Diabetes
Pathophysiology Course
Signs & Symptoms
Pathophysiology Basics
INsulin = puts INto the cell (sugar & K+)
IN
sulin
GLycogen = Stored GLucose in Liver
Pathophysiology & Causes
HIGH sugar
LOW sugar (70 or LESS)
hot and dry = sugar high
“Hyperglycemia”
(blood turns to mud)
3 P’s:Polyuria
Polydipsia
Polyphagia
cold and clammy need some candy
Hypoglycemia
MORE SEVERE! “Hypogly Brain will Die!”
• Cool, pale “pallor”, sweaty,
clammy = candy NOT hot or flushing
• Trembling, Nervous, Anxious
• HIWASH = Headache, Irritable, Weakness,
Anxious, Sweaty, Shaky, Hungry
Type ONE
None: body does NOT produce insulin
Autoimmune (body attacks the pancreas)
Causes
SON: heredity “you can pass it on”
Type TWO
FEW-insulin receptors work
“Insulin resistance” (Diet)
YOU: your diet (high simple sugars)
& sedentary lifestyle
HIGH sugar (115 or MORE)
LOW sugar (70 or LESS)
• Sepsis (infection #1 cause),
• Stress (surgery, hospital stay),
• Skip insulin
• Steroids (predniSONE)
TREATMENT: Insulin
• Exercise
• Alcohol
• Insulin PEAK times
MOST DEADLY! “Hypogly brain will DIE”
1st TREATMENT:
Awake? Ask to eat:
Juice, Soda, Crackers, Low Fat Milk
NOT high fat milk or peanut butter
Risk Factors
“MetaBOLic Syndrome”-Increased risk for diabetes, heart
disease, stroke
B–BP meds or HTN (over 130 sysolic)
B–Blood Sugar Meds (insulin, oral diabetics) or High
Blood Sugar (over 100+)
O–Obese (waist size: 35+ Female 45+ Male)
L–Lipids HIGH Total Cholesterol/Triglyceride/LDL
200-150-100—HDL 40
(higher LDL and lower HDL are risk factors)
*3 or MORE criteria*
Top Missed Exam Question
Which clients are MOST at risk for developing metabolic
syndrome? Select all that apply
1. 35 year-old male with triglycerides of 140
2. 48 year-old female with fasting blood glucose of 105
3. 55 year-old female with waist size of 40 inches
4. 28 year-old male with blood pressure of 135/85
5. 42 year-old female with high density lipoprotein
(HDL) level of 55
NORMAL
FASTING
70-115
UNDER 100
DM
‘’TOLERANCE’’
GTT
HgBA1C
UNDER 140
UNDER 5.7
100-125 140-199 5.7-6.4
PRE-DM
200+
126+
2 Common Exam Question
A client with type 1 diabetes is only responsive to painful
stimuli with a blood sugar of 42, what is the first action
taken by the nurse?
1. Repeat the blood sugar assessment
2. Give dextrose IV push
3. Call the HCP (doctor)
4. Clock out for lunch - dis too much...
LOW Sugar
‘’hypOglycemia’’
70 or LESS
Awake = Ask them to eat
Sleeping = Stab with IV D50 (dextrose 50)
Which medication could cause risk for hyperglycemia?
1. Labatolol
2. Albuterol
3. Spironolactone
4. Prednisone
Tricky Exam Question
The non diabetic client is admitted for a kidney infection
that has now turned septic. The blood sugars have
increased from 150 to 225, what is the best answer to give
a family member who is asking why insulin is used?
Diagnostic labs
RANDOM
Sleep? Stab them (D50W given IV/IO)
200+
6.5+
1. The client now has type 2 diabetes because of the
infection.
2. Insulin is given to control the hypoglycemia.
3. High sugar is common during infection and stress to
the body, the insulin will help lower the sugar until
the infection resolves.
4. Be QUIET & let me do my job