Quick Facts – Diabetes

Here are some quick study facts about Diabetes:

 

Diabetes:

  • Diabetes mellitus is a chronic multisystem disorder of glucose metabolism related to absent or insufficient insulin supplies, impaired utilization of insulin, or both.

 

  • Current theories link diabetes to genetic, autoimmune and environmental factors.

 

  • Type 1 diabetes mellitus most often occurs in people who are under 30 years or age, a with a peak onset between ages 11 and 13, but can occur at any age.

 

  • Type 1 diabetes is the end result of a long-standing process where the body’s own T cells attack and destroy pancreatic beta cells, which are the source of the body’s insulin.

 

  • Because the onset of type 1 diabetes is rapid, the initial manifestations are usually acute.

 

  • The classic symptoms – polyuria, polydipsia, and polyphagia are caused by hyperglycemia and the accompanying spillover of excess glucose in the urine.

 

  • The individual with type 1 diabetes requires a supply of insulin from an outside source, such as an injection, in order to sustain life.

 

  • Without insulin, the patient will develop diabetic ketoacidosis (DKA), a life-threatening disorder resulting in metabolic acidosis.

 

  • Prediabetes is a condition in which blood glucose levels are higher than normal but not high enough for a diagnosis of diabetes.

 

  • Those with prediabetes will usually develop type 2 diabetes within 10 years if no preventative measures are taken.

 

  • Long-term damage to the body especially the heart and blood vessels may already be occurring in patients with prediabetes

 

  • Type 2 diabetes, the pancreas usually continues to produce some endogenous (self-made) insulin. However, the insulin that is produced is either insufficient for the needs of the body and/or is poorly used by the tissues.

 

  • The most important risk factor for developing type 2 diabetes are more nonspecific, and include fatigue, recurrent infections,recurrent vaginal yeast or monilia infections, prolonged wound healing, and visual changes.

 

  • Gestational diabetes develops during pregnancy and is detected at 24-28 weeks of gestation, usually following an oral glucose tolerance test.

 

  • Although most women with gestational diabetes will have normal glucose levels within 6 weeks postpartum they are more at risk for developing type 2 diabetes in 5-10 years.

 

  • a diagnosis of diabetes is based on one of three methods: fasting plasma glucose level, random plasma glucose measurement, or 2 hour or oral glucose  tolerance test.

 

  • The glycosated hemoglobin test (HbA1c) is useful in evaluating long-term glycemic levels. The American Diabetes Association (ADA) recommends keeping the AiC level below 7%.

 

  • The goals of diabetes management are to reduce symptoms, promote well-being, prevent acute complications of hyperglycemia, and prevent or delay the onset and progression of long-term complications. These goals are most likely to be met when the patient is able to maintain blood glucose levels as near to normal as possible.

 

  • Exogenous (injected) insulin is needed when a patient has inadequate insulin to meet specific metabolic needs.

 

  • Insulin is divided into two main categories: short-acting (bolus) and long-acting (basal) insulin.

 

  • Basal insulin is used to maintain a background level of insulin throughout the day; bolus insulin is used at mealtime to combat postprandial hyperglycemia and at bedtime.

 

  • A variety of insulin regimens are recommended for patients depending on the needs of the patient and their preference.

 

  • Routine administration of insulin is most commonly done by means of subcutaneous injection, intravenous administration of regular insulin can be done when an immediate onset of action is desired.

 

  • The technique for insulin injections should be taught to new insulin users and reviewed periodically with long-term users.

 

  • The speed with which peak serum concentrations are reached varies with the anatomic site for injection. The fastest absorption is form the abdomen.

 

  • Continuous subcutaneous insulin infusion can be administered using a insulin pump, a small battery operated device that resembles a standard paging device in size and appearance.

 

  • An insulin pump is programmed to deliver a continuous infusion of short-acting insulin 24 hours a day with boluses at mealtimes.

 

  • Hypoglycemia, allergic reactions, lipodystrophy, and Somogyi effect are problems associated with insulin therapy.

 

  • Lipodystrophy (atrophy of subcutaneous tissues) may occur if the same injection sites are used frequently, but the incidence is reduced with the use of human insulin.

 

  • The Somogyi effect is a rebound effect in which an overdose of insulin induces hypoglycemia.

 

  • Usually occurring during the hours of sleep the Somogyi effect produces a decline in blood glucose level in response to too much insulin.

 

  • The dawn phenomenon is characterized by hyperglycemia that is present on awaking on the morning resulting from the release of counter-regulatory hormones in the predawn hours.

 

  • Oral agents (OAs) are not insulin; they work to improve the mechanisms by which insulin and glucose are produced and used by the body.

 

  • Metformin (Glucophage) is a biguanide glucose-lowering agent.

 

  • Alcohol is high in calories, has no nutritive value, and promotes hypertriglyceridemia.

 

 

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Author
Anna Curran. RN, BSN, PHN

Anna Curran. RN, BSN, PHN
Clinical Nurse Instructor

Emergency Room Registered Nurse
Critical Care Transport Nurse
Clinical Nurse Instructor for LVN and BSN students

Anna began writing extra materials to help her BSN and LVN students with their studies and writing nursing care plans. She takes the topics that the students are learning and expands on them to try to help with their understanding of the nursing process and help nursing students pass the NCLEX exams.

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