Diabetes

mellitus
Dela Cruz, Mirasol
Jaramillo, Marife
Libao, Kelvin Lemuel

Objectives

To know the signs and symptoms

To correct associated health problems and to reduce morbidity, mortality and
economic
costs of diabetes
To prevent as much as possible acute and long-term complications; to monitor the
development of such complications and to provide timely intervention
To improve the quality of life and productivity of the individual with diabetes

Diabetes Mellitus
-Also known as simply diabetes is a group of metabolic disease in which there are
high blood sugar levels over a prolonged period.
This high blood sugar produce the symptoms:
Polyuria
Polydypsia
Polyphagia
Untreated diabetes can cause many complications, acute complications including:
diabetic ketoacidosis
nonketotic hyperosmolar coma
Serious long term complications including:

Heart disease
Stroke
Kidney failure
Foot ulcer
Damage to the eye
Diabetes is due to either the pancreas not producing enough insulin or the cell of
the body not responding properly to the insulin produced.

There are 3 main types of DM:

Type1 DM- results from the bodies failure to produce enough insulin or no insulin at all
(insulin dependent DM)
causes:
viral or bacterial infection
chemicaltoxins with in food
unidentified component autoimmune reaction
Type 2 DM- begins with insulin resisitance, a condition in which cells fail to respond to
insulin properly (non-insulin dependent DM) the primary cause is excessive body
weight and not enough exercise.
Gestational diabetes- is the third main form and occurs when pregnant woman without
a previous history of diabetes develop a high blood glucose level.
Causes:
-family history of gestational diabetes
-overweight or obese
-suffer from polycystic ovary syndrome
Anatomy & Physiology

Pathophysiology:
Type 1 Diabetes Mellitus

Type 2 Diabetes Mellitus

Signs & Symptoms:

Polyuria
Polydipsia

Polyphagia
Fatigue
Dizziness
Blurry vision
Slow wound healing
Weight loss

Diagnostic test :

Blood sugar
Random Blood Sugar (RBS)

-blood specimen is drawn without preplanning

Fasting Blood Sugar (FBS)

-blood specimen after 8 hours of fasting

Postprandial Blood Sugar

-blood sample is taken 2 hrs after a high CHO meal

Oral Glucose Tolerance Test (OGTT)

-diet high in CHO is eaten for 3 days
-client then fast for 8 hrs
Glycosylated hemoglobin (HbA1c)
-single sample of venous blood is withdrawn
-the amt of glucose stored by the hemoglobin is elevated above 7% in newly
diagnosed client with DM, in one who is noncompliant, or one who is anadequately
treated

Nursing Diagnosis :

Imbalanced Nutrition, Less Than Body Requirements r/t poor nutrition intake.
Activity Intolerance r/t physical weakness.
Risk for Infection r/t high glucose levels
reduction in leukocyte function.

Management:

Insulin
Sulfonylureas- stimulate the beta cells to secrete more insulin

SE: weight gain, hyperglycemia, secondary failure of pancreas due to overstimulation

Classification: antidiabetic drugs
Nonsulfonylureas

Metformin help tissues use available insulin more efficiently.

SE: nausea, vomiting, stomach upset, flatulence, diarrhea

no weight gain and no hyperglycemia unlike sulfonylureas
Classification: biguanides
-Glipizide
SE:Nausea, vomiting, loss of appetite, diarrhea, constipation, upset
stomach, headache, and weight gain may occur.

-Glimepiride
SE:Nausea and upset stomach may occur.
Alpha- glucosidase inhibitors
-Miglitol (Glyset), Acarbose (Precose)
-an intestinal enzyme that breaks down carbohydrates into glucose, when enzyme is
inhibited, the process of forming glucose is slowed and glucose is absorbed more
slowly from the small intestine
-taken 15 minutes before meal
-Thiazolidinediones

SE: weight gain, edema & liver damage

-Meglitinides
SE: same as with sulfonylureas

Treatment:

1. diet
2. oral hypoglycemic therapy
3. insulin treatment
Education of the person with diabetes is an essential component of management
in every case. To ensure appropriate management, the basic knowledge and
skills should be acquired by the patient and his family and the health care team
should work closely with the patient to achieve this objective and to promote selfcare. The person with diabetes should also be involved in setting therapeutic
targets for weight, blood pressure and blood sugar control.