EXIT N493 - Quiz 4 Study Guide.

Type 1 Diabetes Mellitus Type 2 Diabetes Mellitus
 Acute  Gradual
 Autoimmune dysfunction  Progressive
 Destruction of beta cells that produce insulin  Inability of cells to respond to insulin
 Pancreas doesn’t make insulin  Non-insulin dependent
 Insulin dependent  Insulin resistant
 Mostly thin  Body doesn’t use insulin effectively or
doesn’t produce enough


HYPOGLYCEMIA HYPERGLYCEMIA
“cold & clammy, need a candy” “hot & dry, sugar is high”
 Low blood glucose < 70  High blood glucose > 250
 Cold/clammy skin  Polyuria ( urination)
 Numbness of fingers, toes, mouth  Polydipsia ( thirst)
  HR/Palpitations  Polyphagia ( hunger)
 Irritable  Hot & dry skin
 Headache  Weakness
 Tremors/Nervousness/Shakiness  Fatigue
 Dizziness  Headache
 Faintness  Glycosuria
 Unsteady gait  Nausea
 Lack of coordination  Vomiting
 Hunger  Abdominal cramps
 Sweating  Blurry vision
 Blurry vision  Fruity breath
 Seizures  Progression to DKA or HHS
 Coma

, DIAGNOSTIC TESTS LAB TESTS
Self-Monitored Glucose Test (SMBG) Fasting Blood Glucose
 Check accuracy of strips with the control solution  Postpone antidiabetic medication until after levels are drawn
 Use the correct code # in the meter to match strip bottle number  Fast (no food or drink other than water) for the 8 hr. prior to blood test
 Store strips in closed container in dry location Oral Glucose Tolerance Test
 Obtain an adequate amount of blood sample when doing test  Not used for routine diagnosis
 Use appropriate hand hygiene  A fasting blood glucose level is drawn at the start of the test
 Use fresh lancets and avoid sharing equipment to prevent infection  Client is then instructed to consume a specific amount of glucose
 Keep a record of the SMBG (time, date, serum glucose level, insulin dose,  Blood glucose levels are obtained Q 30 min for 2 hrs.
food intake, and other events that can alter glucose metabolism, such as  Assess for hypoglycemia throughout the procedure
activity level or illness)  Instruct client to consume a balanced diet for 3 days prior to test
 Then instruct the client to fast for 10-12 hrs. prior to test
 Only water may be taken during the testing period
 Food or other liquids will affect the test results
Glycosylated hemoglobin (HbA1c)
 Expected range: 4% to 6%
 An acceptable range for diabetes: 6.5% to 8%, with a target goal of < 7%
 Best indicator of the average blood glucose level for the past 120 days
 It assists in evaluating treatment effectiveness & compliance
 Recommended quarterly or twice yearly depending on the glycemic levels
Urine Ketones
 Medical emergency
  ketones in the urine = Hyperglycemia (> 300)
Diagnostic for diabetes include 2 findings (on separate days) of at least 1 of the following:
 Manifestations of diabetes + Casual blood glucose concentration > 200 (without regard to time since last meal)
 Fasting blood glucose > 126
 2-hr glucose > 200 with oral glucose tolerance test
 Glycosylated hemoglobin (A1C) > 6.5%