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Questions and Answers
What characterizes Type 2 Diabetes Mellitus?
What characterizes Type 2 Diabetes Mellitus?
Which of the following is NOT a clinical manifestation of diabetes?
Which of the following is NOT a clinical manifestation of diabetes?
Which of the following diagnostic criteria indicates a possible diagnosis of diabetes?
Which of the following diagnostic criteria indicates a possible diagnosis of diabetes?
What is a key characteristic of Gestational Diabetes?
What is a key characteristic of Gestational Diabetes?
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What percentage of calories should come from fats in a balanced nutritional therapy plan for diabetes management?
What percentage of calories should come from fats in a balanced nutritional therapy plan for diabetes management?
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What is a risk factor associated with the development of Type 2 Diabetes Mellitus?
What is a risk factor associated with the development of Type 2 Diabetes Mellitus?
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What role does insulin play in the body?
What role does insulin play in the body?
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What should patients do to monitor glucose levels effectively during exercise?
What should patients do to monitor glucose levels effectively during exercise?
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Which option best describes the intensive therapy for managing diabetes?
Which option best describes the intensive therapy for managing diabetes?
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Which of the following describes the risk of diabetic ketoacidosis (DKA)?
Which of the following describes the risk of diabetic ketoacidosis (DKA)?
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Study Notes
Diabetes Mellitus: Nursing Management
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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.
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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
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Insulin Actions (normal):
- Increases glucose uptake.
- Promotes glycogen storage.
- Decreases glucose production by liver.
- Aids fat and protein storage.
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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).
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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
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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.
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Nutritional Therapy:
- 50-60% carbohydrates
- 20-30% fats
- 10-20% protein
- Prioritize fiber and portion control.
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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.
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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.
