Diabetes mellitus

Dela Cruz, Mirasol

Jaramillo, Marife

Libao, Kelvin Lemuel

Objectives

• To know the signs and symptoms

• To correct associated health problems and to reduce morbidity, mortality and economic

costs of diabetes

• To prevent as much as possible acute and long-term complications; to monitor the

development of such complications and to provide timely intervention

• To improve the quality of life and productivity of the individual with diabetes

Diabetes Mellitus

-Also known as simply “ diabetes” is a group of metabolic disease in which there are high blood sugar levels over a prolonged period.

This high blood sugar produce the symptoms:

∘ Polyuria

∘ Polydypsia

∘Polyphagia

Untreated diabetes can cause many complications, acute complications including:∘diabetic ketoacidosis∘nonketotic hyperosmolar coma

Serious long term complications including: Heart disease Stroke Kidney failure Foot ulcer Damage to the eye Diabetes is due to either the pancreas not producing enough insulin or the cell of

the body not responding properly to the insulin produced.

There are 3 main types of DM:

Type1 DM- results from the bodies failure to produce enough insulin or no insulin at all (insulin dependent DM)

causes:

∘viral or bacterial infection

∘chemicaltoxins with in food

∘unidentified component – autoimmune reaction

Type 2 DM- begins with insulin resisitance, a condition in which cells fail to respond to insulin properly (non-insulin dependent DM) the primary cause is excessive body weight and not enough exercise.

Gestational diabetes- is the third main form and occurs when pregnant woman without a previous history of diabetes develop a high blood glucose level.

Causes: -family history of gestational diabetes-overweight or obese-suffer from polycystic ovary syndrome

Anatomy & Physiology

Pathophysiology:

Type 1 Diabetes Mellitus

Type 2 Diabetes Mellitus

Signs & Symptoms:

Polyuria

Polydipsia

Polyphagia

Fatigue

Dizziness

Blurry vision

Slow wound healing

Weight loss

Diagnostic test :

Blood sugar Random Blood Sugar (RBS)

-blood specimen is drawn without preplanning Fasting Blood Sugar (FBS)

-blood specimen after 8 hours of fasting Postprandial Blood Sugar

-blood sample is taken 2 hrs after a high CHO meal

Oral Glucose Tolerance Test (OGTT)

-diet high in CHO is eaten for 3 days -client then fast for 8 hrs Glycosylated hemoglobin (HbA1c) -single sample of venous blood is withdrawn

-the amt of glucose stored by the hemoglobin is elevated above 7% in newly diagnosed client with DM, in one who is noncompliant, or one who is anadequately treated

Nursing Diagnosis :

Imbalanced Nutrition, Less Than Body Requirements r/t poor nutrition intake. Activity Intolerance r/t physical weakness. Risk for Infection r/t high glucose levels

reduction in leukocyte function.

Management:

Insulin Sulfonylureas- stimulate the beta cells to secrete more insulin

SE: weight gain, hyperglycemia, secondary failure of pancreas due to overstimulationClassification: antidiabetic drugsNonsulfonylureas

Metformin – help tissues use available insulin more efficiently. SE: nausea, vomiting, stomach upset, flatulence, diarrhea no weight gain and no hyperglycemia unlike sulfonylureasClassification: biguanides-Glipizide SE:Nausea, vomiting, loss of appetite, diarrhea, constipation, upset

stomach, headache, and weight gain may occur.

-Glimepiride SE:Nausea and upset stomach may occur. Alpha- glucosidase inhibitors-Miglitol (Glyset), Acarbose (Precose) -an intestinal enzyme that breaks down carbohydrates into glucose, when enzyme is

inhibited, the process of forming glucose is slowed and glucose is absorbed more slowly from the small intestine

-taken 15 minutes before meal-ThiazolidinedionesSE: weight gain, edema & liver damage-MeglitinidesSE: same as with sulfonylureas

Treatment:

1. diet 2. oral hypoglycemic therapy 3. insulin treatment Education of the person with diabetes is an essential component of management

in every case. To ensure appropriate management, the basic knowledge and skills should be acquired by the patient and his family and the health care team should work closely with the patient to achieve this objective and to promote self-care. The person with diabetes should also be involved in setting therapeutic targets for weight, blood pressure and blood sugar control.