Denise Coffey MSN, RN

American Diabetes Association:www.diabetes.org

Nearly 26 million Americans have diabetes and an estimated 79 million U.S. adults have prediabetes‚ according to new estimates from the Centers for Disease Control and Prevention (CDC).

The National Diabetes Fact Sheet for 2011 says that diabetes affects 8.3 percent of all Americans and 11.3 percent among those aged 20 and older. An estimated 7 million Americans with diabetes do not know they have the disease!!

Insulin: what is it’s function??Glucose: what is it’s function??

Type I –which is?Type 2 –which is?Gestational Diabetes (GDM)Other specific conditions resulting in

hyperglycemia

Hyperglycemia: what would you expect to see?

Lab workWhere do we want to see our

patient’s lab values at?

Hypoglycemia: what are some signs and symptoms?

What are you going to do as the RN assigned to a patient experiencing hypoglycemia?

Microvascular: you tell me! Macrovascular: you tell me!

3 P’s: polyuria, polydipsia, polyphagia

Describe other assessment findings you would need to be on the look out for.

Blood Glucose >110

InsulinResistance

DecreasedInsulin

IncreasedFree Fatty

Acid

OxidativeStress

OxidativeStress

Nitric Oxide

Endothelin-1

Angiotensin ll

Vasoconstriction

Nitric Oxide

Angiotensin ll

Activation of activator protein -l

InflammationhypertensionVascular smoothmuscle cell growth

Release of chemokinesRelease of cytokinesExpression of cellular adhesion molecules

Nitric oxideTissue factorPlasminogen ActivatorProstaccyclin

Thrombosis

Hyper coagulationPlatelet ActivationDecreased Fibrinolysis

Increase in:Ketones

Free Fatty AcidsLactate

ImmuneDysfunction

Reactive 02Species

InfectionDissemination Increase

TranscriptionFactorsLeads to

SecondaryMeadiators

Diet –what teaching would you provide to your patient?

ExercisePO medications- what teaching

would you provide to our patient Insulin therapies

Insulin pumpsPancreas transplant

Patient education: What education would you need to

make sure you patient receives?