Diabetes

Tx for Type 1

Insulin*

Diet

Exercise

Tx for Type 2

Diet* (restrict calories and eat 6 small meals a day)

Oral hypoglycemia med

Exercise

What insulin do you use in an IV drip?

Regular

R= rapid and run

Regular insulin onset, peak, and duration

O: 1 hr

P: 2 hrs

Duration: 4 hrs

NPH onset, peak, and duration

O: 6 hrs

P: 6-8 hrs

Duration: 10-12 hrs

What does NPH insulin look like?

Cloudy

Lispro onset, peak, and duration

O: 15 mins

P: 30 mins

Duration: 3 hrs

When to give Lispro insulin?

With meals, not before

Glargine onset, peak, duration

No onset or peak

Duration: 12-24 hrs

When to give glargine?

Bedtime because there is little to no risk of hypoglycemia

Why is the peak of insulin so impt?

This is the highest risk for hypoglycemia

Hypoglycemia s/s

Looks like a person who is drunk and in shock

Blurred vision

Hypoglycemia tx

If conscious, a carb + starch/meat (ex: fruit juice + crackers)

If unconscious, IM glucagon or D50 IV

Who can get DKA?

T1DM

Cause of DKA

Acute viral resp disease in the past 2 weeks

DKA s/s

Dehydration

Ketones in blood/urine

Kussamal Resps

High K+

Metabolic acidosis

DKA tx

IV fluids (fast)

Regular insulin

Who can get HHS?

T2DM

HHS looks like what?

Dehydration, so treat like dehydration

HHS s/s

Hot, flushes, dry

No ketones or acidosis

HHS tx

IV fluids (fast)

DKA vs HHNS glucose levels

DKA: usually above 250 but do not get as high as 600

HHNS: usually 600+

Most common complication of regular insulin IV infusions

Hypoglycemia

Hypokalemia

-gliptin meds

PO meds used to manage T2DM

Common AE for -gliptin meds

Pancreatitis

N/V, abdominal pain

Characteristic of diabetic nephropathy

Proteinuria (over 300mg in a 24 hr urine collection)

Tx for diabetic nephropathy

ACE inhibitors (-prils)