NURS 115
Diabetes Mellitus
Pancreas
Endocrine clusters of cells- Islets of
Langerhans (3 cell types)
A Cells – G____________
B Cells – I_____________
D Cells – S_____________
I ,
G , and a
more
Tissue Types and Functions of
the Pancreas
•T _______________
• S digestive juic into the
•T ________________________
• S ho into blood
•B_________________ secre insulin,
A________________ secre glucagon, and
D________________ secre somatostatin
Control of Insulin Secretion
•R to elevated blood gluc
•G tran
•G
Actions of insulin and Glucagon
on Glucose
•I_________________
• I glucose transpor into skeletal
and adipose tissue
• I glycogen synthesis
• D gluconeogenesi
•G________________
• P glycogen br
• I gluconeogene
Actions of insulin on Protein
•I act trans of amino
into
•I prot synthes
•D prot breakdown
• B use of glucose fatty acids as fuel
Actions of Glucagon on Proteins
•I t of _________________
hepat cell
•I b of proteins i amino
for use in _______________________
•I co of ________________
glucos precursors
Other Hormones Affecting
Blood Glucose
•C________________________
• E and n
• H to maintain blo glucose levels
periods of stress
Other Hormones Affecting
Blood Glucose
G_____________ H__________________
• I protein synthesi in all cells o the
• M fatty acids from adipose tissue
• A the e of insulin
Other Hormones Affecting
Blood Glucose
•G_______________________
• C to sur during periods of
and starvation
• S gluconeogene by the liver
Diabetes Mellitus
•D of metab –
• C
•P
• F
•A imbalance b insulin ____________
insulin ______________.
Diabetes Mellitus
•C represen :
•A absolute _______________
•I ______________ of insulin
•I______________ d___________ insulin
•P of inac ins or insuli
is
Causes of Beta Cell Dysfunction
in Patients with Diabetes
•A initial in t beta ce mass
•I bet cell a____________/decreas
•L -standing insulin __________________
to be cell
Causes of Beta Cell Dysfunction
in Patients with Diabetes
•C hyperglyce can induce bet cell
(G___________________)
•C el o free fatty acids can cause
to beta c (L_________________)
•A deposit in the b cell cause
Two Types of Diabetes
•T ___________
• L of beta cell functio
• A absolute insul deficienc
•T ___________
• I ability of the tissues to insulin
• A lack of insul or impaired r of
in r to blo glucose levels
Diabetes Mellitus Type I
Signs and Symptoms
“____________________”
•T Polys Of Diabetes
P _______________
P _______________
P _______________
Diabetes Mellitus Type I
Signs and Symptoms
“S Diabetes”
W loss
R blurred v
F
P
Management of Diabetes type I
•N Therapy
•E / weight con
•G monitoring
•H care provider -
•I / In Pump/
P Transplant
Management of Diabetes type I
T pr types of insulin
•_____________
•_________________
•_____________
Metabolic Abnormalities Contributing
to Hyperglycemia in Type 2 Diabetes
•I beta ce function and ins
•P ________________
•I __________________ glucose
Diabetes Mellitus Type II
Signs and Symptoms
O ____________________
•M syndrome
•S symptoms here – W ?
P
P
P
Diabetes Mellitus Type II
Signs and Symptoms
W gain in th mid section
R blurred v
F
P
S infection
Management of Diabetes type II
•N Therapy
•E / weight con
•O agents
•G monitoring
•H care provider -
•F Blood Glucose T
•C Blood Glucos Test
•C Blood test
•S monitori - C Blood
G Level
•G Hemoglob Testi
(H A1C)
•G Tol Testi
(OGTT)
Testing for Diabetes Mellitus
Nursing Considerations Overview
•P Assessment
•P Education
•P an managing
Acute Complications of Diabetes
•D _____________________
•__________________________
state
•___________
Major Metabolic Derangements
in DKA
•H
•K
•M _______________
Definitive Diagnosis of DKA
•H (BG levels >250 /dL)
•L bicarbonate (<15 mEq/L)
•L pH (<7.3)
•K (positive at 1: 2 dilution)
•M ketonuria
•R pattern
Characteristics of Hyperosmolar
Hyperglycemic State (HHS)
•H (BG >600 mg/dL)
•H
( osmol >310 mOsm/L)
•D
•T absenc of ketoacidosi
•D of the sens
•N Consi
Characteristics of Hyperosmolar
Hyperglycemic State (HHS)
•N Consi
• IV – the Osmolari imbalance
• C th cause – ?
• A frequent – LOC, R status
• M el imbalanc
• S care
Factors Precipitating an Insulin
Reaction in Type 1 Diabetes
•E in insul dose
•F to eat
•I exercise
•D insulin after removal of
stress situation
Factors Precipitating an Insulin
Reaction in Type 1 Diabetes
•M changes
•C in insul site
•A
•N Considerations
Somogyi Effect
•H at ni with hyperglyce
the morning-
•C ?
•M common - wi type I DM
•N Consi
Chronic Complications of Diabetes
•D of the
• N , n , and
•M comp
•CAD
•F ulcers
