Pediatrics (Week 10)

Diabetes

• Type 1: no insulin production (genetic)

• Type 2: not enough insulin (obesity, lifestyle)

• Teaching: blood glucose monitor, insulin, nutrition

Hyperglycemia

• thirst, polyuria, fatigue, n/v, confusion

Management

• blood glucose monitor

• Target range individualized

• HgbA1C =3 month average

If high then it’s been going on for a while

Insulin Therapy

Long Acting (glargine)

• 1-4 onset, no peak, 24 hr duration

Rapid (lispro)

• 15-30 min onset, 30-3hr peak, 3-5 hr duration

• Need patients blood glucose at that moment and how many carbs they are going to wear (total-fiber)

• Then give insulin

Management

Exercise

• need more glucose and helps insulin work more efficiently

Illness

• don’t stop insulin, they will need it more

Complications

Hypoglycemia

• need carbohydrates

• s/s = sweaty, glittery, pale, angry

• 15 by 15 by 15 rule

• If unconscious give gludocon

Hyperglycemia

• done

DKA

• Acidic blood (ketones) from hyperglycemia

• kussmall breathes, dehydration, ketones in urine

• NEED FLUIDS AND IV INSULIN