| Question | Answer |
| 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 |
