Type 1
T1DM has _____ insulin production.
None or minimal
Where does T2DM have insulin resistance at?
Liver & peripheral tissues
What causes hypoglycemia?
Insulin-glucose mismatch, alcohol, & cirrhosis
What are the 3 requirements of this syndrome?
HTN, hyperglycemia, & central obesity
When do you give Metformin?
1st line for T2DM & if someone has prediabetes & BMI > 35
Goal HbA1c is _____.
< 7%
Does DM have intented or unintended wt loss?
unintended
What does hypoglycemia look like in a pt?
Increased & irregular HR, pale, shake, hungry, sweaty, tingles, numbness, confusion, seizures, coma, death.
Does this syndrome come before or after someone develops diabetes?
Before T2DM
It is an noninsulin injectable
The 3 P's are:
polyuria, polyphagia, & polydipsia
Labs that should be monitored are:
FPG, OGTT, HbA1c, K+, CBC, CMP, lipids, UA, ABG's
If a pt is conscious and their BS is between 60-70, what do you give them?
15g carbs then repeat Q15 min until >100
What are some risk factors of Metabolic syndrome?
HTN, heart disease, nonalcoholic fatty liver, insulin resistance T2DM, lipid dysfunction, dementia, & PCOS
What kind(s) of insulin do you have to give with consideration to meals?
Short & Rapid acting
What are the longterm complications?
HTN, dyslipidemia, CVD, Nephropathy, Retinopathy, & neuropathy
Lifestyle modification
If a pt is aware and their BS is <59 what do you do?
30g carbs, repeat Q15 min until >70 & asymptomatic or >80. Tell HCP ASAP!
How do you care for this type of pt?
Increase activity as tolerated, low fat diet, stop smoking, CPAP, meds, & bariatric surgery.
Can you give Pioglitazone with food?
No, food slows absorption.
When should you increase the frequency of glucose monitoring?
Symptomatic hypo/hyper glycemia, SNS suppression, taking B-Blockers, illness, gastroparesis, change of therapy, steroids, & pre/post exercise.
If a diabetic is about to exercise and they have ketones present in their urine, should they continue to exercise?
NO
If a pt is unconscious and their BS is <70 what do you do?
IVP 50 mL D50 over 2-5 min or SQ 1 mg Glucagon (turn on side) Tell HCP ASAP
Metabolic Syndrome increases the risk for what cardiovascular disease?
Atherosclerosis
A nurse is preparing to administer morning doses of insulin glargine & aspart to a pt with a BS of 278 mg/dL.
1. Do you hold or give the medicine?
2. Can you give these medicines in the same needle?
1. Give the medication
2. No, must be drawn up in 2 separate needles.