Diabetes Mellitus

Risk Factors
Type 1 DM & Type 2 DM
What is it?
Metabolic disease affecting how the body uses food for energy
Caused by high blood glucose levels (hyperglycemia) due to bodys failure to produce insulin
(Type 1 DM) or inability to process insulin (Type 2 DM)

Age 45 years and older

Increased risk as get older b/c people exercise less = gain more weight and lose muscle mass as they age

Family history/genetics
Hereditary factor if someone in close family has (or had) diabetes, more likely to develop diabetes

Overweight/obesity
Directly related due to added stress on bodys ability to use insulin to properly control blood sugar
body can become resistant to insulin prolonged effects can cause diabetes

Race: African Americans, Hispanics, Native Americans, Asian Americans, Pacific

Islanders

Hypertension: blood pressure 140/90 mmHg

Not enough good HDL cholesterol < 35 mg/dl

Lack of exercise / sedentary lifestyle

Prediabetes = higher than normal blood sugar

Having diabetes while pregnant (gestational diabetes)

Epidemiology

29.1 million people

(9.3% of population) have diabetes

About 1 out of every 11 people

21 million people are diagnosed, 8.1 million undiagnosed

Risk of death for adults with diabetes is 50% higher than

those without diabetes

Diabetes and its complications cause ~200,000+ deaths

each year
Major cause of mortality in U.S.

Pathophysiology
Genetic factors and obesity
Decreased insulin receptors or insulin resistance
Glucose not properly utilized =too much glucose in blood =
hyperglycemia
Body makes too much insulin
Beta cells stop working properly = not enough insulin
produced
(no fat and protein is used)
Hyperglycemia (excessive blood glucose levels)
Type 2 Diabetes develops

Clinical Manifestations

HIGH BLOOD SUGAR

Frequent urination
Extreme thirst
Blurry vision
Feeling very tired

LOW BLOOD SUGAR

Fatigue/weakness
Sweating
Pale
Twitching
Cannot think clearly

Role of Nurse in Disease Prevention

Nurses Teaching Role:

#1: Eating right and getting proper nutrition

#2: Importance of getting enough exercise

#3: How to watch for signs of hyper/hypoglycemia

Following medication regimen as needed

#4: How to use a glucometer to check blood sugar

Show how to monitor and treat high blood sugar level

#5: Demonstrate proper foot care behaviors

#6: Explain what lab tests mean (FBG, HgbA1C)

#7: Possible long-term complications and how to prevent them

#8: What to do when illness occurs

The nurse will work with the older adult and plan treatment goals to prevent
long-term complications (heart, kidney problems, etc.)

Role of Older Adult in Disease Prevention

Older adults should follow these behaviors for managing their
health:

Proper insulin and medication regimen

Proper foot care

Reduces risk of amputation
never go barefoot outside
wear well-fitting shoes
prevent exposure to extreme temperatures
inspect feet daily
see podiatrist for foot inspection yearly

Role of Family Members in Disease

Prevention

Learn about diabetes. The more you know, the more you can
help!

Recognize signs of decreased and elevated blood sugar levels

Attend diabetes education classes if needed

Learn how to give insulin to provide support and

encouragement.

Promote healthy eating and regular exercise.

Talk to a dietician to learn about meal planning.

Be patient! Diabetes is a serious lifelong disease that can

cause major health problems if not managed.

References

Mauk, K. L. (2014). Gerontological nursing: Competencies for care (3rd ed.).

Burlington, MA: Jones and Bartlett Learning.

Mayo Clinic Staff. (2014). Type 2 diabetes: Risk factors. Retrieved from
http://www.mayoclinic.org/diseases-conditions/type-2-diabetes/basics/risk-factors/con20031902

Centers for Disease Control and Prevention. (2014) A snapshot: Diabetes in the United
States [Data file]. Retrieved from
http://www.cdc.gov/diabetes/pubs/statsreport14/diabetes-infographic.pdf