Disbetes Unit 6 Flashcards Preview

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Flashcards in Disbetes Unit 6 Deck (23):
1

Chronic complication - Microvascular

Retinopathy, nephropathy, neuropathy.

2

Chronic complications- Macrovascular

CAD, CVA, MI, PVD (amputations)

3

Etiology of Diabetes

Unknown
Autoimmune - Beta cells destroyed
Viral
Environmental
Genetic
Obesity/inactivity = type 2
Non-immune = secondary to other disease type 1

4

Extra cellular action of insulin

Fats into fatty acid and glycerol, CHO into simple sugars, proteins to amino acids

5

Intracellular action of insulin

Insulin stimulates entry of amino acids into cell & enhances protein formation

6

Glycogen metabolic action

Stimulates breakdown of protein & fat stores

7

Hyperglycemia (metabolically)

Causes metabolism of protein and fats. Increases protein wasting & ketones- deposits of lipids in vascular walls

8

Diagnostic fasting blood glucose ? Oral glucose tolerance test?
Hb A1C ?

FBG is = > 126mg/dl
OGTT => 200
A1C > 6.5%

9

Hyperglycemia causes

Illness/infection
Too much food
Too little medication
Inactivity
Stress
Corticosteroids

10

Hypoglycemia causes

Alcohol intake without food
Too little food
Too much medication
Too much exercise
Weight loss without changing meds
Beta blockers masking symptoms

11

Hyperglycemia signs & symptoms

3 P's
Weakness fatigues
Blurred vision
Headache
N/V
Abdom cramps
Glycosuria
Progression to DKA

12

Hypoglycemia signs & symptoms

Cold clammy
Numbness in fingers, toes, mouth
Tachycardia
Emotional changes
Headache
Nervousness, tremor
Unsteady gait
Slurred speech
Coma

13

Hypoglycemia Interventions

15-20 grams of simple carbs
Check and take again in 15 if not resolves
Carry CHO on you
If unresolved get medical attention

14

Hyperglycemia Inteventions

Medical care if symptomatic
Check BS frequently
Drink fluids frequently
Take medication as prescribed

15

Metabolic Syndrome?

Combination of symptoms - Any 3 out of 5

Waist >40 in men and >35 in in women
Triglicerides >150 mg/dl or on meds
HDL 130/85 or on meds
FBG >110

16

Somogi Syndrome is?
Treat?

Hyperglycemic in the morning and Hypoglycemic (counter-regulatory hormones) at night
Treat: Decrease evening insulin dose, FS between 2-4 am.

17

Dawn Phenomenon ?
Treat?

Hyperglycemia in the morning - hormones (GH & Cortisol)
Treat: Increase evening insulin dose

18

Diabetic Ketoacidosis ?
Treat?

Blood sugar increases to 300-800 - Dehydration, HypoTN

Treat: Acute = O2 (Kussmaul breathing), protect airway, NS IV until urine output is >30ml/hr, regular insulin drip 2u/hr.
Recovery= Slow hydration with IV fluids, replace K, Mg, Phos, Na, Chl with lab monitoring

19

Hyperosmolar Hyperglycemic Syndrome

Non-Ketonic
Patient produces enough insulin but not enough to prevent hyperglycemia
Hypotention due to osmotic Diresis
Dehydration & Tachy
Seizures & Cerebral Dehydration
Common with PNA, UTI, sepsis
TREAT: Control Blood sugar, hydrate

20

Ultra Short Acting Insulin?
Onset, Peak, Dur?

Lispro (Humalog), Aspart (Novalog)
O= 5-15 min
P= 30-60 min
D=2-4 hr

21

Short acting insulin?
Onset, Peak, Dur?

Regular (Humulin), R-Novolin
O= 30min-1hr
P= 2-3 hr
D= 4-6 hr

22

Intermediate Acting?
Onset, Peak, Dur?

NPH Humulin N, Novolin
O = 2-4 hr
P = 4-12 hr
D = 16-20 hr

23

Long Acting insulin?
Onset, Peak, Dur?

Glargine (Lantus), Detemir (Levemir)
O= 1 hr
P= continuous/no peak
D = 24 hr