Week 1 Diabetes Part 1 PDF

Diabetes Part 1 NUR 146 Fall 2024 Professor Mounitz 1 Diabetes Mellitus A group of metabolic diseases characterized by hyperglycemia Causes: o Decreased insulin secretion o Impaired insulin action (insulin resistance) o Combination of both Estimated to affec...

Diabetes Part 1 NUR 146 Fall 2024 Professor Mounitz 1 Diabetes Mellitus A group of metabolic diseases characterized by hyperglycemia Causes: o Decreased insulin secretion o Impaired insulin action (insulin resistance) o Combination of both Estimated to affect 34.1 million adults in the US Incidence is on the rise Ethnic and racial minority populations 2  Leading cause of nontraumatic amputations Epidemiolo Leading cause of ESRD gy Leading cause of new onset blindness in adults Seventh leading cause of death in the US 3 Diabetes Classification Prediabetes Type 1 Type 2 Latent autoimmune diabetes of adults (LADA) Gestational diabetes 4 Pancreas Location Hormones of the pancreas (Endocrine) o Islets of Langerhans  Insulin – beta cells  Glucagon – alpha cells  Somatostatin – delta cells Enzymes of the pancreas (Exocrine) o Amylase o Lipase 5 Insulin Hormone secreted by beta cells of pancreas Storage hormone Insulin release is stimulated by o Parasympathetic stimulation o Elevated serum glucose o Increased GI hormones o Increased serum potassium Insulin release is inhibited by o Sympathetic stimulation o Low serum glucose o High levels of insulin 6  Effects on glucose o Metabolizes glucose to be used as energy Insulin Action o Increased glycogenesis - transport of glucose into cells, resulting in increased glycogen synthesis o Results in lowered blood sugar Effects on fats o Increases lipogenesis - glucose transport into adipose cells for storage o Inhibit lipolysis - breakdown of fat Effects on liver o Inhibits glyconeogenesis - signals liver to stop converting glycogen to glucose o Inhibits glycogenolysis – conversion of stored glycogen to glucose Effects on protein o Facilitates transport of amino acids into cells Effects on potassium o Facilitates intracellular transport of potassium 7  Acts to keep blood glucose elevated o Antagonist to insulin Stimulated by o Sympathetic stimulation o Decreased serum glucose o Secretion of growth Glucagon hormone Action Decreased stimulation by o Increased glucose levels Functions o Stimulates glycogenolysis o Stimulates gluconeogenesis o Enhances lipolysis 8 Somatostati n Interferes with the release of growth hormone from the pituitary gland Exerts a hypoglycemic effect 9 Quick Recap Our cells can only use glucose as energy, not glycogen Insulin's goal is to decrease blood sugar and store energy for LATER Glycogen's goal is to release stored sugar into blood to use for energy NOW! 10 Diabetes Classifications Type 1 diabetes Type 2 diabetes Gestational diabetes Latent autoimmune diabetes of adults (LADA) Prediabetes 11  Type 1 Diabetes Characterized by destruction of the beta cells Causes o Genetic o Immunologic o Environmental Results in: o Decreased insulin production o Elevated blood glucose levels o Increased glucose production by the liver Onset is usually abrupt Approx 5% of patients with diabetes have Type 1 Age at diagnosis Treatment 12 Type 1 Diabetes - Manifestations Acute onset Symptoms depend on the level of hyperglycemia Classic triad "The 3 P's" o Polyuria o Polydipsia o Polyphagia Other o Glycosuria o Weight loss o Fatigue o Sudden vision changes o Nausea, vomiting or abdominal pain if patient is in DKA 13 Diagnostic Criteria Casual (random) blood glucose >200 mg/dl Fasting blood glucose >126 mg/dl Glucose tolerance test >200 mg/dl Hemoglobin A1c >6.5% Refer to Chart 46-2 in textbook 14 Treatment - Type 1 Diabetes Medication management Insulin only No oral anti-diabetic meds Nutrition Exercise Blood glucose monitoring Patient education 15  Achieving blood glucose control Goal is for euglycemia without hypoglycemia Treatment ADA recommends Hgb A1c