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Diabetes Mellitus

"Trouble moving glucose"

Osmosis

This video was created by Osmosis.

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Their channel can be found here.

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Pathophysiology

Type 1: the immune system attacks and destroys the insulin-producing beta cells of the pancreas. Beta-cell deficiency leads to complete insulin deficiency. Thus, it terms it as an autoimmune disease where there are anti-insulin or anti-islet cell antibodies present in the blood. This causes destruction of the islet of the pancreas, and while destruction takes time, the onset is rapid and may happen over a few days or weeks.

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Type 2: This type is caused by a deficiency of insulin that is not absolute. The body is able to produce insulin, just not enough to meet the needs of the body.

Pathophysiology

Etiology

Causes of Diabetes Mellitus include:​​

  • Type 1:

    • Autoimmune disorder

    • Genetic association

    • Ketosis

    • no presence of insulin

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  • Type 2:

    • Insulin resistance

    • Obesity

    • Family history

    • insulin is present in the body

Etiology

Lab & Diagnostics

​Labs and diagnostics for Diabetes Mellitus  include:

  • Blood Glucose to test for abnormally high blood sugar.

  • FPG or Fasting plasma glucose – in a lab after fasting for 8 or more hours.

  • 2-hour, post-load test – tested 2 hours after the pt. receives glucose

  • HgbA1c (A1C) Test Test for microalbuminuria

  • Serum creatinine level

  • Urinalysis

  • Electrocardiogram

Lab&Diag

Signs & Symptoms

S/S of Diabetes Mellitus include:

  • 3 P's

    • Polyuria (increased urination)

    • Polydipsia (increased thirst)

    • Polyphagia (increased appetite)

  • Fatigue

  • weakness

  • sudden vision changes

  • tingling or numbness in hands or feet

  • dry skin

  • slow-healing wounds

  • recurrent infection

 

Type 1: sudden weight loss or nausea, vomiting, or abdominal pains, if DKA (Diabetic Keto Acidosis) has developed.

S/S

Risk Factors

Risk factors for Diabetes Mellitus include:

  • Being of the minority population

  • Family history

  • Obesity

  • Age equal to or greater than 45

  • Hx of gestational diabetes or delivery of a baby over 9 lb

Risk Factors

Treatment

The main goal of treatment is to normalize insulin activity and blood glucose to reduce the development of complications.

 

Medical: Insulin Injections, Insulin Pump, frequent glucose monitoring. SMBG Therapy (Self-monitoring of blood glucose)

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5 components of management:

  • Nutrition (can reverse type 2)

  • exercise

  • monitoring

  • pharmacologic

  • education

 

Pharmacologic:

  • Type 1: Insulin for life

  • Type 2: can be controlled by meal planning, but may require long-term insulin for those that cannot meal plan or oral agents are ineffective.

Treatment

Nursing

Interventions

Manage the patient glucose level while hospitalized.

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Patient Teaching:

  • Develop an education plan,

  • educate about basic skills in administering insulin.

  • Access the patient's knowledge level, and willingness to learn.

  • Teach pt. how to self administer insulin.

 

Injections: The nurse needs to know all info regarding insulin (types, needles, etc.)

Interventions
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