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NURS200 > DM > Flashcards

DM Flashcards

(58 cards)

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1
Q

Foods with a high glycemic index release glucose ____

A

Fast

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2
Q

Foods with a low glycemic index release glucose ____

A

Slow

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3
Q

The slow adn steaduy release of glucose in low glycemic goods is helpfu lor

A

Keep glucose level under control

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4
Q

What part of a meal has the greatest influence over BG?

A

Carbs consumed

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4
Q

Reasons to eat low glycemic index food

A

Eating foods with a low Glycemic Index may help you to:

Contrl BG

Control your cholesterol level

Control your appetite

Lower risjk. for heart disease

Low risk of DMT2

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5
Q

Fiber rich food and glycemic index

A

Low glycemic index, releases glucose slowly

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6
Q

Protein intake for DM?

A

Protein intake similar to general population, high protein discouraged in those with kidney disease.

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7
Q

Recommended dietary fat in DM pts

A

Similar to general population, however, mono-saturated fats and omega 3s are encouraged

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8
Q

Body weight and DM

A

Weight loss is encouraged especially early in type 2 diabetes as fat can increase insulin resistance.

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9
Q

ICR

A

Insulin to Carb Ratio

usually 1:10

60 carb meal - 6 units

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10
Q

Most adults with diabetes aim for how many carbs per meal?

A

45-60 - heavily dependent on lifestyle and activities

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11
Q

What lifestyle changes can have a great impact on DMT2

A

Exercise
Diet (Lower carbs/glycemic index foods)
Smoking cessation

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12
Q

It is critical that insulin dosages be balanced with regular food intake and exercise. WHY?

A

So you don’t go hypoglycemic

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13
Q

All people diagnosed with DM should see who?

A

Registered Dietician

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14
Q

People with DMT1 require ______ to survive

A

Insulin

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15
Q

Almost all insulin is ____ obtained with recombinant tech

A

Human

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16
Q

Insulin often includes _____ to help with duration of action

A

Zinc

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17
Q

When is the critical time to watch for hypoglecemia in insulin using pts?

A

At it’s peak

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18
Q

If Insulin is taken when food has not been eaten and there is little to no glucose in the blood _____________ can occur.

A

Hypoglycemia

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19
Q

Most common adverse adverse effect

A

Too much insulin
Wrong time
Meal skipped

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20
Q

Hypoglycemia treated with

A

Dextrose and sugar

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21
Q

As insulin levels increase, what happens to K+?

A

It is driven into the cells since glucose

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22
Q

Morning hyperglycemia

A

Insulin level decreases during the night

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23
Q

Dawn phenomenon

Study These Flashcards
A

Bw 4 and a am GLucose levels rise

a natural increase in blood sugar levels that occurs in the early morning. It’s a common cause of high blood sugar in people with diabetes.

24
Somogyi Phenomenon
Rapid decrease in blood glucose usually in the night This stimulates the release of hormones that elevate blood glucose Epiniephrine, Cortisol and Glugagon. Resulting in an increased blood glucose in the morning.
25
Response to somagyi
more food at night, adjusted insulin dose timing
26
Why would someone be hyperglycemic post surg despite being NPO
Stress results in hyperglycemia
27
Insulin pump
Adinsters insluin automatically in early morning
28
Always have what in another IV when a person is on insulin IV?
Dextrose
29
What kind of insulin is used in an IV?
Regular insulin
30
Nursing Considerations For Patients Receiving Insulin Therapy
Obtain complete health history including allergies and drug history Assess vital signs including signs of infection. Why? Assess blood glucose levels Assess ability and willingness of patient to have next meal. Why? Assess subcutaneous areas for potential injection sites
31
Client teaching- What should we teach the client receiving Insulin?
Education regarding hypogleciam, knowing their BG Where to inject themselves Storage of insulin
32
Pharmacotherapy with Oral Antihyperglycemics
Prescribed after diet and eexercise fail to manage their DM May cause hypoglecemia Not effective for DMT1
33
Alpha-Glucosidase Inhibitors
Block enzymes in the small intestine responsible for breaking down complex carbohydrates into monosaccharides Hypoglycemia may occur when combined with insulin or a sulfonylurea
34
Incretin enhancers
Incretins are hormones secreted by the intestine in response to a meal and signal the pancreas to release insulin and the liverto stop producing glucagon. Ex: Sitagliptin (Januvia)
35
4 classess of incretin enhncers
Glucagon-like peptide (GLP-1) Dipeptidyl peptidase 4 (DPP-4) Sodium –glucose cotransorter-2 (SGLT2) Pramlinitide (Symlin) injectable for type 1 and 2 given after meals slows he absorption
36
Sodium –glucose cotransorter-2 (SGLT2)
SGLT2i in T2D and CKD 36 SGLT2 inhibitors have demonstrated an ability to slow eGFR decline and reduce hard renal outcomes in clinical trials
37
Sulfonyrlureas
Divided into first- and second-generation categories Stimulate release of insulin from pancreatic islet cells Increase sensitivity of insulin receptors on target cells
38
Januvia
Increases
39
Therapeutic effects of sulfonylurea
Lowers blood glucose levels in patients with type 2 diabetes Stimulates release of insulin from pancreatic beta cells
40
Adverse effects of sulfonylurea
Nausea, vomiting, loss of appetite Photosensitivity, rashes Urticaria, pruritis Hypoglycemia especially in adults
41
Thiazolidinediones
Reduce blood glucose by decreasing insulin resistance and inhibiting hepatic gluconeogenesis Hypoglycemia does not occur with this class.
42
Planning for pts recieving oral antihyperglyceics
Have patient demonstrate ability to monitor blood glucose
43
Remember Type 2 diabetes is a progressive condition and many people diagnosed with it will eventually need insulin, or they may need insulin in periods of ______ and _______.
Stress and illness
44
1 food item gernally = how many grams of carbs
15
45
Rapid action insulin time/onset profile
Novorapid, Apidra, Lispro 10-15 min onset 1-2 hr peak 3-5 hr duration To be given 0-15 minutes before (or after meals)
46
Short acting insulin time action profile
Humulin R/Toronto Onset 30 min 2-3 hr peak 6.5 hr Duration Given with one or more meals per day, admin'd 30-45 mins before start of meal
47
Insulins included in Bolus category
Rapid acting and short acting
47
Basal insulins are
Intermediate action and long acting, usually given once daily - set the baseline insulin amount
48
Intermediate acting insulin time action profile
Humulin N/NPH Onset 1-3 hour Peak 5-8hrs Duration up to 18hours Often given at bedtime, not given in regard to meals (QD or BID)
49
Long acting insulin
Glargine (Lantus, Basalgar), Detemir (Levemir) Onset 90 min NK peak Duration up to 24 hours Often given at bedtime, regardless of meals. (QD or BID)
50
T1DMs use which insulin
Premix of Humulin R and Novolin Given with one or more meals before day, admined before meals
51
Which type of insulin is availble in the highest conc?
Insulin glargine - up to 300 units
52
Mechanism of action for Humulin R/Novolin ge Toronto
Insulin produced through recombinant DNA techniques; replacement for endogenous insulin Can be mixed with Humulin (NPH)
53
Correcting Hyperglycemia in the AM
Avoid carbohydrates at bedtime. Adjust your dose of medication or insulin Switch to a different medication. Change the time when you take your medication or insulin from dinnertime to bedtime Use an insulin pump to administer extra insulin during early-morning hours.
54
Secretagogues examples
Sulfonylureas Meglitinides
55
Drug types used to increase insulin sensitivity
Bigunaides Thiazolidinediones
55
Biguanides
Decreases the hepatic production of glucose and reducing insulin resistance. Does not promote insulin release from the pancreas. Most side effects are minor, and GI related. Does not cause hypoglycemia or weight gain. Can cause lactic acidosis in those with decreased liver function. Ex Metformin

NURS200 (30 decks)

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