Welcome to Scribd. Sign in or start your free trial to enjoy unlimited e-books, audiobooks & documents.Find out more
Standard view
Full view
of .
Look up keyword
Like this
0 of .
Results for:
No results containing your search query
P. 1
diabetes- clinical (handout).doc

diabetes- clinical (handout).doc

|Views: 10|Likes:
Published by Becky Kipling
Diabetes information for nurses
Diabetes information for nurses

More info:

Published by: Becky Kipling on Oct 29, 2013
Copyright:Attribution Non-commercial


Read on Scribd mobile: iPhone, iPad and Android.
download as DOC, PDF, TXT or read online from Scribd
See more
See less





DiabetesDiabetes Mellitus:
a metabolic disorder characterized by high blood glucose levels andaltered metabolism of proteins and fats; associated with thickening of the basement membrane,leading to numerous complications (Karch, 2011).
Types of Diabetes:
Diabetes mellitus type 1
Diabetes mellitus type 2
Gestational diabetes mellitus (GDM)Insulin:
Insulin is a hormone that promotes the storage of the body’s fuels, facilitates thetransport of various metabolites and ions across the membranes, and stimulated the syntheses of glycogen to glucose, of fats from lipids, and of proteins from amino acids. Insulin does thesethings by reacting with specific sites on the cell (Karch, 2011).
Signs and Symptoms/Clinical PresentationDiabetes Mellitus - Type 1
Polyuria(frequent urination)
Polydipsia(increased thirst)
Polyphagia(increased hunger)
Weight loss
Diabetes Mellitus – Type 2
A large percentage of those with type 2 diabetes are obese and show increasing signs of:
Recurrent infections
Prolonged wound healing
Vision changes
Classic diabetic symptoms: polyuria, polydipsia, polyphagia and weight changes
Nursing Implications:
The nurse will explain that diabetic treatment involves lifelong medical observation,education, physical self-assessment, as well as lifestyle modification.
The nurse will advise patient to seek medical attention for new or worsening symptoms.
:Insulin’s are available to provide short and long term coverage. These preparations are processedwithin the body like endogenous insulin.
Treating diabetes is aimed at tightly regulating blood glucose levels through the use of insulin or other glucose-lowering drug
 Types of Insulin:
Route Onset Peak Duration
regular30-60 min 2-4 h8-12 hsemilente NPH1-1.5 h5-10 h12-16 hHPH (Humulin N)1-1.5 h4-12 h24 hultralente (HumulinU)4-8 h10-30 h20-36 hlispro (Humalog)<15 min30-90 min2-5 haspart (novoLog)15 min30-90 min2-5 hglargine (Lantus)60-70 minNone24 hglulisine (Apidra)2-5 min30-90 min1-1.25 hdetemir (Levemir)1-2 h6-8 h24 h
NPH and regular30-60 min 2-4 h then, 6-12 h6-8 h, then 18-24 h(Humulin 70/30Novolin 70/30Humulin 50/50Humalog 75/25
Insulin can be given:
- Subcutaneously- Intramuscularly- IntravenouslyInsulin is usually given by a subcutaneously with a insulin syringe with a 25 gauge, 1/2 inchneedle. The injection is made at a 45 degree angel into loose connective tissue underneath the
skin of the abdomen, upper thigh or upper arm. Injection sites need to be rotated regularly to prevent tissue damage (Karch, 2011).
Blood SugarMonitoring Blood Sugar
Monitoring blood sugar refers to measuring the glucose level in a blood sample. It is anessential component of diabetes management
Verifying that blood sugar levels are within the safe range
To detect changes in levels signifying hypoglycemia or hyperglycemia
Routine monitoring
supports an effective diabetes treatment plan
 Happens if Blood Sugar is Out of the Normal Range?
seizures, coma, and death
diabetic ketoacidosis, hyperglycemic hyperosmolar nonketotic syndrome
vascular damage: neuropathy, retinopathy, and renal failure
Blood sugar levels depend on several factors, including: physical activity, meals, andinsulin administration.
Normal blood sugar levels:
70–130 mg/dL before meals
< 180 mg/dL after meals
Blood glucose range
4 to 7 mmol/L
Sliding scale
The term “sliding scale” refers to the progressive increase in the pre-meal or nighttime insulin dose, based on pre-defined blood glucose ranges. Sliding scaleinsulin regimens approximate daily insulin requirements.
Common sliding scale regimens:
Long-acting insulin (glargine/detemir or NPH), once or twice a day with shortacting insulin (aspart, glulisine, lispro, Regular) before meals and at bedtime
Long-acting insulin (glargine/detemir or NPH), given once a day
Regular and NPH, given twice a day
Pre-mixed, or short-acting insulin analogs or Regular and NPH, given twice aday
(Adler & Schube, 2012).

You're Reading a Free Preview

/*********** DO NOT ALTER ANYTHING BELOW THIS LINE ! ************/ var s_code=s.t();if(s_code)document.write(s_code)//-->