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Specializes in Gerontological, cardiac, med-surg, peds.

excellent free resource (article is free, ce credit will cost money):

metabolic syndrome: a growing epidemic

metabolic syndrome, a constellation of conditions and/or risk factors, leads to an increased incidence of cardiovascular (cv) disease as well as type 2 diabetes mellitus. it was first described in 1988 and has been referred to by a variety of names, including "reaven's syndrome," "deadly quartet," "syndrome x," "insulin resistance syndrome" and "dysmetabolic syndrome." in general, the components include central adiposity, hypertension, dyslipidemia, insulin resistance and a proinflammatory state. each component is independently associated with an increased cardiovascular risk and diabetic risk. together, the potential health effects are made more significant. accurate diagnosis and aggressive treatment with lifestyle modifications and/or pharmacotherapy is necessary to reduce morbidity and mortality.

approximately 47 million adults in the united states currently have metabolic syndrome. this represents nearly 1 in 4 adults over 21 years of age. based on population-weighted estimates, approximately 1 million adolescents have metabolic syndrome and as many as 40% of adults over 60 years of age.

http://www.netce.com/courseoverview.php?courseid=320

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Specializes in Gerontological, cardiac, med-surg, peds.

Another free resource on metabolic syndrome:

The Metabolic Syndrome: Time for a Critical Appraisal: Joint statement from the American Diabetes Association and the European Association for the Study of Diabetes. R Kahn, J Buse, E Ferrannini, M Stern

Diabetes Care 2005 9;28(9):2289-304

http://www.biocritique.com/viewref.cfm?messageid=04436fee-fdd0-4517-9496-4fca430911c1

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Specializes in Gerontological, cardiac, med-surg, peds.

tight insulin control: making it work

diabetes in pregnancy and beyond

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Specializes in Gerontological, cardiac, med-surg, peds.

the insulin pump

an insulin pump consists of a reservoir (essentially, a large syringe) containing rapid-acting insulin, a battery-powered pump, and a computer chip controller. the pump delivers insulin via an infusion set (catheter tubing and a needle or soft cannula).

the pump closely mimics a healthy pancreas. it delivers rapid-acting insulin as a continuous infusion of small amounts (the basal dose) and can be programmed to release a bolus of additional insulin to compensate for carbohydrates consumed during meals or for high blood glucose levels. patients can choose to receive a bolus of rapid-acting insulin before, during, or after the meal; other options include the square-wave bolus (a bolus released evenly over a set period of time, usually 30 minutes to two hours).

because the pump allows for more efficient insulin absorption, most people need 25% less insulin when using the pump than when using injections. 1 whoever prescribes the insulin pump should calculate the patient's initial dosage. typically, 50% of the initial dosage is delivered at the basal rate and 50% is reserved for boluses. but patients must also learn how to verify the accuracy of their basal and bolus doses through frequent blood glucose monitoring and meticulous record keeping. for a beginning pump user, the basal rate can be calculated according to either body weight or total combined daily dosage of longer- and shorter-acting insulins given via injections.

http://www.nursingcenter.com/prodev/ce_article.asp?tid=408052

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