CASE STUDY 77
1. 3 methods used to diagnose DM are hemoglobin AIC, urinalysis, and metabolic panel control tests.
2. 3 functions of insulin include, glucose metabolism, fat regulation, and growth stimulation.
3. glucagon, cortisol, and growth hormones
4. Since hypoglycemia is the most adverse effect, it could be life threatening, so you want to make sure theYL has emergency sugar supply with her at all times. Ex. Hard candies, juices, etc. and carbs (to stabilize). Also make sure to not dilute or mix it with any other glargine with other insulin or solution.
5. Lispro is a very fast-acting insulin and designed to take effect 15-30 minutes and reach its peak sugar-lowering effect after 60 to 90 minutes. It is usually given 5-10 minutes before a meal and is effective for 3 to 5 hours. It must also be given with food so meal must be in place before injecting. Regular is defined as short acting. It begins lowering blood sugar from 30 to 60 minutes once injected. Its peak effect is 2.5-5 hours, and is effective for 5 to 8 hours. Short-acting insulin covers insulin needs for meals eaten within 30-60 minutes.
6. Peak: 60-90 minutes duration: 3-5 hours
7. The advantage of glargine is it provides patients a longer duration of insulin (20-24 hours), therefore, decreases the risk for nocturnal hypoglycemia. The advantage of lispro is its fast acting and absorption abilities over other insulin options.
8. CHO counting is a system for controlling the amount of carbohydrates you eat at meals and snacks. By counting carbohydrates in food, you can control the portion you have in every meal and the total you have for the entire day. It will help YL improve her blood glucose control (which will decrease risk for other future complications) and help her to better interpret her blood glucose readings.
9. Her complaints of her burning feet sensation of “pins in them.”
10. Her high HgbA1c is an indication of increased risk for neuropathy