Diabetes Notes PDF

Diabetes functions of Insulin transports metabolizes glulose for energy a of in liver muscle stimulates storage glucose as glycogen...

Diabetes functions of Insulin transports metabolizes glulose for energy a of in liver muscle stimulates storage glucose as glycogen release of glucose Signals the liver stop to of fat enhances storage anelerates amino acid transport the breakdown of stored inhibits a fat glucose protein Type I beta cells pancreas destroyed in by autoimmune process little to no insulin produced Dka sets in a thats when it's diag 3P polyuria frequent voids Polydipsia thirsty Polyphagia hungry 2 beta cell fune I insulin prod Type impaired tx initially diet exercise Type I Sudden weight loss clinical manifestations nausea stomach pain Rafique irritability skin wounds vaginal infec blurred vision Risk Factors Type 1 not inherited but genetic predispotion combined w immunologic and possibly enviro viral factor Type family history of diabetes obesity race or older than 45 hypertension ethnicity more than gestational diabetes babies feigning Diagnostic Findings more AIC of 6.5 or glycated hemoglobin cell glucose consumed by random glucose exceeding 11.1mmol L normal range 4.0 mmol L 7.0 mmol A Oral glucose tolerance 75g T glucose above 11.1 mmol L Role of the nurse Dietary Management meet energy needs be knowledgeable about dietary managemen achieve and maintain reinforce patient understanding reasonable weight support prevent I it Edges serum lipids Glycemia Index how much food blood glucose of in fruit fibre slows absorption glucose Fats SEE istgaite slowly absorbed natural of blood sugar Exercise is a for hypoglycemia  I If ketones present do not exercise I 14.0 mmol L of carbs before mod exercise eat 15g Insuli Onset Therapy 5 15min Rapid acting short 30 60min acting Np intermediate 24hr5 very long acting 1 6hr5 Continuous inhaled cismins Two injections per day Pro more similar normal pancreatic Func to diet regime con must stay close daily exercise premixed cannot be adjusted Three or four injeltions per day test more often can adjust fun mimics pancreatic and more Flexible w meals exercise Insulin pump bolus occurs at mealtime must manage diabetes I yr before You can get pump Hold insulin if pt take rapid insulin if skipping meal Hypoglycemia low blood glulose 3.7 mmol L tremors tachycardia Symptoms Sweating palpitations nervousness hunger CNS headache light headedness confusion slurred speech severe disorientation seizures arousing from sleep difficulty and loss of consciousness of hypoglytemia Managment bs give 15g fast acting ca glulose tabs 3 4 or Soda 125mL of juice 3 hand candies 15mL of Sugar or honey Provide snack w protein a starch Diabetic Ketoacidosis Deal amount of insulin inadequate abnormal metabolism of carb fat protein Features does Hyperglycemia not Yaffa 1085 Dehydration ele trolyte acidosis pH 7 5  Looks like polyuria polydipsia blurred vision acetone breath anorexia hyperventilation w Kussmal resp and mental status changes order hydration electrolytes acidosis hyperglycemia of DKA not related to severity blood glucose level 16.00mmol L 44.4mmol 14 Keto acidosis low serum bicarbonate and low pit low PCO 2 reflects resp lompensation Ketone is of fat breakdown product Tx rehydrate of infusion reg insulin continuous w balance reverse acidosis electrolyte monitor blood glucose renal function ECG electrolyte levels V5 ABG lung ass signs of fluid overload  Prevention of DKA Silk day rules take insulin as usual Test blood 3 4hr5 need to supplemental doses may of insulin 3 4hr5 reg every Type I nannot keep fluids down may need to go to hospital Hyperglycemic Hyperosmolar Syndrome HHS lack of effective insulin ketosis is minimal or absent causes osmotic diuresis hyperglycemia with loss of water and electrolytes less water electrolytes more concentrated manifestations hypotension dehydration tachycardia neurologic signs high mortality TX of HHS rehydration insulin administration monitor fluid electrolytes Prevention BGSM of dibetes management diagnosis self care managementskills  of Diabetes Long term complications macrovasular atherosclerotic changes coronary artery disease ulcers m ex stroke microvascular damage to eyes or kidneys neuropathic changes autonomic peripheral neuropathy neuropathies sex dysfunction