170 Med-Surg Exam 3: Study guide
Type 1 Diabetes
Autoimmune destruction of pancreatic beta cells → no insulin production
Sudden onset, often in childhood or adolescence. Usually appears before age 30
Often triggered by viral illnesses such as: Coxsackie virus, mumps, rubella, and COVID-19
Requires insulin for life
Fat breakdown leads to ketone production and risk for DKA.
Risk Factors Type 1:
Viral illness, genetics, family history of autoimmune disorders, childhood/adolescence (Because of
hormone changes)
TYPE 1 NEW PATIENT TEACHING
Frequent BG checks
How to draw up and inject insulin
Recognizing hypo/hyperglycemia
Emergency hypoglycemia plan (glucose tabs)
Rotate injection sites
Sick day rules
Foot care
Carry medical alert ID
Type 2 Diabetes
Cells become insulin resistant
Pancreas eventually produces less insulin
Strongly linked to obesity, inactivity (sedentary lifestyle), older age, and family history
Gradual onset, often undiagnosed for years
Risk Factors Type 2:
Obesity, inactivity (sedentary lifestyle), family history, hypertension, hyperlipidemia, gestational
diabetes, older age, poor diet, smoking, African American/ Hispanic/Native American/ Pacific islander
ethnicity, Metabolic syndrome
,TYPE 2 PATIENT TEACHING
Diet teaching
Annual eye exams
Exercise increases insulin sensitivity
150 minutes of exercise/week
Weight management
Medication adherence
Foot care
BG monitoring
Managing stress and illness
Diabetes Nutrition
No single % of carbs/protein/fat fits all → nutrition is individualized.
Choose healthy carbs: veggies, fruits, whole grains, legumes, dairy.
Avoid sugary drinks and “empty calorie” foods.
Aim for ≥25 g fiber/day.
Focus on quality fats (Mediterranean-style): avocados, nuts, seeds, olives, dark chocolate lean meat.
Include omega-3s (fish or plant sources).
Limit trans fats, saturated fats, and cholesterol.
Carb counting basics:
Read labels, measure portions.
Standard starting ratio: 1 unit rapid insulin per 15 g carbs.
Adjust based on post-meal or next pre-meal BG.
LAB VALUES TO KNOW
Fasting blood glucose:
Normal: 70–99 mg/dL
Prediabetes: 100–125 mg/dL
Diabetes: ≥126 mg/dL
A1C:
Normal: <5.7%
Prediabetes: 5.7–6.4%
Diabetes: ≥6.5%
, INSULIN TYPES
Rapid-Acting
Lispro (Humalog), Aspart (Novolog), Glulisine (Apidra)
• Onset: 10–15 minutes
• Peak: 1 hour
• Duration: 3–5 hours
Key Points:
Highest risk of HYPOGLYCEMIA
• MUST have food available before or at the time of injection
• Used for mealtime coverage and sliding scale
• Can be mixed with NPH (draw up rapid/regular first)
• Clear appearance
Remember:
“Rapid = Right Now”
HumaLOG, NovoLOG = Logs roll rapidly down a hill
Short-Acting (Regular)
(Humulin R, Novolin R)
• Onset: 30–60 minutes
• Peak: 2–4 hours
• Duration: 5–8 hours
Key Points:
• ONLY insulin you can give IV (DKA, HHS, emergencies)
• Timed with meals
• Can be mixed with NPH (draw up Regular first)
• Used for scheduled doses & sliding scale
Mnemonic:
“R = Regular = IV Ready”
Type 1 Diabetes
Autoimmune destruction of pancreatic beta cells → no insulin production
Sudden onset, often in childhood or adolescence. Usually appears before age 30
Often triggered by viral illnesses such as: Coxsackie virus, mumps, rubella, and COVID-19
Requires insulin for life
Fat breakdown leads to ketone production and risk for DKA.
Risk Factors Type 1:
Viral illness, genetics, family history of autoimmune disorders, childhood/adolescence (Because of
hormone changes)
TYPE 1 NEW PATIENT TEACHING
Frequent BG checks
How to draw up and inject insulin
Recognizing hypo/hyperglycemia
Emergency hypoglycemia plan (glucose tabs)
Rotate injection sites
Sick day rules
Foot care
Carry medical alert ID
Type 2 Diabetes
Cells become insulin resistant
Pancreas eventually produces less insulin
Strongly linked to obesity, inactivity (sedentary lifestyle), older age, and family history
Gradual onset, often undiagnosed for years
Risk Factors Type 2:
Obesity, inactivity (sedentary lifestyle), family history, hypertension, hyperlipidemia, gestational
diabetes, older age, poor diet, smoking, African American/ Hispanic/Native American/ Pacific islander
ethnicity, Metabolic syndrome
,TYPE 2 PATIENT TEACHING
Diet teaching
Annual eye exams
Exercise increases insulin sensitivity
150 minutes of exercise/week
Weight management
Medication adherence
Foot care
BG monitoring
Managing stress and illness
Diabetes Nutrition
No single % of carbs/protein/fat fits all → nutrition is individualized.
Choose healthy carbs: veggies, fruits, whole grains, legumes, dairy.
Avoid sugary drinks and “empty calorie” foods.
Aim for ≥25 g fiber/day.
Focus on quality fats (Mediterranean-style): avocados, nuts, seeds, olives, dark chocolate lean meat.
Include omega-3s (fish or plant sources).
Limit trans fats, saturated fats, and cholesterol.
Carb counting basics:
Read labels, measure portions.
Standard starting ratio: 1 unit rapid insulin per 15 g carbs.
Adjust based on post-meal or next pre-meal BG.
LAB VALUES TO KNOW
Fasting blood glucose:
Normal: 70–99 mg/dL
Prediabetes: 100–125 mg/dL
Diabetes: ≥126 mg/dL
A1C:
Normal: <5.7%
Prediabetes: 5.7–6.4%
Diabetes: ≥6.5%
, INSULIN TYPES
Rapid-Acting
Lispro (Humalog), Aspart (Novolog), Glulisine (Apidra)
• Onset: 10–15 minutes
• Peak: 1 hour
• Duration: 3–5 hours
Key Points:
Highest risk of HYPOGLYCEMIA
• MUST have food available before or at the time of injection
• Used for mealtime coverage and sliding scale
• Can be mixed with NPH (draw up rapid/regular first)
• Clear appearance
Remember:
“Rapid = Right Now”
HumaLOG, NovoLOG = Logs roll rapidly down a hill
Short-Acting (Regular)
(Humulin R, Novolin R)
• Onset: 30–60 minutes
• Peak: 2–4 hours
• Duration: 5–8 hours
Key Points:
• ONLY insulin you can give IV (DKA, HHS, emergencies)
• Timed with meals
• Can be mixed with NPH (draw up Regular first)
• Used for scheduled doses & sliding scale
Mnemonic:
“R = Regular = IV Ready”
