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Diabetes
DIABETES- Test 2- Sami's lecture
| Question | Answer |
|---|---|
| Diabetes Mellitus | a group of diseases. Inability to metabolize gluecose properly. |
| Diabetes causes | hyperglycemia with resultant vascular, neurological, renal, and vision disorders. |
| Insulin reduces | gluecose in the blood by permitting transport into cells |
| Insulin continues to | reduce gluecose throught storage of excess gluecose (liver or fat) |
| Type 1 | No insulin secretion |
| Type 2 | Insulin resistance, Beta cell fatigue with diminished secretion |
| Insulin allows gluecose to | turn in to fat |
| Classic symptoms of Diabetes | Polyuria, polydipsia, polyphagia, Wt. loss |
| 110-126 | "pre-diabetic" |
| Fasting BG | Equal to or less then 126 |
| OGTT stands for | Oral Gluecose tolerance test |
| OGTT above | 200 |
| What is a OGTT | -fast, -blood draw, -syrup like drink, -blood draw is one hour after last sip of drink, - no eating, smoking, drinking or gum in between last drink and test |
| A1C | Avg. blood sugar over 3 month period, taken as random draws |
| Type 1 diabetes is | an Autoimmune disorder, equal in Males and females, increased in Caucasians, |
| Ave. age of on set (type 1) | Puberty |
| Sudden onset symptoms | polyuria, polydipsia, polyphagia, wt.loss, acidosis |
| Without insulin = | death |
| Liver stores | 60% of gluecose (every meal)-> gylcogen |
| TYPE 2 (WARNING SIGNS) | -Family Hx, -Increased waist circumference, -Increased BMI (the heavier you are the greater chance for diabetes), Chances increase with age, People who live in the deep south (Mississippi) |
| Type 2 diabetes: ethnic groups | AFRICAN-AMERICAN, Native American, Asians, Hispanics, Pacific Islanders |
| Blood gluecose level over 140= | impaired gluecose tolerence "aka: prediabetes" |
| Rapid acting insulin | works rapidly |
| Types of rapid acting insulin | Onset: 15 min, peak 60-90 min, durationis 3-4 hr. (lispro- humalog), : (aspart- Novolog), : (glulisine- Apidra) |
| Short acting Insulin | Onset:1/2 hr.- 1 hr, peak 2-3 hr, duration 3-6 hr. (Regular- Novolin R, Humulin R) |
| Intermediate- Acting | Onset 2-4 hr, peak 4-10 hr, duration 10-16 hr.(NPH- Novolin N, Humulin N) |
| NPH stands for | Neutral protimine Hagadorn known as N |
| Regular insulin (R) is | What your body normally makes |
| Nov. 14th is | Diabetes day |
| Banteen and Bess | in 1900 ground the pancreas of a dog and in justed it in to a young boy. This boy make a recovery from his diabetes |
| Elile and Lilly | Pantented Insulin (didn't create at all) |
| Insulin R had to | be given 4x per day |
| In 1936 Hagadorn created | time released Insulin that lasted 24 hr.s |
| 24 hr insulin is aka | NPH/ daily insulin |
| Bolus | means body makes lg. amount. Body makes about 25 |
| Basal | Your body gives @ 1 unit of insulin every single hr. @ 25 units per day |
| Pre-mixed | 70/30, 50/50, 75/25. |
| Top number and bottom number of premixed | top is NPH, bottom is R |
| Long acting | Onset:1-2 hr., peak: no pronounced peak, duration 24h.(glargine- Lantus), (detemir- Levemir) |
| Long acting is | crystalized: no peak and lasts 24 hours |
| With long acting, your pancreas pumps | just right amount of insulin |
| Diabetes was diagnosed | 3500 yrs ago! |
| Sliding scale aka | correction dose @100 |
| development: | R came first, then NPH came second |
| Routes | Subcutaneous injection, SCII, IV, INtranasal |
| Subcutaneous injection | Insulin syringes, Insulin pens |
| SCII | Insulin pump |
| IV | 100 mL/100U, delivered with a pump adjusted with protocol |
| INTRANASAL | Exubra- removed from market 1/08 |
| Dosages | Basal and Bolus, Correction or sliding scale |
| Mixing insulins | (fixed-mix), customize mixing |
| Factors Affecting Insulin Absorbtion | -Site of injection, -Depth of injection, -dose, - exercise,- heat/massage |
| Hypoglycemia | blood sugar less then 60 |
| Hypoglycemia causes | Over dose of insulin or oral anti-diabetic agent, -unusually rapid absorbtion, -omitting or delaying a meal, - exercise without food coverage, -Illness, -Alcohol intake, -weight loss |
| Hypoglycemia symptoms | hunger, headache, drunken feeling, combativeness, dilopia, cold,clammy skin, tremors, irritability, anxiety, hypothermia, piloerrection, unconsciousness, convultions, diabetic encephalopathy |
| Treatment for hypoglycemia | quick acting gluecose, gluecose gels, 50% Dextrose IV, Gluecagon Injectable |
| Foot care: Path logical changes | Nerve damage, vascular damage, infection, foot changes |
| Assessments | Circulation, Skin integrity, pain, paresthesia, deformities |
| Teach patient to | Keep blood sugar under control (take medication, exercise,eat prescribed diet, monitor blool glucose). |
| Teach patient to wash their feet every day and to | look for cuts, sores blisters, swelling and infected toenails. Use a mirror to look at bottom of feet if they can't see them clearly. |
| Teach patient to keep skin soft with | a thin coat of skin lotion on top and bottom of feet, do not apply between toes. |
| Teach patient to wash feet | every day.(Don't soak feet). Use a mild soap. Make sure to test the water with elbow or thermometer (90-95 degrees is good). Dry feet well. |
| teach patent: DO NOT | cut corns and calluses. DO not use razor blades, chemicals to remove warts, corns or calluses. |
| Teach patient to see a: | EACH st at least once a year. |
| Teact pt.to Trim toenails | straight across. Smooth with an emery board.If you have difficulty seeing or cutting toenails, have foot dr. trim them. |
| Teach pt to wear: | shoes and socks ALL the time. Do NOT walk barefoot. Always wear socks, stockings or nylons with your shoes to avoid blisters. |
| Teach pt. to wear socks made of | cotton. this is to keep feet dry and warm. Check the inside of shoes before putting them on. Wear shoes that fit well, don't but "stupid shoes". |
| Teach pt. to protect feet from | cold or heat. Don't use a heating pad or hto water bottle. Wear shoes at the beach or no hot pavement. Wear cotton socks at night to keep feet warm. KEEP feet warm in cold weater (good warm boots). |
| Teach pt. to encourage | good blood flow! Put your feet up when you are sitting. Do feet and leg exercises several times a day. Don't cross legs. Don't wear tight socks that restrict blood flow. Do not wear garders or roll socks. |
| Teach pt. to NEVER, EVER | SMOKE! Nicotine causes capillary constriction. |
| Teach pt. to GET | MOVING. Exercise regularly! You mightwant to avoid running long disance or hiking, this may be to hard on the feet. Wear well fitting athletic shoes. |
| Teach pt. to Call | their doctor as soon as they notice any foot problems. |
| What puts diabetic pt. a such high risk for foot ulcers? | Diabetic Neuropthoy. It is farthest away from heart so they get the least blood flow. Bone shape often changes in diabetic patients. Diabetic patients often cannot feel their feet. |
| When assessing feet of a diabetic pt.: | - do a visual exam of foot, -sensory exam , -palpation (pulses, temp, callus formation) |
| When assesing look for: | circulation, skin integrity, pain, paresthesia, deformities. Look for lesions, deep groves (fizzers), edema, pain, ask if experiencing night leg pain?, toe nails, corn, callisus, muscle weakness |
| Appropriate interventions to promote healing of foot ulsers: | Clease with a neutral solution, keep pressure off foot, exercise foot, A topical gel of recombinant platelet, skin graff or amputation is last resorts |
| Purpose for blood glucose monitoring | to make managment desions regarding diet and medication as well ad dectecting for hyper or hypo glycemia |
| Acidosis | cells don't get enough glucose. |
| When you burn fat you leave behind: | Keytone |
| Keytone acidosis | body becomes acidic. bodys responce is to vomit. |
| Keytone acidosis typically takes | three weeks to kill the patient |
Created by:
Megaroo2222
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