ENDOCRINE REPORT
DIABETES
MELLITUS
MAGSICO, RAMIREZ, SONGCAL
DIABETES MELLITUS
WHAT’S A DM?
Diabetes mellitus refers to a group of diseases
that affect how the body uses blood sugar
(glucose). Glucose is an important source of
energy for the cells that make up the muscles
and tissues. It's also the brain's main source of
fuel.
The main cause of diabetes varies by type. But
no matter what type of diabetes you have, it
can lead to excess sugar in the blood. Too
much sugar in the blood can lead to serious
health problems.
THREE TYPES OF DM
TYPE 1
TYPE 2
Type 1 diabetes is a chronic illness characterized by the
body’s inability to produce insulin due to the autoimmune
destruction of the beta cells in the pancreas. Although onset
frequently occurs in childhood, the disease can also develop
in adults.
The pathophysiology of type 2 diabetes mellitus is
characterized by peripheral insulin resistance, impaired
regulation of hepatic glucose production, and declining βcell function, eventually leading toβ -cell failure.
GESTATIONAL
GDM is usually the result of β-cell dysfunction on a
background of chronic insulin resistance during pregnancy
and thus both β-cell impairment and tissue insulin
resistance represent critical components of the
pathophysiology of GDM.
RISK FACTORS
WHAT ARE THOSE RISKS?
•Family history of diabetes (ie, parents or siblings with diabetes)
•Obesity (ie, 20% over desired body weight or BMI 27 kg/m2)
• Race/ethnicity (eg, African Americans, Hispanic Americans, Native Americans, Asian Americans, Pacific Islanders)
• Age 45 years and above
• Previously identified impaired fasting glucose or impaired
glucose tolerance
• Hypertension (140/90 mm Hg)
• HDL cholesterol level 35 mg/dL (0.90 mmol/L) and/or
triglyceride level 250 mg/dL (2.8 mmol/L)
• History of gestational diabetes or delivery of babies over 9 lbs
THREE PS
POLYURIA, POLYDIPSIA, POLYPHAGIA
CLINICAL
MANIFESTATIONS
Clinical manifestations depend on the patient’s level
of hyperglycemia. Classic clinical manifestations of all
types of diabetes include the “three Ps”: polyuria,
polydipsia, and polyphagia. Polyuria (increased
urination) and polydipsia (increased thirst) occur as a
result of the excess loss of fluid associated with
osmotic diuresis. Patients also experience polyphagia
(increased appetite) that results from the catabolic
state induced by insulin deficiency and the breakdown
of proteins and fats. Other symptoms include fatigue
and weakness, sudden vision changes, tingling or
numbness in hands or feet, dry skin, skin lesions or
wounds that are slow to heal, and recurrent infections.
COMPLICATIONS
DIABETES MELLITUS HAS 3 COMMON COMPLICATIONS:
There are three major acute complications of diabetes related to short-term
imbalances in blood glucose levels: hypoglycemia, DKA, and hyperglycemic
hyperosmolar non-ketotic syndrome, which is also called hyperglycemic
hyperosmolar syndrome or state.
DIAGNOSTICS
DX AND LABS
LABS/DX
An abnormally high blood glucose level
is the basic criterion for the diagnosis
of diabetes. Fasting plasma glucose
(FPG), random plasma glucose, and
glucose level 2 hours after receiving
glucose (2-hour postload) may be
used.
DIABETES MELLITUS
COLLABORATIVE
GOAL
The main goal of diabetes
treatment is to normalize insulin
activity and blood glucose levels to
reduce the development of vascular
and neuropathic complications like
the development and progression
of complications such as
retinopathy, nephropathy, and
neuropathy.
NUTRITIONAL
Nutrition, meal planning, and weight
control are the foundation of diabetes
management. The most important
objectives in the dietary and nutritional
management of diabetes are control of
total caloric intake to attain or maintain a
reasonable body weight, control of blood
glucose levels, and normalization of
lipids and blood pressure to prevent
heart disease.
EXERCISE
Exercise is extremely important in
diabetes management because of its
effects on lowering blood glucose and
reducing cardiovascular risk factors.
Exercise lowers blood glucose levels by
increasing the uptake of glucose by body
muscles and by improving insulin
utilization. It also improves circulation
and muscle tone.
PHARMACOLOGIC
In type 1 diabetes, exogenous insulin must
be administered for life because the body
loses the ability to produce insulin. In type 2
diabetes, insulin may be necessary on a
long-term basis to control glucose levels if
meal planning and oral agents are
ineffective.
Blood glucose monitoring is a cornerstone of
diabetes management, and self-monitoring
of blood glucose (SMBG) levels has
dramatically altered diabetes care.
NURSING MANAGEMENT
Nursing management of patients with diabetes can involve treatment of a wide
variety of physiologic disorders, depending on the patient’s health status and
whether the pa- tient is newly diagnosed or seeking care for an unrelated health
problem
NURSING MANAGEMENT
PROVIDING PATIENT EDUCATION
Diabetes mellitus is a chronic illness that requires a
lifetime of special self-management behaviors.
PROMOTING HOME AND
COMMUNITY-BASED CARE
If problems exist with glucose control or with the
development of preventable complications, it is the nurse’s
responsibility to assess the reasons for the patient’s
ineffective management of the treatment regimen.
DIABETES MELLITUS
THANK YOU
For listening!
MAGSICO, RAMIREZ, SONGCAL
Endocrine Report