1. By Evelyn Stone, RN. BSN.,M.Ed.
Diabetes
By Evelyn Stone, RN. BSN.,M.Ed.

2. What is Diabetes?
Diabetes is a disease affecting how your body makes insulin
How your body uses sugar
Insulin is a hormone
Insulin helps the body use sugar

3. Hyperglycemia
Causes: Too much food, too little insulin, illness or stress
Onset: Gradual, may progress to diabetic coma
Blood Sugar: above 150 mg/dl
acceptable range:

4. Two Types of Diabetes Type 1 – usually happens in children
Type 2 - happens after age 30 or 40
but usually happen younger

5. Why Take Care of Diabetes?
Make you feel bad
Cause other health problems
Can hurt your eyes, heart, kidneys, and nerves
Blood circulation
Teeth and gums

6. Why Healthy Eating
Reach and stay at a weight that is good for the body
Keep blood sugar in range
Prevent heart and blood vessel disease

7. Meal Plan Eat a variety of foods that your body get nutrition
Eat food from the pyramid food group
Refrain from eating sweets and sugar

8. Food Pyramid Milk & milk products
Meat, chicken, fish, beans, cheese & eggs
Fruits & vegetables
Bread, Cereal, Rice, Noodles, & potatoes

9. Diabetes Medicines
Name your diabetes medicine, the dose and when you should take it.
Explain how the medicine works and there are any side effects.
If you use insulin you should be able to draw up and give an insulin injection using the correct sites and rotation.

10. If you don’t use insulin or take diabetes pills
Many people with Type2 diabetes don’t have to use insulin or take diabetes pills.

11. If you take diabetes pills
If you have Type 2 diabetes your doctor may prescribe diabetes pills. Diabetes pills only work in people whose bodies make some insulin of their own. Diabetes pills are not the same as insulin.

12. Get regular exercise
Exercise is good for your diabetes. Walking, swimming, dancing riding a bicycle, playing baseball, and bowling are all good ways to exercise
Exercise helps keep weight down.
Exercise helps insulin work better to lower blood sugar.
Exercise is good for your heart and lungs.
Exercise gives you more energy.

13. Things to know about your insulin
Type
Source
Brand
Expiration Date
Storage

14. Type There are 5 main types of insulin Humalog (also called Lispro)
R (also called regular)
N (also called NPH)
70/30
U (also called ultralente)

15. Humalog Insulin How it acts - very fast Starts to work in 15 minutes
Peaks in… ½ to 1 ½ hours
Lasts… 5 hours or less

16. Regular Insulin Acts fast Works in ½ hours Peaks in 2-4 hours
Lasts 6-8 hours

17. NPH Acts slowly Starts to work in 1-3 hours Peaks in 6-12 hours
Lasts hours

18. U
Very slowly
Work in 4-8 hours
Peaks in12-18 hours
Lasts hours

19. Different Diabetic Pills
Brand name (generic name)
Glucotrol and
Glucotrol XL
(glipizide)
Micronase
Diabeta
Glynase
Glyburide
Amaryl
(Glimpiride
Prandin
Repaglinide
Glucophage
Metformin
Precose
Acarbose
Glyset (miglitol)
Rezulin
troglitazone
Avandia
Rosiglitazone
Actos
pioglitazone

20. Brands of Insulin
Lily
Novo Nordisk

21. Site Selection and Rotation
Injected into the soft, fatty tissue between the skin and muscle.
Stomach - except the waistline and 2 inches around the navel
Upper thighs (front and outside)
Upper outer arms
Buttocks

22. Storage of Insulin Do not let it freeze. Keep it between 36 and 86F
Keep it away from heat and sunlight.

23. When to Take Insulin
The Physician will write order & give time of day to give insulin
It may be given before breakfast, before lunch, before supper, at bedtime or a combination such as before breakfast and before supper.

24. Insulin Syringes
For injecting insulin

25. Site Selection and Rotation
Insulin should be injected into the soft, fatty tissue between your skin and muscle.
Stomach (except the waistline and 2 inches around the navel)
Upper thighs (front and outside)
Upper outer arms
Buttocks

26. Insulin Syringe Disposal
Never throw loose needles or lancets into the trash.
Used needles and lancets are to be disposed of into hard plastic or metal container with a screw on – top (example: Soda bottle or bleach bottle). mark the container “used syringes and lancets”.
Place the container into the trash. Do not put it in the recycle bin.

27. What is Normal Blood Sugar Level?
Normal range - 70 to 110
Blood sugar goes up after eating, but returns to the normal range in 1 or 2 hours.

28. (Continued)
Everyone is different. A good blood sugar range for every one may be different
For example, a blood sugar of 80 may be too low for some people.

29. Low Blood Sugar Low blood sugar can come on fast.
Blood sugar reading lower than 70 is to low.
If you give insulin or diabetic pill to a client low blood sugar can happen.

30. Low Blood Sugar (continued)
Take too much diabetes medicine( pills or insulin)
Miss or delay a meal or snack
Exercise too much
Drink too much alcohol
Other medicines can cause blood sugar to drop

31. Symptoms of Low Blood Sugar
Shaky or nervous
Faint or mixed up
Dizzy
Grouchy, unhappy
Hungry
Tired
Sweaty
Headache
If blood sugar drops lower, one can get very confused, sleepy, or irritable, or may pass out or have a seizure.

32. What Cause High Blood Sugar?
Not giving diabetes medicine
Eat too much of the wrong kinds of food
Not enough exercise
Stressed or upset
Sick or have an infection
Other medicine may cause high blood sugar

33. To many carbohydrates
Certain medications

34. Symptoms of High Blood Sugar
Very thirsty or have a dry mouth
Frequent urination
Blurry vision or problems seeing
Very weak and tired
Very hungry
Naseau & vomiting

35. Documenting the Blood Sugar Reading
Always document on the MAR or the special glucose monitoring sheet
Document in the progress notes

36. Medical Follow Up Always inform the doctor if there are problems
Call the administrator for directions
Call the Nurse if there are questions

37. Conclusion
Always remember to check the blood sugar as ordered by the doctor
Keep OJ and sugar available in the event of low blood sugar
Always monitor what the client is eating
Remember to call 911 if the client goes into insulin shock or diabetic coma
Remember to inform the doctor of changes in blood sugar levels

38. Other Services “Q” professional services for group homes
Medication Administration
Mental Illness
Medication Aide
RN Instructor for Medication Aide
Blood Borne Pathogens
Client’s Rights

39. Other Services (continued)
Developmental Disabilities
Incidents
Seizure Management
Group Homes Policy and Procedure Manual
Preventing Client Abuse

40. To Contact Instructor Evelyn Stone 1008-F Big Oak Court
Knightdale, NC 27545
(919)
(919) Fax