Diabetes Prevention and Treatment

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Questions and Answers

What are the complications that diabetes mellitus can lead to?

Pheochromocytoma and aldosterone excess

Cushing's syndrome and adrenal insufficiency

Diabetic ketoacidosis and hyperglycemic coma (correct)

Hypoglycemia and hyperinsulinemia

Which of the following is not a part of the medical management of diabetic ketoacidosis?

Adrenal hormone therapy (correct)

Intensive fluid replacement

Insulin infusion

Potassium replacement

What is a major nursing focus for patients with DKA or HHNC?

Monitoring electrolyte levels (correct)

Assessing for allergic reactions

Administering corticosteroids

Checking blood type compatibility

What can improper foot care in diabetic patients lead to?

Increased risk of amputation Signup and view all the answers

Which condition is primarily associated with microvascular lesions in diabetes mellitus?

Retinopathy Signup and view all the answers

What is the primary treatment for patients with pheochromocytoma?

Surgery Signup and view all the answers

Which of the following factors contributes to the development of both IDDM and NIDDM?

Autoimmunity Signup and view all the answers

In the case of bilateral pheochromocytoma tumors, what is a consequence after surgery?

Lifelong glucocorticoid replacement therapy Signup and view all the answers

Which symptom is NOT typically associated with insulin-dependent diabetes mellitus (IDDM)?

Weight gain Signup and view all the answers

What is the mechanism by which activities like straining can affect patients with pheochromocytoma?

Increase catecholamine release Signup and view all the answers

Which demographic group is reported to have a higher occurrence of diabetes mellitus?

Native Americans Signup and view all the answers

What differentiates non-insulin-dependent diabetes mellitus (NIDDM) from insulin-dependent diabetes mellitus (IDDM)?

IDDM has no insulin production Signup and view all the answers

Which of the following symptoms is commonly associated with both IDDM and NIDDM?

Polyphagia Signup and view all the answers

What is the primary focus of tertiary prevention for diabetes mellitus?

Preventing progression of complications Signup and view all the answers

What dietary recommendation is advised for carbohydrates in managing diabetes mellitus?

55% to 60% Signup and view all the answers

Which of the following is considered a survival skill in diabetes education?

Recognizing symptoms of hypoglycemia Signup and view all the answers

What should be done if a patient experiences hypoglycemia symptoms?

Give 10 to 15 g of simple carbohydrates Signup and view all the answers

What effect does exercise have in relation to diabetes management?

It may increase hyperglycemia if blood glucose is over 300 mg/dl Signup and view all the answers

Which factor should be closely monitored to determine medication needs in diabetes management?

Blood glucose levels Signup and view all the answers

How should normal daily carbohydrate intake be distributed during short illness for a patient on insulin?

Over 24 hours Signup and view all the answers

Which component is NOT included among the five primary treatment modalities for diabetes mellitus?

Medication adherence Signup and view all the answers

Study Notes

Prevention of NIDDM

Primary prevention targets measures to prevent and treat obesity.
Secondary prevention involves screening for undiagnosed cases, which may comprise 50% of the population.
Tertiary prevention focuses on detecting complications and preventing their progression.

Treatment Modalities for Diabetes Mellitus

Five main treatment modalities: diet, exercise, hypoglycemic agents, monitoring, and education.
Dietary recommendations include:
- Carbohydrates: 55% to 60% of total caloric intake.
- Fat: 20% to 30%, with saturated fat limited to 10%.
- Protein: 20% with restrictions on cholesterol, sodium, and refined simple carbohydrates.
- Emphasis on complex, unrefined carbohydrates.

Exercise and Its Effects

Exercise generally has a hypoglycemic effect but can raise blood glucose levels in situations where levels exceed 300 mg/dl or during intense activity.
Promotes cardiovascular fitness, aids in weight reduction and maintenance, and decreases insulin resistance.

Nursing Management for Diabetes Mellitus

Assessment includes gathering data on metabolic status and evaluating cardiovascular-renal health, vision, and nerve function.
Careful examination of lower extremities is essential to prevent complications.
Diabetes education should be individualized with a focus on gradual, ongoing learning. Initial education should cover basic survival skills.
Immediate treatment for hypoglycemia involves administering 10 to 15 grams of simple carbohydrates at onset of symptoms.

Signs and Symptoms of Diabetes Mellitus

Common signs of insulin-dependent diabetes mellitus (IDDM): polyuria, polydipsia, polyphagia, weight loss, weakness, and fatigue.
NIDDM symptoms may include weight gain and signs of hyperglycemic, hyperosmolar, nonketotic coma or related complications like neuropathy.
Regular foot care is essential: daily inspections, preserving skin integrity, injury prevention, and referral to podiatry are recommended.

Complications of Diabetes Mellitus

Life-threatening conditions associated with uncontrolled diabetes include diabetic ketoacidosis (DKA) and hyperglycemic, hyperosmolar, nonketotic coma (HHNC).
Common precipitating factors: infections, stressors, and non-adherence to treatment protocols.
Treatment of DKA and HHNC involves intensive fluid replacement, low-dose insulin infusion, and potassium replacement, potentially along with phosphate and magnesium.

Risks of Uncontrolled Diabetes

Poorly controlled diabetes is a significant predictor of microvascular (nephropathy, retinopathy), macrovascular (atherosclerotic disease), and neuropathy complications.
Limb amputation may be required due to vascular alterations, nerve trauma, and infections in patients with poor skin integrity and insensitivity to pain.
Effective foot care practices can significantly reduce the risk of infection and subsequent amputation.

Nursing Focuses in DKA and HHNC Management

Monitor critical parameters: intake and output, weight, vital signs, mental status, ECG, blood glucose, urine ketones, serum electrolytes, and osmolality.
Implementation of medical plans must be vigilant with immediate reporting of any unexpected changes in the patient's condition.

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Description

This quiz explores the various prevention strategies and treatment modalities for obesity and non-insulin-dependent diabetes mellitus (NIDDM). It covers primary, secondary, and tertiary prevention measures, including dietary recommendations and lifestyle changes. Test your knowledge on effective methods for managing and preventing diabetes.