Hyperglycemia
- Insulin Resistance
- Too Little Insulin/Medication
- Infection/Illness
- Corticosteroids
- Elevated Blood Glucose
- Polyphagia
- Polydipsia
- Polyuria
- Hypotension
- Fatigue/Drowsiness
Insulin
- Rapid Acting
- Insulin Lispro (Humalog)
- Insulin Aspart (Novolog)
- Insulin Glulisine (Apidra)
- Short Acting
- Regular Insulin (Humulin R)
- Intermediate Acting
- Isophane NPH (Humulin N)
- Long Acting
- Detemir (Levemir)
- Glargine (Lantus)
Mixing NPH and Regular Insulin for Injection
- Verify Order
- Roll NPH Insulin
- Alcohol to Multiuse Vials
- Inject Air into NPH Insulin (Cloudy)
- Inject Air into Regular Insulin (Clear)
- Withdraw Regular Insulin Units
- Withdraw NPH Units
- Verify with 2nd Nurse
- Discard if Error
Pregnant Diabetic Patient Interventions
- Increase Insulin then Decrease
- Metformin
- Nutrition
- Exercise
- Increase Insulin
- More Likely to Develop Hypoglycemia than Hyperglycemia
- Double or Quadruple Insulin
- Early Delivery
- Drastically Decrease Insulin
- Monitor Neonate for Hypoglycemia
Diabetes Interventions
- Early Diagnosis
- Insulin
- Oral Hypoglycemics
- Glucose Monitoring
- Routine Exercise
- Diabetic Diet
- Monitor for Complications
- Insulin Therapy
- Diabetic Ketoacidosis (DKA)
Pramlintide (Symlin)
- Synthetic Amylin Analog
- Diabetes Type 1 and 2
- Supplement Mealtime Insulin
- Nausea
- Skin Reactions at Injection Site
- Hypoglycemia When Combined with Insulin
- Delayed Absorption of Oral Drugs
Acarbose (Precose) and Miglitol (Glyset) (Alpha Glucosidase Inhibitors)
- Alpha Glucosidase Inhibitors
- Delays Absorption of Carbohydrates
- Type 2 Diabetes
- Flatulence
- Diarrhea
- Anemia
- Cramps
- Monitor LFTs
- Oral Glucose for Hypoglycemia
Glyburide and Glipizide (2nd Generation Sulfonylureas)
- 2nd Generation Sulfonylureas
- Blocks Potassium Channels in Beta Cells
- Stimulate Release of Insulin
- Type 2 Diabetes
- Hypoglycemia
- More Potent
- Beta Blockers Reduce Effects
- Avoid Alcohol
- Avoid Breastfeeding
Exenatide (Byetta)
- Incretin Mimetic
- GLP-1 Synthetic Analog
- Type 2 Diabetes
- Hypoglycemia
- Nausea and Vomiting
- Diarrhea
- Thyroid Cancer
- Pancreatitis
- Renal Failure
- (Give Exenatide) One Hour After Other Medications
- Adjunct Therapy
Glucagon (GlucaGen)
- Increases Glucose
- Hypoglycemic Emergency
- Nausea and Vomiting
- Reconstitute Powder
- Consume Oral Carbohydrates
- 50% Dextrose IV (If No Effect)
Hypoglycemia Intervention
- Mild to Moderate Hypoglycemia
- Simple Carbohydrate (Oral Dextrose, Fruit Juice, Candies)
- Complex Carbohydrate (Whole Grains, Vegetables)
- Severe Hypoglycemia or Unconscious
- 50% Dextrose
- Glucagon
- Monitor Blood Glucose Q 10-15 Minutes
- Give Small Meal After Intervention
- Hypoglycemia Prevention
- Encourage Self-Monitoring
Pancreas
- Acinar Cells Release Digestive Enzymes
- Ductal Epithelial Cells Release Bicarbonate
- Islets of Langerhans
- Beta Cells Release Insulin
- Alpha Cells Release Glucagon
- Delta Cells Release Somatostatin
- Somatostatin Inhibits Alpha and Beta Cells