Diabetes Mellitus Type II

Description

Mind Map on Diabetes Mellitus Type II, created by oliviayinli on 03/03/2016.
oliviayinli
Mind Map by oliviayinli, updated more than 1 year ago
oliviayinli
Created by oliviayinli almost 9 years ago
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Resource summary

Diabetes Mellitus Type II
  1. Pathophysiology
    1. Risk Factors
      1. Pre-diabetes
        1. Impaired glucose tolerance (IGT)
          1. 2h OGTT: 7.8-11.1 mmol/L (ADA, 2004)
          2. Impaired fasting glucose (IFG)
            1. FPG 5.6-6.9 mmol/L (ADA, 2004)
          3. Genetics
            1. Obesity
              1. Aging
                1. Metabolic Syndrome (Grundy et al., 2004)
                  1. Dyslipidemia
                    1. Abdominal obesity
                  2. Diagnosis
                    1. CLINICAL MANIFESTATIONS
                      1. MANAGEMENT
                        1. PHARMACOLOGICAL
                          1. Insulin
                            1. Preparations
                              1. rapid-acting: peak 1.5-2.5h
                                1. short-acting (regular): peak 2-4h
                                  1. Intermediate (NPH - cloudy): peak 6-8h
                                    1. Long-acting: no peak
                                    2. Admin
                                      1. self-admin
                                        1. subcutaneous
                                          1. abdomen, buttocks, thigh, deltoid
                                            1. rotate injection sites
                                          2. intravenous
                                        2. Oral Anti-hyperglycemic Agents
                                          1. α-glucosidase inhibitors
                                            1. mech: slow carb digestion
                                            2. DPP-4 inhibitors
                                              1. mech: slow incretin hormone inactivation
                                              2. Biguinides (i.e. metformin)
                                                1. FIRST-LINE OHA TREATMENT! (Nathan et al., 2009; Inzucchi et al., 2012)
                                                2. Thiazolidinediones
                                                  1. mech: decrease insulin resistance
                                                  2. sulphonylureas
                                                    1. metglitinides
                                                      1. mech: increase insulin production by β cells
                                                  3. STRESS MANAGEMENT (Surwit et al., 2002)
                                                    1. Muscle Relaxation
                                                      1. Cognitive Behavioural
                                                        1. Recognizing stressors
                                                          1. Guided imagery
                                                        2. EXERCISE
                                                          1. 150 min/week moderate intensity
                                                            1. Mechs
                                                              1. ↓ blood glucose
                                                                1. ↑ insulin sensitivity
                                                                  1. weight loss
                                                                2. NUTRITION
                                                                  1. Diet Teaching
                                                                    1. Personalized diet planning (Inzucchi et al., 2012)
                                                                      1. Fat <7% of daily intake
                                                                        1. Carbs < 10% of daily intake from sucrose
                                                                          1. Protein: 15-20% of daily intake
                                                                      2. Nursing Considerations
                                                                        1. Nursing Process
                                                                          1. 1. Assessment
                                                                            1. Learning needs, motivation and the ability to learn
                                                                              1. Physical history
                                                                                1. BMI, height, weight, vital signs
                                                                                  1. Current medication
                                                                                    1. Past surgical procedure
                                                                                      1. History of infection
                                                                                      2. Lifestyle
                                                                                        1. Stress
                                                                                          1. Exercise
                                                                                        2. 2. Plan
                                                                                          1. Determine goals and expected outcome with the patient
                                                                                            1. Setting priorities
                                                                                              1. Learning objectives
                                                                                                1. Selecting teaching methods
                                                                                              2. 3. Implementation
                                                                                                1. Home care
                                                                                                  1. Importance of medication adherence
                                                                                                    1. Travel
                                                                                                      1. Adequate medication
                                                                                                        1. Diabetic medical bracelet
                                                                                                      2. Health promotion
                                                                                                        1. Patient education
                                                                                                          1. Diet
                                                                                                            1. Define the disease
                                                                                                              1. Purposeful factiities that can control the disease
                                                                                                                1. Self monitoring blood glucose
                                                                                                                  1. Important resources
                                                                                                              2. 4. Evaluation
                                                                                                                1. Patient understanding
                                                                                                                  1. Up-to-date immunizations
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