Sudden onset of Type 1 diabetes is like white water rafting holding on to a log for dear life. Sugar Bear was in the PICU and then moved to the regular part of the hospital after a few days. Then we had a day of education. Not really even a day. Part of the education was injecting saline into each others arms, learning as much info as possible about carbs and how they effect BS. And we all had to pass a test before we could take him home. It was a whirlwind of emotions and information and then he was released in our care. His life literally in our hands. We've learned so much more since then. And still not enough. I thought it might be interesting to post the 36 questions we had. They were multiple choice. I'll post the answers later in the week. Here are the questions:
1. Without insulin, blood sugar:
a. goes up
b. goes down
c. disappears
d. stays the same
2. The most accurate way of testing the amount of sugar in the body is by:
a. urine testing
b. blood testing
c. observation for signs of high and low blood sugar
d. smelling the breath
3. In using your blood glucose monitor, it is important to:
a. make certain the code number on the test strip vial or packet matches the code number on he monitor
b. use only those strips made for your blood glucose machine
c. make sure you have an adequate blood drop to perform the test
d. all of the above
4. If your blood glucose reads out 45mg/dl on your blood glucose monitor, the first thing you should do is:
a. call the doctor immediately
b. drink 4 oz. of fruit juice or sugar containing beverage
c. take more insulin
d. eat a leafy green salad
5. If your blood sugar reads out 450mg/dl on your blood glucose monitor, you should:
a. call the rescue squad
b. check your urine for ketones and get in touch with your doctor
c. drink 4 oz. of juice or a sugar containing beverage
d. all of the above
6. Blood sugar should always be tested:
a. once a week
b. once a day
c. after meals and after bedtime snack (at least 4 times per day)
d. before meals, at bedtime and whenever your child feels like he or she has a low blood sugar (at least 4-6 times per day)
7. If your blood glucose monitor reads out "HI", it means:
a. the meter is not working correctly
b. your child is having an insulin reaction
c. your meter is giving you a greeting
d. your meter can not read the blood sugar because it is greater than 600mg/dl
8. Blood and urine test strips should be:
a. stored at room temperature
b. re-capped as soon as strip is removed from bottle
c. used before the expiration date
d. all of the above
9. You should check your urine for ketones:
a. once a day in the AM for the first few weeks
b. when Blood sugar is over 300
c. when ill
d. all of the above
10. When testing urine with Ketostix, compare the colors after:
a. 15 seconds
b. 2 minutes
c. 5 minutes
11. Unopened bottles of insulin should be stored:
a. in the refrigerator
b. in the freezer
c. in the kitchen cabinet
d. in the oven
12. Novolog insulin should be given:
a. mixed with Lantus
b. no longer than 15 minutes before a meal
c. within 30-40 minutes after starting a meal
d. b & c
13. When injecting insulin, you should:
a. give it in the same place every day
b. give it in a different site every day, using your site rotation chart
c. I don't know
14. Mark Novolog (N) or Lantus (L) beside the following things about insulin.
____Starts acting 10-15 minutes after injection
____Lasts approximately 24 hours after injection
____Is a long acting insulin without a true peak
____Lasts about 3-5 hours
____Peaks approximately 2 hours after injection
____Starts acting about 2 hours after injection
____Clear insulin in a short & wide bottle, or cartridge
____Clear insulin in a skinny, taller bottle
15. Mark the following statements as True or False (T or F).
____Lantus can be mixed in the same syringe with Novolog
____Insulin raises blood sugar
____Lantus should be given at the same time every day
____Injecting air in the insulin bottle is not important in helping withdraw the appropriate amount of insulin
16. If ketones are present in the urine of a person with diabetes, they will need to:
a. call the physician if the ketones are moderate or large
b. be inactive
c. to drink water or sugar free fluids
d. all of the above
17. Pick the best answer for the following question.
A blood sugar of 300 is:
a. too high
b. too low
c. normal
18. Match the term high blood sugar (H) or low blood sugar (L) with each of the following:
____Caused by too much food and not enough insulin
____Caused by infections, sunburns, or poison ivy
____Symptoms may include feeling ill, vomiting, and deep rapid breathing, increased thirst & urination
____May need to give extra Novolog insulin
19. Which of the items below may cause a low blood sugar?
a. illness, i.e. earache, infection, tonsillitis
b. skipping insulin
c. hard exercise (playing hard)
20. A low blood sugar is caused by
a. too much insulin
b. too little insulin
c. too little exercise
21. A blood sugar of 30 is:
a. too high
b. too low
c. normal
22. A glucagon injection is used when a person with diabetes:
a. has low blood sugar and is unable to safely take sugar containing liquid by mouth, is unconscious, or is having a seizure
b. has high blood sugar
c. has the flu
d. all of the above.
23. If your child has a low blood sugar, you should:
a. give 15 gms or 4 oz. (1/2 cup) of orange juice or regular pop
b. call the doctor for insulin instructions
c. tell him/her to go lie down
d. give him/her an extra bread exchange at next meal or snack
24. Match the term high blood sugar (H) or low blood sugar (L) with each of the following:
____Pale, sweaty, shaky, may have headache
____Confusion: if left untreated can progress to seizure
____Treat with sugar or glucagon
25. What raises blood sugar?
a. stress
b. illness
c. exercise
d. a and b
e. all of the above
26. When a person with diabetes is ill and vomiting, he should:
a. check the BG and ketones, then call the doctor
b. give the same amount of insulin
c. not take any insulin
d. I do not know
27. Before hard exercise, a person with diabetes should:
a. take more insulin
b. check blood sugar. If low, treat with juice & then pre-treat for exercise with carbs.
c. take less insulin if exercising after the meal
d. b or c
28. The short term and long term goals in managing diabetes are:
a. blood sugars as near normal as possible
b. normal growth
c. freedom from complications
d. all of the above
29. In Type 1 diabetes (insulin dependent or juvenile diabetes), blood sugar is controlled by:
a. carefully controlling insulin, diet, and exercise
b. removing the pancreas
c. seeing the doctor every two weeks
d. losing weight
30. The best range listed for a child with diabetes who is taking insulin is;
a. 150-250 mg/dl
b. 60-100 mg/dl
c. 80-150 mg/dl
d. 190-200 mg/dl
31. Mark the following statements as true or false (T or F):
____Food raises blood sugar
Exercise lowers blood sugar
Illness and stress usually lower blood sugar
_____Blood sugar should be checked at least 4-6 times per day.
32. Just before a soccer game, your blood sugar is 58 mg/dl. What should you do?
a. Drink juice to treat the low blood sugar
b. Pre-treat for the soccer game by eating extra carbohydrates
c. Take Novolog for the carbohydrates eaten for pre-treatment
d. a & b only
33. Before a meal, your blood sugar is 62 mg/dl. What should you do?
a. Call the rescue squad
b. Eat the meal & subtract 15 grams from the total carbs eaten to treat the low BG
c. Do not give any insulin
Use the following insulin doses to answer the next 4 questions:
Blood Glucose (BG) result Daytime Correction Scale Bedtime Correction Scale
Under 150 0 units 0 units
150-200 1 unit 0 units
201-250 2 units 1 unit
251-300 3 units 2 units
301-350 4 units 3 units
351-400 5 units 4 units
over 401 6 units 5 units
Lantus insulin= 5 units to be given daily @ 9pm.
Carb to insulin ratios:
- Breakfast = 15 grams :1 unit
- Lunch = 10 grams : 1 unit
- Dinner = 20 grams :1 unit
34. Before eating breakfast, your child's blood glucose was 100. He/she ate 60 grams of carbohydrates. How much Novolog should your child get?
a. 2 units
b. 3 units
c. 4 units
d. 5 units
35. Before eating lunch, your child's blood glucose was 340. You checked for ketones, and they were negative. He/she ate 78 grams of carbohdrates for lunch, and is planning to watch a movie now. How much Novolog should your child get?
a. 10 units
b. 11 units
c. 12 units
d. 13 units
36. Before eating dinner, your child's blood glucose was 210. He/she ate 85 grams of carbohydrates. You are planning to take them to the park after dinner to play. How much Novolog should your child get?
a. 5 units
b. 6 units
c. 7 units
d. 8 units
37. You checked your child's blood glucose at 9pm for bed, it was 279. How much insulin should they get?
a. 5 units of Lantus & 2 units of Novolog in separate syringes
b. 5 units of Lantus & 2 units of Novolog mixed in the same syringe
c. 5 units of Lantus & 3 units of Novolog in separate syringes
d. 7 units of Lantus
That was the whole test. My husband, my teenager, and myself all had to pass before we took Sugar Bear home. Reading over these again I can chuckle at some of the humor and find this to be so second nature on the most part. So how do you think you did?
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