Diabetes Mellitus Outline For Bb

Diabetes Mellitus Islets of Langerhans (pancreas)--secrete protein substances, thus adequate protein in diet important Secretions/Functions 1. Insulin

2. Glucagon

Health Deviations of Pancreas 1. Hypofunction of Pancreas------Diabetes Mellitus

Types of DM a. Type I (formerly called insulin-dependent diabetes mellitus--IDDM)

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S&S of Type I DM

b. Type II (formerly called noninsulin-dependent diabetes mellitus-NIDDM)

DX Procedures for Hypofunction of Pancreas 1. Fasting blood sugar (FBS)

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2. Postprandial blood glucose (PPG)

3. Glucose tolerance test (GTT)

4. Capillary blood glucose monitoring (CBGM) or also called self monitoring of blood glucose (SMBG)

5. Glycosylated Hemoglobin (Ghb or HbA1c)--normal 4 - 8%; poor control 13 - 20%

6. Urine ketone levels

DM CONTROL CRITERIA 1. Optimal weight 2. Glycosylated HGB wnl 3. FBS < 140 4. BS < 180 1 - 2 hours after meal.

Medical Management of DM 1. Diet

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2. Medications a. Oral hypoglycemic agents (OHAs) also called oral antidiabetic agents

b. Insulin Therapy

Types of Insulin a. Rapid acting (Humalog or insulin lispro)

b. Short acting (clear)

c. Intermediate acting (cloudy)

c. Long acting (cloudy)-Ultralente

d. Pre-mixed (cloudy)

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e. Mixing Regular and NPH

Types of Insulin Administration SQ Injections Insulin Pens IV

Insulin Pump

Insulin Complications 1. Allergic reaction a. Local

b. Systemic

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2. Lipodystrophy

3. Insulin resistance

4. Morning hyperglycemia a. Somogyi phenomenon

b. Dawn phenomenon

3. Exercise

Nursing Mgt of DM

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Planning for "Sick Day"

Acute Complications of DM 1. Hypoglycemia

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2. DKA

3. HHNK (also called HHNS)

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Chronic Complications of DM 1. Macrovascular

2. Microvascular

a. Diabetic retinopathy

b. Diabetic nephropathy

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c. Diabetic neuropathy