Type One
Diabetes 1 patho
lack of insulin --> immune system attacks the insulin producing beta cells in the pancreas
type 2 patho
insulin resistance--> defects in the cell membrane that causes the normal action of insulin
Hemoglobin A1c test
shows the average BG level during 6-12 weeks and the goal level is <6.5.
What is the color of the insulin caps?
orange
S/S of DKA
Kussmaul breathing- rapid shallow breathing, fruity smelling breath, muscle stiffness, flushed face, N/V
Causes
autoimmune, genetic, environmental
Causes
BMI, sedentary lifestyle, metabolic syndrome, HTN, high cholesterol, genetics, ethnicity, having a baby over 9lbs
Fasting BG
measures glucose levels after 12-24 hours fast, goal is <110 mg/dL
How long can insulin be stored in the fridge?
good for 28 days, take out of the fridge before using
TX for DKA
Fluid replacement, electrolyte replacement, insulin therapy
S/S
polyuria, polydipsia, polyphagia, fatigue, weight loss
S/S
polyuria, polydipsia, polyphagia, fatigue, poor wound healing, cardiovascular disease, visual disturbances, renal insufficiency, reoccurring infections
Two hour postprandial (after meals)/Oral glucose tolerance test
determines how the body responds to sugar and starch after eating a meal. Usually used to diagnose gestational diabetes. Goal is <200 mg/deciliter
How should insulin be stored
store standing, needle up
What is hyperosmolar hyperglycemic state (HHS)?
occurs when blood sugar is too high for too long, leads to dehydration and confusion, requires immediate medical intervention
Normal glucose level
70-110
What is Dawn phenomenon?
BG increases in the morning, managed by providing more insulin in an overnight period
When should BG be checked?
before meals and before bed
S/S of hypoglycemia?
“cold and clammy, give them candy”, dizzy, sweaty, hungry, confused, shaky, palpitations
TX for hyperosmolar hyperglycemic state?
rehydration, electrolyte replacement, insulin
Foot care basics
inspect feet daily, wear proper fitting shoes, trim toenails straight across, dont go barefoot, keep dry, dont soak in water
Somogyi effect management
managed by insuring adequate dietary intake at bedtime and evaluating the insulin dose and exercise programs
What does fasting state mean?
not eating for 8 hours
TX of hypoglycemia
apple juice, soda, crackers→ 15g of sugar, check BG in 15 minutes
or glucagon for emergencies
What is a main vascular effect of diabetes?