Week 6

DIABETES MELLITUS 1 VS DIABETES MELLITUS

GLENDA SHERRY PEVETO

UNITED STATES UNIVERSITY

OVERVIEW

• IN DEVELOPED COUNTRIES, THERE HAS BEEN A STARTLING RISE OF DIABETES DIAGNOSIS. IN 2010, THERE WERE 26 MILLION PEOPLE IN THE US WITH DIABETES, BY 2015 THAT NUMBER HAD INCREASED TO 30.3 MILLION. (CDC, 2017).

• FIRST RECOGNIZED BY IN 1500BC (KNIGHT, NIGAM, & ANDRADE, 2017)./

• INCREASE BLAMED ON DIET CHANGES

• TYPES OF DIABETES – TYPE 1 AND TYPE 2

TYPE 1 DIABETES VS TYPE 2 DIABETES

• TYPE 1 DIABETES (INSULIN-DEPENDENT DIABETES)

• BEGINS IN CHILDHOOD

• MUCH MORE COMPLICATIONS

TYPE 2 DIABETES

• THE MOST COMMON FORM OF DIABETES

• STILL SERIOUS COMPLICATIONS

• NON-INSULIN DEPENDENT

Knight, Nigam, & Andrade, 2017

TYPE 1 DIABETES PATHOPHYSIOLOGY

• AUTOIMMUNE RESPONSE AGAINST ALTERED PANCREATIC BETA CELL ANTIGENS

• CIRCULATING INSULIN LOW OR ABSENT

• PANCREATIC BETA CELLS FAIL TO RESPOND

• DESTRUCTION OF INSULIN- SECRETING CELLS OF THE ISLETS OF LANGERHANS, CAUSING INSULIN DEFICIENCY

• (AACE, 2019)

TYPE 1 DIABETES

• MORE FREQUENT GLUCOSE TESTING

• HIGHER RISK OF COMPLICATIONS

• STRICTER DIET AND EXERCISE ROUTINES

• Much more complications

• Starts at younger age

• Insulin dependent

TYPE 1 DIABETES TREATMENT THERAPIES • INSULIN

(Ryan, 2016)

TYPE 2 DIABETES

• THE MOST COMMON FORM OF DIABETES

• ADULT-ONSET MOSTLY

• NON-INSULIN DEPENDENT

• 26 MILLION AMERICANS DIAGNOSED

TYPE 2 DIABETES PATHOPHYSIOLOGY • IMPAIRED REGULATION OF

HEPATIC GLUCOSE PRODUCTION

• PERIPHERAL INSULIN RESISTANCE

• DECLINING BETA CELL FUNCTION, EVENTUALLY LEADING TO BETA CELL FAILURE (MAHLER & ADLER, 1999)

TYPE 2 DIABETES TREATMENT THERAPIES

• DIET MODIFICATIONS

• EXERCISE

• MEDICATIONS Class  Mechanism of action  Indication(s) 

Sulfonylureas and repaglinide  Increase insulin secretion  Insulinopenia 

Biguanides  Decrease hepatic gluoneogenesis  Obesity+ insulin resistance 

   Decrease peripheral insulin resistance    

Thiazolidenediones  Decrease peripheral insulin resistance  Insulin resistance 

   Reduce fatty acids    

α-glucosidase inhibitors  Slow absorption of carbohydrates  Postprandial hyperglycemia 

Table 1. Oral agents used in the management of type 2 diabetes mellitus

NEEDS AND RESOURCES FOR PATIENT AND FAMILY

• PARTNERSHIP FOR PRESCRIPTION ASSISTANCE

• DIETICIAN OR NUTRITION CONSULT

• HOME HEALTH TO TRAIN PATIENT AND FAMILY ON GLUCOSE MONITORING

• INFORMATION FOR YOUR PATIENTS AT U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

REFERENCES: • AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AACE DIABETES RESOURCE CENTER. (2019).

• RETRIEVED FROM HTTP://OUTPATIENT.AACE.COM/TYPE1-DIABETES/PATHOPHYSIOLOGY

• CASTANEDA, R. (2019, FEBRUARY 11). DIFFERENCES BETWEEN TYPE 1 AND TYPE 2 DIABETES. RETRIEVED

• FROM HTTPS://HEALTH.USNEWS.COM/CONDITIONS/DIABETES/DIFFERENCES-BETWEEN-TYPE-1-AND-TYPE-2-

• DIABETES

• DANSINGER, M. (2019, FEBRUARY 16). DIABETES MELLITUS: TYPE 1 VS 2, SYMPTOMS, CAUSES, &

• TREATMENTS. RETRIEVED FROM HTTPS://WWW.WEBMD.COM/DIABETES/GUIDE/TYPES-OF-DIABETES MELLITUS#1

• KNIGHT, J., NIGAM, Y., & ANDRADE, M. (2017, MARCH 14). DIABETES MANAGEMENT 1: DISEASE TYPES,

SYMPTOMS AND DIAGNOSIS. RETRIEVED FROM HTTPS://WWW.NURSINGTIMES.NET/7016461.ARTICLE

SEARCH=HTTPS://WWW.NURSINGTIMES.NET/SEARCHARTICLES?PARAMETRICS=CATEGORYCLINICAL

• SUBJECTS|13228&KEYWORDS=DIABETESPART&PAGESIZE=10&CMD=ADDPM&VA WVSECTIONCODE|19

• MAHLER, R., & ADLER, M. (1999, APRIL 01). TYPE 2 DIABETES MELLITUS: UPDATE ON DIAGNOSIS,

PATHOPHYSIOLOGY, AND TREATMENT. RETRIEVED FROM

HTTPS://ACADEMIC.OUP.COM/JCEM/ARTICLE/84/4/1165/2864079

REFERENCES CONT.

• “New CDC Report: More than 100 Million Americans Have Diabetes or Prediabetes | CDC • • Online Newsroom | CDC.” (2018). Centers for Disease Control and Prevention, • • www.cdc.gov/media/releases/2017/p0718-diabetes-report.html. • • Osborn, C. (2017, August 24). What's the Difference Between Type 1 and Type 2 Diabetes? • • Retrieved from https://www.healthline.com/health/difference-between-type-1-and-type-2- • • Diabetes • • Ryan, L. (2016). Understanding Insulin Administration. Retrieved from • https://www.rn.com/nursing-news/understanding-insulin-administration/