Fernandez, Glabrion Uriel

Pathophysiology
DIABETES MELLITUS

Diabetes Mellitus: more commonly referred

to as “diabetes”

 Is a chronic disease associated with

abnormally high levels of the sugar
glucose in the blood. Diabetes is due to
one of two mechanisms:

1. Inadequate production of insulin

(which is made by the pancreas and
lowers blood glucose), or
2. Inadequate sensitivity of cells to the
action of insulin.

The two main types of diabtes correspond

to these two mechanisms and are called
insulin dependent (type 1) and non-insulin
dependent (type 2) diabetes. In type 1
diabetes there is no insulin or not enough
of it. In type 2 there is enough insulin but
the cells upon which it should act are not
normally sensitive to its own.
Signs and Symptoms
1. The early symptoms of untreated
diabetes are related to elevated blood
sugar levels, and loss of glucose in the urine
can cause increased urine output and lead
to dehydration.
2. The dehydration also causes increased
thirst and water consumption
3. A relative or absolute insulin deficiendy
eventually leads to weight loss
4. The weight loss of diabetes occurs
despite an increase in appetite
5. Some untreated diabetes patients also
complain fatigue
6. Nausea and vomiting can also occur in
patients with untreated diabetes.
7. Frequent infections are more likely to
occur in people with untreated or poorly-
controlled diabetes
8. Fluctuations in blood glucose levels can
lead to blurred vision
9. Extremely elevated glucose level can lead
to lethargy and coma
Diagnostic Exams
1. Glucose Tolerance Test- The glucose
tolerance test identifies abnormalities in
the way your body handles glucose after a
meal — often before your fasting blood
glucose level becomes abnormal.
Type 2 diabetes:
You'll drink about 8 ounces (237 milliliters)
of a syrupy glucose solution containing 2.6
ounces (75 grams) of sugar
Two hours later, your blood glucose level
will be measured again
Gestational diabetes:
A fasting blood sugar will be obtained.
You'll drink about 8 ounces (237 milliliters)
of a glucose solution containing 3.5 ounces
(100 grams) of sugar.
2. Blood Glucose Test- A blood glucose test
is used to find out if your blood sugar levels
are in the healthy range. It is often used to
help diagnose and monitor diabetes.
 Nutrition and Fluid Balance
3. Hemoglobin A1c (HbA1c)- The Risk for Imbalanced Nutrition
hemoglobin A1c test tells you your average Risk for Unstable Blood Glucose
level of blood sugar over the past 2 to 3 Risk for Deficient or Imbalanced Fluid
months. It's also called HbA1c, glycated
Volume
hemoglobin test, and glycohemoglobin.
Skin Integrity
4. Postprandial Blood Glucose- The word Risk for Impaired Skin Integrity
postprandial means after a meal; therefore, Risk for Thermal Injury
PPG concentrations refer to plasma glucose Risk for Infection
concentrations after eating. Risk for Delayed Surgical Recovery
Health Management
Treatment and Management Deficient Knowledge
Ineffective Health Management
There is no cure for diabetes, but it can be Chronic Pain
treated and controlled. The goals of
managing diabetes are to: Nursing Care
 Keep your blood glucose levels as near
1. Restore the balance of fluids, electrolytes
to normal as possible by balancing
and the acid-base balance.
food intake with medication and
2. Correct/reverse abnormal metabolic
activity.
functions.
 Maintain your blood cholesterol and
3. Help manage the underlying cause of
triglyceride (lipid) levels as near the normal
diabetes and the disease process.
ranges as possible.
4. Prevent diabetic complications.
 Control your blood pressure. Your
5. Educate patients about diabetes and how
blood pressure should not go over 140/90.
it affects the body, self-care and necessary
 Decrease or possibly prevent the
treatments.
development of diabetes-related health
problems.
You hold the keys to managing your
References:
diabetes by:
https://www.mayoclinic.org/tests-
 Planning what you eat and following a
procedures/glucose-tolerance-
balanced meal plan
test/about/pac-20394296
 Exercising regularly
https://diabetes.diabetesjournals.org/conte
 Taking medication, if prescribed, and
nt/66/2/241
closely following the guidelines on how and
https://www.webmd.com/diabetes/guide/
when to take it
glycated-hemoglobin-test-hba1c
 Monitoring your blood glucose and
https://care.diabetesjournals.org/content
blood pressure levels at home
/24/4/775
 Keeping your appointments with your
https://my.clevelandclinic.org/health/dise
healthcare providers and having laboratory
ases/7104-diabetes-mellitus-an-
tests completed as ordered by your doctor.
overview/management-and-treatment
https://degree.lamar.edu/articles/nursing
 Oral medications
/how-can-nurses-help-diabetes-
 Inulin
patients.aspx
 Insulin pump

Nursing Diagnoses