DES MOINES AREA COMMUNITY COLLEGE

NURSING PROGRAM – CARROLL CAMPUS

ASDN 228 ADULT MED-SURG

DIAGNOSTIC TESTS

            FBS – fasting blood sugar >126mg/dl (N=70-110)

            RBS – Random blood sugar >200,g/dl

            Postprandial blood sugar – 2 hr after meal

            GTT or OGTT (oral glucose tolerance test)  2hr p 75mg sugar load >200

            (N=<140)

            HbgA1c (glycosylated hemoglobin)  - Long term control of blood sugar

            Levels over the past 2-3 months.

            Urine glucose and Ketones – presence of ketones  indicator of DKA

            Urine for albumin – albuminuria may signal onset of neuropathy

            Serum cholesterol and triglyceride levels -  recommend even lower levels for

            Diabetic clients LDL <100, HDL.>45 and Triglycerides <150

            Serum electrolytes – imbalances in presence of DKA

TERMS:

            Lipodystrophy – hypertrophy of subcutaneous tissue or lipoatrophy  - atrophy of

                Subcutaneous tissue in areas of repeated injections. – alter absorption of insulin

                Injected into these areas.

INSULINS:

            Types of insulins – see handout worksheet

            Mixing insulins --  ALWAYS REGULAR FIRST

            Insulin that can be given IV

            Timing of injections

ORAL  HYPOGLYCEMIC AGENTS

            Sulfonylureas – Stimulates the pancreatic cells to secrete more insulin and increasing the sensitivity of peripheral tissues to insulin

                        Amaryl, glucotrol, diabeta, micronase, tolinase, orinase

            Meglitinides

                        Lower blood glucose levels by stimulating release of insulin from the pancreatic islet cells

            Prandin

            Biguanides

                        Decreases the overproduction of glucose by the liver, and may also make insulin more effective in peripheral tissues.

            Glucophage (Metformin)

            Alpha-glucoside inhibitors

                        Work in small intestine to slow carbohydrate digestion and delay glucose absorption.

                        Precose – Glyset

            Thazolidinediones

                        Sensitizing peripheral tissue to insulin  may be used alone or in combination with sulfonylureas, metformin and insulin

                        Avandia - actos           

            D-phenylalanine derivative

                        Stimulates rapid and short insulin secretion from the pancreatic beta cells to decrease spikes in glucose

                        Starlix