Diabetes Mellitus
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| definition of Diabetes mellitus DM? | a complex disorder of carbohydrate, fat, and protein metabolism caused by deficiency or absence of insulin secretion by the beta cells of pancreas or by defects of the insulin receptors
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| classic signs and symptoms of Diabetes: | 1.Elevated blood sugar (hyperglicemia), 2.Elevated sugar in urine (glycosuria), 3.Excessive excretion of urine (polyuria), 4.Excessive thirst (polidipsia), 5.Excessive hunger (polyphaisa)6. Weight gain, 7.Fatigue
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| Type I Diabetes | insulin dependent
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| onset of Type I Diabetes | abrupt oneset iof symptoms in the age of puberty, juwenile
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| what is the etiology of DM? | acuired, familial, idiopathic, neurogenic, nephrogenic, possible viral, and genetic
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| characteristic of IDDM | decrease in size and number of islet cells resulting inadequate prodution of insulin
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| what is the patient that had IDDM prone to? | ketoacidosis
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| What is type II DM? | noninsulin-dependent
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| what is the age of diagnosis with NIDDM | maturity, adolescent, over the age of 40
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| what is the onset of NIDDM? | gradual
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| What is the Impaired Glucose Tolerance? | assymptomatic or borderline diabetes with abnormal response to oral glucose test. many peole will convert to type II DM within 10 years
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| what is the Gestational DM? | glucose intolerance associated with pregnancy, in III trimester
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| possible causes of HYPOGLYCEMIA: | failure to eat after taking insulin, excessive insulin, precipitated by exerciseing
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| what is a hypoglycemia? | low blood sugar, <60 mg/dL
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| what is a hyperglycemia | high blood sugar ,>250 mg/dL
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| CNS changes with Hypoglycemia? | libile, irritable, headache, blurred vision, slured speech, difficulty concentrating, confusion, incoordination
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| what are the sympathetic changes with hypoglycemia? | diaphoresis, pallor, pillow erection, tachycardia, heart palpitation, nervousness, irritability, weakness, shekiness, trembling, hunger
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| what is a hypoglycemic coma? | a loss of conciousness taht results from an abnormal low sugar in the blood
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| what to do when patient has signs of hypoglycemia? | give sugar, candy, orange juice
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| what is the onset of hyperglycemia? | gradual ( days)
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| what are the CNS signs in hyperglycemia? | dulled sense, confused, diminished reflexes, parasthesias,
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| sympathetic signs of hyperglycemia? | thurst, flushed ( signs of dehydration), nausa, vomiting, abdomianl pain, deep, rapid respiration,pulse is rapid and weak, fruity odor to the breath, weakness,
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| what is a hyperglycemic coma? | a diabetic coma caused by hyperosmolarity of extracellular fluid and dehydration, can lead to death,
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| what is the hollmark of DM | frequent urination and increased thirst
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| when not to exercise patient after insulin injection? | between 2-4 hours after insulin injection
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| what is the best time to exercise Pt with DM? | 1 hour after meal
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| proper foot care in DM? | wash feet daily in warm water, apply petroleum jely or lotion, clean white socks should be worn, with minimal wrinkles and wide.
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| what to do if glucose level is < 70 mg/dL? | a carbohydrate snack or juice should be give to PT, and the level checked again in 15 min.
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| what to do if glucose level. 250 mg/dL? | pt should not exercise
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| what to do if glucose between 70- 100 mg/dL? | food should be given if symptoms for hypoglycemia are present
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| what are the secundary effects of DM? | kidney failure, atherosclerosis, neropathies, infections, retinopathy, cardiac complications,
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| what are the tests for DM? | fasting plasma glucose test, urine analisis
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