Mark Klimek Lecture 5: Diabetes

Diabetes Diabetes – you don’t metabolize your glucose right. Due to lack of insulin or cells become resistant to insulin. Type 1 Diabetes Vs. Type 2 Diabetes • Type 1 o Insulin dependent o Juvenile onset o Ketosis Prone (makes ketones) • Type 2 o Non insulin dependent o Adult onset o Non ketosis prone • S/s o Polyuria o Polydipsia (increased thirst) o Polyphagia (increased hunger) Treatment • Type 1 – insulin, exercise, diet (in order of importance) • Type 2 – diet, oral hypoglycemic, activity (obesity reduction) can be treated with diet alone. Diet Restrictions of type 2 diabetics • Calorie restrictions • 6 small feedings/day Insulin – LOWERS the blood glucose. • Regular Insulin (humalin R, anything that ends in R) o Onset – 1 hour o Peak – 2 hours o Duration – 4 hours o Clear (solution) CAN BE IV drip o Short rapid acting insulin (R stands for Rapid and Run) • NPH – intermediate acting o Onset – 6 hours o Peak – 8-10 hours o Duration – 12 hours o Cloudy (suspension) o N stands for Not so fast, Not in the bag (IV) • Humolog, lispro – the most fastest acting insulin o Onset – 15 minutes o Peak – 30 minutes o Duration – 3 hours o GIVE with meals • Lantus, Glargine – long acting insulin, so slow to absorb there is no esstential peak, they will not go hypoglycemic, only one you can give at bedtime o Duration – 12 – 24 hours • ALWAYS check the expiration date on all insulins before opening, if you open an insulin it expires 30 days after opening • Exercise potentiates (does the same thing) as insulin, if a diabetic is going to play soccer in the afternoon what should the nurse tell him to do? Take a carbohydrate snack to the game. • When a diabetic is sick their insulin needs are going to go up, they have increased glucose. Sick diabetic has two problems; hyperglycemi