Type 2 diabetes in adults: management of type 2 diabetes ...
Diabetes August 2012. Type I or Type II Type IType II Juvenile diabetesMost common form of diabetes...
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Transcript of Diabetes August 2012. Type I or Type II Type IType II Juvenile diabetesMost common form of diabetes...
Type I or Type II
Type I Type II
Juvenile diabetes Most common form of diabetes
Usually diagnosed in children and young adults
Millions diagnosed and many unaware they have it
Body will not produce insulin
Either the body does not produce enough insulin or the cells ignore the insulin
Only 5% of diabetics are a type I
Symptoms – Type I
Frequent urination
Unusual thirst
Extreme hunger
Unusual weight loss
Extreme fatigue and irritability
Symptoms – Type II
Any of the type I symptoms
Frequent infections
Blurred vision
Cuts and bruises that are slow to heal
Tingling or numbness in the hands or feet
Recurring skin, gum or bladder infections
Prevention
Type II can be prevented or delayed
Lead a healthy lifestyle
Change your diet
Increase your physical activity
Maintain a health weight
Myths
• Diabetes is not that serious of a disease
• If you are over weight you will eventually develop type II diabetes
• Eating too much sugar can cause diabetes
• People with diabetes must eat special foods
• People with diabetes cannot eat carbs or sugars
• It is ok to eat as much fruit as you want because it is healthy
Diabetic Ketoacidosis (DKA)
Insulin deficiency and excessive stress hormone
Typically in Type I but can be in Type II
Elevated glucose promotes osmotic diuresis and dehydration
• Stress hormones stimulate free fatty acids which cause a release of ketones
• Causes decreased myocardial contractility and cerebral function
• Usually brought on by infection and stress
Interventions
• Gradually return to normal metabolic balances
• FSBS and notify the MD of the results
• 2 large bore IV’s• NS at a rate of 1 liter per hour• O2 and maintain ABC’s• Insulin drip per protocol• Monitor patient every 5-15 minutes
until stable• Closely monitor intake and output• Cardiac monitor
Hyperglycemic Hyperosmolar Nonketotic Coma (HHNC)
• Occurs in type II• Profound dehydration from elevated
glucose and osmotic diuresis• No ketones-not enough insulin to start
the process• Can be caused by infection, stroke or
sepsis• High mortality rates
Interventions
• FSBS and notify the MD of the results• May require intubation• 2 large bore IV’s• NS 1 liter over 1 hour• Insulin drip per protocol• Monitor the patient every 5-15
minutes until stable• Closely monitor the intake and output• Cardiac monitor
Hyperglycemia
• Serum glucose drops below 50• Below 35-the brain cannot adequately
extract oxygen• Results in hypoxia and eventually
coma• Any person with an altered level of
consciousness should be considered to have low glucose until proven otherwise
Interventions
• O2 and maintain ABC’s• FSBS and notify MD of results• If alert and oriented x3, give oral
glucose solutions (oj, milk, etc. )• Establish IV• ½ to 1 amp of 50% dextrose (D50) per
MD’s orders• Monitor the mental status closely• Monitor the FSBS every 15-30 minutes• Order a meal tray STAT• Cardiac Monitor