Term
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Definition
| disease of carbohydrate metabolism, occurs when the bodies production of insulin is absent or insufficient |
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Term
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Definition
| is a condition in which an excessive amount of glucose circulates in the blood plasma. fasting plasma glucose level >100mg/dl |
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Term
| Type 1 Diabetes Mellitus (IDDM-insulin dependent diabetes mellitus) |
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Definition
| caused by an autoimmune destruction of the beta cells in the pancreas, since there are no insulin secretion from the pancreas, the patient requires insulin to be injected |
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Term
| Type 2 Diabetes Mellitus (NIDDM- non-insulin-dependent diabetes mellitus) |
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Definition
| it is characterized by a decrease in beta cell activity, insulin resistance, or an increase in glucose production by the liver. Over time the beta cells of the pancreas fail and injections of insulin may be required. |
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Term
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Definition
| occurs when women have abnormal glucose tolerance during pregnancy |
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Term
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Definition
| is an intermediate state between normal glucose homeostasis and diabetes. |
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Term
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Definition
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Term
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Definition
| increased frequency of urination |
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Term
| Describe the intensive therapy for diabetes management |
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Definition
| primary treatment of diabetes is normalization of blood glucose levels. Dietary treatment of diabetes using medical nutrition and exercise constitutes the basis for management of most patients especially those with type 2 diabetes |
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Term
| Name the groups of oral antidiabetic agents (used for type II diabetes) |
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Definition
| sufonylureas, biguanide, thiazolidinediones, alpha-glucosidase inhibitors, and thiazolidinediones |
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Term
| What are the usual causes of hypoglycemia |
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Definition
| too much insulin, insufficient food intake to cover insulin taken, imbalances from diarrhea and vomiting, or excessive exercise without additional carbohydrate intake are the common causes |
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Term
| When should ketone testing of the urine be preformed |
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Definition
| when serum glucose is 240 mg/dL or above |
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Term
| What types of visual complications are people with diabetes mellitus more susceptible too |
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Definition
| Blurred vision may occur with hypoglycemia. Microangiopathies (changes in small blood vessels in the eyes. Retinal hemorrhages, degeneration of retinal vascular tissue, cataracts and blindness may also occur |
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Term
| How often should people diagnosed with diabetes mellitus have an eye exam |
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Definition
| eye exams should be performed annually or more often when deemed by health care provider |
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Term
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Definition
| Insulin is a protein in the human body, secreted by the beta cells in the pancreas, that decreases the levels of glucose in the blood by moving them into cells (lowers blood sugar level) |
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Term
| The names of rapidly acting insulins are |
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Definition
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Term
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Definition
| is the only dosage form of insulin that is approved to be injected both intravenous and subq routes of administration |
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Term
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Definition
| is a hormone secreted by the alpha cells of the pancreas that converts glycogen to glucose resulting in elevated blood glucose levels (raises blood sugar level) |
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Term
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Definition
| are nonsulfonylurea oral hypoglycemic agents that lower blood glucose by stimulating the release of insulin from the beta cells of the pancreas |
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Term
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Definition
| this can be prevented by rotating the insulin injection sites |
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Term
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Definition
1 .polydipsia-excessive thirst
2. polyuria-excessive urination.
3. polyphasia-excessive hunger |
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Term
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Definition
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Term
| Insulin Protein must be taken parenterally because |
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Definition
| if taken orally it has no hypoglycemic effect, since it is inactivated in the gastrointestinal tract |
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Term
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Definition
| by the cells of the body in order for them to remove and use glucose from the blood. From glucose the cells produce the energy that they need to carry out their functions. |
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Term
| The Only Insulin Given IV is |
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Definition
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Term
| Insulin is administered by |
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Definition
| sub q injection or regular insulin only may be given IV |
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Term
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Definition
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Term
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Definition
| in a cool place or refrigerate and should be used 30 days from the time you opened it. You should roll it in your hand to mix it up. Do not freeze or heat above 98 degrees. |
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Term
| Names of short acting insulins |
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Definition
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Term
| names of Intermediate Acting Insulins are |
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Definition
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Term
| names of Long Acting Insulins are |
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Definition
| Ultralente and Glargine(Lantus) |
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Term
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Definition
| Do NOT dilute or mix Lantus® with any other insulin or solution. LANTUS® is a long-acting insulin injected once a day at the same time each day. LANTUS® is released steadily throughout the day to help control your blood sugar for a full 24 hours.Lantus® must only be used if the solution is clear and colorless with no particles visible. |
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Term
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Definition
| is a serious condition that can lead to diabetic coma (passing out for a long time) or even death. When your cells don't get the glucose they need for energy, your body begins to burn fat for energy, which produces ketones. Ketones are acids that build up in the blood and appear in the urine when your body doesn't have enough insulin. They are a warning sign that your diabetes is out of control or that you are getting sick. High levels of ketones can poison the body. |
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Term
| Signs and Symptoms of Ketoacidosis |
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Definition
* Thirst or a very dry mouth
* Frequent urination
* High blood glucose (sugar) levels above 250
* High levels of ketones in the urine
Then, other symptoms appear:
* Constantly feeling tired
* Dry or flushed skin
* Nausea, vomiting, or abdominal pain
* A hard time breathing (Kussmaul respirations- short, deep breaths)
* Fruity odor on breath
* A hard time paying attention, or confusion |
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Term
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Definition
| normal fasting blood glucose levels for people who don't have diabetes is 70 mg/dl to 99 mg/dl. The normal postprandial range (after eating) is 70 mg/dl to 140 mg/dl. A normal A1c is 4.5 to 5.5. |
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Term
| Hemoglobin A1c (H A1c) test |
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Definition
| The A1C test gives you a picture of your average blood glucose control for the past 2 to 3 months. The results give you a good idea of how well your diabetes treatment plan is working. |
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Term
| Normal Hemoglobin A1c (H A1c) range is |
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Definition
| 4-5% in a healthy person. for a diabetic the target range set up by the physician is usually below 7% |
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Term
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Definition
| occurs when blood sugar (or blood glucose) concentrations fall below a level necessary to properly support the body's need for energy and stability throughout its cells. |
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Term
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Definition
1. give glucagon
2. have the patient eat glucose tablets, corn syrup, honey, fruit juice, or non-diet soft drink
3. monitor blood glucose levels
4. Acarbose will not work swiftly enough to raise blood glucose levels. Patient will require oral tablets or IV administration of glucose |
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Term
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Definition
| causes frequent urination. The large volume of urine is diluted, mostly water. To make up for lost water, you may feel the need to drink large amounts. You are likely to urinate frequently, even at night, which can disrupt sleep or, on occasion, cause bedwetting. Because of the excretion of abnormally large volumes of dilute urine, you may quickly become dehydrated if you do not drink enough water. |
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Term
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Definition
*insulin (beta cells-moves glucose into cells
*glucagon (alpha cells-converts glycogen to glucose) |
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Term
| Fixed combination insulin |
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Definition
| is a combination of an intermediate with a rapid acting in a specific combination |
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Term
| Examples of Fixed combination insulins |
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Definition
*Humulin 70/30- 70 NPH with 30 Regular
*Humulin 50/50- 50 NPH with 50 Regular
*Novolin 70/30- 70 NPH with 30 Regular |
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Term
| Intermediate and long acting insulins contain |
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Definition
*protamine, zinc or both
*used to prolong the actions of insulin |
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Term
| Rapid acting Lipro and Aspart should be given |
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Definition
*with breakfast not before
*they are very fast acting
*do not mistake for Humalog or Humulin when administering |
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Term
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Definition
*stress of illness may affect insulin needs
*patients are given insulin according to blood sugar levels |
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Term
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Definition
*stimulates insulin secretion from beta cells of the pancreas
*beta cell must be present
*improves sensitivity to insulin in tissue
*results in lower glucose levels |
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Term
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Definition
*decrease the production of glucose
*increase uptake of glucose
*does not increase insulin from the pancreas |
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Term
| Alpha-glucosidase inhibitors |
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Definition
reversibly inhibits the enzyme alpha-glucosidase in the small intestines
*results in delayed absorption of glucose
*must be taken with meals to avoid after eating excessive blood glucose elevations |
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Term
| Thiazolidinediones actions |
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Definition
*decrease insulin resistance
*insulin sensitizing agents
*increase glucose uptake and use in skeletal muscle
*inhibit glucose and triglyceride production in the liver |
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Term
| Oral anti-diabetic agents indications |
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Definition
use alone or in combination with other agents (lifestyle change and diet change) to lower blood glucose levels in patients with type II diabetes
*dont drink with alcohol
*photosensitivity can occur |
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Term
| Side Effects of Solfonylureas |
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Definition
*hypoglycemia
*hematologic effects
*nausea
*epigastric fullness
*heartburn
*others |
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Term
| Side Effects of Biguanides (Metformin) |
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Definition
*abdominal bloating
*nausea
*cramping
*diarrhea
*metallic taste
*reduced Vit. B12 levels |
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Term
| Side Effects of Alpha-glucosidase inhibitors |
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Definition
*flatulence
*diarrhea
*abdominal pain |
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Term
| Side Effects of Thiazolidinediones |
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Definition
*moderate weight gain
*edema
*mild anemia
*hepatic toxicity |
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Term
| before giving any drugs that alter glucose levels |
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Definition
* assess patients ability to consume food
* assess for nausea and vomiting
* consult physician if client is NPO and requiring anti-diabetic therapy |
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Term
| concerns for diabetic patient increases when |
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Definition
*client is under stress
*has an infection
*has an illness or trauma
*is pregnant |
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Term
| patient teaching is essential regarding |
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Definition
*disease process
*diet and exercise recommendations
*self-administration of insulin or oral agents
*potential complications |
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Term
| before giving ordered insulin make sure |
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Definition
*check blood glucose level before giving
*correct route
*correct insulin
*correct time for dose
***insulin order is prepared and then second check done by another nurse
*correct dosage |
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Term
| Things to know about insulin |
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Definition
*ensure correct storage
*only use insulin syringes because they are calibrated in units
*ensure correct timing of insulin doses with meals
when drawing up two types of insulins draw up the regular insulin first
*provide thorough patient education regarding self-administration, timing of doses, monitoring of glucose levels, and injections site rotation |
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Term
| before giving oral anti-diabetics |
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Definition
*check glucose levels
*give 30 minutes before meals
*alpha-glucosidase is given with the first bite of a meal
*Biguanides (Metformin)is taken with meals to avoid GI upset
*assess for signs of hypoglycemia |
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Term
| Monitor for therapeutic response of oral antidiabetics |
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Definition
*a decrease in blood glucose levels to the levels prescribed by DR
*measure hemoglobin A1c to monitor long-term compliance with diet, exercise and drug therapy |
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Term
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Definition
*gauges clients success in managing diabetes in the past 6-12 weeks
*reference range 4-5% in healthy person, target by the physician is usually under 7%
*the lower the A1c the lower the risk for diabetes complications |
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Term
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Definition
| ******CAN NOT MIX WITH ANY OTHER INSULIN******* |
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Term
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Definition
| inject required dosage of air into non-regular insulin, inject required dosage of air into regular insulin and then withdrawal required dose of regular insulin into the syringe. they withdrawal required amount from the non-regular insulin. |
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Term
NOVALOG(aspart)onset, peak and duration
***Rapid acting insulin*** |
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Definition
*onset: 0.2-0.33 HR
*peak: 1-3 HRS
*duration: 3-5 HRS
*hypoglycemia within: 1-3 HRS |
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Term
HUMALOG (lispro)onset, peak and duration
***Rapid acting insulin*** |
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Definition
*onset: 0.2-0.33 HR
*peak: 0.5-2.5 HRS
*duration: 3-6.5 HRS
*hypoglycemia within: 1-3 HRS |
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Term
HUMULIN R (human)onset, peak and duration
***Short acting insulin*** |
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Definition
*onset: 0.5-1 HR
*peak: 2.5-5 HRS
*duration: 5-10 HRS
*hypoglycemia: before lunch |
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Term
NOVOLIN R (human)onset, peak and duration
***Short acting insulin*** |
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Definition
*onset: 0.5-1 HR
*peak: 2.5-5 HRS
*duration: 8 HRS
*hypoglycemia: before lunch |
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Term
HUMULIN N (NPH)onset, peak and duration
***Intermediate acting insulin*** |
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Definition
*onset: 1-2 HR
*peak: 4-12 HRS
*duration: 16-28 HRS
*hypoglycemia: 3PM TO SUPPER |
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Term
NOVOLIN N (NPH)onset, peak and duration
***Intermediate acting insulin*** |
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Definition
*onset: 1-2 HR
*peak: 4-12 HRS
*duration: 24 HRS
*hypoglycemia: 3PM TO SUPPER |
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Term
HUMULIN 50/50-(50%NPH + 50%regular)
***Intermediate acting insulin*** |
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Definition
*onset: 0.5-1 HR
*peak: 4-8 HRS
*duration: 24 HRS
*hypoglycemia: 3PM TO SUPPER |
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Term
NOVOLOG MIX 70/30-(70%aspart protamine + 30%aspart)
***Intermediate acting insulin*** |
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Definition
*onset: 0.2-0.33 HR
*peak: 2-4 HRS
*duration: 18-24 HRS
*hypoglycemia: 3PM TO SUPPER |
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Term
LANTUS,(glargine) onset, peak and duration
***Long acting insulin*** |
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Definition
*onset: 1.1 HR
*peak: _1 HRS
*duration: 24 HRS
*hypoglycemia: _1 |
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Term
| Hypoglycemia signs and symptoms |
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Definition
*sweating
*nervousness
*confusion
*tremors
*cold, clammy skin
*slurred speech
*blood sugar level below 60 mg/dl |
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Term
| hyperglycemia signs and symptoms |
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Definition
*3 p's-polydipsia, polyphagia, polyuria
*fruity breath odor
*Kussmaul respirations)-very deep and very gasping respirations
*rapid and thready pulse
*dry mucous membranes and poor turgor
*blood sugar above 250 mg/dl |
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Term
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Definition
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