Diabetes Mellitus

Diabetes Mellitus

Diabetes mellitus is a chronic disease caused by inherited and /or acquired deficiency in production of insulin by the pancreas, or by the increased insulin resistance such a deficiency results in increased concentrations of glucose in the blood, which in turn damage many of the body's systems, in particular the blood vessels and nerves.

Definition

The term Diabetic mellitus describes a metabolic disorder of multiple etiologies characterized by chronic hyperglycemia with disturbance of carbohydrate fat and protein metabolism resulting from defects of insulin secretion, insulin action or both.

Types

•               Type 1

•               Type 2

•               Prediabetes

•               Gestational diabetes

Type 1 diabetes/Insulin dependent/ Diabetes mellitus (IDDM)

Type 1 diabetes is also referred to as Juvenile diabetes Mellitus. It results from destruction of pancreatic β cells which produce insulin leading to absolute insulin deficiency.

Etiology

•               Viral

•               Autoimmune

•               Environmental factors.

Type 2 diabetes/Non-Insulin dependent diabetes mellitus(NIDDM)

Most common form of diabetes. Body produces insulin, but do not use it properly, glucose doesn’t move into cells, they pile up in the bloodstream.

Risk factors

•               Genetic

•               Autoimmune

•               Stress

•               Environmental factors

•               Obesity

Prediabetes

Slight elevation of blood glucose levels, regarded as indication that the person is at risk of progressing to Type 2 diabetes.

Gestational Diabetes Mellitus (GDM)

is defined as carbohydrate intolerance during pregnancy.

Risk factors

•               Polycystic ovary syndrome

•               women under age 25

•               Hydraminos

Causes

•               Family history of diabetes

•               Overweight prior to pregnancy

Signs and Symptoms

•               Hyperglycemia - Polyuria, Polydipsia, Polyphagia

•               Weight loss

•               Fatigue

•               Blurred vision

•               Poor wound healing

•               Recurrent infection

Diagnosis

Urine analysis

•               Glucose

•               Ketone

•               Microalbuminuria

Blood chemistry

•               Blood glucose estimation, fasting and random blood sugar

•               Oral Glucose tolerance test (OGTT)

•               Check HbA1c (GLYCOSYLATED HAEMOGLOBIN LEVEL)

Management

Type 1

•               Maintain and control sugar level

•               Insulin therapy

•               Healthy life style – exercise and diet.

•               Islet transplantation

•               Oral Antidiabetic agents

•               Lipid control

•               DIET

•               Meal plan for Caloric restriction

•               Weight reduction

•               EXERCISE: Regularly scheduled, moderate exercise performed 30 to 60 minutes/day.

•               Islet transplation

Type 2

•               Maintain a healthy lifestyle

•               Oral hypoglycemic agent and injection insulin if needed

•               Dietary management and exercise

Gestational diabetes

•               Insulin

•               Physical activity

•               Diet

•               Plan Increase fiber intake

Nursing management

•               Monitoring blood glucose.

•               Administering antidiabetics/insulin.

•               Foot care.

•               Monitoring for hyper/hypoglycemia.

•               Offering snacks at bedtime if permitted.

•               Lifestyle management

Prevention

Complications of uncontrolled diabetes

•               Hypoglycemia

•               Macroangiopathy

•               Peripheral Neuropathy

•               Micro angiopathy

•               Autonomic Neuropathy

•               Diabetic Keto acidosis (DKA)