Glucose Regulation - CCC1

What is diabetes mellitus?

A disorder of glucose regulation caused by an imbalance between nutrient intake, insulin action, and cellular glucose uptake

What is the normal blood glucose range?

70–110 mg/dL

Which pancreatic cells produce insulin?

Beta cells in the islets of Langerhans

What is the average daily insulin secretion in adults?

0.6 units/kg/day

What causes Type 1 diabetes?

Autoimmune destruction of pancreatic beta cells

What causes Type 2 diabetes?

Insulin resistance and decreased insulin production

What environmental factors contribute to Type 2 diabetes?

Obesity and sedentary lifestyle

What is the primary function of insulin?

Transports glucose from the bloodstream into cells

Which tissues are insulin dependent?

Skeletal muscle and adipose tissue

Where is excess glucose stored?

Liver and muscle as glycogen

What is exogenous insulin?

Insulin obtained from an outside source

Who requires exogenous insulin therapy?

All patients with Type 1 diabetes and some with Type 2 diabetes

Which insulin has the fastest onset of action?

Rapid-acting insulin

Examples of rapid-acting insulin?

Lispro, aspart, glulisine

When should rapid-acting insulin be administered?

Within 15 minutes of meals

Which insulin can be administered intravenously?

Regular insulin

Which insulin has little or no peak?

Long-acting insulin

Examples of long-acting insulin?

Glargine, detemir, degludec

Which insulin is cloudy in appearance?

NPH insulin

What is the onset of rapid-acting insulin?

10–30 minutes

What is the peak of short-acting insulin?

2–5 hours

What is the duration of intermediate-acting insulin?

12–18 hours

What is the purpose of sliding scale insulin?

To correct elevated blood glucose levels

At what blood glucose level should the provider be notified?

Greater than 400 mg/dL

Which injection site provides the fastest insulin absorption?

Abdomen

Why should insulin injection sites be rotated?

Prevents lipohypertrophy and ensures consistent absorption

At what angle should insulin be injected subcutaneously?

45–90 degrees

Why can insulin not be taken orally?

It is destroyed by gastric enzymes

How long can opened insulin be kept at room temperature?

Up to 4 weeks

How should unopened insulin be stored?

Refrigerated

What does an insulin pump deliver?

Continuous basal insulin with bolus doses

What is the main benefit of an insulin pump?

Tighter blood glucose control

What are classic symptoms of hyperglycemia?

Polyuria, polydipsia, polyphagia

Why does hyperglycemia cause dehydration?

Osmotic diuresis from excess glucose

What cognitive changes occur with hyperglycemia?

Headache, confusion, blurred vision, coma

What is hypoglycemia defined as?

Blood glucose less than 70 mg/dL

What are early signs of hypoglycemia?

Shakiness, sweating, hunger, anxiety

What are severe symptoms of hypoglycemia?

Confusion, seizures, coma

Why can hypoglycemia mimic stroke or intoxication?

Causes altered mental status and speech changes

Which hormones counteract hypoglycemia?

Glucagon, epinephrine, cortisol, growth hormone

What is gluconeogenesis?

Production of glucose by the liver

What is glycogenolysis?

Breakdown of glycogen into glucose

Why is self-monitoring of blood glucose important?

Guides diet, exercise, and medication decisions

Who must perform self-monitoring of blood glucose?

All insulin users

What is continuous glucose monitoring?

Continuous measurement of glucose that tracks trends and alerts abnormalities

What does the A1C test measure?

Average blood glucose over the past 2–3 months

What is the target A1C for most adults?

Less than 6.5–7%

Which conditions can affect A1C accuracy?

Anemia and sickle cell disease

Which insulin regimen most closely mimics natural insulin secretion?

Basal-bolus regimen

What insulin provides basal background coverage?

Long-acting or intermediate-acting insulin

Which insulin is drawn up first when mixing?

Clear insulin before cloudy insulin

Which insulin types should never be mixed?

Long-acting insulins

What is the Somogyi effect?

Rebound hyperglycemia following nighttime hypoglycemia

How is the Somogyi effect treated?

Bedtime snack or reduced insulin dose

What is the dawn phenomenon?

Morning hyperglycemia caused by early-morning hormone release

What is essential diabetic foot care teaching?

Inspect feet daily, wear proper footwear, avoid walking barefoot

Why is diabetes education important?

Prevents complications and improves glucose control