Nursing Assessment, Management and Treatment of Autoimmune Diseases
222
Treatment T1D is managed with a variety of insu- lins. Patients, families, and the healthcare team must work together to find the best treatment regimen. Types of insulin may include the following (JDRF, n.d.): ● Rapid acting : Starts working in about 15 minutes after injection. It peaks in about 1 hour and continues for about 2 to 4 hours after injection. Examples include aspart (Novolog), glulisine (Apidra), and lispro (Humalog). ● Regular or short acting : Starts working 30 minutes after injection, peaks from 2 to 3 hours after injection, and continues to work for about 3 to 6 hours. An example is Humulin R. ● Intermediate acting : Starts working 2 to 4 hours after injection. It peaks about to 12 hours later and lasts 12 to 18 hours. An example is Novolin N. ● Long acting : Long acting is often combined with rapid or short acting insulin. It starts to work several hours after injection and tends to lower glucose levels up to 24 hours. An example is Lantus. ● Ultra-long lasting : Starts to work in 6 hours, but it does not peak and lasts an estimated 36 hours. An example is Tresiba. Insulin is administered in a variety of ways. Historically, insulin was administered via injection using a syringe. Today, other op- tions are available including the following (CDC, 2021a; JDRF, n.d.): ● Insulin pen : Some pens use cartridges that are inserted into the pen while others are pre-filled and discarded after all insulin is used. The dose of insulin is dialed on the pen and the insulin is injected through a needle.
with attached glucose. An A1C level of 6.5% or higher on two separate tests is an indicator of T1D. ● Random blood glucose test : This test requires that a blood sample be obtained at a random time and confirmed by repeat testing. A random blood glucose level of 200 mg/dL or higher suggests T1D, particularly if the patient has signs and symptoms of T1D. ● Fasting blood glucose test: The fasting blood glucose test requires that a blood sample be obtained following an overnight fast. A fasting blood glucose level of less than 100 mg/dL is normal. A level from 100-125 mg/dL is classified as prediabetes. A level of 126 mg/dL or higher on two separate tests is diagnostic for T1D. ● Antibody test: If a diagnosis of diabetes is made, the healthcare provider may order blood tests to check for antibodies that are common in T1D. Presence of antibodies helps to differentiate between T1D and type 2 diabetes when the diagnosis is uncertain. | NURSING CONSIDERATION Certain conditions such as pregnancy or having a hemoglobin variant may interfere with the accuracy of the A1C test. In these types of cases, the health- care providers will rely on additional blood tests to determine an accurate diagnosis.
Powered by FlippingBook