Terms in this set (32)
what is the treatment for type 1 dm?
-multiple daily injections (MDI)
-continuous subcut insulin infusion (CSII)
what are the warning signs for T1DM?
polydipsia, polyuria, flu-like symptoms, lehargy, vomiting, dehydration.
when do you check ketones in a diabetic patient?
when BG is 250 or higher
***increase insulin and fluids
what is hypoglycemia and what are its symptoms?
a plasma glucose less than 70.
shaky,sweaty, light-headedness, and tachycardia.
what is mild to moderate hypoglycemia and what is severe?
mild to mod= 54-70
severe= less than 54
how do you treat hypoglycemia?
mild o mod= 15-20 g of carbs
severe= 20-30 g of carbs
15 grams= 1/2 cup of fruit juice or regular soft drink, 6-7 lifesavers, 4 glucose tablets or 1 tube glucose gel.
when is a Glucagon kit used ?
only when a hypoglycemic pt is unconscious.
*it helps the liver release stored glucose. injected in the thigh. counsel family on use since pt will be unconscious.
rapid acting insulin
onset= 15-30 mins
peak= 1-2 hours
when is rapid acting insulin taken?
0-15 mins before meals.
what is the color of rapid acting insulin and what are examples.
-humalog (u-100 and u-200)
novolog- novo nordisk
afrezza (inhaled)- onset 12-15 mins, peak 1 hr, duration 2.5-3 hours
when do you take short acting insulin?
20-30 mins before meals.
what is the onset, peak, and duratio of short acting insulin?
onset= 30-60 mins
peak= 2-3 hours
duration= 3-6 hours
**no prescription needed
what are the short acting insulins?
humulin R and Novolin R
Humulin R U-500 is _____ times more potent than u-100 and is___ only.
what is the onset, peak, and duration of intermediate insulins
onset= 2-4 hours
what is the appearance of intermediate insulin and examples.
*no RX needed.
-basal insulin (b.w meals and during sleep)
-humulin nph and novolin nph
what is the onset,peak, and duration of long acting insulins
onset= 2-4 hrs
duration= 22-24 hours(lantus u-100)
14-24 hrs (levemir)
30 hours (toujeo u_300)
what are the basal insulins?
intermediate and long acting insulins
what are the pre-meal insulins? (bolus insulins)
rapid and short acting insulins
which insulin is cloudy and must be rolled before use?
what are the two premixed conventional insulins?
humulin 70/30 and novolin 70/30
70% nph and 30% regular insulin **take 20-30 mins b4 meal
what are the three types of fixed ratio insulin analog mixes?
Humalog 75/25 75% insulin lispro protamine suspension with 25% insulin lispro
Humalog 50/50 50% insulin lispro protamine suspension with 50% insulin lispro
Novolog 70/30 70% insulin aspart protamine suspension with 30% insulin aspart
What are the limitations with mixed insulins such as Humulin 70/30?
-Lack of coverage during lunch
-Need for scheduled mealtimes
-Need for scheduled dosing every 12 hours
-Lack of dosing flexibility
what insulins CAN be mixed?
NPH and rapid or short acting
which ones CAN NOT be mixed with other insulin?
Lantus, Basaglar, Levemir, and Toujeo
what is the average total daily dose for insulin in type 1 ?
Half of the TDD should be ___ insulin and the other half should be _____ for MDI/ basal bolus injections
basal and bolus (50/50)---if more than 2 injections a day.
how do you dose premixed syringes ?
2/3 at breakfast (am) and 1/3 at dinner (pm)
2/3 NPH at breakfast and 1/3 regular insulin at breaskfast.
2/3 NPH at dinner and 1/3 regular insulin at dinner.
general tips for insulin dosing
- individualize and think like a pancreas
fix fasting first then post prandial
-For new patient, assume 1-2 units of insulin will decrease FBG by 40-50 mg/dl (correction/ insulin sensitivity factor)
unless all glucose levels are over 200, adjust one dose at a time
what the average daily requirements for insulin in t1dm?
-when first initiating in newly diagnosed pts
- 0..4-0.6 units/kg
-honeymoon phase-0.1-0.4 units/kg
-w. ketosis or infection- 1.0-1.5 units/kg
what is the honeymoon phase?
insulin is administered _____
syringes, pens,and pumps.
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