Answers
Type 1 diabetes
- age of onset: usually young than 30 yr
- abrupt onset, thirst, hunger, increased urine output, weight loss
- etiology: viral infection, autoimmunity
- pathology: pancreatic beta cell destruction
- usually nonobese
Type 2 diabetes
- may occur at any age in adults
- symptoms: frequently none; thirst, fatigue, blurred vision, vascular or neural
complications
- etiology: not know, genetic predisposition
- pathology: insulin resistance, dysfunctional pancreatic beta cell
Fasting blood glucose
- 100 mg/dL (normal); older adults: levels rise 1mg/dL per decade of age
,- levels > 100 mg/dL indicate impaired fasting glucose (IFG)
- levels > 126 mg/dL obtained on at least two occasions are diagnostic of diabetes,
even in older adults
- Fasting blood glucose should be under 100
Glucose tolerance test (2hr postload result)
- < 140 mg/dL (normal)
- levels > 140 mg/dL and < 200 indicate impaired glucose tolerance (IGT)
- levels > 200 mg/dL indicate provisional diagnosis of diabetes
Glycosylated hemoglobin (A1C) test
- 4-6% (normal)
- levels of 5.7-6.4% indicate prediabetes and an increased risk for development of
diabetes
- levels > 6.5% indicate diabetes
- levels > 8% indicate poor diabetes control and need for adherence to regimen or
changes in therapy
Criteria for diagnosis of diabetes
, 1. A1C > 6.5%.
AND
Fasting (no caloric intake for 8 hrs) blood glucose ≥ 126 mg/dL
OR
2. two hr blood glucose ≥ 200 mg/dL during oral glucose tolerance testing
2. Fasting Plasma Glucose (FPG) ≥ 126 mg/dL.
OR
3. In a pt w/ classic manifestations of hyperglycemia/hyperglycemic crisis, a
casual/random blood glucose concentration > 200 mg/dL
* in in absence of unequivocal hyperglycemia, repeat testing for 1st 3 criteria
Steps for Insulin admin (vial & syringe)
- wash hands
- inspect bottle insulin type & expiration date
- gently roll bottle of intermediate-acting insulin in palms of hands to mix
- clean rubber stopper w/ alcohol swab
- remove needle cover & pull back plunger to draw air into syringe. Amount of air
should = insulin dose. Push needle through rubber stopper & inject air into bottle
- turn bottle upside down & draw insulin into syringe
- remove air bubbles in syringe (tap on syringe/inject air back into bottle). Redraw
correct amount