Diabetes Mellitus:

Diabetes is a metabolic disease in which blood glucose level increases as compared to the normal range and abnormality of insulin hormone.

Normal range of blood glucose 

• fasting -70-110mg/dl
• 2 hours after a meal - Less than 140mg/dl 

Characteristics of diabetes 

• hyperglycemia 
• polyuria
• polydipsia
• polyphagia 

TYPES OF DIABETES:- There are mainly two types of Diabetes Mellitus.

1. IDDM (Insuline depended  Diabetes Mellitus, Type 1st)
2. NIDDM(Non-insulin depended Diabetes Mellitus,type2nd)

PRODUCTION OF INSULIN:- 

•  Insulin is a hormone made by the pancreas
• There are special cells in the pancreas named islets of Langerhans.
• Langerhans are made from a different cell, insulin secretes from beta-cell

    The functions of Insuline:-

• Transportation & metabolism of glucose for energy
• Stimulation of the storage of glucose in the liver
• Signals the liver to stop the release of glucose 

 

1. IDDM:- It is also known as juvenile diabetes because it is diagnosed in childhood. In this type of diabetes beta cells of the pancreas don't produce insulin. In this type of diabetes, a patient needs an insulin injection. 

       2. NIDDM:- It is the 2nd type of diabetes. In this type of diabetes, the beta cell produces insulin that is not enough to metabolize the glucose. The main risk factor of NIDDM is obesity, in this type of diabetes patients don't need insulin injections, it can be treated by oral hypoglycemic agents or changes in dietary patterns.

    Signs and symptoms of diabetes:-

• Hyperglycemia
• polyphagia 
• polydipsia
• polyuria
• glycosuria
• foully smell from mouth 
• blurred vision
• hypovolemia
• fatigue
• dry skin
• abdominal pain
• nausea
• vomiting

Diagnostic Tests:-

• fasting & after-meal blood glucose analysis
• HBA1C 
• RPG ( Random plasma glucose)
• GTT(glucose tolerance test)

MANAGEMENT  OF DIABETES:-

• Pharmacological treatment:- 

1. Insulin therapy:- insulin therapy is for those patients who have been diagnosed 1st type of diabetes.it is administrated in the subcutaneous layer. the commonest site for administering insulin is the abdominal because in the abdominal area because subcutaneous tissues are found in very large amounts and from there it gets easy to absorb in the blood fastly.

• Types of insulin:- 
• .Rapid-acting insulin - it has a concept for only 10-15min
• Short-acting insulin-It is also known as crystalline zone insulin. It injected 30min before taking the meal. It concept approx 2to 3 hours
• Intermediate action insulin- It is also known as "Insuline R" onset of action of this is 3to 4 hours  
• Long-acting insulin- It is also known as Peak 101 Insuline. It absorbs in 68 hours and makes effective to 20-30 hours 
• Insulin doses-     0.5unit/kg/day

            

     2. Oral hypoglycemic agents:-  OHA is given to a patient who is diagnosed with type                                                                        2nd diabetes. EXAMPLE- Metformine, glynase20, etc

    3. Dietary changes:- By taking some changes in diet can also help to reduce blood sugar levels. For that, you can eat low-fat food and a sugar-free diet. 

  4. Exercises:- For diabetes patients it's important to do some lite exercise to reduce blood                                             glucose level 

Nursing Diagnosis of Diabetes Mellitus:-

• Risk of hypovolemia R/T excessive urination, polyuria
• Risk of hypotension R/T low sodium retention 
• Risk of diabetes keto acidosis R/T Decrease insuline production
• Impaired nutritional level R/T Polyphagia
• Risk of injury by falling at night R/T blurred vision 
• Anxiety and fear R/T Alteration in health status