Glucose Regulation

what is considered hypoglycemia

<70 mg/dL

what is considered hyperglycemia

<110 mg/dL

insulin

lowers blood sugar level via moving glucose into cells

produced in pancreas

glucagon

increase blood sugar via suppressing insulin and stimulating hepatic glucose levels

counterregulatory hormones

oppose action of insulin to raise blood glucose

glucagon, epinephrine, growth hormone, cortisol

why is pregnancy a risk factor for blood glucose imbalance?

hormonal changes increases the risk of hyperglycemia

why are infants at risk for blood glucose imbalance

at risk for hypoglycemia

why are older adults at risk for blood glucose imbalance?

impaired glucose metabolism and hyperglycemia because of reduced lean muscle

individual risk factors

genetics

medication

modifiable risk factors

diagnostic testing

blood glucose testing

antibody testing

lipid analysis

renal function test

sulfonylureas examples

glipizide, glyburide, glimepiride

sulfonylureas use

treat type 2 diabetes

sulfonylureas MOA

srimulate sbeta cells to produce insulin

sulfonylureas side/adverse effects

GI upset

extreme hypoglycemia

nursing implications for sulfonylureas

monitor blood sugar prior to administration

teach patient to avoid alcohol

monitor elderly patients and patients taking beta blockers closely for signs and symptoms of hypoglycemia

contraindication for sulfonylureas

pregnancy

type 1 diabetes

DKA

metformin use

type 2 diabetes

metformin MOA

reduces hepatic glucose production

doesn't cause hypoglycemia

Metformin Contraindications/Precautions

renal disfunction

metabolic acidosis

DKA

nursing implications for metformin

- take w/ meals

- periodic test of renal function and liver function

- must hold drug at least 2 days before and after procedures require iodine (hypaque): may decrease renal perfusion