Diabetes mellitus a group of genetically and clinically heterogeneous Type 1 Diabetes Mellitus - results from progressive destruction of -cell …
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|DEFINITION: |RELATED DIAGNOSTIC TESTS: |
|Diabetes mellitus - a group of genetically|Blood glucose, postprandial blood |
|and clinically heterogeneous disorders |glucose, glycosylated hemoglobin; lipid, |
|characterized by abnormalities in glucose |cholesterol, and trilgyceride levels; |
|homeostasis resulting in hyperglycemia |BUN; creatinine; and electrolytes |
| |Urine for complete urinalysis, |
| |microalbuminuria, CS, glucose and |
| |acetone |
| |Neurologic and funduscopic examination |
| |BP and weight |
| |Doppler scan to determine the presence |
| |and degree of PVD |
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|ETIOLOGY: |MEDICAL MANAGEMENT: |
|Hyperglycemia associated with diabetes is |Management of DM is primarily aimed at |
|caused by a decrease in the secretion or |achieving tight blood glucose control by |
|activity of insulin |use of a balanced of diet, activity, and |
| |medications together with appropriate |
| |monitoring and patient and family |
| |education |
| |Two types of glucose-lowering agents used|
| |in the treatment of diabetes are insulin |
| |and oral antihyperglycemics OAs |
| |Exogenous insulin is needed when a |
| |patient has inadequate insulin to meet |
| |specific metabolic needs and the |
| |combination of
nutritional therapy, |
| |exercise, and OAs cannot maintain a |
| |satisfactory blood glucose level |
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|PATHOPHYSIOLOGY: |NURSING MANAGEMENT: |
|Type 1 Diabetes Mellitus - results from |Goals: The patient with DM will be an |
|progressive destruction of -cell |active participant in the management of |
|function as a result of an autoimmune |the diabetes regimen; experience minimal |
|process in susceptible individuals Islet|or no episodes of DKA, HHNK, or |
|cell antibodies and insulin autoantibodies|hypoglycemia; prevent or delay the |
|cause a reduction in -cells of 80 to 90 |occurrence of chronic complications of |
|of normal before hyperglycemia and |diabetes; and adjust lifestyle to |
|symptoms occur Onset and progression of |accommodate the diabetes regimen with a |
|symptoms is more rapid and acute than in |minimum of stress |
|Type 2 Without treatment, ketoacidosis
|Interventions: The nurse may be involved |
|DKA can progress to coma and death |in any or all aspects of management, but |
|Type 2 Diabetes Mellitus - is a |the focus of nursing care has two aims: |
|combination of genetically determined |1 to care for the patient during acute |
|defects in skeletal muscle, fat, and liver|episodes and 2 to assist the patient in|
|receptors for insulin and an eventual |learning to live with diabetes |
|decrease in insulin due to -cell | |
|secretory exhaustion and abnormal hepatic | |
|glucose regulation Obesity appears to | |
|play a major role in Type 2 diabetes | |
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|SIGNS SYMPTOMS: |HEALTH DEVIATION SELF-CARE REQUISITES: |
|Absolute insulin deficiency or decreased |Ineffective management of therapeutic |
|insulin activity occurs, glucose is not |regimen R/T lack of knowledge of exercise|
|used properly Glucose remains in
the |program, diet and weight control, |
|bloodstream and pro an osmotic effect on |administration and potential side |
|intracellular and interstitial fluid |effects and complications of |
|This shift in fluid balance results in |glucose-lowering agents, glucose |
|symptoms of frequent urination polyuria |monitoring, and care during acute minor |
|and thirst polydipsia and hunger |illness |
|polyphagia Varying degrees of |Risk for infection R/T depressed immune |
|polyuria, polydipsia, and polyphagia are |system, inadequate circulation, and |
|the hallmark symptoms of DM |environmental pathogens |
| |Self-esteem disturbance R/T lifestyle |
| |changes imposed by diabetes, its |
| |treatment, and frustration at progression|
| |of disease |
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|REFERENCE PAGES:
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|Medical-Surgical Nursing Clinical | |
|Companion, Dirksen, Lewis, Heitkemper, | |
|pps 189-200 | |
Source:diabetesnv.org
