Diabetes 
Normal fasting glucose for a nondiabetic 80 to 90 mg/dL with a range fo 70 to 120 mg/dL 
Fasting glucose levels exceeding 126mg/ dL or higher or random glucose level exceeding 200mg/dL  is diagnostic for diabetes 
Type 1 diabetes 
•	Insulin dependant 
•	Most commonly affects children and young adults
•	Autoimmune disease
•	* ketoacidosis develops because of excessive amounts of kentones ( formed from the breakdown of fats)*
•	Large amounts of alcohol can be converted to fats, increasing risk for diabetic ketaocidsis 
Type 2 diabetes
•	Associated with older adults
•	Two main problems: 
o	Insulin resistance 
o	Impaired insulin secretion
•	*diabetic ketoacidosis does not typically occur *
Manifestations
•	* the three Ps * 
o	Polyuria ( increased urination)
o	Polyduosia ( increased thirst)
o	Polyphagia ( increased appetite) 
•	Other symptoms
o	Dehydaration
o	Weight gain
o	Fatigue & weakness
o	Vision changes
o	Tingling or numbness in extremities
o	Skin lesions or wounds that are slow to heal
o	Recurrent infections

Complications:
•	Hypertension
•	Death from heart disease
•	Stroke
•	Leading cause of nontraumatic amputations
•	Blindness
•	End stage renal disease
Insulin 
•	Hormone produced by the pancreas that controls blood glucose levels by regulating the production, use, and storage of glucose
•	Insulin promotes hypoglycemia & glucagon promotes hyperglycemia 
•	Major danger of alcohol consumption is hypoglycemia especially pts who take insulin 

Time/type	Name 	onset	duration	indications	
Rapid acting	Lispro( humalog)
Aspart (novolog)
Glulisine( apidra)	15 min 	3- 5 hr 	Used for rapid reduction treats hyperglycemia/ prevent nocturnal hypoglycemia
“meal time insulin”  	
Short acting	Reg (humulin R, Novolin-R)	½ -1 hr	4-6 hr	Administered 20- 30 min before meal may be taken w/ long acting or alone 	
Intermediate and long acting 	NPH (humlin N, Novolin- N) 
Glargine ( lantus)
Determir (levemir)	2-4 hr 

2 hr 	24 hr 	Taken after food 

Used for constant (basal)  dose