Diabetes Mellitus Type I

BY: APRILLE ROSE URBANO EDSEL JAN IBONES

Definition
A metabolic disorder characterized by

an absence of insulin production and secretion from autoimmune destruction of beta cells of the islets of Langerhans in the pancreas;

Risk Factors
Family History Genetics Geography

Autoimmune

Signs & Symptoms

3 Ps: polyuria, polydipsia &

polyphagia Fatigue & weakness Sudden vision changes Tingling or numbness in hands or feet,

Signs & Symptoms

Dry skin Slow Healing of wounds

Recurrent infections

Pathophysiology

Management
Collaborative management Pharmacologic management Nursing Management

Supportive care
Education and Health Maintenance

Collaborative management
The diet plan eliminates concentrated sweets and

follows recommended allowances from the four basic food groups.

The diet should be composed of approximately 55%

carbohydrate (mostly complex carbohydrates), 30% fat and 15% protein.

Foods should be distributed throughout the day to

accommodate varying peak action of insulin.

 Exercise therapy

Pharmacologic Management
Insulin therapy

Nursing Management
Monitor I/O, BP, serum electrolytes & daily weights. Monitor urine for ketones if the patient is ill or if

glucose is greater than 240 mg/dL.

Observe for hypoglycemia caused by overtreatment

of insulin.

 Monitor insulin injection sites. Watch for lipodystrophy (localized tissue buildup

from giving injections in the same site). Observe for signs of irritation; avoid injection site for several weeks if theses occur. Observe for signs of hypersensitivity reaction to insulin and notify doctor immediately.

Supportive care
Administer intravenous fluids as ordered during

periods of dehydration.
Provide an adequate diet plan for the patient.

 Beware of the factors that influence insulin therapy,

especially exercise and infection.

Exercise tends to lower blood sugar level; encourage

normal activity, regulated in amount and time.

Infection or illness increases insulin requirement

(insulin still administered during illness). Be alert for signs of infection and dehydration.

 Teach patient the chosen method for blood glucose

monitoring.
Blood glucose measurements are usually made four

times a day, before meals and at bedtime. May be more frequent during hypoglycaemic episodes or other problem situations.

 Have glucagon available if hypoglycaemic reaction

occurs.

Education and Health Maintenance

Teach patient to recognize the symptoms of insulin

shock and DKA and review related emergency management.

 Teach the patient the causes, signs and symptoms

and treatment of hypoglycaemia.

Watch for a pattern of activity or time of day that

precedes hypoglycaemic reactions, and work with the family to alter behaviour to prevent reactions.
If prescribed, teach the patient and the family how to

use an emergency glucagon.

 Instruct patient regarding prevention of infection. Attend to regular hygiene with special attention to

foot care.
Report any breaks in the skin; treat promptly.

 Use only properly fitted shoes. Take measures to

prevent calluses and blisters.

Dress appropriately for the weather.
Follow regular dental checkups and maintenance

every 6 months.

 Have the patient carry a medical alert card or

bracelet.
Do not expose vials of insulin to extreme

temperatures and pressures which may affect stability of insulin.