Escolar Documentos
Profissional Documentos
Cultura Documentos
What is diabetes?
Regulation of Plasma
Glucose Level
Classification of DM
1. Type 1 DM
It is due to insulin deficiency
and is formerly known as.
Type I
Insulin Dependent DM (IDDM)
Juvenile onset DM
2. Type 2 DM
It is a combined insulin
resistance and relative
deficiency in insulin secretion
and is frequently known as.
Type II
Noninsulin Dependent DM (NIDDM)
Adult onset DM
3. Gestational Diabetes
Mellitus (GDM):
Gestational Diabetes
Mellitus (GDM)
developing during some
cases of pregnancy but
usually disappears after
pregnancy.
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Who are
at risk?
Risk
Factors
Obesity
Race
History of CVD
HTN
Physical inactivity
Familial history
Polycystic Ovary Syndrome
Gestational Diabetes
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Clinical Presentation
Type 1 DM
Type 2 DM
Polyuria
Polydipsia
Polyphagia
Weight loss
Weakness
Dry skin
Ketoacidosis
Lab diagnosis
Laboratory Tests
Urinalysis
1.Glucosuria
2. Ketonuria
To detect ketonbodies in urine by a paper
strip
Semi-quantitative
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(HbA1c
)
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Diagnostic Criteria
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Monitoring
Yearly- hole body check up
3 monthly- F,PP, HbA1c
6 monthly lipid profile, micro
albumin, RFT
EYE test, ECG,ECHO
Complications of Diabetes
Complications
Metabolic complications of low blood glucose levels
(hypoglycaemia) and of high blood glucose levels
(hyperglycaemia).
e.g. Diabetic coma
Hypoglycemia
CHRONIC COMPLICATIONS OF
DIABETES MILLETUS
NEPHROPATHY
DAMAGE & OBLITERATION OF CAPILLARIES SUPPLYING
THE KIDNEY
HEART DISEASE
MI FROM ATHEROSCLEROSIS
SKIN CHANGES
DIABETIC DERMOPATHY HYPERPIGMENTED & SCALY
PRETIBIAL AREAS (Acanthosis Nigricans)
LIVER CHANGES
ENLARGEMENT & FATTY INFILTRATION
EYE COMPLICATIONS FROM ANOXIA
CATARACT
DIABETIC RETINOPATHY
RETINAL DETACHMENT
MILLETUS
DIABETIC KETO-ACIDOSIS (DKA)
INSULIN SHOCK
HYPERGLYCEMIC, HYPEROSMOLAR,
NONKETOTIC (HHONK) COMA
Dawn phenomenon
The dawn phenomenon is a normal rise in blood
sugar as a person's body prepares to wake up.
In the early morning hours, hormones (
growth hormone,cortisol, andcatecholamines)
cause theliverto release large amounts of sugar
into the bloodstream. For most people, the body
produces insulinto control the rise in blood
sugar.
If the body doesn't produce enoughinsulin,
blood sugar levelscan rise. This may cause high
blood sugar in the morning (before eating).
Somogyi effect
If the blood sugar level drops too low in the
early morning hours, hormones (such as growth
hormone, cortisol, and catecholamines) are
released. These help reverse the
low blood sugarlevel but may lead to blood
sugar levels that are higher than normal in the
morning. An example of the Somogyi effect is:
A person who takesinsulindoesn't eat a
regularbedtimesnack, and the person'sblood
sugar level drops during the night.
The person's body responds to the
low blood sugarby releasing hormones that
raise thebloodsugar level. This may cause a
high blood sugar level in the early morning
Diabetes Mellitus
Summary
Treatable, but not curable.
Preventable in obesity, adult
client.
Controllable- DIET and EXERCISE
Diagnostic Tests
Signs and symptoms of
hypoglycemia and
hyperglycemia.
Nursing implications
monitoring, teaching and
assessing for complications.
Any Questions???
Quiz - 1
Abnormally high levels of blood
glucose is called: a) Hypercalcaemia
b) Hyperglycaemia
c) Hypernatremia
d) Hyperinsulinism
Quiz - 2
Excessive amounts of glucose are
converted to glycogen and stored: a) In the stomach
b) In the spleen
c) In the liver
d) In the kidneys
Quiz - 3
Insulin is secreted by:
A. Liver
B. Kidney
C. Pancrease
D. Heart
Quiz - 4
Quiz - 5
Amount of glucose required for OGTT
test is.
A. 75 gm
B.50 gm
C. 1.75gm/kg body weight
D. 100 gm
Quiz - 6
Blood sample is collected for PP test
is:
A. After 2 hours of regular meal
B. After 1 hour of break fast
C. Exact 2 hour after a regular lunch
D. any time in between 7am to 7 pm.
MODIFICATION IN LIFESTYLE
Of
course too
much is
bad for U.
O
Y
you
K
N
A
TH