100%(1)1 out of 1 people found this document helpful
This preview shows page 4 - 7 out of 12 pages.
Signs & Symptoms •Slow progression!•Diabetic complications due to high glucose –Blurred vision/Retinopathy–Paresthesia / PVD–Fatigue–Frequent infections (e.g. Candida Albicans)–Slow wound healing–Polydipsia/polyuriaHyperosmolar Hyperglycemic State (HHS)Insulin supply depleting: BG > 600mg/dL- Most common in type 2oOsmotic diuresis/extracellular fluid depletion (very severe); Slow progressionS/S: polyuria, decreased LOC, seizures, coma, aphasia, hypotension, tachypnea Labs:Hyperglycemia (usually > 600 mg/dl)Hyperosmolarity (serum osmo > 320 mOsm/l)- Cells shrivel Generally, pH > 7.35ABSCENCE of KETONES!-High mortalityviscous blood-thrombus
Metabolic Syndrome Cluster of conditions that increases risk for heart disease, stroke, DMThree or more(or take meds to control) of the listed criteria below:Comparing Type I and Type IIType I -Peak age: 12-14 yrs•Autoimmune/Idiopathic •Destruction of beta-cells•80-90% destroyed before symptoms occur•No insulin secretion!Type II-Peak age > 40 yrs •Defect in insulin receptors•Increased insulin resistance•Beta cells compensate by increasing insulin output•Hyperglycemia increases destruction of beta cells!Medical Management of DiabetesBalance -Medications, Exercise, Diet, Monitoring glucose levelsInsulin availablefor metabolism when food digesting and absorbedFood availablewhile insulin is acting to prevent hypoglycemic reactionsMedical Management: Goals-Maintain BG levels as near normal as possibleoGoal: HbA1c < 7.0%-Modify lifestyle for prevention and treatment oObesity oDyslipidemiaoAtherosclerosisoCardiovascular disease oRetinopathyoNephropathyoNeuropathy
Chronic ComplicationsResult of end-organ diseasefrom damage to blood vesselssecondary to hyperglycemiaMicrovascular (small vessels)-•Result from a thickening of the vessel (basement) membranes in small vessels•They become thicker but less strong and more permeable!–Found throughout the body•Most common –Eyes - retinopathy–Kidneys - nephropathy –Skin- dermopathy, prone to infection/injuryMacrovascular (large vessels)-Disease of large and medium sized vesselsAtherosclerotic plaque formation accelerated–Cerebrovascular (stroke)–Cardiovascular- hypertension & coronary artery disease (CAD)–Peripheral vascular disease – ulcers & gangreneTreatment aimed at:–Control risk factors (obesity, smoking, hypertension, high fat intake, sedentary lifestyle)–Treatment of disorders!Diabetic Retinopathy (Microvascular)oDecreased blood flow to the retinaoIschemia develops; collateral circulation formsoHemorrhages & potential retina detachmento80% of Type II have some degree of retinal diseaseDiabetic Nephropathy (Microvascular)Damage to small vessels of glomeruli oHypertension oLeakage of protein into urine (microalbuminuria)oProgressive renal insufficiencyoMost common cause of renal failure!