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DIABETES MELLITUS

TYPE I TYPE II GESTATIONAL DIABETES

DIABETES MELLITUS - A disorder caused by insufficient or absent

production of the hormone insulin by the pancreas, or because the tissues are resistant to the effects. Insulin is responsible for the absorption of glucose into cells. Lack of insulin causes high blood levels of glucose, resulting in the passage of large quantities of urine and excessive thirst. Other symptoms are weight loss, hunger, and fatigue. Urinary tract infections may also occur. Lipid (fat) metabolism is affected and small blood vessels degenerate. Undiagnosed diabetes can lead to blurred vision, boils, and tingling or numbness of the hands and feet.

DIABETES MELLITUS

Is a group of serious and chronic disorders affecting the metabolism of carbohydrates on glucose intolerance. It may be heredity, on environmental factors may contribute to its occurrence, viruses on obesity may precipitate the disease in people who have a genetic predisposition. is a defined as 8-hour fasting glucose level of 126 mg/dL or higher. A related disorder is called impaired fasting glycemia which indicates a fasting blood glucose of between 110 to 125 mg/dL and which is thought to be precursor of diabetes. (Gestational Diabetes develops in

Diabetes can be conveniently classified

into (1) Type I diabetes is an autoimmune disorder where beta cells are destroyed. The hormone, insulin, which is produced by beta cells in the pancreas for the metabolism of sugar in the body, is sorely lacking in this type of diabetes.(2) Type II diabetes has multigenic causation. It can be prevented in some case by proper diet, weight control and regular exercise. This is the common type of diabetes

Types of Diabetes
Type I develops when the bodys immune system destroys the pancreas beta cells
Requires insulin injection Acute onset before age 30

Type II usually occurred in adults over 40


Decreased sensitivity to insulin (insulin resistance) Treated with diet and exercise Supplemented with oral hypoglycemic agents .

Gestational Onset

during pregnancy, at the

Risk Factors
Genetics Auto immune Obesity Impaired glucose tolerance Hypertension Stress Smoking Alcohol Sedentary life style Sex Age Menopause

Sign and Symptoms

Glycosuria excess sugar in the urine Polyuria excessive urination Polydipsia excessive thirst Polyphagia excess hunger Fatigue Weight loss Increase frequency of infection Pruritis

Complications
Peripheral Vascular Disease (PVD) Angiopathy Retinopathy Nepropathy Neuropathy Infections Diabetic Ketoacidosis (DKA) Hyperglycemia Hypoglycemia Hypertension Cardiovascular disorder Cataracts

Nutritional Management
The dietician will need to know the clients diet history. Food likes and dislikes and lifestyle. The clients calorie needs will depend on age, activities, learn muscles mass and size. Fats should be limited to 30% of total calorie, and protein should be limited from 15% - 20% of total calorie, Lean proteins are advisable because they contain limited amounts fats. Client with Type I diabetes needs a nutritional plan that balances calories and nutrients needs with insulin therapy and exercise. It is important that meals and snack be composed of similar nutrients and calories and eaten at regular times each day. Small meals plus two or more three snacks may be more helpful in maintaining steady blood glucose levels. Client with type II diabetes may be over weight. The nutritional goal for this client is not only to keep blood glucose levels in the normal range but to lose weight as well.

Health Teaching
Client with Type I Diabetes > Female, 60 y/o >Wt. 64 kgs. >Height 5 4 Client is a retired public accountant living with her husband and daughter in a residential home. Family is earning an average income monthly. The client is living in a sedentary life. Discharge Plan: Goal A. Keep Blood sugar as normal as possible B. Provide optional nourishment for the client

Plan for the Client


Provide all essential food constituents. Help the client to maintain ideal weight by

teaching the proper diet


Teach the client to review food exchange

method of meal and snack planning with client family


Assist the client the proper management of

insulin regimen
Promote proper exercise diet and therapy

regimen to avoid further complications


Consult to Physician for ulcer on the feet.

Meal Plan
Breakfast 2 slice of tasted bread 1 oz fat free cheese 1 cup non fat milk 1 medium size apple Lunch cup of rice 1 cup mixed vegetables 1 slice roast chicken 1 medium size banana Dinner cup of rice Snacks 4 pcs. wheat crackers 1 slice papaya cup orange juice