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

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

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: 70 -150

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

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

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

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

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

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.

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.

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.

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.

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

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)

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

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

NPH Acts slowly Starts to work in 1-3 hours Peaks in 6-12 hours Lasts 18- 26 hours

U Very slowly Work in 4-8 hours Peaks in12-18 hours Lasts 24-28 hours

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

Brands of Insulin Lily Novo Nordisk

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

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

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.

Insulin Syringes For injecting insulin

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

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.

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.

(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.

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.

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

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.

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

To many carbohydrates Certain medications

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

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

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

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

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

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

To Contact Instructor Evelyn Stone 1008-F Big Oak Court Knightdale, NC 27545 (919) 266-7050 (919) 266-7052 Fax www.qprofessionalmeantalhealthservice.com Email: stn_vlyn@yahoo.com