fast decline in blood glucose.
Which (Human or animal) sources have the shorter duration of action?
- Animal derived insulin although effective still triggers an immune response slowing the availibilty.
Clients taking this type of insulin should not postpone eating for more than ____-____mins to avoid hypoglycemia.
- Rapid acting-humalog, novulog or apidra
- 5-15 minutes
This type of insulin is the only one approved for IV administration.
These insulins have a pH of 4 and cannot be mixed with any other insulin.
Long acting- lantus and levemir
Morning hyperglycemia results from nocturnal surges of _______ hormone secretion.
Basal rate of insulin is usually between ___ to___ units/hr.
.5 to 2 units per hour
What are the 1st gen. sulfonylureas?
What are the three main causes of DKA?
- decreased or missed dose of insulin
- illness or infection
- undiagnosed or untreated diabetes
These S/S are indictative of ________ and ________.
Polyuria, polydipsia, blurred vision, weakness, H/A, orthostatic hypotension, rapid weak pulse, anorexia, nausea, vomiting, abdominal pain, fruity breath, lethargia, and kussmauls respirations.
2nd gen. Sulfonylureas are Glipizide,Glyburide, and amaryl. What do they do?
- They stimulate the beta cells to secrete more insulin
- May improve the binding of insulin to insulin receptors
- Increase the number of insulin receptors
This drug works by inhibiting the production of glucose by the liver, increases the cellular sensitivity to insulin, decreases the hepatic synthesis of cholesterol.
- Metformin with glyburide (Glucovance)
This inhibitor must be taken with the first bite of food to be effective. It delays absorption of complex carbs, slowing the entry of glucose into the blood stream.
- Alpha-Glucosidase Inhibitor
If a vial of insulin will be used within ___ month(s) it can be kept at _____ temp.
A patient with dehydration caused by DKA(polyuria) can loose up to ___ liters of fluid in a 24hr period. They also loose large amounts of these electrolytes, ____ and _____.
Treatment of DKA with an insulin drip should not be stopped till the client can _____ and ______ insulin therapy has been resumed.
T or F
When mixing an insulin drip, the line should be primed and the first 50ml should be discarded.
T- insulin molecules adhere to the IV adminstration set, so the first 50 ml can be an ineffective concentration.