ln18CuuC1lCn

ulobetes mellltos ls a condlLlon ln whlch Lhe pancreas no longer produces enough lnsulln or cells sLop respondlng Lo Lhe lnsulln LhaL ls produced so LhaL glucose ln Lhe blood cannoL be absorbed
lnLo Lhe cells of Lhe body

CLASSIIICA1ICN CI DIA8L1LS
lnsullnuependenL ulabeLes MelllLus (luuM 1ype l)
1 LlLLle or no endogenous lnsulln requlrlng ln[ecLlons of lnsulln Lo conLrol dlabeLes and prevenL keLoacldosls
2 LLlology uLolmmunlLy vlral and cerLaln hlsLocompaLlblllLy (PL) anLlgens as well as a geneLlc componenL
3 usual presenLaLlon ls rapld wlLh classlc sympLoms of polydlpsla polyphagla polyurla and welghL loss
4 MosL commonly seen ln paLlenLs under age 30 buL can be seen ln older adulLs
3 3 Lo 10 of all dlabeLlc paLlenLs have luuM
8 nonlnsulln uependenL ulabeLes MelllLus (nluuM 1ype 2)
1 Caused by defecL ln lnsulln manufacLure and release from Lhe beLa cells or lnsulln reslsLance ln Lhe perlpheral Llssues
2 LLlology SLrong heredlLy componenL ofLen assoclaLed wlLh obeslLy
3 usual presenLaLlon ls slow and ofLen lnsldlous wlLh sympLoms of faLlgue welghL galn poor wound heallng and recurrenL lnfecLlon
4 lound prlmarlly ln adulLs over 30 years of age
3 aLlenLs wlLh Lhls Lype of dlabeLes buL who evenLually may be LreaLed wlLh lnsulln are sLlll referred Lo as havlng nluuM or Lype ll dlabeLes
C lmpalred Clucose 1olerance (lC1)
1 bnormallLy ln glucose levels lnLermedlaLe beLween normal and overL dlabeLes (formerly called laLenL or predlabeLes)
2 sympLomaLlc lL can progress Lo overL dlabeLes or remaln unchanged
3 May be rlsk facLor for Lhe developmenL of hyperLenslon coronary hearL dlsease and hyperllpldemlas
u CesLaLlonal ulabeLes MelllLus (CuM)
1 ueflned as carbohydraLe lnLolerance occurrlng durlng pregnancy
2 Cccurs ln approxlmaLely 3 of pregnancles and usually dlsappears afLer dellvery
3 Women wlLh CuM are aL hlgher rlsk for dlabeLes aL a laLer daLe
4 CuM ls assoclaLed wlLh lncreased rlsk for feLal morbldlLy
3 Screenlng for CuM for all pregnanL women should occur beLween Lhe 24
Lh
and 28
Lh
weeks of gesLaLlon
L ulabeLes ssoclaLed WlLh CLher CondlLlons
1 CerLaln drugs chemlcals hormones and geneLlc syndromes can decrease lnsulln acLlvlLy resulLlng ln hyperglycemla
a CorLlcosLerold
b Cushlng's ulsease or syndrome
2 ulsease sLaLes affecLlng Lhe pancreas affecL lnsulln producLlon
a ancreaLlLls cancer of Lhe pancreas

ISk IAC1CS
Modlflable
1 uleL
2 LlfesLyle
3 CbeslLy
8 nonModlflable 8lsk lacLors
1 ge
2 Sex
3 PeredlLary


9IMA SM91CMS CI D|abetes
Larly Slgns of ulabeLes MelllLus
1 Lxcesslve LhlrsL
2 Lxcesslve hunger
3 lrequenL urlnaLlon
4 laLlgue
3 Sudden welghL loss
8 Mlnor or Less 8ecognlzable SympLoms of ulabeLes MelllLus
1 8lurry vlslon
2 numbness
3 Slowheallng wounds
4 8ecurrenL yeasL lnfecLlons
3 ury skln

DIAGNCS1IC 1LS1
8andom blood glucose LesL for a random blood glucose LesL blood can be drawn aL any Llme LhroughouL Lhe day regardless of when Lhe person lasL aLe random blood glucose level
of mg]dL (111 mmol/L) or hlgher ln persons who have sympLoms of hlgh blood glucose suggesLs a dlagnosls of dlabeLes
8 lasLlng blood glucose LesL fasLlng blood glucose LesLlng lnvolves measurlng blood glucose afLer noL eaLlng or drlnklng for 8 Lo 12 hours (usually overnlghL) normal fasLlng blood
glucose level ls less Lhan 100 mg/dL fasLlng blood glucose of mg]dL (7 mmo|]L) or hlgher lndlcaLes dlabeLes 1he LesL ls done by Laklng a small sample of blood from a veln or
flngerLlp lL musL be repeaLed on anoLher day Lo conflrm LhaL lL remalns abnormally hlgh
C Pemoglobln 1C LesL (1C) 1he 1C blood LesL measures Lhe average blood glucose level durlng Lhe pasL Lwo Lo Lhree monLhs lL ls used Lo monlLor blood glucose conLrol ln people
wlLh known dlabeLes buL ls noL normally used Lo dlagnose dlabeLes normal values for 1C are 4 Lo 6 percenL 1he LesL ls done by Laklng a small sample of blood from a veln or flngerLlp
u Cral glucose Lolerance LesL Cral glucose Lolerance LesLlng (CC11) ls Lhe mosL senslLlve LesL for dlagnoslng dlabeLes and predlabeLes Powever Lhe CC11 ls noL rouLlnely recommended
because lL ls lnconvenlenL compared Lo a fasLlng blood glucose LesL

1LA1MLN1
1reaLmenL of 1ype l ulabeLes
1 1reaLmenL requlres a sLrlcL reglmen LhaL Lyplcally lncludes a carefully calculaLed dleL planned physlcal acLlvlLy mulLlple dally lnsulln ln[ecLlons and home blood glucose
LesLlng a number of Llmes per day
8 1reaLmenL of 1ype ll ulabeLesuleL
2 1reaLmenL Lyplcally lncludes dleL conLrol exerclse home blood glucose LesLlng and ln some cases oral medlcaLlon and/or lnsulln pproxlmaLely 40 of people wlLh
Lype 2 dlabeLes requlre lnsulln ln[ecLlons

NUSING MANAGLMLN1
C
1 uleLary conLrol wlLh calorlc resLrlcLlon of carbohydraLes and saLuraLed faLs Lo malnLaln ldeal body welghL
2 vold salL whenever posslble
3 lncrease Lhe lnLake of soluble and lnsoluble flber
4 use alcohol only ln moderaLlon
3 use alLernaLlve nonnuLrlLlve noncalorlc sweeLeners ln moderaLlon
Lxerclse
1 etclsloq teqolotly can help regulaLe Lhe blood sugar levels and lose welghL heavy workouL ls noL necessary and a walk or a moderaLe workouL of 30 mlnuLes would
do eople who are under oral medlcaLlons and lnsulln Lherapy musL check Lhelr blood glucose levels before and afLer exerclslng Whlle dolng heavy workouLs check
Lhe sugar level every 13 mlnuLes lso lf Lhe sugar level becomes low durlng Lhe exerclse sesslon Lake a llghL snack Lo compensaLe for lL use frulLs or salads lnsLead of
snacks
8 MedlcaLlons
1 Cral hypoglycemlc agenLs for paLlenLs wlLh nluuM/1ype ll who do noL achleve glucose conLrol wlLh dleL and exerclse only
a cL by sLlmulaLlng lnsulln secreLlon from funcLlonlng beLa cells posslbly reduclng hepaLlc glucose producLlon and by enhanclng perlpheral senslLlvlLy Lo lnsulln
b May cause hypoglycemlc reacLlons
2 lnsulln Lherapy for paLlenLs wlLh luuM who requlre replacemenL
a May also be used for nuuM when unresponslve Lo dleL exerclse and oral hypoglycemlc agenL Lherapy
b Pypoglycemla may resulL as well as rebound hyperglycemla