What is the Loss of fat tissue in areas of repeated injection that results from an immune reaction to impurities in insulin?
What is an increased swelling of fat that occurs at the site of repeated injections?
What is it when you have a nightime release of growth hormone that causes blood glucose elevations at about 5-6am?
What is it when a pt has morning hyperglycemia from the counterregulatory response to nightime hypoglycemia?
What happens during Type 1 Diabetes?
The pancreas does not produce insulin and leads to a buildup of Glucose
What are the signs and symptoms of Type 1 Diabetes?
Polyuria, Polydipsia, Polyphagia
Tingling in hands & feet
Blood sugar is elevated _________.
Blood sugar is elevated CONSISTENTLY.
In depth, What happens when you have an insulin deficiency?
Fat breaks down releasing fatty acids
Conversion of fatty acids to KETONE bodies provides a backup energy source
Because ketones are abnormal breakdowns of fatty acids they collect in the blood when insulin is not available
What kind of diet would you suggest for Type 1 diabetes?
Adequate nutrients for growth & development
When is the onset usually in Type 1 Diabetes?
Under 30 or Childhood
You can give oral hypoglycemics for Type 1 Diabetics.
What are some considerations to take with Insulin injections?
Avoid giving cold - Vasoconstriction
Don't substitute "brands"
Never leave in car, baggage or compartment of plane
Always have insulin available
Inspect insulin integrity before injecting
Always wear medic-alert band
Regular is ONLY one given IV
Draw up rapid 1st (clear) then Intermediate (cloudy)
With a sliding scale, how much insulin would you five for the following BS levels?
What happens during Type 2 Diabetes?
The pancreas doesn't produce enough insulin or doesn't use it properly
Who is at risk for Type 2 diabetes?
My Husband :)
What are some signs and symptoms of Type 2 diabetes?
When you do a FSBS, what are some things that can change the results?
Alcohol not being dried
Do not squeeze finger
What kind of insulin flows through an insulin pump?
What are 3 Rapid acting insulins?
What are 3 Short-acting insulins?
What are 6 Intermediate-Acting Insulins?
What do sulfonylureas do?
They stimulate the pancrease to secrete insulin
What are 3 examples of sulfonylureas?
What are some side effects of sulfonylureas?
What do meglitinides do, what are some side effects, and what are two examples?
Target the Pancreas to secrete more insulin
Take 0-30 min before meal
If client doesn't eat DON'T give
Biguanides are oral hypoglycemics, what does it do, what are some side effects and teaching?
Targets the liver and blocks it from secreting extra glucose
(Hypoglycemia is NOT a SE)
Thiazolidinedione (TZD) is an oral hypoglycemic, what does it do, what are some side effects and teaching?
Targets the muscles and adipose to inprove insulin sensitivity
Inc cardiac risks
3 wks til onset of action
12 wks for max effect
DO NOT TAKE w/ CHF or liver dysfunction
What do you want to teach clients that are on oral hypoglycemics about diet?
Increase water and soluable fibers
Use sugar substitues
Alcohol in moderation
Coffee, tea and seasonings can cause inc in glucose
What do you want to teach a diabetic about exercise?
Prepare for exercise and exercise regularly
Guidelines of exercise are based on blood glucose levels and urine ketone levels
DONT exercise if ketones are present in the urine
DONT exercise within 1 hour of insulin injection or at peak time of insulin
EAT a CARB containing snack before exercise and always carry a snack to the gym
What are some diagnositc and lab tests?
NPO for 8 hrs - 70-100 ideal
PPBS (Post Prandial Blood Sugar)
Done 2 hours after you START eating meal
GTT (Glucose Tolerance Test)
Check for ketones in urine