BSN 2144 Theory Learning Activity #3 Diabetes Mellitus, Types 1 & 2 Prepare answers to the following questions: a) UNDERSTANDING

i. ii. iii. Hypoglycemia blood glucose levels less than 4.0mmol/L Hyperglycemia blood glucose levels greater than 7.0mmol/L Diabetic Ketoacidosis also referred to as diabetic acidosis or diabetic coma. It is an acute metabolic complication of diabetes occurring when fats are metabolized in the absence of insulin. It is most likely to occur in people with type 1 diabetes but has been seen in people with type 2 in conditions of severe illness or stress when the pancreas cannot meet the extra demand for insulin. When the circulating supply of insulin is insufficient, glucose cannot be properly used for energy so the body breaks down fat stores as a secondary source of fuel. Ketones are acidic by-products of fat metabolism that alter pH causing metabolic acidosis to develop. iv. Type 1 diabetes formerly known as juvenile onset or insulin dependent. Most often type 1 occurs in people under 30 years old, with peak onset between 11 and 13 years old. Type 1 diabetes results from progressive destruction of pancreatic beta cells due to an auto-immune process. This is referred to as Type 1A diabetes. When there are no immune factors causing the diabetes, it is referred to as Type 1B diabetes. v. Type 2 diabetes by far the most prevalent type of diabetes. Type 2 usually occurs in people over 35 years and most are usually overweight at the time of diagnosis. There is a tendency for it to run in families and probably has a genetic basis. In Type 2 diabetes the

pancreas usually continues to produce some insulin. However, the insulin it does produce is either insufficient for the needs of the body, is poorly utilized by the tissues or both vi. Kussmauls respirations deep, rapid and gasping breathing pattern often associated with severe metabolic acidosis, particularly diabetic ketoacidosis but also renal failure. vii. Diabetic ketoacidosis and hyperglycaemic hyperosmolar nonketonic syndrome a life threatening syndrome that can occur in the client with diabetes who is able to produce enough insulin to prevent diabetic ketoacidosis but not enough to prevent severe hyperglycemia, osmotic dieresis and extracellular fluid depletion. b) ASSESSMENT comparison tables can be found in the Med-Surg text book Type 1 & type 2 - table 50-1 page 1336 Hyper vs. hypoglycaemia table 50-16 - page 1359 c) ASSESSMENT There are several care plans for diabetes mellitus outlined on page 1357-1358: NURSING CARE PLAN 50-1 d) ASSESSMENT Care plans and information for the rest of these questions are available outlined in the book. It seems redundant for me to retype them and create an infinite number of care plans for multiple comorbid illnesses that have impact to Diabetes.