Patient's Profile:

Patient's name: Bana, Elizabeth Colita

Age: 60 years old
Date of birth: June 8, 1948
Address: 4 Capoas St. Masambong Quezon city
Nationality: Filipino
Religion: Roman Catholic
Admitting Diagnosis: Neuropathic foot, DM
Date of Admission: 12:30am
Definition:
Diabetes mellitus- Is a group of metabolic diseases characterized by elevated
levels of glucose in the blood ( hyperglycemia ) resulting from defects in insulin
secretion , insulin action or both.
Neuropathy- A long term complication of diabetes resulting from damage to the
nerve cell.

Types of diabetes mellitus:

1. Type 1 diabetes or insulin dependent diabetes mellitus- Absolute deficiency
of insulin is due to absence of Islet of langerhans in the pancreas.
2. Type 2 diabetes or Non-insulin dependent diabetes mellitus – with relative
lack of insulin or resistancce to the action of the insulin;ussually insulin is
sufficient too stabilized fat and protein metabolism but not to deal with
carbohydrate
3. Gestational diabetes-
4. Diabetes mellitus associated with other conditions or syndrome

Signs and symptoms:

Type1 Type 2
 polyuria, polydipsia, polyphagia  Polyuria, polydipsia, polyphagia
 weight loss  Obesity
 Fatigue  Fatigue
 increased frequency of infection  Increased frequency of infection
( pus, WBC) (pus, WBC)
 Rapid onset – rapid appearance of  gradual onset – insidous
clinical manifestation  controlled by oral andiabetic
 control by exogenous insulin mediation and insulin
 Hypoglycemia (less than or equal  hyperglycemia ( greater than 250
to 50 mg/dl) mg/dl )
 cool clammy skin  hot dry skin
 diaphoresis  Absence of diaphoresis
 Anxiety, irritability, confusion,  Alert to coma ( varies )
blurred vision
 hunger  Nausea and vomiting, abdominal
pain

Diagnostic procedure
1. Fasting blood glucose- ensure that the client has fasted for the 8 hour prior
to the blood draw
2. Oral glucose tolerance test
3. Glycosylated hemoglobin
 4. Pre-meal glucose

Treatment Goal Is to Normalize Blood Glucose Levels

Intensive control dramatically decreases vascular and neuropathic

complications
Anatomy and physiology

Organs function
a. Hypothalamus - Controls the release of pituitary hormones
− CRH (corticotropin-
releasing hormone
− TRH ( Thyrotropin-
releasing hormone)
− GHRH ( growth
hormone-releasing
hormone)
− GnRH ( gonadotropin-
releasing hormone )
b. Pituitary glands
- Stiimulates growth of bone and muscle, promotes
− Growth hormone (GH) protein synthesis and fat metabolism, decreases
carbohydrate metabolism
- Stimulates synthesis and secretion of of adrenal
− Adrenocorticotropic cortical hormones
(ACTH) - Stimullates synthesis and secretion of thyroid
hormone
− Thyroid stimulating
hormone ( TSH ) - female: stimulates growth of ovarian follicle,
− Follicle-stimulating ovulation
hormone ( FSH ) male; Stimulates sperm production
− Lutienizing hormone - female: stimulates development of corpus luteum,
(LH) release of oocyte production of estrogen and
progesterone
male: Stimulates secretion of testosterone,
developmeeent of interstitial tissue of testes
c. Pancreas
− Alpha cells - produces glucagon
− beta cells - produces innsulin
d. Liver - Carbohydrates, protein, and fats metabolism
e. Gatrointestinal tract - breaksdown and absorb nutrients
Pathophysiology
Laboratory Results
Hematology
Components Results Normal Values Interpretation
WBC 13.7 5-10 Above normal, +
iinfection
Hemoglobin 94 120—170g/L below normal,
hematocrit 0.287 0.38-0.48 anemia
below normal,
anemia
Differential count:
lymphocytes 0.15 2-35% Below normal,
neutrophils 0.78 0.45-0.73 anemia
above normal,
monocytes 0.01 0.02-0.08 acute infection
below normal,
eosinophils 0.06 0.00-0.04 infections
above normal,
Mean corpuscular 32.7 33-35 infections
hemoglobin below normal,
concentration anemia
results Normal values interpretation
Albumin 18.2 34-50 Below normal
BUN 2.1 2.5-8.1 below normal
Potassium 2.4 2.6-5.2 below normal, vit d
deficiency
Urinalysis
results Noormal values interpretation
Macroscopic
color Light yellow Straw dark yellow
transparency turbid clear
specific gravity 1.015 1.016-1.022 Below normal

chemical test:
RBC 15.38/HPF 0-2/HPF
WBC many 0-2/HPF + infection
bacteria numerous negative + infection