Chapter 14.1 Flashcards
(54 cards)
- State the location and specific cells responsible for the secretion of insulin and glucagon.
Location – pancreas
Alpha cells produce GLUCAGON
Beta cells produce INSULIN
- State the composition and classification of the insulin molecule
It is a large polypeptide of 51 amino acids
- List the characteristics of patients with type 1 diabetes regarding age of onset, insulin levels, and response to insulin. (will be on test)
Onset – juvenile
Insulin level – low level
Response to insulin – normal response
don’t make insulin - deficiency - You can’t use sugar for energy so the body uses fats causing ketoacidosis. Can also start to remove glycogen out of muscles
Type 2
Onset – adults
Insulin level – normal/high levels
Response to insulin – decreased response
do make insulin - make too much or too little
- State the percent of all diabetic patients who have type 1 and type 2 diabetes
Type 1 – 5-10%
Type 2 – 90-95%
- State the routes of administration for insulin and why these routes are used
Insulin NOT suitable for oral administration – usually administered through sub-Q injection – automatic glucose sensor – insulin pump
Alternative administration
Inhalation or nasal spray
- State how insulin is produced today
Produced using cell cultures & recombinant DNA techniques
Biosynthetic techniques to produce insulin analogs
- Define insulin analogs
It is like insulin but varies by a few amino acids - it alters the amino acids to change how the insulin works
- Classify the following insulins as rapid acting: lispro, NPH, and glargine. (will be on test)
Lispro
intermediate acting
NPH
long acting
Glargine
- State the rationale for insulin mixtures.
Patients will need different activity levels of insulin. For example if pt. is eating and needs it right away they can use rapid acting, while intermediate acting ones can be used to control insulin levels throughout the day.
to put two speeds in at the same tim
- State the peak effect and duration of the following insulins: rapid acting (lispro) and long acting (glargine).
(will be on test)
rapid acting (lispro)
peak effect .5 – 1.5 hrs.
long-acting (glargine).
Peak effect 3 – 24 hrs.
- List the physiologic actions of insulin.
Increase glucose entry & storage in tissue (muscles & liver)
Increase protein synthesis & lipid storage
- List the physiologic actions of glucagon.
The primary effect of glucagon is to increase blood glucose to maintain normal blood glucose levels and to prevent hypoglycemia.
- State the acute problems associated with insulin insufficiency
Hyperglycemia followed by hypoglycemia
Shift to fat metabolism/ketones
Chronic problems
Repeated prolonged hyperglycemia – small vessel angiopathy - occlusion
- State how chronic hyperglycemia causes angiopathy.
In repeated high blood sugar (Hyperglycemia), glucose binds to proteins in the vessel wall and makes the walls thick and blood can’t get through & effects tissue
- List the microangiopathic clinical outcomes of poorly controlled diabetes mellitus. (will be on test)
Amputation – blindness – end stage renal failure & peripheral neuropathy
macroangiopathic
Hypertension – MI (heart attack & stroke) – CVA
- Define the concepts of intensive insulin therapy .
Monitoring blood glucose often & adjusting insulin dosage & food intake to keep insulin level in normal range.
a basal-bolus insulin regimen
Using both a basal & bolus dose to help control insulin levels. Basal doses give background level of long or intermediate acting for control over day/night while bolus dose to deal with glucose as a pt. is eating.
- List the symptoms of hypoglycemia.
Headache – shaking – sweating – tired – weakness – hunger
- State reasons that a patient on an insulin regimen might experience hypoglycemia.
Dose too high – delayed/missed meal – strenuous exercise
