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Diabetes Mellitus

Diabetes Mellitus. Ch 13 ~ Endocrine System Med Term. 18.8 million adults & children diagnosed 7.0 million diagnosed 79 million are prediabetic. History of the Disease. 1500 BC ~ Egyptian physician Hesy-Re described disease with polyuria

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Diabetes Mellitus

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  1. Diabetes Mellitus Ch 13 ~ Endocrine System Med Term

  2. 18.8 million adults & children diagnosed • 7.0 million diagnosed • 79 million are prediabetic

  3. History of the Disease • 1500 BC ~ Egyptian physician Hesy-Re described disease with polyuria • 1st century AD ~ described as ‘melting down of flesh & limbs into urine’ • Up to 11th century ~ diagnosed by ‘water tasters’ who tasted the urine of suspected diabetics. Latin for ‘honey’ is ‘mellitus’

  4. Dec. 1921 ~ insulin discovered by Dr. F. Banting • 1940s ~ advances made in understanding of diabetes and better use of insulin • 1950s ~ oral preparations discovered

  5. What is diabetes? • Chronic disorder characterized by high blood glucose levels • Body is not able to utilize insulin to aid with the absorption of glucose into the cells • May be due to a deficiency in the amt of insulin or due to the individual’s resistance to their own insulin

  6. What is insulin? • A hormone secreted by the pancreas • Functions to ‘carry’ glucose through the cell wall so the cell can produce energy • Released after a meal when glucose is absorbed into the bloodstream

  7. What is normal blood sugar? • Narrow range of 70 – 110 mg/dl of blood • BS naturally remains elevated aprox. 2 hrs after a meal or drink then returns to normal

  8. Signs & Symptoms of DM • If insulin is deficient and sugars in blood are not utilized by the cells for energy then the following S&S will appear: • Extreme fatigue • Blurred vision • Polyuria *dehydration * polydipsia • Polyphagia • Unexplained weight loss • Slow healing

  9. Types of Diabetes • Type I Diabetes ~ (insulin deficiency) * it’s all about lack of insulin * formerly known as ‘juvenile diabetes’, an autoimmune insulin deficiency * treated with insulin (injected), diet , exercise

  10. Etiology of Type I • * autoimmune onset triggered by an event such as viral illness • * insulin in not produced in type I

  11. Type I Signs & Symptoms • Extreme weakness/fatigue • Extreme thirst - dehydration (polydipsia) • Increased urination (polyuria) • Abd. Pain • N & V • Blurred vision • Slow healing wounds • Mood changes • Amenorrhea • Unexplained weight loss

  12. Treatment of Type I DM • Obtaining ideal body wt. • Close monitoring of blood sugar levels • Following a diabetic diet with prescribed calories (16 cal/lb per day) • Regular exercise • Insulin injections

  13. Type II Diabetes • Formerly known as ‘adult onset diabetes’ • Usually develops in middle age but more children & young adults are now susceptible • Associated with insulin resistance or lack of insulin • Usually hereditary tendency

  14. Predisposed by obesity & hi caloric intake • As obesity rates increase in the US, the diabetic rate increases in ALL age groups

  15. Type II Signs & Symptoms • Come on more gradually than Type I • Polyphagia • Polydipsia • Polyuria • Weight loss • Extreme fatigue • Slow healing

  16. Treatment of Type II DM • Diet • Exercise • Oral hypoglycemic agents • Insulin (injections, pump)

  17. Long Term Complications of Diabetes Mellitus • Chronic elevated blood sugars →→ • Microvascular Complications due to atherosclerosis →→ arteriostenosis →→ Coronary artery disease diabetic retinopathy Chronic kidney disease diabetic neuropathy

  18. Complications cont • Slow wound healing • Decreased ability to fight infection • Decrease sensation leads to increased injury

  19. Diabetic Foot Ulcers

  20. Gestational Diabetes • Cause is unknown; probably insulin resistance • Mother not using available insulin • Hyperglycemia apparent at aprox. 28 weeks • Extra glucose from mother crosses placental barrier

  21. Baby can’t utilize all the extra glucose and stores it as fat. • Baby likely to be higher birth weight • May be complications at birth due to ↑ size

  22. Gestational Diabetes • Babies of mothers with GD may have ‘macrosomia’ • Higher risk of obesity as they grow • Moms with GB at higher risk of developing DM as they get older

  23. Diabetic Testing • Blood sugars = finger sticks FBS = done with pt. fasting and at least 2 hrspostprandial Hemoglobin A1C = measures average bld sugars for past 2-3 months

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