6 Diabetes .docx - Lecture Notes NURS 360 Diabetes A chronic multisystem disease related to Abnormal insulin production(pancreas not making enough

6 Diabetes .docx - Lecture Notes NURS 360 Diabetes A...

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Lecture Notes NURS 360 Diabetes A chronic multisystem disease related to Abnormal insulin production (pancreas not making enough) Impaired insulin utilization (insulin resistance)- body’s inability to take up insulin Or both conditions Epidemiology Leading cause of blindness, ESRD, and lower extremity amputations Diabetes MellitusEtiology and Pathophysiology Produced by the cells o Islets of Langerhans Released continuously into bloodstream in small increments with larger amounts released after food intake o Stabilizes glucose range to 70 to 120 mg/dl Average daily secretion 0.6 units/kg body weight (20-50 units/day) Insulin Promotes glucose transport from bloodstream across cell membrane o Decreases glucose in the bloodstream ↑ Insulin after a meal o Stimulates storage of glucose as glycogen in liver and muscle o Inhibits gluconeogenesis o Enhances fat deposition o ↑ Protein synthesis Diagnosis of Diabetes Excessive plasma glucose is diagnostic of diabetes Patient must be tested on two separate days, and both tests must be positive Three tests o Fasting plasma glucose (FPG) - don’t eat after midnight and check blood sugar (should be low) o Casual plasma glucose- “finger stick” o Oral glucose tolerance test (OGTT)- gestational diabetes- check FPG and then drink 300 ml of 75 g sugar and check over couple hours Hemoglobin A1c - 120 day life cycle of hgb molecule and gives average of blood sugar Prediabetes Known as impaired glucose tolerance (IGT) or impaired fasting glucose (IFG) o IFG: Fasting glucose levels higher than normal (>100 mg/dl, but <126 mg/dl) o (OGTT) IGT: 2-hour plasma glucose higher than normal (between 140 1
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Lecture Notes and 199 mg/dl) Not high enough for diabetes diagnosis Increase risk for developing type 2 diabetes If no preventive measure taken—usually develop diabetes within 10 years Long-term damage already occurring o Heart, blood vessels Usually present with no symptoms Must watch for diabetes symptoms-3 p’s o Polyuria - d/t increase thirst o Polyphagia Insulin isn’t working- so eat more because insulin isn’t providing glucose to cells o Polydipsia - compensatory Type 1 Diabetes Mellitus Formerly known as “juvenile onset” or “insulin dependent” diabetes Two peaks ages 4 and 11-13 Genetic/ environmental Absolute deficiency of insulin pancreas doesn’t make insulin AT ALL A test of C-Peptide levels will show how much insulin the body is making Type 2 Diabetes Mellitus Most prevalent type of diabetes Usually occurs in people over 35 years of age 80% to 90% of patients are overweight Prevalence increases with age (d/t decrease insulin production) Genetic basis Greater in some ethnic populations o Increased rate in African Americans, Asian Americans, Hispanic Americans o Native Americans and Alaskan Natives (Highest rate of diabetes in the world) Type 2 DiabetesEtiology and Pathophysiology Four major metabolic abnormalities 1. Insulin resistance o
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  • Spring '16
  • Kim McCarron

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