Diabetes

Pathophysiology Course

Pathophysiology Basics Signs & Symptoms

INsulin = puts INto the cell (sugar & K+) IN HIGH sugar LOW sugar (70 or LESS)
GLycogen = Stored GLucose in Liver sulin hot and dry = sugar high cold and clammy need some candy
“Hyperglycemia” Hypoglycemia
(blood turns to mud) MORE SEVERE! “Hypogly Brain will Die!”
Pathophysiology & Causes 3 P’s:Polyuria
Polydipsia
• Cool, pale “pallor”, sweaty,
clammy = candy NOT hot or flushing
Polyphagia • Trembling, Nervous, Anxious
• HIWASH = Headache, Irritable, Weakness,
Type ONE Anxious, Sweaty, Shaky, Hungry
None: body does NOT produce insulin
Autoimmune (body attacks the pancreas)
SON: heredity “you can pass it on” Causes

Type TWO HIGH sugar (115 or MORE) LOW sugar (70 or LESS)
FEW-insulin receptors work
• Sepsis (infection #1 cause), • Exercise
“Insulin resistance” (Diet)
• Stress (surgery, hospital stay), • Alcohol
YOU: your diet (high simple sugars) • Skip insulin • Insulin PEAK times
& sedentary lifestyle • Steroids (predniSONE) MOST DEADLY! “Hypogly brain will DIE”
TREATMENT: Insulin 1st TREATMENT:
Awake? Ask to eat:
Risk Factors Juice, Soda, Crackers, Low Fat Milk
NOT high fat milk or peanut butter
“MetaBOLic Syndrome”-Increased risk for diabetes, heart Sleep? Stab them (D50W given IV/IO)
disease, stroke
B–BP meds or HTN (over 130 sysolic)
B–Blood Sugar Meds (insulin, oral diabetics) or High 2 Common Exam Question
Blood Sugar (over 100+)
A client with type 1 diabetes is only responsive to painful
O–Obese (waist size: 35+ Female 45+ Male) stimuli with a blood sugar of 42, what is the first action
L–Lipids HIGH Total Cholesterol/Triglyceride/LDL taken by the nurse?
200-150-100—HDL 40 LOW Sugar

1. Repeat the blood sugar assessment ‘’hypOglycemia’’

(higher LDL and lower HDL are risk factors) 2. Give dextrose IV push
70 or LESS

*3 or MORE criteria* 3. Call the HCP (doctor) Awake = Ask them to eat

4. Clock out for lunch - dis too much...

Sleeping = Stab with IV D50 (dextrose 50)

Top Missed Exam Question Which medication could cause risk for hyperglycemia?
Which clients are MOST at risk for developing metabolic 1. Labatolol
syndrome? Select all that apply
2. Albuterol
3. Spironolactone
1. 35 year-old male with triglycerides of 140
4. Prednisone
2. 48 year-old female with fasting blood glucose of 105
3. 55 year-old female with waist size of 40 inches
4. 28 year-old male with blood pressure of 135/85
5. 42 year-old female with high density lipoprotein Tricky Exam Question
(HDL) level of 55 The non diabetic client is admitted for a kidney infection
that has now turned septic. The blood sugars have
increased from 150 to 225, what is the best answer to give
a family member who is asking why insulin is used?
Diagnostic labs
RANDOM FASTING GTT HgBA1C 1. The client now has type 2 diabetes because of the
‘’TOLERANCE’’
infection.
NORMAL 70-115 UNDER 100 UNDER 140 UNDER 5.7 2. Insulin is given to control the hypoglycemia.
3. High sugar is common during infection and stress to
PRE-DM 100-125 140-199 5.7-6.4 the body, the insulin will help lower the sugar until
the infection resolves.
200+ 126+ 200+
6.5+
DM
4. Be QUIET & let me do my job