Diabetes type 2 / Diabetes Mellitus
Not enough insulin is produced by the pancreas or the body is not using insulin effectively
Major distinction between type 1 and type 2, is that there is an absence of endogenous
insulin in type 1
Metabolic abnormalities have a role in type 2:
Insulin resistance: body tissues do not respond to the action of insulin because insulin
receptors are unresponsive, are insufficent in number or both.
2nd factor: decrease in the ability of pancreas to make insulin, B cells become fatigued
from compensentory overproduction of insulin or when B-cell mass is lost. In addition
the aplha cells of the pancreas increase production of glucagon.
Etiology:
Genetic
Autoimmune
Environmental
Disorder of glucose metabolism related to
abenset/insufficent /and poor utlization of
insulin
Sedentary lifestyle
Fructosamine
Islet cell autoantibody testing
Glycosylated hemoglobin aka A1C: 6.5% goal
Lipid, BUN, creatinine, electrolytes
less than 6.5% to 7% (reduces complications) Albumin & urnine acetone
Fasting plasma glucose (FPG) >126 mg/dL
Classic symptoms of
hyperglycemia/
2-hr. plasma glucose level
hyperglycemic crisis or
during OGTT > than 200 mg/dL
a random plasma glucose
BP, ECG, eye, dental, foot, neuro exam, ABI, weight
level >200 mg/dl
glucose for hypoglcemia treatment
Drugs: Insulin:
Rapid-acting : lispro (Humalog)
Short-acting : Regular (Humulin R)
Intermediate-acting : NPH (Humulin N)
Long-acting: glargine (Lantus)
Combination Therapy (premix)
NPH/Regular 70/30 (Humulin 70/30)
Oral: Metformin (glucophage)
glipizide (gluctorol)
glyburide (DiaBeta)
sitagliptin (Januvia)
canagliflozin (Invokana)
empagliflozin (Jardiance)
Polyuria: lots of peeing
Polydispia: thirsty
Polyphagia: hungry alot
fatigue
Recurrent infections
Recurrent vaginal or candida infection
Prolonged wound healing
Visual problems
Diabetes Ketoacidosis
HHS
Hypoglycemia
Diet
reading labels & serving basis
Exercise
SMBG
IV drip