Beta blockers can mask SNS response to hypoglycemia tachycardia tremors

Beta blockers can mask sns response to hypoglycemia

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Beta-blockers can mask SNS response to hypoglycemia (tachycardia, tremors, palpitations, diaphoresis), making it difficult for clients to identify hypoglycemia Beta blockers also decrease effectiveness by inhibiting insulin release. Types of Diabetes o Type 1 diabetes (T1DM) o Treatment Physical activity Insulin replacement Management of hypertension An ACE inhibitor (for example, lisinopril) or an ARB (for example, losartan) can reduce the risk of diabetic nephropathy Dyslipidemia Statins (for example, atorvastatin o Type 2 diabetes o Insulin resistance and impaired insulin secretion o Hyperinsulinemia o Insulin resistance o Strong family association o Treatment Similar to type 1, requires comprehensive plan Patient should be screened and treated for: Hypertension, nephropathy, retinopathy, neuropathy, dyslipidemias Glycemic control with: Modified diet and physical activity Drug therapy o Gestational o Placenta produces hormones that antagonize the actions of insulin o Production of cortisol increases threefold o Glucose can pass freely from the maternal to the fetal circulation (fetal hyperinsulinemia) o Short-term o Hyperglycemia o Ketoacidosis o Hypoglycemia o Long-term o Macrovascular damage Heart disease Hyertension Stroke Hyperglpycemia Altered lipid metabolism Retinopathy
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Nephropathy: Angiotensin-converting enzyme (ACE) inhibitor or angiotensin II receptor blocker (ARB) Sensory and motor neuropathy Gastroparesis Amputation secondary to infection Erectile dysfunction o Diagnosis of Diabetes o Hemoglobin A 1c: 6.5 % or higher is diagnostic o Tests based on glucose: Fasting plasma glucose (FPG) test: ≥126 mg/dL Casual plasma glucose test: ≥ 200 mg/dL Oral glucose tolerance test (OGTT): 2hr plasma glucose ≥ 200 mg/dL o PREDIABETES Impaired fasting plasma glucose between 100 mg/dL and 125 mg/dL Monitoring Treatment o Self-monitoring of blood glucose (SMBG) o Common target values for blood glucose 70-130 mg/dL before meals 100-140 mg/dL at bedtime Hemoglobin A1c: < 7.0 % Provides an index of average glucose levels over the prio 2 to 3 months Goal below 8% may be appropriate for patients with a history of severe hypoglycemia, limited life expectancy, or advanced microvascular or macrovascular complications Measure 2-4 times a year to access long term control Peak postmeal plasma glucose < 180 mg/dL ` Insulin MOA: promotes cellular uptake of glucose (decreases glucose levels), converts glucose into glycogen, moves potassium into cells (along with glucose) Therapeutic Use: Insulin is used for glycemic control of diabetes mellitus (type 1, type 2, gestational) to prevent complications. Lispro Insulin (Rapid-acting) Humalog Onset: 15-30 mins (10 to 20 mins) Peak: 30 mins- 2.5 hrs Duration: 3-6 hrs ( 3-5 hrs) Administered immediately before eating of even after eating Usual route is subQ via injection or use of an insulin pump Acts faster than regular insulin Should be injected 5-10 minutes before meals
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  • Spring '14
  • DeborahL.Schiavone
  • Nursing, blood glucose, Blood sugar, Glucose tolerance test

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