Diabetes Mellitus: Nursing Management
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Questions and Answers

What characterizes Type 2 Diabetes Mellitus?

  • Always requires insulin therapy
  • Autoimmune destruction of pancreatic beta cells
  • Insulin resistance and impaired insulin secretion (correct)
  • It only occurs during pregnancy

    • Which of the following is NOT a clinical manifestation of diabetes?

  • Fatigue
  • Slow-healing wounds
  • Polyuria
  • Gastroesophageal reflux disease (correct)

    • Which of the following diagnostic criteria indicates a possible diagnosis of diabetes?

  • HbA1C <5.0%
  • Fasting glucose <100 mg/dL
  • 2-hour postload glucose <140 mg/dL
  • Random glucose >200 mg/dL with symptoms (correct)

    • What is a key characteristic of Gestational Diabetes?

    <p>It is caused by placental hormones inducing insulin resistance (A)</p> Signup and view all the answers

    What percentage of calories should come from fats in a balanced nutritional therapy plan for diabetes management?

    <p>20-30% (C)</p> Signup and view all the answers

    What is a risk factor associated with the development of Type 2 Diabetes Mellitus?

    <p>Obesity (B)</p> Signup and view all the answers

    What role does insulin play in the body?

    <p>Stimulates glucose uptake and metabolism (A)</p> Signup and view all the answers

    What should patients do to monitor glucose levels effectively during exercise?

    <p>Avoid exercise if glucose is &gt;250 mg/dL with ketones (C)</p> Signup and view all the answers

    Which option best describes the intensive therapy for managing diabetes?

    <p>Multiple daily insulin injections or insulin pumps with frequent glucose monitoring (B)</p> Signup and view all the answers

    Which of the following describes the risk of diabetic ketoacidosis (DKA)?

    <p>Caused by osmotic diuresis and lipolysis (A)</p> Signup and view all the answers

    Flashcards

    Type 1 Diabetes Mellitus

    A type of diabetes caused by the autoimmune destruction of the insulin-producing beta cells in the pancreas

    Type 2 Diabetes Mellitus

    A type of diabetes characterized by insulin resistance and impaired insulin secretion.

    Gestational Diabetes

    Diabetes that develops during pregnancy.

    Insulin action

    Promotes glucose uptake, glycogen storage, and inhibits glucose production, crucial in managing blood sugar.

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    Hyperglycemia

    High blood sugar levels.

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    Diabetic Ketoacidosis (DKA)

    A serious complication of diabetes, characterized by high blood sugar and ketones, requiring immediate medical attention.

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    Risk Factors of Diabetes

    Factors that increase the chance of getting diabetes, including family history, obesity, age, high blood pressure etc..

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    Diagnostic Criteria HbA1C

    A blood test measuring average blood glucose over several months. A reading of 6.5% or higher suggests diabetes.

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    Nutritional Management of Diabetes

    Dietary plans for controlling blood sugar levels by targeting carbohydrates, fats, and proteins along with portion control.

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    Exercise and Diabetes

    Increases insulin sensitivity, helps control blood sugar levels, requires precautions if blood glucose is high.

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    Study Notes

    Diabetes Mellitus: Nursing Management

    • Definition: Diabetes mellitus (DM) is a group of metabolic disorders marked by high blood sugar (hyperglycemia). This is due to problems with insulin production, effectiveness, or both.

    • Types:

      • Type 1 DM (Insulin-dependent): Autoimmune attack damages insulin-producing cells.
      • Type 2 DM (Non-insulin-dependent): Insulin resistance and impaired production.
      • Gestational DM: Develops during pregnancy due to placental hormones.
      • Prediabetes: Elevated blood sugar, but not yet diagnostic DM.

    Pathophysiology

    • Insulin Actions (normal):

      • Increases glucose uptake.
      • Promotes glycogen storage.
      • Decreases glucose production by liver.
      • Aids fat and protein storage.

    • Type 1 DM Patho:

      • Lack of insulin means high blood sugar, both fasting and after eating.
      • Increased urination (osmotic diuresis) from excess sugar in urine.
      • Breakdown of fats produces ketones, potentially leading to diabetic ketoacidosis (DKA).

    • Type 2 DM Patho:

      • Body tissues are resistant to insulin.
      • Insulin production may eventually decrease.
      • High blood sugar occurs. Advanced cases can result in hyperglycemic hyperosmolar syndrome (HHS).

    Risk Factors

    • Family history
    • Obesity
    • Age over 45
    • High blood pressure (hypertension)
    • Abnormal cholesterol (dyslipidemia)
    • Gestational diabetes in pregnancy
    • Certain races/ethnicities

    Clinical Manifestations

    • Fatigue, weakness, frequent infections, slow-healing sores.
    • Type 1 symptoms (specific): Unexpected weight loss, nausea, vomiting, and abdominal pain (with DKA).
    • Three Ps: Increased urination (polyuria), extreme thirst (polydipsia), and increased hunger (polyphagia).

    Diagnostic Criteria

    • Random blood sugar >200 mg/dL with symptoms
    • Fasting blood sugar ≥126 mg/dL (after 8 hours without food)
    • 2-hour post-meal blood sugar ≥200 mg/dL during glucose tolerance test (OGTT)
    • HbA1c ≥6.5% (measures average blood sugar over time).

    Management of Diabetes

    • Goals:

      • Maintain healthy blood sugar levels.
      • Prevent long-term complications.
      • Improve overall quality of life.
      • Intensive therapy utilizes multiple daily insulin injections or an insulin pump, along with frequent glucose monitoring.

    • Nutritional Therapy:

      • 50-60% carbohydrates
      • 20-30% fats
      • 10-20% protein
      • Prioritize fiber and portion control.

    • Exercise:

      • Improves blood sugar control and insulin sensitivity.
      • Caution—Avoid exercise if blood sugar >250 mg/dL with ketones present. Consider snacks while on insulin for needed glucose adjustments.

    • Pharmacologic Therapy:

      • Insulin: Various regimens based on individual needs (conventional vs. intensive).
      • Oral antidiabetics: Used for Type 2 when diet/exercise alone are insufficient.

    Complications of Diabetes (Acute)

    • Hypoglycemia: Low blood sugar levels.

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    Description

    This quiz covers the essentials of diabetes mellitus, including its definitions, types, and pathophysiology. It focuses on nursing management aspects and the implications of insulin actions in diabetes. Understand the differences between type 1, type 2, and gestational diabetes.

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