Diabetes

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Author:
dgroce2123
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62064
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Diabetes
Updated:
2011-01-29 13:54:48
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Diabetes
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Description:
FR II Nursing Lecture Diabetes
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  1. Type 1 DM is also known as
    Insulin-dependent
  2. Onset of Type 1 diabetes is
    Juvenile - before age 30
  3. In Type 1 what bonds to islet cells and insulin?
    Antibodies
  4. In Type 1 there is little to no ______ insulin?
    Endogenous
  5. The treatment for Type 1 is?
    Insulin
  6. What is DKA?
    Diabetic Ketoacidosis
  7. Type 2 is also known as?
    • Non-insulin dependent
    • (but not so much anymore, due to Type 2 diabetics can also be insulin dependent)
  8. On set of Type 2?
    Adult - usually after age 30
  9. Type 2 diabetics have?
    Decreased sensitivity to insulin or insulin resistance
  10. Treatments for Type 2 in order
    • Weight loss through diet and exercise
    • oral anti-diabetic medication
    • Insulin
  11. What is HHNS?
    Hyperglycemic hyperosmolar nonketotic syndrome
  12. The 3 P's of signs and symptoms of Hyperglcemia
    • Polyuria (increased urination)
    • Polydipsia (increased thirst)
    • Polyphagia (increased appetite)
  13. Risk Factors for DM
    • Family Hx
    • Obesity
    • Dark skin or caucasion Apples
    • Previous impaired FG or impaired glucose level
    • HTN 140/90
    • HDL < 35, Triglyceride > 250
    • Hx of gest. diabetes/baby > 9lbs

  14. RBG (Random Blood Glucose)
    • 200 or greater
    • on 2 occations on 2 different days
  15. FBG (Fasting Blood Glucose)
    • 126 or greater
    • on two occations on two different days
  16. 2HRPPBG (2 hour post prandial blood glucose) 2 hrs after meals
    • 200 or greater
    • on two occations on 2 different days
  17. What kind of cells produce insulin?
    Beta
  18. Energy
    Transports/metabolizes glucose
  19. Stored Energy
    Stimulates glucose storage in live/muscle - glycogen
  20. Reserve energy
    Storage in adipose tissue of fat
  21. Transports protein derived amino acids in to cells =?
    Energy
  22. Family History is based on what members of the family?
    Mother, Father, Brother, Sister, Children
  23. Type 1 - What do antibodies do to the beta cells of the pancreas?
    Destroy them
  24. Type 1 are genetically predisposed because of
    HLA - Human Leukocyte Antigen
  25. Type 1 autoimmune reponse is?
    Antibodies attack normal body tissue, ie. Autoantibodies against islet cells
  26. Type 1 Environmental factors?
    Viruses/toxins cause autoimmune response
  27. Excess glucose produced by liver causes fasting because?
    The body is in "starvation mode" there is no insulin to bind with sugar
  28. Causes of Type 2
    • Poor Diet
    • Physical inactivity
    • decrease in lean body mass
    • altered insulin secretions
    • insulin resistance
  29. Management of Type 2
    • Nutrition
    • Exercise
    • Monitor BG
    • Pharmacologic Treatment
    • Education
  30. In Type 2, if you loose 5-10% of your body weight, how does this help?
    • The number of insulin receptors on cells increase thereby allowing glucose to better enter the cells
    • Weight loss can also reduce/eliminate need for po/subcut meds
  31. Develope __________ meal plans for the pt r/t eating habits and lifestyle
    Personalized
  32. Carbohydrates should make up ____% of calories in your diet
    60
  33. Increased consumption of Carbs (CHOs) =
    increased PPBG
  34. Fat should make up ___% of calories
    < 30
  35. Protein should make up ___% of calories in diet
    10-20
  36. Fiber does what?
    • Decreases total cholestrol
    • Decreases LDL
    • Imporves BG
  37. Names of RAPID ACTING insulin
    • Lispro(Humalog)
    • Glulisine (Apidra)
    • Aspart (NovoLog)
  38. Onset for RAPID ACTING insulin
    10 - 15 minutes (have food in the room ready to eat)
  39. Peak for RAPID ACTING insulin
    1-2 hours
  40. Duration for RAPID ACTING insulin
    3-4 hours
  41. Name for SHORT ACTING insulin
    Regular (Humulin R, Novolin R)
  42. Onset for SHORT ACTING insulin
    30 minutes - 1 hour
  43. Peak for SHORT ACTING insulin
    2-3 hours
  44. Duration for SHORT ACTING insulin
    4-6 hours
  45. Names for INTERMEDIATE ACTING insulin
    Isophane/NPH (Humulin N, Novolin N)
  46. Onset for INTERMEDIATE ACTING insulin
    3-4 hours
  47. Peak for INTERMEDIATE ACTING insulin
    • 4-12 hours (mid point is 8 hours) with the belly is most empty
    • Watch for Hypoglycemic at MID POINT!!
  48. Duration for INTERMEDIATE ACTING insulin
    20 -30 hours
  49. Names for LONG ACTING insulin
    Ultralente (Humulin U)
  50. Onset for LONG ACTING insulin
    6-8 hours
  51. Peak for LONG ACTING insulin
    12-16 hours
  52. Duration for LONG ACTING insulin
    20 - 30 hours
  53. MIXED INSULIN names (not on Test)
    • Novolog Mix 7-/30
    • Humalog Mix 75/25
    • Humulin 70/30
    • Humulin 50/50
    • Novolin 70/30
  54. Peak for MIXED INSULINS
    30 minutes to 12 hours

    • Acts quick like Rapid
    • Ex: Novolog 70/30
    • 70 - is the Intermediate
    • 30 - is the Rapid
  55. Names for CONTINUOUSLY ACTING insulin
    • Determir (Levemir)
    • Glargine (Lantis)
    • Usually a HS (bedtime shot)
    • And is the basal dose of insulin
  56. A1C or Glysosylated Hemoglobin is
    • a 3 month average of all sugars
    • Should be around 6
  57. Onset for CONTINUOUSLY ACTING insulin
    1 hours
  58. Peak and Duration for CONTINUOUSLY ACTING insulin
    24 hours
  59. When is the only time you "snack" a type 2
    when they are shaky/sweaty (hypoglycemic)
  60. #1 side effect for Oral Anti-diabetic Agents
    Hypoglycemia
  61. What are the other 4 side effects of Oral Anti-diabetic Agents
    • GI
    • Liver
    • Lactic Acidosis
    • Hyperglycemia
  62. What are the 4 actions of Oral Anti-diabetic Agents
    • Stimulates pancreas to release insulin
    • Decreases glucose production by liver
    • Facilitates insulin's action on peripheral receptor sites
    • Delays glucose absorption in intestines
  63. What is a "normal" range for fasting BG
    70-110
  64. What is considered "impaired" range for fasting BG
    111-125
  65. Why is milk a better choice than oj for a pt that is hypoglycemic? And why?
    • Because is milk is sugar and protein.
    • And because OJ will make the sugar "spike" and bottom out, where as the milk will "spike" it and bring it down slower

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