Diabetes Mellitus
Ch 13 ~ Endocrine System
Med Term
• 18.8 million adults & children diagnosed
• 7.0 million diagnosed
• 79 million are prediabetic
History of the Disease
• 1500 BC ~ Egyptian physician Hesy-Re
described disease with polyuria
• 1st century AD ~ described as ‘melting down
of flesh & limbs into urine’
• Up to 11th century ~ diagnosed by ‘water
tasters’ who tasted the urine of suspected
diabetics. Latin for ‘honey’ is ‘mellitus’
• Dec. 1921 ~ insulin discovered by Dr. F.
Banting
• 1940s ~ advances made in understanding of
diabetes and better use of insulin
• 1950s ~ oral preparations discovered
What is diabetes?
• Chronic disorder characterized by high blood
glucose levels
• Body is not able to utilize insulin to aid with
the absorption of glucose into the cells
• May be due to a deficiency in the amt of
insulin or due to the individual’s resistance to
their own insulin
What is insulin?
• A hormone secreted by the pancreas
• Functions to ‘carry’ glucose through the cell
wall so the cell can produce energy
• Released after a meal when glucose is
absorbed into the bloodstream
What is normal blood sugar?
• Narrow range of 70 – 110 mg/dl of blood
• BS naturally remains elevated aprox. 2 hrs
after a meal or drink then returns to normal
Signs & Symptoms of DM
• If insulin is deficient and sugars in blood are not
utilized by the cells for energy then the following
S&S will appear:
• Extreme fatigue
• Blurred vision
• Polyuria
*dehydration
* polydipsia
• Polyphagia
• Unexplained weight loss
• Slow healing
Types of Diabetes
• Type I Diabetes ~ (insulin deficiency)
* it’s all about lack of insulin
* formerly known as ‘juvenile diabetes’, an
autoimmune insulin deficiency
* treated with insulin (injected), diet ,
exercise
Etiology of Type I
• * autoimmune onset triggered
event such as viral illness
• * insulin in not produced in type I
by an
Type I Signs & Symptoms
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Extreme weakness/fatigue
Extreme thirst - dehydration (polydipsia)
Increased urination (polyuria)
Abd. Pain
N&V
Blurred vision
Slow healing wounds
Mood changes
Amenorrhea
Unexplained weight loss
Treatment of Type I DM
• Obtaining ideal body wt.
• Close monitoring of blood sugar levels
• Following a diabetic diet with prescribed
calories (16 cal/lb per day)
• Regular exercise
• Insulin injections
Type II Diabetes
• Formerly known as ‘adult onset diabetes’
• Usually develops in middle age but more
children & young adults are now susceptible
• Associated with insulin resistance or lack of
insulin
• Usually hereditary tendency
• Predisposed by obesity & hi caloric intake
• As obesity rates increase in the US, the
diabetic rate increases in ALL age groups
Type II Signs & Symptoms
• Come on more gradually than Type I
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Polyphagia
Polydipsia
Polyuria
Weight loss
Extreme fatigue
Slow healing
Treatment of Type II DM
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Diet
Exercise
Oral hypoglycemic agents
Insulin (injections, pump)
Long Term Complications of
Diabetes Mellitus
• Chronic elevated blood sugars →→
• Microvascular Complications due to
atherosclerosis →→
arteriostenosis →→
Coronary artery disease
diabetic retinopathy
Chronic kidney disease
diabetic neuropathy
Complications cont
• Slow wound healing
• Decreased ability to fight infection
• Decrease sensation leads to increased injury
Diabetic Foot Ulcers
Gestational Diabetes
• Cause is unknown; probably insulin resistance
• Mother not using available insulin
• Hyperglycemia apparent at aprox. 28 weeks
• Extra glucose from mother crosses placental
barrier
• Baby can’t utilize all the extra glucose and
stores it as fat.
• Baby likely to be higher birth weight
• May be complications at birth due to ↑ size
Gestational Diabetes
• Babies of mothers with GD may have
‘macrosomia’
• Higher risk of obesity as they grow
• Moms with GB at higher risk of developing
DM as they get older
Diabetic Testing
• Blood sugars = finger sticks
FBS = done with pt. fasting and
at least 2 hrs postprandial
Hemoglobin A1C = measures average bld
sugars for past 2-3 months