Flashcards in Diabetes Deck (85)
Alpha cells produce
Beta cells produce
Delta cells produce
What is the pathophysiology of diabetes mellitus?
Insulin deficiency --> glucose cant enter cells so they stay in blood causing hyperglycemia
What is the pathophysiology of glycosuria?
Serum glucose rises and spills into urine
What is glycogenesis?
cells break down protein for conversion to glucose by liver
What are the effects of hyperglycemia on Na, K, & P?
Na: low sodium concentration
K: Potassium leaves body via urine
P: low phosphate
What is the pathophysiology of Ketoacidosis?
1. When glucose not available, body breaks down fat
2. Ketones released and eliminated via urine/lungs
3. Ketones (strong acids) lower blood pH and cause ketoacidosis
What are consequences of acidosis?
1. Kussmaul respiration
2. Hypocapnia (low CO2) causes cerebral vasoconstriction --> headaches
3. Circulatory depression
4. Oxygen dissociation curve shifted to right (O2 unloaded quicker)
5. limited effect on CNS (BBB poorly permeable to bicarbonate & hydrogen)
What clinical manifestations are Red Flags for Type 1 Diabetes?
1. Rapid weight loss over 1-2 weeks
2. constant thirst
3. frequent urination
4. always tired even with adequate sleep
Nurse Pearls for Urine Dip test
1. Ketones should not be present
2. Send to ER
3. Draw labs before administering Insulin
What is a normal blood sugar level?
What are symptoms of hyperglycemia?
1. Weight loss
3. More prone to infection
4. Insulin dependent
What are characteristics of Type 1 Diabetes?
2. Rapid Onset
3. Polyuria, Polydipsia, weight loss over 1-2 wks
4. Lifetime insulin
6. High risk if father has Type 1 DM
What is the "Honeymoon" phase in Type 1 Diabetes?
1. Directly after diagnosis
2. Diabetes seems to get better and require less insulin.
3. Only temporary
Characteristics of Type 2 Diabetes
1. Slower Onset
2. Related to obesity
3. Seen in kids after puberty
4. Treated with oral meds/insulin
5. Dietary changes needed
What causes insulin resistance?
1. Genetic disposition
2. Little exercise
3. Body fat
4. Leptin receptors are desensitized --> hypephagia (very hunger
What is acanthosis nigircans?
dark, thick skin around neck
decreases with weight loss/exercise
How is Type 1 Diabetes managed?
2. Glucose monitoring
3. HgA1C measurements
4. Urine test for ketones (test when 240 mg/dL or higher)
Patient Education for Diabetes and Insulin
1. Know type/duration/peak/onset/etc of insulin
2. Meal planning (carbohydrate counting)
3. Insulin pump (if they are responsible)
4. Monitor glucose (4x daily type 1)
What are the common insulin administration sites? Which is the best absorption site?
1. Upper arm
4. Upper outer thighs
Abdomen is best site for absorption
When is rapid acting insulin given?
Within 15 minutes of meals (before/after)
What is Insulin Aspart (Novolog)
Rapid Acting Insulin
When is the onset of rapid acting insulin?
When is the peak effect of rapid acting insulin?
What is the duration of rapid acting insulin?
How often should you give rapid acting insulin?
No more than Q3H
What is Regular Insulin?
Short acting insulin
What is short acting insulin used for?
1. Control blood sugar during meals and snacks
2. Correct high blood sugars