Chapter 56: Diabetes Mellitus

Question 1

normal fasting glucose l

Answer 1

74 to 106 mg/dL

Question 2

Lispro should be given ___ minutes before a meal.

Answer 2

Lispro is a FAST acting insulin and should be given 10 minute before meal.

Question 3

Metformin

Answer 3

(Biguanide) lowers glucose by inhibiting liver glucose production, decrease absorption and increase insulin sensitivity.

Question 4

Dapagliflozin
(SGLT2 inhibitor)

Answer 4

prevents kidney reabsorption of glucose and excretes it through urine.

Question 5

Pioglitazone

Question 6

Glipizide

Question 7

metformin is contraindicated with ____ disease.

Answer 7

Kidney disease

Question 8

which insulin lasts 24 hours?

Answer 8

Glargine

Question 9

if patient is awake and alert during episode of hypoglycemia, give:

Answer 9

oral carbohydrate replacement.

Question 10

normal Hemoglobin A1C

Answer 10

4 to 5. 7 %

Question 11

this diabetes medication is safe for kidney and heart failure.

Answer 11

Glipizide

Question 12

s/sx of hypoglycemia

Answer 12

diaphoresis.
shaking.
weakness.
dizzy.
tachycardia.
anxious or nervous.
feeling hungry.

Question 13

Repaglinide

Answer 13

DM medication works by increasing insulin secretion from pancreas.

Question 14

glycosylated hemoglobin

Answer 14

6.5 % or greater indicates DM.

Question 15

What is the etiology of Kussmaul respirations?

Answer 15

To compensate for metabolic acidosis, respirations are deep and rapid.

Question 16

what two labs do you need to monitor while patient is receiving IV insulin for DKA?

Answer 16

Potassium and BUN.

because an increase of BUN means dehydration

Question 17

alcohol can cause ____glycemia

Answer 17

hypoglycemia

Question 18

The Somogyi effect

Answer 18

The Somogyi effect is the term for rebound morning hyperglycemia after nighttime hypoglycemia. It is often caused by too much insulin or lack of an adequate bedtime snack

Question 19

HHS

Answer 19

Medical emergency. HHS primarily affects type 2 diabetics who are significantly dehydrated w/ highly elevated blood glucose levels. NO ketones present.

Question 20

Symptoms of diabetes complication

Answer 20

Burning sensation of toes.
Protein in Urine.
Non healing sore foot or wounds.

Question 21

Glucagon

Answer 21

a hormone secreted by the pancreas to protect the body when blood glucose levels drop

Question 22

treatment of choice for severe HYPOGLYCEMIA through IV access

Answer 22

50 ml of 50% Dextrose IV Push (over 5 minutes).

Question 23

Big difference between DKA & HHS

Answer 23

In HHS, ketones are absent or very minimal in both blood serum and urine.

Also, acidosis occurs in DKA only due to ketones (ketones are acidic). Due to acidosis, body will try to get rid of acid by Kausmall Respirations (rapid breathing to rid of excess co2).

Question 24

HYPERglycemia symptoms

Answer 24

3 P’s (polyphagia, polyuria, polydipsia)
Dry mouth / dehydration/ increase thirst
Abdominal cramp
Dizziness
Warm, dry skin
Present of ketones in urine & blood
Tachycardia
Hypotension (due to excess urination).

Question 25

HYPOglycemia symptoms

Answer 25

Diaphoresis Weakness Blurred or double vision Confusion / HA Dizziness / Tremors Cold, clammy , sweaty skin Tachycardia / palpitations NO ketones present

Question 26

PRE - Diabetic A1C level

Answer 26

5.7 - 6.4

Question 27

Pre Diabetic fasting glucose level

Answer 27

if 126 or more.

Question 28

which insulin is safe for fasting patients?

Answer 28

long acting insulin (ie insulin Glargine). it provides a steady , peakless insulin level for up to 24 hours

Question 29

what are risks of taking Metformin?

Answer 29

it is contraindicated for those with kidney disease. It gives risk for lactic acidosis.

Question 30

Anti diabetic drugs:

Answer 30

metformin (Biguanides). Glipizide (Sulfonylureas). Semaglutide (GLP agonist). Canagliflozin - increases risk for dehydration, hyponatremia

Question 31

Diabetic Keto acidosis (DKA)

Answer 31

occurs in Type 1 DM. glucose +300 ketosis present (metabolic acidosis), Kussmaul respirations, fruity breath.

Question 32

HHS

Answer 32

occurs in Type 2 DM. glucose +600. severe HYPOTENSION due to hypovolemia ( due to excess urination of sugar out of the body. Mental status change, almost coma.

Question 33

Treating DKA or HHS

Answer 33

Administer Regular insulin IV bolus then drip. Once BS reaches 250, initiate D5W in 1/2 NS to prevent hypoglycemia and brain edema/ damage. ***Watch out of hypokalemia with insulin IV. insulin pulls K into cells causing hypokalemia in blood serum.

Question 34

A1C goal for diabetics

Answer 34

< 7.0 %