dx
What are the "three p's," aka the 'classic symptoms' of diabetes?
Polyphasia
Polyuria
Polydipsia
What is the difference between type 1 and type 2 diabetes?
Type 1: can't make insulin (pancreatic cell destruction=no more insulin production)
Type 2: can't use insulin (insulin resistance=all the insulin you want but no cell response)
When administering insulin you should push the dose slowly and wait 5 seconds before withdrawing the needle. What's the rationale for the waiting period?
Insulin will leak out through the puncture point/to prevent losing the dose.
What are some risk factors for type 2 diabetes?
obesity
low physical activity
low socioeconomic status
ethnicity
family hx
Discuss treatment goals of pediatric type 2 diabetes.
Normalize BG
Normalize HbA1C
Normal weight
Increase activity
Normalize lipid profile, BP, and prevent complications
Other than thirst, nausea, and peeing alot, what is another clinical manifestation of DKA?
Hint: One of them you can test for the other you observe and is a LATE SIGN
Ketones
Kussmal respirations (in an attempt to release the acid buildup caused by ketones)
Type 1 diabetes is characterized by the autoimmune destruction of what type of cells from what organ?
Beta cells from the pancreas.
How often should you check a BG level on a child who is sick?
What is at least every 4 hours?
Describe some times/conditions kids with diabetes should have their glucose checked more often.
illness
stress
physical activity
symptoms of high or low blood sugar
Discuss treatment goals of hyperglycemia and DKA.
Restore fluid volume (ALWAYS START WITH FLUID)
Replace electrolytes
Correct acidosis
Return to glucose utilization state
What must the diabetic student have on file with the school?
What is a diabetic action plan?
Name two long-term complications of diabetes.
Damage to small blood vessels
-i.e. eyes, kidneys, nerves
Damage to large blood vessels
-i.e. heart and coronary arteries
What is the duration of rapid (has a two hour interval), intermediate (has a 3 hour interval), and long-acting insulins?
Rapid: 3-5 hours
Intermediate: 12-15 hours
Long-acting: 24 hours
List 4 symptoms of hyperglycemia.
Thirst
Headache
Blurred vision
Drowsy
Nausea
Frequent urination
What is the target A1C for a child with type 1 diabetes?
7.5
Which of these test results is/are diagnostic for pediatric diabetes?
A) Random glucose of 180mg/dl
B) Fasting glucose of 135mg/dl
C ) HgbA1c of 7%
D) A and C
E) B and C
E) B and C
Random of 200 or over
Fasting of 126 or over
and A1c of 6.5% or over are diagnostic for diabetes.
What are three of the four main ways pts can reduce their risk of long-term complications?
optimal BG control (A1C below 7.5%)
no smoking
healthy diet and weight
regular screenings
Insulin pumps contain this type of insulin.
What is rapid acting insulin?
List 7 symptoms of hypoglycemia.
Shaky
Hunger
Anxiety
Dizzy
Fast heartbeat
Sweating
Irritable
Weak or tired
Headache
Blurry vision
Before what three events should blood glucose always be checked?
Meals
Exercise
Bedtime
Kids with type 2 diabetes may or may not have 'the three p's' for diagnosis. What skin condition do they often present with instead?
Acanthosis nigricans, or the hyperpigmentation/thickening of neck or axillary skin folds.
How often do kids with diabetes need regular screening for eye, kidney, and neuropathy? Every ___months.
q3mo clinic visit
What is the peak of rapid, intermediate, and long acting insulins?
rapid: 30-90 min
intermediate: 3-8 hours
long-acting: no peak
Parents need to understand the treatment "rules of 15." What is the treatment rules of 15?
if BG is less than ____mg/dl, you give ___ grams rapid acting carbs.
Recheck BG in ____minutes. If BG is below ___mg/dl, repeat steps above.
If BG is above ___mg/dl you should give the pt solid food.
if BG is less than 60mg/dl, you give 15 grams rapid-acting carbs.
Recheck BG in 15 minutes. If BG is below 70 mg/dl, repeat steps above.
If BG is above 70 mg/dl you should give the pt solid food.
How many times per day should a kid's blood glucose be checked?
4 or more