Diabetic Drugs

Type 1 = no insulin production

Type 2 = low insulin production / insulin resistance

What is the main difference between diabetes type 1 and diabetes type 2?

Insulin

_____ = the only treatment for type 1 diabetes.

• two consecutive fasting BG levels exceeding 126 mg/dL (6.99 mmol/L)

• Hemoglobin A1C of 7% or higher

What is the diagnostic criteria for diabetes mellitus?

glycosylated hemoglobin

A hemoglobin A1C of 7% or higher is referred to as _____. 

average blood glucose over the last 3 months

Hemoglobin A1C reflects the _____.

Two consecutive fasting BG levels between 100 and 125 mg/dL (5.55-6.94 mmol/L)

What is the criteria for prediabetes?

hyperglycemia and hypoglycemia

What are the complications associated diabetes mellitus?

100 mg/dL

Hyperglycemia = fasting BG levels above _____.

• polydipsia (increased thirst)

• polyurea (increased urine output)

• polyphagia (increased appetite)

• weight loss

What are the signs of hyperglycemia?

70 mg/dL

Hypoglycemia = fasting BG levels below _____.

• diaphoresis (sweating)

• pallor

• inability to concentrate

• shaky feeling

What are the signs of hypoglycemia?

consume sugar (OJ, glucagon gel, candy)

What is the easiest treatment for hypoglycemia?

an IM injection of glucagon

If a person is unconscious and hypoglycemic, what should be done?

under the tongue (sublingually) for fast absorption

Where should glucagon gel be administered? Why?

venous sampling or capillary sampling

BG is often measured via _____.

about 70-100 mg/dL

What is approximate normal BG?

diabetic ketoacidosis (DKA)

Extreme hyperglycemia in patients with type 1 diabetes may result in _____.

The body lacks insulin to break down sugars, therefore, BG levels rise, and the body breaks down fats and proteins for energy, leading to ketoacidosis.

What happens during DKA?

metabolic acidosis

DKA causes a drop in pH, which means the person may present with _____. 

hyperglycemic hyperosmolar non-ketotic syndrome (HHNS)

Extreme hyperglycemia in patients with type 2 diabetes may result in _____.

800 mg/dL

A person with HHNS may not experience symptoms until there BG levels reach _____. 

1000 mg/dL

People with HHNS typically don’t seek care until BG levels reach _____. 

there is no ketotic state

What is the defining characteristic of HHNS?

adequately hydrate the person because a lack of hydration will cause a shift of potassium and water into cells due to insulin administration, which can lead to brain herniation and lethal dysrhythmia

The first step to treat DKA and HHNS is to _____. Why?

0.9% nss or Ringer’s lactate)

The fluid of choice for the initial management of DKA and HHNS is _____.

regular insulin

After the first liter of 0.9% nss is infused, _____ is added to the second liter.

• serum osmolarity

• potassium

• glucose

What needs to be monitored when treating DKA and HHNS.

They mimic natural insulin in a people whose pancreas does not produce or produces too little insulin.

How do insulins work?

• Humalog (lispro)

• Novolog (aspart)

• Apidra (glulisine)

List some rapid-acting insulins.

• regular insulin (humulin, actrapid, novolin)

• Velosulin

List some short-acting insulins.

• NPH

• Lente

List some intermediate-acting insulin.

• Ultralente

• Lantus (glargine)

• levemir (detemir)

What are some long-acting insulins?

• Humulin 70/30

• Novolin 70/30

• Novolog 70/30

• Humulin 50/50

• Humalog 75/25

List pre-mixed insulins.

regular insulin and insulin lispro

Which two insulins are the only ones available for IV administration?

SUBQ tissue of the abdomen (fastest absoprtion)

Insulin is most often administered where?

Insulin injection sites need to be rotated in order to prevent lipodystrophy, a condition of the adipose tissue resulting in toughening of the tissue and dimpling of the skin.

Why should insulin injection sites be rotated?