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Diabetes Mellitus - Coggle Diagram
Diabetes Mellitus
Diabetes Mellitus
TYPE 1
CAUSED BY
Exposure to a virus
Genetic predisposition (human leukocyte antigens (HLAs)) (Lewis & Dirkson, 2019).
WHAT HAPPENS?
A virtual absence of endogenous insulin occurs in type 1 diabetes (Lewis & Dirkson, 2019).
Progressive destruction of pancreatic B- cells by body’s own T cells (Lewis & Dirkson, 2019).
Autoantibodies cause a reduction of 80% to 90% in normal B-cell function before manifestations occur (Lewis & Dirkson, 2019).
Accounts for approximately 5% to 10% of all people with diabetes (Lewis & Dirkson, 2019).
TYPE 2
The presence of endogenous insulin is the major distinction between both types (Lewis & Dirkson, 2019).
Pancreas continues to produce some endogenous insulin (Lewis & Dirkson, 2019).
Insulin being produced is insufficient or is poorly utilized by tissues (Lewis & Dirkson, 2019).
4 major metabolic abnormalities
1. Insulin resistance
Results in hyperglycemia
Body tissues do not respond to insulin (Lewis & Dirkson, 2019).
Insulin receptors are either unresponsive or there are not many of them
2. Pancreas ability to produce insulin decreases
β cells fatigued from compensating (Lewis & Dirkson, 2019).
β-cell mass lost (Lewis & Dirkson, 2019).
3. Inappropriate glucose production from liver (Lewis & Dirkson, 2019).
The liver does not stay consistent in regulating release of glucose (Lewis & Dirkson, 2019).
4. Alteration in production of hormones and adipokines (Lewis & Dirkson, 2019).
Play a role in glucose and fat metabolism (Lewis & Dirkson, 2019).
Diabetes Mellitus
NURSE WILL
Provide medical identification bracelet for clients at risk for injury
Teach the client to problem solve
Refer client to a diabetes treatment and teaching program (DTTP) for training in flexible intensive insulin therapy and dietary freedom
Collaborate with the client to identify strengths such as the ability to relate the facts and to recognize the source of stressors
Encourage moderate aerobic exercise as appropriate
Diabetes Mellitus
PATIENT WILL
Actively participate in management of diabetes regimen
Have few or no hypoglycemic or hyperglycemic episodes
Maintain blood glucose at normal levels
Adjust lifestyle to accommodate diabetes mellitus regimen without stress
Avoid tobacco use
Use community and church settings as a forum for advocacy, teaching, and program implementation
NURSING CARE CONSIDERATIONS
Be knowledgeable of diabetic’s risk for infection, shock, impaired skin integrity, dysfunctional gastrointestinal motility, vision loss, unstable blood glucose levels, pressure ulcer development, and hemorrhage
Monitor for patient’s complications and risk factors
Assess client’s sociocultural backgrounds in teaching self-management and self-regulation
Nurses must collaborate with patients to identify successful coping strategies
Identify cultural beliefs, values, lifestyle practices, and problem-solving strategies when assessing the client’s level of self-care
PERTINENT GOALS AND INTERVENTIONS
Control blood glucose by medication/insulin
Skin care & foot care
Cut toenails straight across
Inspect feet daily
Regulate cholesterol levels
Control blood pressure
Provide patient teaching
Medication adherence importance
Assess client’s sociocultural backgrounds in teaching self-management and self-regulation
Nurses must collaborate with patients to identify successful coping strategies
Refer overweight clients to dietitian for weight loss counseling
Watch for age-related cognitive changes that can impair self-management of diabetes
Provide culturally appropriate diabetes health education, and literacy-appropriate education for self-care activities