Derek&John's DM Presentation

​Priority Medications for Type I

• ​Insulin: Rapid-acting ( 30 minute-3Hr peak),

• Short-Acting (Human, Humulin R and Novolin R 2-5Hr peak),

• Intermediate (NPH 4-12 Hr)

• Long-acting (detemir, glargine: No peak)

​Priority medications for Type II

• ​Biguanides: Metformin/Glucophage (Increases Insulin sensitivity and glucose uptake, reduces hepatic glucose production)

• ​Sulfonylureas: Glipizide/Glucotrol and Glyburide/DiaBeta (Stimulates release of insulin from pancreas and increases sensitivity to insulin)

• ​Thiazolidinediones: Pioglitazone/Actos and rosiglitazone/Avandia (Increases glucose uptake in muscle, reduces endogenous glucose production)

​Priority Collaborative Goals

• ​Nutritional therapy: Making diet adjustments with dietician to make individualized meal plans. For Type I, this means planning meals around usual intake, insulin, and excercise/activity for consistency in blood glucose levels. Type II emphasizes diet changes to achieve specific glucose level goals and modest weight loss in people with diabetes who are overweight or obese.

• ​Exercise and activity: Exercise reduces insulin resistance and can result in weight loss which further decreases resistance. Caution is needed as it can result in hypoglycemia in patients using insulin, sulfonylureas and meglitinides. Collaboration with Physical Therapy can create individualized plans.

• ​Self-care/management: Medication administration, Foot care, adherence to exercise and meal plans

​Potential and Actual Complications Type I

• ​Nephropathy and Kidney Failure

• ​Diabetic Ketoacidosis

• ​Retinopathy

​Potential and Actual Complications Type II

• ​Nephropathy and Kidney Failure

• ​Hyperglycemic Hyperosmolar Syndrome

• ​Retinopathy

​References

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Bristol, T. J., Herrman, J. W., & Stephenson, W. (2019). Nclex-Rn® Conceptual Review Guide: Clinical-based for Next Gen Learning. NurseThink, published by NurseTim, Inc.

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Harding, M., Kwong, J., Hagler, D., Roberts, D., & Reinisch, C. (2020). Lewis's medical-surgical nursing: Assessment and management of clinical problems. Elsevier.