General 1
General 2
Insulin/Meds
Medications
Labs/tests
100

What are the 3 "P" classic signs of type 1 DM and what do they mean?

Polyuria: Peeing

Polydipsia: Thirsty

Polyphagia: Hungry

100

Which P is not included as a classic sign of type 2 DM?

Polyphagia, they do not have the constant hunger because their body is making some insulin
100

The only insulin you can give IV

Regular

100

What medication is given IV during a serious hypoglycemic episode?

Glucagon! 

100

What is the normal fasting blood glucose level?

70-100mg/dL

200

What are 2 environmental factors that can cause type 1 DM?

Rubella/mumps 

rotavirus

smoked meats

200

What are 2 other types of Diabetes (not type 1 or type 2)

Gestational (during pregnancy)


Steroidal (with prolonged steroid use)

200

Rapid Acting Insulin

Lispro (Humalog), Aspart (Novalog)

Clear

Used in Pumps

Onset: 15min

Peak: 1 hr

Duration: 3 hr


200

What are the 4 "red flags" for oral agents

1. Age (what drug can you not give if the pt is 80+)

2. Renal impairments

3.Liver impairments

4.Heart impairments 

200

What is the normal A1C level?

4-7%

250

Why does physical fitness decrease insulin resistance?

Muscles can uptake glucose and may decrease the needs of insulin

250

What is the difference between Dawn phenomon and somogyi phenomon? 

Dawn: happens 4-8am

Somogyi: increased because of a low sugar at night, may need a bedtime snack

250

Short acting 

Regular Humilin, Novolin

Clear

Onset: 30 min

Peak: 2 hr

Duration: 8 hr

Used in IV: check glucose Q1hr 

HUGE risk of hypoglycemia


250

Biguanides 

Glucophage Metformin

PO

-Insulin resistance and decreases glucose release, so interstitial glucose absorption decreases 

-Not often given in hospitals

- Do not give if pt is over 80 and/or has poor kidney function 

-D/C a few days before hospital because of contrast dye

NO hypoglycemia

LACTIC ACIDOSIS


300

What is DKA? What are the corresponding labs?

Burning ketones for energy, happens in DM 1, can happen from exercising too much, kussmul breathing, fruity breath

Fat stores breakdown 


GS>250 

presence of ketones and glucose in urine

Abnormal Na, K+, and Cl levels

300

What is HHS? and what are the corresponding labs?

More common in type 2 DM

From: surgery, trauma, illness, dehydration  

BG>600

Altered LOC

300

Intermediate 

NPH 

Cloudy

Onset: 2 hrs

Peak: 8 hrs

Duration: 16 hrs

300

Amylin mimetics

SQ

decrease stomach emptying, decrease amount of glucose released by liver

HYPOGLYCEMIA 

300

What RENAL labs are important to monitor with a DM patient and why?

Creatinine, BUN, and creatinine 

Albuminuria: early signs of kidney damage

Electrolytes: from Polyuria 

350

Neuropathies, common cause

ANS & Peripheral nerves

DISTAL PARESTHESIAS

impaired GI function=slow gut

gabapentin is a nerve pacifier

350

Hypoglycemia, why is it so serious, whos at risk, symptoms, and complications

Whos at risk: sudden NPO, TPN/CPN DC'd, insulin given without meal, decrease in corticosteroid dosage

Symptoms: 

Neurolycopenic:headache, slow thinking, blurred vision, slurred speech tingling, dizziness, coma

Autonomic: hunger, nausea, anxiety, pale cool skin, sweating, shakiness, tachycardia, hypotension, irritable. 


Can eventually lead to death

350

Long acting

Glargine (lantus) and detemir (levemir)

Onset: 2 hours

Peak: NONE

Duration: 24 hr

350

Alpha glucosidase inhibitors

PO

Acarbose (precose)

Starch blocker 

If hypoglycemic you need glucose tabs, JUICE WONT WORK

Taken with first bite of food

Slows absorption of glucose

possible liver damage

400

Foot care

WEAR SHOES AND SOCKS

Dont walk barefoot

check feet daily

dont sit cross-legged (bad circulation

400

management

Frequent BS monitoring

dont take PO meds until you can keep food down 

400

GLP

SQ

slows stomach emptying, increases insulin release

Weight loss

400

DPP 

PO

stimulates pancreases and decreases glucose release from liver

No weight gain, no hypoglycemia

pancreatitis 

400

Hormones

Alpha Cells: Glucagon

-Glycogenolysis: breakson of glycogen

-gluconeogenesis: formation of glucose from fat/proteins

Beta Cells: Insulin and Amylin

Basal (when not eating) Prandial (when eating)

400

Hormones

Delta cells: somatostatin

inhibits glucagon/insulin production: slows GI motility 


Small Intestines: incretin effect (glucagon like) Signals pancreas to secrete insulin after eating

400

Meglitinides

PO

Repaglinide (Prandin)

taken 15 min before eating 

Stimulates pancreas

HYPOGLYCEMIA

400

SGLT

PO

Reduces glucose reabsorption by kidney, increased excretion of glucose

NO hypoglycemia

UTIs

400

Sulfonylureas

PO for DM2 (NOT FOR DM1)

Glipizide & Glyburide

stimulates pancreas (monitor AST, creatinine, ALT)

HYPOGLYCEMIA

400

Thiazolidinediones (TZDs)

PO

Insulin resistance and decreased glucose made in liver

liver issues