Get to the Point (about injection technique)
- glycemic (glucose) variability
- hypoglycemia (unexplained)
What is the impact of injecting into a lipohypertrophy?
Soluble fiber (lentils, beans, psyllium)
What type of fiber reduces LDL cholesterol?
Pop, Juice, Honey, Dex 4, Glucogel are …
What are acceptable treatments for hypoglycemia less than 4mmol/L?
infections
increased length of stay
readmission
list three complications of hyperglycemia in hospital
Long acting and works over 24-72 hours
What is basal insulin?
- Poor site rotation
- Too much force
- Extended needle use (not changing the needle with each injection)
What is causes lipohypertrophy, according to 2020 Fit4 guidelines?
Protein and carbohydrate
Peanut butter and toast (bread)
Crackers and cheese
Nuts and plain yogurt
What are examples of healthy snacks?
Retest their blood sugar after 15 min
Have a carb and protein snack if meal is more than an hour away and blood sugar is more than 4 mmol/L
Repeat treatment if blood sugar is less than 4mmol/L after the first treatment
After treating a low blood sugar list 3 things a patient should do
polyphagia
List the three most common symptoms of hyperglycemia
Elevated ketones
DKA
For someone living with type 1 diabetes what complication can occur, in as little as 4 hours, if insulin is held?
- Arms (under arm)
- Buttocks
- Abdomen
- Thighs (out)
What are acceptable sites for insulin injection?
¼ protein, ¼ carb (starch), ½ plate veg
What is the Healthy Plate Method?
3/4c pop/juice; 1tbsp honey, 3 tsp sugar in water, 4 dex4 tabs
What are 15g of fast acting sugars
Potassium replacement
Diabetic Ketoacidosis treatment requires what three things?
Check urine or blood ketones immediately
give correction with bolus insulin if ketones present
What do you do for type 1 diabetes if blood glucose is above 14 mmol/L?
4 mm or 5 mm autoshield duo
What are acceptable insulin pen needle sizes for injection?
Pop choose low carb bubbly (Perrier)
Juice choose fresh fruit
Fried choose baked
White rice choose brown rice
Cold cereal choose hot oats
Chips choose popcorn, nuts
What are alternative healthy options for different unhealthy snacks?
More than 5mmol/L
What is the acceptable blood sugar range when driving?
Normal or mildly elevated blood sugars with abnormal electrolytes, +/- ketones, caused by dehydration or SGLT2i
What is euglycemic DKA
Inject sc insulin 1-4 hours prior to stopping IV insulin
Risk of DKA or elevated ketones
90 degrees
What is the degree at which you inject the insulin pen needle?
Chicken breast
Fish
Lentils, beans, legumes
Peanuts, nut butters
Cheese (in moderation)
eggs
What are some healthy sources of protein?
A severe hypoglycemia (low blood sugar) of XX mmol/L should be treated with XX
less than 3mmol/L; 30 g of fast acting carbohydrate (2 glucose gel packs, 2 juice cartons, etc.)
HHS and/or DKA
Increased mortality and death
What are complications of hyperglycemia?
Humulin R, Regular insulin, Toronto insulin, short acting
What type of insulin is used for IV administration?