Handout - Diabetes Mellitus (4).rtf - Nursing Management Diabetes Mellitus \u2013 NURS 2106 \u2013 Adult I Diabetes Mellitus A chronic multisystem disease

Handout - Diabetes Mellitus (4).rtf - Nursing Management...

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Nursing Management: Diabetes Mellitus – NURS 2106 – Adult I Diabetes Mellitus A chronic multisystem disease r/t… Abnormal insulin production Impaired insulin utilization, or both Disorder of carbohydrate metabolism characterized by… Elevated glucose (hyperglycemia) Defective insulin secretion, action, or both Prevalence of Diabetes Mellitus About 29.1 million people in U.S. (National Diabetes Statistics Report, 2014---CDC) 9.3 % U.S. population 21 million diagnosed 8.1 million undiagnosed 1.7 million new cases in persons 20 years old and older in 2012 Estimated 86 million Americans have prediabetes Annual cost in medical expenses & lost workdays 1997 - $98 billion 2002 - $132 billion 2007 - $174 billion 2012 - $245 billion 50% of people older than 65 suffer some degree of glucose intolerance Leading cause of new cases of blindness, end-stage renal disease, & foot or leg amputations (nontraumatic) Major cause of heart disease and stroke
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7 th leading cause of death in the U.S. World Heath Organization (WHO) 2000 150 million cases (Ganong, 2005) 2010  predicted to be 221 million cases 2011  346 million cases 2016  422 million cases Sources of Glucose in the Blood Ingested food in the gastrointestinal (GI) tract From glucose stored in the liver as glycogen From glucose stored in muscle as glycogen If need be, protein can be converted to glucose (gluconeogenesis) Normal serum glucose level: 70 – 110 mg/dL 70 to 120 mg/dl –Lewis, 2014 68 to 105 mg/dL (3.6 to 5.8 mmol/dL) _ Ignativicius, 2006 Hyperglycemia May result in: Diabetic ketoacidosis (DKA) Hyperglycemic hyperosmolar nonketotic syndrome (HHNS, HHK, HHS) Long-term effects contribute to: Macrovascular complications (CAD, CV disease, PVD)
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Microvascular complications (kidney and eye disease) Neuropathic complications (diseases of the nerves) Insulin and Glucagon Insulin Anabolic Increases the storage of glucose, fatty acids, and amino acids “Hormone of abundance” Glucagon Catabolic Mobilizes glucose, fatty acids, and amino acids Insulin Controls the level of glucose in the blood by: Allows glucose in the blood to move into cells to make energy Accelerates transport of amino acids into cells Causes K+ to enter cells In the liver… promotes the production & storage of glycogen (glycogenesis) inhibits glycogen breakdown into glucose (glycogenolysis) In muscle… promotes production & storage of glycogen (glycogenesis) In fat cells… Enhances storage of dietary fat in adipose tissue (as triglycerides)
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Inhibits gluconeogenesis (conversion of proteins to glucose) Inhibits the breakdown of stored glucose, protein, and fat Daily Insulin Secretion 40 to 50 units of insulin daily directly into the bloodstream via two ways… Basal insulin secretion… Low levels during fasting Post-prandial secretion Increased levels after eating Facilitated Diffusion
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