(Print) Use this randomly generated list as your call list when playing the game. There is no need to say the BINGO column name. Place some kind of mark (like an X, a checkmark, a dot, tally mark, etc) on each cell as you announce it, to keep track. You can also cut out each item, place them in a bag and pull words from the bag.
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Understanding Diabetes and the Pancreas' Role
Blood Glucose:
Normal Fasting Level: Less than 100 mg/dL.
Diet: Emphasize balanced meals, carb counting, and limiting sugar intake.
Type 1 Diabetes:
Hemoglobin A1C:
Glucose Tolerance Test:
Pancreas Functions:
Treatment: Insulin IV, fluids, and monitoring electrolytes.
Type 2: Obesity (high BMI), sedentary lifestyle, family history, certain ethnicities (Hispanic, African American, Native American, Asian American, Pacific Islander), and history of gestational diabetes. Symptoms usually develop gradually.
Cause: High blood glucose with ketone production (due to lack of insulin).
Signs and Symptoms
Beta cells: These cells release insulin and amylin when blood glucose is high. Insulin helps cells absorb glucose for energy, while amylin slows down the absorption of glucose and controls blood sugar spikes.
Complications of Diabetes
Diabetes Mellitus (DM): Types and Differences
Biguanides (e.g., metformin) decrease glucose production in the liver.
What is Diabetes Mellitus?
Insulin is essential. Treatment involves:
Checks for glucose and ketones in the urine, as elevated levels may indicate diabetes or uncontrolled blood glucose.
Urine Screening:
Exocrine Function: This involves producing enzymes that help digest food.
Regular insulin injections or an insulin pump.
Blood sugar rises in the early morning due to hormone release. Managed by adjusting insulin timing.
Type 2 Diabetes:
Sick Day Rules: Maintain blood sugar checks, even if not eating much, as stress and illness can increase blood sugar.
Normal Range: Blood glucose should be between 70-110 mg/dL. The brain relies on a steady glucose supply, as it cannot store glucose, making blood glucose regulation crucial for brain function.
Blood sugar drops during the night (often due to excess insulin before bed), and the body compensates by raising blood glucose, resulting in high morning glucose. Managed by adjusting insulin dosage or adding a bedtime snack.
Higher risk for DKA due to the complete lack of insulin.
Insulin Resistance: The body produces insulin but doesn't use it effectively, often due to obesity, inactivity, and genetic factors.
Focus on lifestyle changes first:
Should be below 140 mg/dL after 2 hours of consuming glucose.
Blood Glucose Monitoring: Educate on frequency and techniques.
Higher risk for Diabetic Ketoacidosis (DKA), a life-threatening condition where blood becomes acidic due to a lack of insulin.
Cause: Extremely high blood glucose with dehydration, typically in Type 2.
Insulin Sensitizers (e.g., pioglitazone) make cells more responsive to insulin.
Type 1 Diabetes:
Treatment: Insulin IV, fluids, and electrolyte replacement.
Weight gain is common, and HHS is a risk due to high blood glucose without ketones.
Dawn Phenomenon:
Higher risk for Hyperosmolar Hyperglycemic State (HHS), where blood sugar rises dangerously high without the presence of ketones (no acidosis).
Reflects average blood glucose levels over the past 3 months. A normal A1C is between 4-6%.
Some patients may eventually need insulin.
Exercise: Can lower blood glucose but requires careful planning to avoid hypoglycemia.
Medication Types and Insulin Administration
Long-Acting Insulin (e.g., Lantus): Works slowly without peaks, providing steady insulin levels over 12-24 hours.
Liver's Role:
Diabetes Risk Factors
Type 2 Diabetes:
Diabetic Ketoacidosis (DKA):
Monitoring blood sugar multiple times daily.
Therapeutic Management and Nursing Interventions
Rapid-Acting Insulin (e.g., Humalog): Works within 15 minutes and is given before or with meals.
Diet control through carbohydrate counting.
Type 1 Diabetes:
Intermediate-Acting Insulin (e.g., NPH): Takes 1-2 hours to start working; used to cover blood sugar between meals.
Types of Insulin:
Understanding Dawn Phenomenon vs. Somogyi Effect
Autoimmune Condition: The immune system attacks and destroys beta cells in the pancreas, which stops the production of insulin.
Insulin stimulators (e.g., glipizide) help the pancreas release more insulin.
Symptoms: Extreme thirst, confusion, dry mouth, no ketones.
Quick onset of symptoms, including weight loss, increased appetite, and the "3 Ps" (polyuria, polydipsia, polyphagia).
Hyperglycemia (High Blood Sugar): When blood glucose rises, the pancreas releases insulin to help cells absorb glucose and lower blood sugar levels.
Oral Hypoglycemics for Type 2:
Endocrine Function: The pancreas also regulates blood sugar (glucose) levels. This happens through tiny clusters called the Islets of Langerhans, which contain two critical types of cells:
Common in people under 30 and often diagnosed abruptly.
Nursing Interventions:
Hypoglycemia (Low Blood Sugar): When blood glucose drops, the pancreas releases glucagon to signal the liver to release glucose.
Diet, exercise, and potentially oral medications that help lower blood glucose.
The liver stores glucose in the form of glycogen. When blood glucose levels drop, glucagon from the pancreas tells the liver to release stored glucose, raising blood glucose levels. When blood glucose is high, insulin encourages the liver to stor
Common onset is around age 50 and tends to develop gradually.
Diabetes Mellitus is a condition where the body cannot regulate blood glucose properly, resulting in chronic hyperglycemia (high blood sugar).
Key Lab Values and Diagnostic Tests
Hyperosmolar Hyperglycemic State (HHS):
Symptoms: Often similar to Type 1 (polyuria, polydipsia, polyphagia), but less noticeable.
Gradual onset, with symptoms often less noticeable.
Blood Glucose Basics:
Alpha cells: These cells release glucagon when blood glucose is low. Glucagon signals the liver to convert stored glycogen back into glucose and release it into the bloodstream, raising blood sugar.
Type 1: Family history, genetic predisposition, autoimmune conditions, and sometimes following viral infections. It’s more common in those under 30.
