Type 1/Type 2
Name the key differences between type 1 and type 2
type 1- autoimmune disorder, no insulin
type 2- develops over time, produce some insulin
When should you hold Metformin (Glucophage) and what class is it in
when having surgery or getting contrast dye (not all docs do this)
class-Biguanide
Glucose
sugar absorbed from carbs we eat, use to make energy
The only insulin that can be given IV drip
Regular Insulin
What glucose level will you see
<70
Name two risk factors of Type 2 diabetes
overweight
obesity
advanced age
family history
Why are Thiazolidinediones hardly used
adverse effects (HF MI Stroke)
Insulin
hormone released from beta cells of the pancreas, help transport glucose into cells.
How soon after giving Rapid-acting Insulin does the patient need to eat?
10-15 minutes
Name two things that can happen if left untreated
•Can progress to loss of consciousness, seizures, coma, and death
What is an A1C and what # will you typically see for a diabetic
3 month average of blood sugars
6.5 or higher
Oral Anti Diabetic Agents work on what three defects of type 2
insulin resistance
decreased insulin production
increased hepatic glucose production
Glucagon
hormone released from the alpha cells of the pancreas. glucagon tells the liver to release glucose, raising the blood glucose
What is the difference between Basal Insulin and Bolus Insulin?
Basal(background)- manage glucose levels in between meals and overnight
Bolus (mealtime) - controls blood sugar with meals, need to eat shortly after given
When will you see signs and symptoms of hypoglycemia
no warning signs/symptoms until glucose critically low (hypoglycemic unawareness)
Name four signs and symptoms of Type 1 Diabetes
Polyuria
Polydipsia
Polyphagia
weight loss
weakness
fatigue
When should you NOT take Meglitinides
•Should not be taken if meal skipped
Glycogenesis
creation/making of glycogen
Which insulins can be mixed together?
•Can mix short- or rapid-acting insulin with intermediate-acting insulin in same syringe
Name the four causes of hypoglycemia
•Too much insulin or oral hypoglycemic agents
•Too little food
•Delaying time of eating
too much exercise
Name three signs and symptoms of DKA
Dehydration
lethargic/weakness
abdominal pain/anorexia/nv
Kussmaul respirations
sweat, fruity breath
blood glucose level >250
How do SGLT2 work in the kidneys
blocks reabsorption of glucose, leaves in urine, lowering blood glucose level
Gastroparesis
delayed gastric emptying in autonomic neuropathy
Name the three long acting insulins
Glargine (Lantus)
Detemir (Levemir)
Degludec (Tresiba)
What is the rule of 15?
15 g of a simple carb (4-6oz juice)
recheck glucose level in 15 minutes
repeat if still <70
avoid foods with fat and overtreatment
give complex carbafter recovery