Diabetes Mellitus

Question 1

Diabetes Mellitus vs Diabetes Insipidus

Answer 1

Problem with glucose metabolism vs. polyuria + polydipsia (drinking a lot) leading to dehydration

Question 2

T1DM vs T2DM

Answer 2

insulin dependent/ketosis prone vs. non-insulin dependent/non-ketosis prone

Question 3

s+s DM

Answer 3

3 P’s - polyuria, polydipsia, polyphagia (increased appetite - ONLY in DM -> frequent swallowing)

Question 4

treatment for T1DM vs T2DM

Answer 4

diet + insulin + exercise vs.
diet + PO pill + activity

Question 5

T2DM diet

Answer 5

reduce carbs, no sugars, eat 6x a day

Question 6

MUST KNOW 4 types of insulin

Answer 6

RN LISPRO GLARGINE

regular (takes 1 hour to lower BSL, peak 2 hours, lasts 4 hours given subcut or IV)
NPH (acts longer, intermediate. takes 6 hours to work, peaks 8-10 hours, lasts 12. Cloudy NO iv bag only subcut)
Lispro (humalog, goes into insulin pump WORLDS FASTEST ACTING INSULIN 15 min, 30 min, 3 hours - THEY BETTER BE EATING! give with meals)
Glargine (long acting, 12-25 hours. Very slowly absorbed, no peak, no danger for hypoglycemia.

Question 7

What to do if a diabetic is sick

Answer 7

3 rules - take insulin or pill, take sips of water, stay as active as possible

Question 8

Complications of DM

Answer 8

hypoglycemia causes permanent brain damage HIGH PRIORITY
3 causes: not enough food, too much insulin, too much exercise

Same sx as drunk and shock (cognitive impairment, vasomotor collapse, pale, cold, clammy, low BP, weak thready pulse, headache)

Question 9

Tx for low BS in T1DM

Answer 9

15/15 x 3
15 gm of glucose, wait 15 minutes, if glucose under 60, give 15 gm more and wait 15 minutes, if <60 give 15 gm more and wait 15 min, if <60 call HCP.

Unconscious? 2 options - give glucagon IM or run D10-D50 IV

Question 10

S&S DKA

Answer 10

DKA (dehydration, ketones/kussmual/high k+ (potassium)

2 things - pump full of fluids, give high flow IV rate 200/hr + IV with insulin in another IV on another arm

Question 11

High glucose in T2DM

Answer 11

Rehydrate with IV, don’t need insulin

Question 12

Long term complications of diabetes

Answer 12

2 - poor tissue perfusion + peripheral neuropathy

Question 13

which lab test is the best indicator or long-term blood glucose control

Answer 13

HA1C, also called glycosylated hemoglobin