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diabetes is the leading cause of?
end-stage renal disease, blindness, amputations
Type 1
born with absent or minimal insulin production
type 2
develops insulin resistance, decreased production
gestational
prediabetes
drug related
when pregnant
at high risk for diabetes d/t high BG
normally from corticosteroids
How to end drug related diabetes
discontinue the drug
What is more likely to develop d/t diabetes
heart disease and hypertension
signs and symptoms of diabetes type 1 (3 p’s)
polyuria, polydipsia(thirst), polyphasia(hunger)
what cells produce insulin
b cells
how much insulin does our body secrete?
40-50 units
other name for prediabetes
impaired glucose tolerance
what is the fasting glucose level for someone who has prediabetes?
100-125
what is the IGT for someone w prediabetes
140-199
how long does it take someone with prediabetes to develop type 2 diabetes?
10 years
what labs should you look at to look for prediabetes?
BG and A1C
what is an A1C
monitors BG over months
What ethnic populations is type 2 most common in?
African Americans, Asian Americans, Hispanic Americans, Native Americans, Alaskin natives
what ethnicites have the highest rate of diabetes?
native and alaskan americans
what are the 4 major metabolic abnormalities ?
1 insulin resistance
2 pancreas decreased ability to produce insulin
3 inappropriate glucose production from liver
4 alternation in production of hormones and adipokines
secondary diabetes
results from another medical condition
ex) treatment of a medical condition that causes abnormal blood glucose levels (corticosteroids)
usually resolves when underlying condition is treated
sx of DM 2
3 P’s, fatigue, recurrent infections, recurrent vaginal yeast, prolonged wound healing, visual changes,
sx of DM 1
3 P’s, weight loss, fatigue, increased infection rate, rapid onset, insulin dependent, loss of sensation, impaired wound healing
How often should you monitor BG with DM 1?
every 2 hours
what are the interventions for DM 1?
continous insulin through an insulin pump, self-monitoring BG, meal plan, nutritionist, inuslin drip, UTI and opthomology checks
what BG levels are DM for oral glucose tolerance test?
oral glucose tolerance test >200
what BG levels are DM for A1C?
>6.5%
what are BG levels are DM for fasting BG?
>126
what are BG levels are DM for random BG?
>200
what is the pt education for DM1?
how to use the insulin pump
limit ETOH consumption
complications of the disease
sx of hypo and hyperglycemia
monitor BG before meals
monitor BG before, during, and after working out
what are the interventions for DM2?
identifying those at risk
dietition/nutritionist
insulin pen
monitoring BG before and after meals
foot and oral care
metformin
medical ID bracelet
what can’t metformin be taken with?
IV contrast
proliferative diabetic neuropathy
abnormal blood vessels grow on the surface of the retina (advanced stage)
non-proliferative retinopathy
early stage where there are mild or no sx of abnormal vessels on the retina
sx of hyperglycemia
3 p’s, somogyi effect, dawn phenomenon, increased HR, increased BP, increased resps., fatgiue, headache, LOC, dry mouth
somogyi effect
when an episode of low BG at night turns into hyperglycemia in the morning
dawn phenomenon
the hormones in your body naturally increase your BG levels in the am
what does a pts vitals look like with hypergylcemia?
increased HR, BP, and resps
what should someone with hyperglycemia report to their dr?
blurred vision
what can hyperglycemia turn into?
HHS
what is the pnemonic for hyperglycemia?
“hot and dry, sugar is high”
when should a pt eat who has just been given fast-acting, rapid, or intermediate acting insulin?
15-30 mins after administration
metformin
the only oral diabetes med a pt can take
what pts can take metformin?
type II pts
when should D5 be pushed?
LOC and BG less than 70
what has similar sx as drunkeness?
hypoglycemia
what are the names of the rapid acting insulins?
aspart
lispro
glusine
what is the name of the short acting insulin
regular insulin
what is the name of the intermediate acting insulins?
NPH
what are the names of the long term insulins?
glargine
detemir
degludec
what are the sx of hypoglycemia?
visual changes, irritability, hunger, weakness, sweaty, LOC, seizure, coma
what is considered hypoglycemia?
less than 70
what are the interventions of hypoglycemia?
juice/pop, no fatty foods, recheck BG every 15 mins, recheck BG 45 mins after treatment
when should the BG of someone who is hypoglycemic be checked?
15 mins after juice is given and then after 45 mins
what are the brand names for rapid acting inuslin?
Novolog
humalog
apidra
what is the brand name for short acting insulin?
humulin
what are the brand names for intermediate acting insulin?
Novolin N
Humulin N
what are the brand names for long-acting insulins?
Lantus
Levemir
Tresiba
