Cheat Sheet
Diabetes Part 1
17 terms | Week 1
Type 1 DM
Definition
Autoimmune beta-cell destruction, absolute insulin deficiency
Simple Version
No insulin made, must inject
Memory Trick
Type 1 = 1 treatment option (insulin only)
Clinical Tip
Always have a glucagon kit available; these patients are highly ketosis-prone.
Type 2 DM
Definition
Insulin resistance with progressive beta-cell failure
Simple Version
Cells ignore insulin, pancreas wears out
Memory Trick
Type 2 = 2 problems (resistance + declining production)
Clinical Tip
Metformin is first-line; hold before contrast dye procedures to prevent lactic acidosis.
A1C Target
Definition
Less than 7% for most diabetic adults per ADA guidelines
Simple Version
3-month blood sugar average should be under 7%
Memory Trick
A1C goal = 7 (like a lucky number for good control)
Clinical Tip
Each 1% drop in A1C reduces microvascular complications by approximately 25%.
Hypoglycemia
Definition
Blood glucose below 70 mg/dL
Simple Version
Dangerously low blood sugar
Memory Trick
Rule of 15: Give 15g carbs, wait 15 min, recheck
Clinical Tip
Treat before re-testing if symptomatic. If patient cannot swallow, give glucagon IM or dextrose IV.
3 P's
Definition
Polyuria, Polydipsia, Polyphagia
Simple Version
Peeing a lot, drinking a lot, eating a lot
Memory Trick
3 P's = 3 ways the body tries to deal with sugar it cannot use
Clinical Tip
In Type 1, the 3 P's plus unexplained weight loss often prompt initial diagnosis.
Insulin Injection Sites
Definition
Abdomen (fastest), arms, thighs, buttocks (slowest)
Simple Version
Belly absorbs insulin fastest
Memory Trick
A-A-T-B: Abdomen Always Takes Best (fastest absorption)
Clinical Tip
Rotate within one region before moving to another to maintain consistent absorption rates.
DKA Triad
Definition
Hyperglycemia >250, Ketosis, Metabolic acidosis (pH <7.30)
Simple Version
High sugar + ketones + acid blood
Memory Trick
DKA = Dangerously Ketotic and Acidotic
Clinical Tip
Always check ABGs, BMP, and serum ketones. Monitor every 1-2 hours until stable.
HHNS Values
Definition
Glucose >600, Osmolality >320, minimal/no ketones, pH >7.30
Simple Version
Super high sugar, very dehydrated, but no acid problem
Memory Trick
HHNS = High High No Significant ketosis
Clinical Tip
Fluid deficit can be 8-12 liters. Expect massive fluid resuscitation orders.
Potassium Rule
Definition
K+ must be >3.3 before starting insulin in DKA
Simple Version
Fix potassium before giving insulin
Memory Trick
3.3 is the K+ key to start the insulin IV
Clinical Tip
Place patient on continuous cardiac monitoring. Hypokalemia causes U waves, flattened T waves, and dysrhythmias.
Kussmaul Respirations
Definition
Deep rapid breathing compensating for metabolic acidosis
Simple Version
Body trying to breathe off the acid
Memory Trick
Kussmaul = Kompensating for Ketoacidosis
Clinical Tip
Present in DKA, NOT in HHNS. If you see Kussmaul breathing with hyperglycemia, think DKA.
Glucose Correction Rate
Definition
Lower BG by 50-75 mg/dL per hour maximum
Simple Version
Do not drop sugar too fast
Memory Trick
Slow and steady wins the race: 50-75 per hour
Clinical Tip
When glucose reaches 250 in DKA, switch IV fluids to D5 with NS to prevent hypoglycemia while continuing insulin to clear ketones.
Rapid-Acting Insulin
Definition
Lispro, Aspart, Glulisine. Onset 10-15 min, peak 1-2 hr, duration 3-5 hr
Simple Version
Give right before meals
Memory Trick
RAG = Rapid Acting Group (lispRo, Aspart, Glulisine)
Clinical Tip
Give within 15 minutes of eating. Monitor for hypoglycemia 1-2 hours after injection.
Regular Insulin
Definition
Humulin R / Novolin R. Onset 30-60 min, peak 2-4 hr, duration 6-8 hr
Simple Version
Give 30 min before meals, only IV insulin
Memory Trick
Regular = the only one Regular enough for IV
Clinical Tip
Used in insulin drips for DKA. When mixing with NPH, draw up Regular FIRST.
NPH Insulin
Definition
Humulin N / Novolin N. Onset 1-2 hr, peak 6-10 hr, duration 12-18 hr
Simple Version
Cloudy, medium-acting, covers half the day
Memory Trick
NPH = Not Perfectly Honest (it is cloudy, not clear)
Clinical Tip
Must be gently rolled (not shaken) to resuspend. Peak at 6-10 hours is when hypoglycemia risk is highest.
Glargine (Lantus)
Definition
Long-acting. Onset 1-2 hr, no peak, duration ~24 hr. Clear solution.
Simple Version
Once-daily background insulin, no peak
Memory Trick
Glargine = Goes all day long. Never mix, never IV.
Clinical Tip
Give at the same time daily. NEVER mix with other insulins. NEVER give IV.
Mixing Rule
Definition
Clear before cloudy: Regular (clear) drawn up first, then NPH (cloudy)
Simple Version
Clear first, cloudy second
Memory Trick
RN = Regular then NPH, just like an RN nurse always goes first
Clinical Tip
Inject air into NPH vial first, then air into Regular vial, draw up Regular, then draw up NPH.
Site Rotation
Definition
Rotate injection sites to prevent lipodystrophy. Stay within one region before switching.
Simple Version
Move your injection spot around to avoid lumps
Memory Trick
Think of a clock face on the abdomen: rotate to the next hour position each injection
Clinical Tip
Abdomen gives most consistent absorption. Document injection sites to ensure proper rotation.