Diabetes Mellitus Flashcards
type I
- beta cells of the pancreas that normally produce insulin are destroyed by an autoimmune process
- typically diagnosed before 30
- about 5-10% of diabetic pt
type II
- a decreased sensitivity to insulin or decreased amount of insulin production
- occurs more freq. in people older than 30
- 90-95% of diabetic pt
diabetes mellitus risk factors
ethnicity
- Caucasians more prone to type I DM
- Indigenous, Hispanic, African American people more prone to type II DM
increased age
high BP
1st degree relative w/ DM
obesity
low birthweight
high cholesterol
complications of diabetes
– acute
- hypoglycemia
- diabetic ketoacidosis (DKA)
- hyperglycemic hypermolar nonketoic syndrome (HHNS)
complications of diabetes
– chronic (After 10-15 yrs)
CV disease: Atherosclerosis
Macrovascular (large vessel) disease:
> Affects coronary, peripheral vascular, and cerebral vascular function (increased risk for stroke)
Microvascular (small vessel) disease:
> Affects eyes (retinopathy) or kidneys (nephropathy).
Neuropathic disease:
> Affect sensory motor and autonomic nerves (ex. foot ulcer)
Peripheral neuropathy and neuropathic pain
Increased risk for amputation
Higher risk for infection (elevated glucose encourages bacterial growth)
GI paresis (decreased peristalsis)
> Nausea, vomiting, constipation, ‘bloating,’ heartburn
Clinical Manifestations of
Hypoglycemia
- Diaphoresis
- Weakness/ fatigue
- Tremors/ shaking
- Blurred/ double vision
- Confusion/ headache
- Irritability/ hunger
- Pallor
- Incoherent speech
Clinical Manifestations of
Hyperglycemia
- Thirst
- Frequent urination
- Abdominal cramping
- Lethargy
- Anorexia, N/V
- Signs of dehydration
- Fruity breath (if ketotic)
- Kussmaul breathing
nursing assessment
- monitor laboratory signs for electrolyte imbalances
- assess for signs of DKA
- evaluate typical daily schedule (work, meals, exercise, travel plans, etc.)
- assess ability to perform diabetes self-care activities
- evaluate patients’ social situation that influences diabetic treatment
