When is Insulin used?
- when the blood glucose levels are high and need to be lowered
- made by the Beta cells
When is glucagon used?
- when glucose levels are low and need to be raised
- produced by Alpha cells
What are some metabolic changes that occur with Diabetes?
- hyperglycemia
- glycosuria
- polyphagia
- polydipsia
- lipolysis
- ketosis
- acidosis
What are some diseases and disorders associated with diabtetes?
- atherosclerosis
- retinopathy
- neuropathy
- nephropathy
What is type 1 diabetes?
- primary beta cells making absolutely NO insulin
- is auto immune
What is type 2 diabetes?
- the pancreas makes either (a) less insulin or (b) the body rejects the insulin
What are the different diabetic labs?
- neonates: 30-60 mg/dL
- infant: 40-90 mg/dL
- child under 2: 60-100 mg/dL
- child over 2: 70-110 mg/dL
What are nursing considerations for insulin?
- know the onset peak and duration for the type of insulin being given
- know what the b,old sugar of your pts are before giving insulin
- monitor pts food intake
- don’t use discolored insulin
What are some nursing implications for insulin?
- unopened vials are kept refidgerated
- once opened, may be kept at room room temp for one month or refrigerated for 3 months
- never freeze insulins, never store in direct sunlight or in a high temp
- opened vials of insulin lose their strength after three months
What are the sxns of hypoglycemia?
- tachycardia, sweating, pallor, shakiness, cloudy mentation, hunger, headache
What is something to teach your pt about hypoglycemia?
- the 15 and 15 rule: 15 grams of carbohydrates and then the pt should check blood sugar in 15 minutes
What are the sxns of hyperglycemia?
- skin is hot, dry, dehydration, decreased perspiration, reparations are rapid and deep, acetone breath, decreased LOC, orthostatic hypotension, ketones present in blood and urine
What is the action of Sulfonylureas (anti- diabetic)?
- stimulates insulin secretion from beta cells
- may enhance actions of insulin in liver, muscle, adipose tissues
- decreases insulin resistance
What are some side effects of sulfonylureas (Anti- diabetes)?
- hypoglycemia
- GI distress, rash, and weight gain
- can cause bone marrow disturbances ad changes in blood count
What is the action of Biguanides (anti- diabetic)?
- decreases liver glucose production
- decreased intestinal absorption of glucose
- increase use of glucose by muscle and fat cells
What are the side effects of Bihuanides (Anti-diabetes)?
- bloating, nausea, diarrhea, can cause renal failure
What is the action of DPP- 4 Inhibitor (Anti- diabetes)?
- minimizes inactivation of incretin hormones
- results in ore insulin for longer period of time and decrease hepatic glucose production
What are the adverse effects of using DPP-4 (Anti- diabetes)?
- upper respiratory tract infections, runny nose, headache
What is the action of Incretin Mimetics (Anti-diabetes)?
- incretin hormone release by small intestine
- slows breakdown of insulin
- slows rate of digestion
What are the side effects of Incretin Mimetics (Anti-diabetes)?
- minor GI effects, weight loss, headache, can cause hypoglycemia
What are some things to teach pts taking Anti- diabetic drugs?
- take exactly as prepared
- teach symptoms of hypoglycemia and how to treat
- do not skip snack or meals
- need to maintain healthy diet
- encourage weight losses d exercise
- monitor blood glucose levels
- avoid alcohol
What type of diabetes can Anti- diabetes drugs be used with?
- type 2 ONLY
What is the peak, onset, and duration of regular insulin?
- onset: 30-60 mins
- peak: 2-4 hrs
- duration: 6-12 hrs
What is the onset, peak, and duration of NPH insulin?
- onset: 1-1.5 hr
- peak: 4-12 hrs
- duration: 24 hrs
