-slow intestinal absoprtion of carbs -stimulate insulin secretion -decrease cellular insulin resistant -enhance insulin action ** can be from multiple categories but not 2 from the same category. if you see that question the patient
What does insulin therapy do?
Mimics normal body insulin -daily dosing and intenstive therapy
What are 2 Oral Hypoglycemic Agents that ⬇ insulin resistance
What is an example of a Biguanides & what are the characteristics?
- ⬇ insulin resistance - can cause kidney damage - may be discontinued while in hospital - don't give if having a test containing dye - hold 48 hrs before & 48 hrs after test with dye. If ER then flush kidneys & then stop for 2 days afterwards - if dehydrated DON'T take → acute renal failure
- lowers basal & post meal glucose levels in pts w/ type 2 diabetes by reducing hepatic glucose production & tissue sensitivity to insulin
What is an example of a Thiazolidinediones (TDZ) & what are the characteristics?
What are 5 Nursing Implications for Insulin administration?
1. adjust dose on BS, carb (CHO) intake, illness, level of activity (patient usually aware of their carb intake) 2. absorption varies by site and activity of site (rotate sites → thighs, back of arms & abdomen) 3. hypoglycemia risk varies w/ type of insulin- must know OPD of each type 4. Mixing; clear-> cloudy. Do not mix glargine, detemir (long acting insulins) 5. usually held if pt. is NPO
What is Intensive Insulin Therapy/sliding scale insulin (2)?
1. Several doses of regular insulin given during the day based on BS levels - before meals & at bedtime (IV and injection in hospital, injections at home) 2. Insulin pump therapy
What is Insulin Sliding Scale (5)?
1. Insulin dose is adjusted to blood glucose levels 2. almost all hospitalized its (b/c stress of trauma) - Ex. infection, surgery, steroids → may cause patient to have to get insulin while hospitalized 3. usually before meals and HS when sleeping (ACHS bs) 4. scheduled (q6 hrs) when NPO 5. type of insulin specified- rapid or short acting NEVER intermediate or long acting
When is insulin usually checked when a patient is on a sliding scale (3)?
- before meals - at bedtime - q6 hours when NPO
What insulin's are NEVER given when a patient is on a sliding scale (2)?
Intermediate and Long Acting
What is Insulin Pump Therapy (8) & complications (3)?
1. continuous insulin 2. rapid/short acting insulin 3. catheter in abd. 4. basal rate (continuous/regular rate) and bolus - depending upon BS & what they ate 5. frequently check BS (4x per day) 6. change needle & site every 2-3 days 7. always worn 8. Most common w/Type 1
Complications: infection in site, hypoglycemia, hyperglycemia