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Nur100 DM

Diabetes Mellitus

Diabetes Mellitus "to siphon" and "sweet", "an outpouring of sweet urine" has two types
Type one the result of pancreatic islet cell destruction and no insulin production
Type two insulin resistance with a defect in compensatory insulin secretion
pancreases hormones metabolism of carbohydrates, proteins, and fats, hormones in islets of Langerhans, the three types of cells; alpha, beta, delta
alpha cells produce glucagon, stimulates breakdown of glycogen in the liver, stimulates formation of carbohydrates in the liver, stimulates breakdown of lipids in liver and adipose tissue
Major function of glucagon decrease glucose oxidation, increase blood glucose levels, uses glycogenolysis and gluconeogenesis to keep blood sugar normal
glycogenolysis breakdown of liver glycogen
gluconeogenesis formation of glucose from fats and proteins
beta cells secretes insulin, helps movement of glucose across cell membrane thus decreases blood glucose, prevents excessive breakdown of glycogen in liver and muscle, facilitates lipid formation, inhibits breakdown of stored fats
delta cells produce somatostatin, neurotransmitter inhibits production of glucagon and insulin
blood glucose homeostasis all tissues require glucose, not all tissues require insulin for glucose uptake, normal blood glucose through cations of insuin and glucagon, counterregulatory hormones stimulate release of glucose
manifestations of type 1 Hyperglycemia Causes serum hyperosmolality so water drawn into vessels Have increased renal blood flow and hyperglycemia acts as osmotic diuretic Polyuria and glucosuria Polydipsia Polyphagia
manifestations of type 2 Slow onset Polyuria Polydipsia Blurred vision Fatigue Paresthesias Skin infections
diagnostics criteria Symptoms plus casual plasma glucose over 200 mg/dl Fasting plasma glucose over 126 mg/dl Two-hour plasma glucose over 200 mg/dl during oral glucose tolerance test (OGTT)
types of insulin Rapid acting Short acting Intermediate acting Long acting Insulin for the type 1 diabetic or type 2 when ill, oral meds not working
goals of nutrition Maintain near normal blood glucose Achieve optimal serum lipid levels Provide adequate calories Prevent & treat acute complications Improve overall health
sick day management Prevent dehydration Provide nutrition Diabetic must Monitor blood glucose Test urine Take insulin 8-12 oz fluid every hour Use easilty digested foods Call MD if unable to eat for 24 hr
hyperglycemia Dawn phenomenon Somogyi phenomenon Diabetic ketoacidosis (DKA): type 1 Hyperosmolar hyperglycemic state (HHS) :type 2
hypoglycemia Blood sugar below 70 mg/dL Signs and symptoms from compensatory automonmic nervous system response and impaired cerebral function Manifestations vary, esp. in older adults Onset sudden: blood Glucose 45-60
chronic complications Cardiovascular system Coronary artery disease (CAD) Hypertension Cerebrolvacular (CVA) Peripheral vascular disease (PVD) Diabetic retinopathy Diabetic nephropathy Diabetic neuropathy Mood alterations Increased susceptibility to infection
complications of the feet High risk for amputation Teaching important Wear shoes, well fitting Avoid traumas Look at feet every day Do not self treat—see MD and/or podiatrist Wear white, cotton socks
Nursing interventions Risk for impaired skin integrity Risk for infection Risk for injury Sexual dysfunctin Ineffective coping Deficient knowledge: self management
Created by: katpeterson