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DIABETES 2

QuestionAnswer
HHNKS - cause TPN & Dialysis
HHNKS - s/s no ketones but BS greater than 600
HYPOGLYCEMIA TX - awake feed 15g carbs ex milk
HYPOGLYCEMIA TX - unconscious IV dextrose or IM glucagon 1mg. Once conscious, feed
EXERCISE for diabetics decrease need for insulin due to muscle is sensitive to fat/insulin
ILLNESS for diabetics check BS freq. hydrate/fluids, check urine for KETONES
FYI diabetics need to eat at reg intervals to stabilize/maintain BS
alcohol choices for diabetic pts wine or light beer
SOMOGYI PHENOMENON hypo at night and hyper in AM. Checking BS @2am; if less than 60, then pt is confirmed. TX: bedtime snack and decreased insulin
DAWN PHENOMENON NOT RELATED TO HYPOGLYCEMIA. AM = elevated BS. BS is normal between 2-3am. PT becomes hyperglycemic probably due to REM Sleep. TX: give insulin later at night and bedtime snack.
PREVENTING COMPLICATIONS ABC = A1C (LESS THAN 6.5) B= BP (SYSTOLIC LESS THAN 130, DIASTOLIC LESS THAN 80) C=CHOLESTEROL (LESS THAN 200)
CARDIOVASCULAR COMPLICATIONS increased Triglycerides & fatty acids as a result of thick blood
DIABETIC NEUROPATHY no feeling or painful
BEST TEST: MONITOR BS Q3M. A1C LESS THAN 6.5 TO PREVENT COMPLICATIONS
AVOID EXERCISE IF BS IS GREATER THAN 250 OR LESS THAN 100
BEST PREDICTOR OF COMPLICATIONS POOR GLYCEMIC CONTROL
DRAWING UP INSULIN DO NOT MIX. 1ST IS REG. NO NPH IN REGULAR
MACROVASCULAR CAD (Coronary artery disease), CVA (Cerebral Vascular Accidents), PVD (Peripheral Vascular Disease)
NEUROPATHIC TX normalize blood glucose, normalize serum lipids, normalize body weight
EXERCISE TYPE 1 - may experience HYPERGLYCEMIA. TYPE 2 - may experience HYPOGLYCEMIA
INSULIN MIXING CLEAR TO CLOUDY. Humulin N is cloudy, Humulin R is clear so draw regular first
FYI INSULIN all rapid acting and short acting insulins are clear
LIPOHYPERTROPHY swelling or bumps
LIPOATROPHY hollowing or pitting of subcutaneous tissue
LIPODYSTROPHY painful injection resulting from cold insulin
Created by: jekjes
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