GLUCOSE REGULATION

Concept 12
Goals for This Concept Presentation
1. Define and describe the concept.
2. Notice risk factors for impaired glucose
regulation.
3. Recognize when an individual has
compromised glucose regulation.
4. Provide appropriate nursing and
collaborative interventions to optimize
glucose regulation.
Definition and Description
Glucose regulation is the process of
maintaining optimal blood glucose levels
The ultimate end result of glucose
metabolism is cellular use of glucose for
energy (adenosine triphosphate [ATP])
synthesis
Key Terms
Collaborative Learning #1
In your learning group, discuss the meaning
of the listed key terms and the link of each
term to the concept definition.
Glycogenolysis
Counterregulatory hormones
Insulin resistance
Gluconeogenesis
Scope of Concept
Categories of Glucose Regulation
Hypoglycemia
State of insufficient
or low blood levels,
defined as less than
70 mg/dL
Hyperglycemia
State of elevated
blood glucose levels,
defined as more
than 100 mg/dL in a
fasting state or 140
mg/dL when not
fasting
Risk Factors
Risk for impaired glucose regulation
Age
Racial and ethnic groups
Family history
Lifestyle
Medical risk factors
Selected medications
Individual Risk Factors
Collaborative Learning #2
In your learning group, create a list of individual risk factors
and health conditions associated with impaired glucose
regulation, and include a rationale. Indicate if the risk factor
is modifiable.
Risk Factors and Health
Conditions
Rationale Modifiable
(Yes or No)
Review of Endocrine System
Anatomy and Physiology
Anterior
pituitary
gland
Pancreas
Adrenal
glands
Posterior
pituitary
gland
Physiologic Processes:
Maintaining Glucose Balance
Hormone to lower glucose
Insulin
Counterregulatory hormones to raise
glucose
Glucagon
Cortisol
Problems arise when hormones are
deficient or excessive or when production is
not balanced with the blood glucose need
Consequences: Hyperglycemia
Short-term consequences
Inadequate glucose reaching the cells
Dehydration
Long-term consequences
End-organ disease due to microvascular damage
Retinopathy
Nephropathy
Peripheral neuropathy
Macrovascular angiopathy
Hypertension
Cardiovascular and peripheral vascular disease

Consequences: Hypoglycemia
Irritability
Fatigue
Mental confusion
Seizures
Unconsciousness
Potentially leads to cellular death
Assessment: History
Current medications
Personal or family medical history markers
Central obesity
Diabetes
Hypertension
Cardiovascular disease
Cancer
Review of symptoms
Assessment: Examination
Anthropometric measurements
Body mass index
Waist-to-hip ratio


Recognizing Impaired Glucose
Regulation
Collaborative Learning #3
In your learning group, create a list of common
symptoms and clinical findings associated with
hypoglycemia and hyperglycemia. Discuss the
symptoms and findings from a physiologic
perspective.
Symptoms and
Significance
Clinical Findings and Significance
Hyperglycemia
Hypoglycemia
Common Diagnostic Tests
Glucose screening
Assess antibodies to confirm type 1
diabetes mellitus
Lipid analysis
Microalbuminuria
C-reactive protein
Clinical Management:
Screening
Laboratory tests
Hemoglobin A1c
Cholesterol
Microalbuminuria
Screening to detect complications
Blood pressure
Dental, foot, and eye examinations

Clinical Management:
Collaborative Interventions
Education about glucose regulation
Nutrition therapy
Pattern management: monitoring meal-
related blood glucose values
Pharmacologic agents
Oral hypoglycemic agents
Insulin
Interrelated Concepts