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Unfolding Comprehensive Gero Assessment Pathophysiology Map, Type 2…

- - - - HDL level less than or equal to 35 mg/dL
        
        triglyceride level greater than or equal to 250 mg/dL
        
        Metabolic Syndrome
        
        Body Mass Index (BMI) of greater than 26
  - - - Hypertension
        
        History of cardiovascular disease
        
        Older adult
        
        PCOS
- - - - Impaired insulin production by the pancreas plays a role in hyperglycemia, leading to the inability of cells to use glucose as energy. Effective management of diabetes means utilizing strategies to replace insulin levels and restoring regular glucose metabolism.
        
        If the cells are unable to access glucose to use as energy- this leads a person's body to feel fatigued and lethargic because of their "lack of fuel". If this condition is left untreated, then eventually hyperglycemia can progress to diabetes mellitus- which is a chronic metabolic disorder characterized by persistent high blood sugar levels, which then leads to more complications down the road as well.
        
        Complications that can occur because of improper care of diabetes mellitus over time include cardiovascular complications, neuropathy, kidney disease, vision problems, skin infections, mental health problems, and more.
        
        Cardiovascular complications that can occur because of untreated diabetes mellitus over time include coronary artery disease, peripheral artery disease, myocardial infarction, and stroke, Hyperglycemia damages the body's blood vessels over time, therefore restricting adequate blood flow to the body's organs.
        
        Neuropathy is common in patients with progressed diabetes mellitus, because the high blood sugar levels over time can wear out the blood vessels- which causes numbness, tingling, lack of sensation, pain, and weakness. This condition then poses a threat of falls, injury, ulcers, and impaired ability to tend to ADLs related to immobility of diabetic neuropathy. This also puts the patient with diabetes at greater risk for infection because they are more likely to develop open foot ulcers than most- stressing the importance of daily foot care is very important in management of this diagnosis.
    - - This causes the body to become less responsive to insulin which can result in hyperglycemia. Since cells are not effectively taking up glucose
        
        Impaired insulin processing and insulin resistance play a factor in hyperglycemia by causing irregularities in normal glucose metabolism, ultimately leading to various metabolic and physiological disturbances in patients with diabetes.
      - This also causes an increase insulin production initially. Which can lead to Hypoglycemia where the body has too much insulin and not enough glucose. This initially happens because the pancreas is trying to compensate for insulin resisting by producing more insulin to try and keep the blood sugar lower although over time the pancreas cannot keep up with the over production which then leads to the high blood sugar and an insulin deficiency. .
        
        Untreated hypoglycemia can lead to blurred vision, difficulty swallowing, altered mental status, confusion, slurred speech and numbness due to there being no energy for the brain to work. Glucose is the primary source of energy for the brain and the CNS. So that being said when a patient is hypoglycemic the brain doesn't receive that energy which then leads to those complications.
  - - - Atherosclerosis is caused by type two diabetes by the way diabetes accelerates not only the development but also the progression of the disease. Hyperglycemia being a leading mechanism because if a patient had a high blood sugar then it can promote advance formation of glycation end products which are harmful compounds that accumulate in tissues overtime like plaque.
        
        Hypertension: This is caused from type 2 diabetes by many factors. One being the Hyperinsulemia. This is a compensatory response to insulin resistance. With this being said when the pancreas tries to compensate for the missing it has effects on the cardiovascular system. Some of these effects are increasing sympathetic nervous system activity, increasing sodium retention by the kidneys, and stimulating the release of vasoconstrictor hormones such as angiotensin II which is directly related to blood pressure. When these effects happen in the body, it can lead to increased vasoconstriction and fluid retention which increase the blood pressure.
        
        CVA: This is caused by type 2 diabetes due to the man other complications that can arise such as atherosclerosis, hypertension, hyperglycemia, hypercoagulability, A fib, diabetic nephropathy, diabetic retinopathy. When there is impaired renal function which leads to impaired blood pressure regulation it increases the risk of sudden loss of blood flow to a part of a brain which results in a CVA.
    - - Kidney Disease: uncontrolled diabetes can cause damage to the blood vessels and the nephrons and can cause them to not function properly
        
        Eye diseases (cataracts, glaucoma, damage to the blood vessels of the retina, blindness)
        
        Bacterial and Fungal infections causing skin conditions.
      - Foot Ulcers: This can be caused by type two diabetes by peripheral neuropathy which is seen in many diabetic patients. This affects the nerves in peripheral places of the body and high blood sugar levels are what causes the damage. This neuropathy reduces the patients ability to have sensation in these extremities meaning that they could be wearing the wrong size shoes, or have a blister or a minor cut and not even feel it which can develop into a food ulcer.
        
        Infection: Foot ulcers can lead to infection due to the open wound and exposure to bacteria if not taken care of properly and/or when discovered
        
        Sepsis: Sepsis can be a complication from infected foot ulcers because of the close exposure to the blood stream. Especially when a patient has diabetes they struggle to heal foot ulcers because of the high blood sugar causing the thickening of blood and slowing of white blood cells to travel to the site. When the ulcer is infected and slow to heal and also exposed to the bloodstream, then causing bacteria to enter the bloodstream=sepsis
        
        Foot deformities
    - - Hearing impairment: high blood sugars can lead to damage in small blood vessels in the inner ear
        
        Sleep Apnea: there can be a lot of underlying conditions that may cause sleep disorders but it is thought to be found that diabetes effects the central respiratory control
        
        Dementia: diabetes can cause apoptosis which is a types of cell death, this can occur in the hippocampus which can increase the risk for the development of dementia
    - - Shock: if you do not get the blood sugar under control the patient can go into a shocked state where the body shuts down because it does not know how to process all the extra glucose
        
        Blood clot formation: Diabetes increases the risk of plaque buildup in the arteries, and the plaque continues to accumulate and can grow large enough to greatly reduce the blood flow through an artery. When this plaque formation becomes hard and brittle or inflamed, it may rupture and can cause a blood clot to form. A clot has the potential to further narrow the artery or even completely block it.
        
        Cerebral edema
  - - - This leaves the cells starving to for energy, starving for sugar. Leading them to breakdown fat for energy in the absence of glucose.....this leads to Diabetic Ketoacidosis.
- - - - Diabetic Diet
        
        Demonstrate an understanding of how to properly inject insulin