DIABETES MELLITUS

Presented by : George G. Claravall Jr.

INTRODUCTION:
Diabetes Mellitus is a condition in which the pancreas no
longer produces enough insulin or cells stop responding to the insulin that is produced, so that glucose in the blood cannot be absorbed into the cells of the body.

TYPES OF DIABETES MELLITUS

Type I (INSULIN DEPENDENT DIABETES MELLITUS) Type II (NON INSULIN DEPENDENT DIABETES MELLITUS) Type III (GESTATIONAL DIABETES MELLITUS)

ANATOMY AND PHYSIOLOGY:

Mouth
Foods enters the digestive tract through mouth or oral cavity.

Pharynx
Is subdivided into the nasopharynx (posterior to the oral cavity); and the laryngopharynx ( which is continous with the esophagus below).

Esophagus
or the gullet, runs from the pharynx through the diaphragm to the stomach. About 25 cm(10inches) long .

Stomach
The C-shaped stomach is on the left side of the abdominal cavity, nearly hidden by the liver and diaphragm. Varies from 15 to 25 cm (6-10 inches).

Small Intestine
Responsible for the absorption of nutrients. Is the bodys major digestive organ.

Large Intestine
Its major function is to dry out the indigestible foods residue by absorbing body as feces.

Pancreas
Is the only organ that produces enzymes that breakdown all categories of digestible foods.

Liver
Largest gland in the body. Its digestive function is to produce bile.

Gallbladder
It stored bile salt when the bile salt is not uses. Every cell in the human body needs energy in order to function. The bodys primary energy source is glucose, a simple sugar resulting from the digestion of foods containing carbohydrates (sugars and starches). Glucose from the digested food circulates in the blood as a ready energy source for any cells that need it. Insulin is a hormone or chemical produced by cells in the pancreas, an organ located behind the stomach. Insulin bonds to a receptor site on the outside of cell and acts like a key to open a doorway into the cell through which glucose can enter. Some of the glucose can be converted to concentrated energy sources like glycogen or fatty acids and saved for later use. When there is not enough insulin produced or when the doorway no longer recognizes the insulin key, glucose stays in the blood rather entering the cells.

PATHOLOGY AND PHYSIOLOGY:

CLINICAL MANFESTATION:
Frequent urination (polyuria) Excessive thirst (polydipsia) Hunger (polyphagia) Lethargy Urinary tract infections Gums disease Slow wound healing

NURSING INTERVENTIONS:

Advice patient about the importance of an individualized meal plan in meeting weekly weight loss goals and assist with compliance. Assess patients for cognitive or sensory impairments, which may interfere with the ability to accurately administer insulin. Demonstrate and explain thoroughly the procedure for insulin self-injection. Help patient to achieve mastery of technique by taking step by step approach. Review dosage and time of injections in relation to meals, activity, and bedtime based on patients individualized insulin regimen. Instruct patient in the importance of accuracy of insulin preparation and meal timing to avoid hypoglycemia. Explain the importance of exercise in maintaining or reducing weight. Advise patient to assess blood glucose level before strenuous activity and to eat carbohydrate snack before exercising to avoid hypoglycemia. Assess feet and legs for skin temperature, sensation, soft tissues injuries, corns, calluses, dryness, hair distribution, pulses and deep tendon reflexes. Maintain skin integrity by protecting feet from breakdown. Advice patient who smokes to stop smoking or reduce if possible, to reduce vasoconstriction and enhance peripheral flow.

MEDICAL MANAGEMENT:
Medications used to treat diabetes include insulin. Everyone with type 1 diabetes and some people with type 2 diabetes must take insulin every day to replace what their pancreas is unable to produce.

Sulfonylurea drugs
These medications stimulate your pancreas to produce and release more insulin. For them to be effective, your pancreas must produce some insulin on its own.

Meglitinides
have effects similar to sulfonylureas, but youre not as likely to develop low blood sugar. work quickly, and the results fade rapidly.

Biguanides (Metformin)
It works by inhibiting the production and release of glucose from your liver, which means you need less insulin to transport blood sugar into your cells. One advantage of metformin is that is tends to cause less weight gain than do other diabetes medications.

Alpha-glucosidase inhibitors
the action of enzymes in your digestive tract that break down carbohydrates. That means sugar is absorbed into your bloodstream more slowly, which helps prevent the rapid rise in blood sugar that usually occurs right after a meal.

Thiazolidinediones
make your body tissues more sensitive to insulin and keep your liver from overproducing glucose.

THANK YOU