Diabetes Mellitus

• Diabetes Mellitus


  A chronic disorder of impaired carbohydrate, protein, and lipid metabolism caused by a deficiency of insulin or insulin resistance
• Type 1 - DM

  Also calles Insulin Dependent DM
• Type 1 - DM

  Juvenile onset
• Type 1 - DM

  Onset is before 30 years of age.
• Type 1 - DM

  Absolute deficiency of insulin is due to absence of Islet of Langerhans in the pancreas.
• Type 1 - DM

  The client is thin.
• Type 1 - DM

  The client is prone to DKA.
• Type 1 - DM: Management

  Mnemonic: DIE
• Type 1 - DM: Management

  D - diet: complex carbo

  I - insulin

  E - exercise
• Type 1 - DM: Management

  Exercise

  • check blood sugar
  • if <120 and >250 - do not exercise
  • 4 times a week
  • for 15 to 30 minutes
  • At pocket: 5 hard candy
• Type 2 - Diabetes Mellitus

  Also called Non-Insulin Dependent DM
• Type 2 - Diabetes Mellitus

  Adult onset; resistant DM
• Type 2 - Diabetes Mellitus

  Onset is after age 30 years
• Type 2 - Diabetes Mellitus

  The client is obese.
• Type 2 - Diabetes Mellitus

  The client is prone to HHNK.
• Type 2 - Diabetes Mellitus: Management

  Mnemonic: DEO
• Type 2 - Diabetes Mellitus:

  Management:

  D - diet

  E - exercise

  O - Oral Hypoglycemic Agents
• Type 2 - Diabetes Mellitus:

  Oral Hypoglycemic Agents

  1. Metformin
  2. Glipizide

  • stimulate pancreas to create new insulin

  3. Acarbose - delays absorption of sugar
• Type 2 - Diabetes Mellitus:

  Oral Hypoglycemic Agents

  1. Metformin

  CI: DM1 and Pregnant
• Diabetes Mellitus

  Signs and Symptoms: Mnemonic - 3Ps
• Diabetes Mellitus

  Signs and Symptoms:

  • Polyuria
  • Polydipsia
  • Polyphagia
• Diabetes Mellitus

  Management:

  • The diet should consist of 20% protein, 30% fats, and 50% carbohydrates.
• Tests for Blood Sugar

  Normal: 80 to 120 mg/dL

  1. RBS: >200 mg/dL + s/sx
  2. FBS: NPO for 8 hours - >126 mg/dL or 7
  3. OGTT: >200 (NPO) - give orange juice or chocolate then check 2 times (1 hour and 2 hours after)
  4. HgbA1C - confirmatory: N - 4.6 to 6.4% (+) 7%

  • can detect 3 months