HS2 - Diabetes Learning Package PDF

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Diabetes Learning Package - Notes taken up in class - Only questions filled out will be testable
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Health Sciences 2 HSCI 10146 Diabetes Diabetes

#1-5, 7-14, 16, 17, 21

OVERVIEW According to Diabetes Canada, “there are 11 million Canadians living with diabetes or pre-diabetes”, and “every 3 minutes another Canadian is diagnosed”. Because diabetes mellitus is so prevalent in Canadian society, it is particularly important to have the necessary nursing knowledge in order to provide care to patients with this endocrine disorder.

LEARNING OBJECTIVES Throughout this learning package you will develop knowledge and understanding of:1 

terminology related to diabetes mellitus

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the etiologies, pathophysiology, and clinical behaviors of type 1 and type 2 diabetes

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how a diagnosis of diabetes is determined

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the complications of diabetes – microvascular, macrovascular, and diabetic ketoacidosis

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pharmacological therapy for type 1 and type 2 diabetes

Health Sciences 2 HSCI 10146 Diabetes

PRE-CLASS ACTIVITIES 2The pancreas, as well as the liver, plays an important role in the regulation of blood glucose levels by releasing the hormones , insulin or glucagon in response to blood glucose levels. Glucagon works primarily with liver cells to raise blood glucose levels by stimulating glycogenolysis. Insulin acts to move glucose into body cells, thereby decreasing blood glucose levels. Complete the following in preparation for class: Diabetes Mellitus 1. Recall from semester one anatomy and physiology, the components of the pancreas which produce insulin and glucagon and the actions of these hormones. -pancreas releases insulin (too high) – or glucagon Note: Alpha Cells: Glucagon – Beta Cells: Insulin 2. 3Insulin and glucagon exert antagonistic effects on blood glucose. a) What is the effect on blood glucose levels with an increase in insulin? -decreases blood glucose levels – by using them or converting it into glycogen b) What is the effect on blood glucose levels with an increase in glucagon? -increases blood glucose levels – by stimulating the liver to convert glycogen into glucose 4Diabetes Mellitus is a chronic health problem affecting millions of Canadians. It is a major risk factor for common cardiovascular problems such as coronary artery disease (CAD), stroke, and peripheral vascular disease (PVD). 3. What is pre-diabetes? Why is it a serious concern? -blood glucose levels higher than normal – but not high enough to be diagnosed as type 2 diabetes (ex. fasting glucose level of 7.0mmol/L – or A1C level of 6.5%) -It is a CONCERN – b/c pre-diabetes is linked w/ long-term complications (ex. heart disease)

Health Sciences 2 HSCI 10146 Diabetes -NOTE: normal range: 4-7mmol/L A classification system is used to differentiate various types of diabetes mellitus. You will learn about the 2 most common types of diabetes – type 1 and type 2. 4. Compare the differences between type 1 and type 2 diabetes mellitus by completing the following chart: Characteristics age of onset

Type 1 (insulin dependant – IDDM) -under 20y/o

Type 2 (insulin resistant – NIDDM) -older age – average 50y/o

typical body weight

-lower body weight

-higher body weight

etiologies/risk factors

-sedentary and poor diet -obesity

pathophysiology

-auto immune disease -WBCs view Beta Cells as foreign -unable to synthesize insulin

treatment

-parenteral insulin (for life)

-cells are resistant to insulin -eventually body will stop making insulin -permanent lifestyle changes -diet changes / exercise -anti-diabetic medications (metformin)

5. 5In type 1, there is a deficit of insulin. In type 2, initially insulin is still being produced but the quantity and quality may be diminished and/or not effective in the transport of glucose into the cell. There are typical signs and symptoms of diabetes mellitus, especially apparent in type 1 related to changes in the body due to the onset of the disease. Complete the following chart to help you understand why these changes are happening: Signs and Symptoms

Definition

glycosuria

-glucose in urine

hyperglycemia

High blood glucose levels

polydipsia

Increased thirst

polyphagia

Increased hunger

Explain Why It Occurs -excess glucose in blood stream -too much sugar in blood -increase water loss in urine -b/c kidneys trying to release glucose molecules in blood -body cells starved from

Health Sciences 2 HSCI 10146 Diabetes

polyuria

Increased urination

weakness

weight loss

glucose – b/c glucose stays in bloodstream -kidneys wasn’t to release glucose molecules in blood -lack of energy / stamina -calories are lost from urinary output -calories are lost

Note: is better to have them stay within a range (even if high) – rather than to fluctuate The main diagnostic and monitoring tools for both types of diabetes mellitus are plasma glucose tests. The three most common plasma glucose tests are: a) fasting plasma glucose b) oral glucose tolerance test c) A1C haemoglobin 6. Briefly describe these tests. 7. Identify the normal fasting plasma glucose levels according to the Diabetes Canada 2018 Clinical Practice Guidelines, for: a) a person without diabetes - 7.0mmol/L

The goal in the management of diabetes mellitus is attainment of blood sugar levels which are neither too low (hypoglycemia) or too high (hyperglycemia). Signs and symptoms of hypoglycemia reflect central nervous system impairment and a sympathetic response to stress.

Health Sciences 2 HSCI 10146 Diabetes 8. Complete the following chart comparing the signs & symptoms of hypoglycemia and hyperglycemia: Hypoglycemia 7.0

weak, drowsy, dizzy, pale, nauseated irritable trembling, sweating tachycardia cold, clammy skin feel hungry

WHEN THEY’RE COLD & CLAMMY – THEY NEED SOME CANDY

     

polyuria polydipsia polyphagia blurred vision, poor wound healing frequent infections dry mouth and dry itchy skin

WHEN THEY’RE HOT & DRY – THEY HAVE A SUGAR HIGH

Complications of Diabetes If glucose is unavailable to cells, fats and then proteins are burned for energy. However, extended use of these for energy is inefficient and produces harmful waste products, i.e. ketones from fat catabolism/metabolism – are acidic Severe or prolonged hyperglycemia in type 1 diabetes mellitus may lead to ketoacidosis, which involves a combination of:   

hyperglycemia dehydration secondary to hyperglycemia acidosis secondary to ketone formation from fat metabolism

9. Explain the pathophysiology of ketoacidosis. -cells can’t use sugar – result to using fat catabolism – then proteins -the extended use of fats & proteins as energy – results in harmful waster products -prolonged hyperglycemia – or insufficient insulin / too much glucose just chilling

Health Sciences 2 HSCI 10146 Diabetes -ketones (acid) are produced & build up in bloodstream – pH becomes acidic (normal 7.35-7.45) (acidic...