Diabetes Lecture Part I

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Diabetes Lecture Part I

• Dr. Kathleen Ethridge
• Northeast Texas Community College

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Anatomy and Physiology

• Endocrine function of the pancreas
• Hormones
• Insulin
• Glucagon
• Glycogen

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Management of Clients with Diabetes Mellitus

• Focus this semester
• Review of Diabetes
• Problems and Complications

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Types of Diabetes

• Type I Diabetes
• Type II Diabetes

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Cardinal Signs of Diabetes

• Polyuria
• Polydyspsia
• Polyphagia

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Diagnostic Tests

• Blood Glucose
• Fasting Glucose
• Postprandial
• Glycosylated Hemoglobin
• Glycosylated Albumin

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Glycosylated Hemoglobin

• Hemoglobin A1C

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Glycosylated Albumin
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Screening and Diagnosis Guidelines

• See Box

(cont.)
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Factors Contributing to Hypoglycemia and
Hyperglycemia

• See Table
• Many drugs can alter glucose levels in the
  diabetic client
• For example, NSAIDs can cause erratic absorption
  of insulin resulting in hypoglycemia

(cont.)
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Medical Management

• Diet
• Exercise
• Oral Antidiabetes Medications
• Insulin Therapy

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Oral Antidiabetic Medications

• See Table for Medications
• Sulfonylureas
• Meglitinides
• Biguanides
• Thiazolidinediones
• Alpha-glucosidase inhibitors

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Types of Insulin

• See Table
• Short-acting
• Intermediate-acting
• Long-acting
• Know Onset/Peak/Duration for each

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Insulin Pumps

• Insulin pumps are worn externally.
• They are connected to an indwelling subcutaneous
  needle.

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Teaching Guidelines for Diabetes

• See Box
• Assess knowledge and misinformation
• Build on previous learned content
• Include general components
• basic information
• symptoms
• diet, exercise, medication
• testing
• complications
• follow-up

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Diabetic Diet

• A standard diabetic diet is no longer prescribed
  for diabetic clients
• Options available
• Four basic food groups
• Diet exchange system
• Calorie counting
• Carbohydrate counting
• Point system

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Nutrition

• Appetite
• Food allergies
• Ethnic and cultural preferences
• Functional Abilities
• Community resources
• Physical acitivity
• Chronic diseases
• GI disease
• Supplements used
• Weight
• Dental health
• Medication and food interactions

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Diabetic Diet

• Avoid adding sugar to food
• Avoid foods sweetened with sugar or honey
• Check blood glucose regularly
• Follow-up care with health care professional
• Be consistent in portions and meal times
• Increase carbohydrates before sustained exercise
• Limit intake of saturated and hydrogenated fats
  and cholesterol

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Exchange List

• See handout

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Insulin Management
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Monitoring Glucose Levels

• Health Organizations are required to keep records
  of personnel competency and training.
• Who can perform glucose monitoring?
• Can in be Delegated?

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Insulin Client Education

• Insulin concentrations
• Insulin syringes
• Insulin storage
• Preparation and injection
• Prefilled syringes
• Site selection and rotation
• Techniques for self-injection

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Modification for the Elderly

• Nutrition
• Functional Limitations
• pain
• vision
• urinary incontinence
• proprioception
• hypotension

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Transplantation

• Clients with Type I diabetes
• Contraindications
• Complications
• Immunosuppressive therapy