Diabetes Diabetes Definition Types Pathophysiology Diagnostic tests Diabetes

Diabetes

Diabetes • • Definition Types Pathophysiology Diagnostic tests

Diabetes classic symptoms • • Polyurea Polydipsia Polyphasia History of recent , sudden weight loss

Types of Diabetes • Two most common types – Type 1 – Type 2 • Other types – Gestational – Prediabetes – Secondary diabetes

Diagnostic tests • • History and physical Blood test Urine ECG BP Weight Dental exam

Blood Glucose monitors

Glucose Continuum

Type I Diabetes • • • Description Causes Diagnostic tests Sign and symptoms Treatments

Normal Insulin Secretion 9

Insulin Preparations 10

Insulin Pen 11

12

Subcutaneous Injection Sites 13

Type II Diabetes • • • Description Causes Diagnostic tests Sign and symptoms Treatments

Diabetes Ketoacidosis

Diabetic Ketoacidosis 16

Hyperosmolar Hyperglycemic Syndrome

Nursing management DKA/HHS – Patient closely monitored • Administration – IV fluids – Insulin therapy – Electrolytes • Assessment – Renal status – Cardiopulmonary status – Level of consciousness – Patient closely monitored • Signs potassium imbalance • Cardiac monitoring • Vital signs 18

Types of Insulin – Rapid-acting: Lispro (Humalog), Aspart (Novolog), and glulisine (Apidra), Exubera – Short-acting: Regular – Intermediate-acting: NPH – Long-acting: Glargine (Lantus), detemir (Levemir) 19

Oral Agents • • • Sulfonylureas Meglitinides Biguanides α-Glucosidase inhibitors Thiazolidinediones 20

Diabetes Nutritional Therapy • Cornerstone of care for person with diabetes • Most challenging for many people • Recommended that diabetes nurse educator and registered dietitian with diabetes experience be members of team • American Diabetes Association (ADA) – Guidelines indicate that within context of an overall healthy eating plan, person with diabetes can eat same foods as person who does not have diabetes 21

Diabetes Exercise • Exercise Essential part of diabetes management ↑ Insulin receptor sites Lowers blood glucose levels Contributes to weight loss Several small carbohydrate snacks can be taken every 30 minutes during exercise to prevent hypoglycemia – Best done after meals – Exercise plans should be started – – – • After medical clearance • Slowly with gradual progression – Should be individualized – Monitor blood glucose levels before, during, and after exercise 22

Nursing Diagnoses • • • Ineffective therapeutic regimen management Risk for injury Risk for infection Powerlessness Imbalanced nutrition: More than body requirements 23