Endocrine System: Diabetes Mellitus and Insulin Management

Vocabulary practice flashcards covering pathophysiology, diagnostic criteria, clinical complications, pharmacology, and nursing protocols for Diabetes Mellitus.

Glucagon

A pancreatic hormone released in response to low blood glucose levels and exercise that functions to elevate circulating blood sugar.

Islets of Langerhans

The endocrine clusters of cells in the pancreas responsible for producing and secreting hormones, such as insulin and glucagon, directly into circulation.

Type 1 Diabetes Mellitus

An autoimmune disorder typically presenting abruptly in childhood characterized by absent or deficient insulin secretion, requiring exogenous long-acting and short-acting insulin therapy.

Diabetic Ketoacidosis (DKA)

An acute metabolic emergency resulting from profound insulin deficiency in type 1 diabetes, presenting with metabolic acidosis, ketone production, Kussmaul respirations, and sweet, acetone (fruity) breath.

Type 2 Diabetes Mellitus

A progressive metabolic condition characterized by insulin resistance and relative insulin deficiency, managed initially with lifestyle changes and first-line oral agents such as metformin.

Metabolic Syndrome

A constellation of clinical risk factors for type 2 diabetes including central obesity, hyperlipidemia, and elevated fasting glucose levels.

Fasting Plasma Glucose (FPG)

A diagnostic blood test requiring an $8\text{-hour}$ fast, where a finding of $>126\,mg/dL$ on two separate days confirms a diagnosis of diabetes mellitus (normal reference range: $70-110\,mg/dL$).

Glycosylated Hemoglobin (Hgb A1C)

A clinical laboratory test that provides an average measurement of blood glucose control over approximately $120\text{ days}$; normal is $4-6\%$, diagnostic threshold for diabetes is $6.5-8\%$, and the target therapeutic goal is $<7\%$.

Diabetic Nephropathy

Microvascular kidney damage caused by chronic hyperglycemia that can progress to end-stage renal disease (ESRD); managed and renal-protected using ACE inhibitors or ARBs.

Diabetic Retinopathy

Microvascular damage to the retina resulting from chronic hyperglycemia, requiring routine annual eye examinations for screening and early detection.

Diabetic Peripheral Neuropathy

Nerve dysfunction and damage secondary to chronic hyperglycemia that leads to bilateral paresthesia, loss of protective sensation, and increased risk for unnoticed lower extremity ulcers.

Rapid-acting Insulin

Insulin formulations such as insulin aspart (NovoLog) and insulin lispro (Humalog) that feature an onset of $15\text{ mins}$, peak in $30\text{ mins}-3\text{ hrs}$, and duration of $3-5\text{ hrs}$; administered with meal trays or for acute coverage.

Short-acting Insulin

Regular insulin (Humalog R, Novolin R) with a subcutaneous onset of $30-60\text{ mins}$, peak of $2-4\text{ hrs}$, and duration of $6-8\text{ hrs}$ (possesses an immediate onset when administered intravenously).

Intermediate-acting Insulin (NPH)

A cloudy subcutaneous suspension (Humulin N, Novolin N) with an onset of $1.5-2\text{ hrs}$, peak of $4-6\text{ hrs}$, and duration of $12-18\text{ hrs}$.

Long-acting Insulin

Basal insulin formulations including insulin glargine (Lantus) and insulin detemir (Levemir) with an onset of $1-2\text{ hrs}$, no peak, and a duration of $24\text{ hrs}$, mimicking continuous basal pancreatic secretion.

Clear-to-Cloudy Insulin Mixing Procedure

The multi-step protocol for combining short-acting regular insulin and intermediate-acting NPH insulin in one syringe: roll the NPH vial, inject air into NPH, inject air into regular, draw up clear regular insulin, and finally draw up cloudy NPH insulin.

Insulin Delivery Devices

Medical equipment used for subcutaneous administration of insulin, consisting of insulin syringes, insulin pens, jet injectors, and continuous insulin pumps.

Sliding Scale Insulin Protocol

A standardized regimen prescribing rapid- or short-acting insulin doses based on blood glucose checks: $0-150\,mg/dL$: no coverage; $151-200\,mg/dL$: $2\text{ units}$; $201-250\,mg/dL$: $4\text{ units}$; $251-300\,mg/dL$: $6\text{ units}$; $301-350\,mg/dL$: $8\text{ units}$; and $>350\,mg/dL$: $10\text{ units}$ plus call provider.

Adult Hypoglycemia Protocol

A standardized emergency procedure directing repeated blood glucose testing and intervention every $15\text{ minutes}$ until blood glucose reaches $70\,mg/dL$ or higher, transitioning to IV therapy if two PO treatments fail or if the patient is unable to take oral intake.

Metformin

A biguanide oral antihyperglycemic medication recognized as first-line pharmacologic therapy for patients diagnosed with type 2 diabetes.