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13520717
Type 1 Diabetes
Description
Type 1 Diabetes Mind Map by Chantalee Dunkley and Ashley Prasad
Mind Map by
Ashley Prasad
, updated more than 1 year ago
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Created by
Ashley Prasad
over 6 years ago
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Resource summary
Type 1 Diabetes
Assessment
Symptoms
Polyuria
Polydipsia
Polyphagia
Weight loss/gain
Fatigue and Weakness
Irritability
Mood changes
Blurred Vision
Erectile dysfunction in men
Risk Factors
Family History
Age
Increased likelihood childhood (ages 4-7) and adolescence (ages 10-14)
May occur in adulthood
Geography
Type 1 Diabetes incidence increase in region further away from equator
Etiology
No tolerance to self-antigens expressed in the islets of Langerhans
Autoimmune destruction of 80-90% of Beta cells
Insulin is no longer released by the beta cells
Increased blood glucose levels
Exposure to a virus
Genetics
Diagnosis
Glycated Hemoglobin (AC1 Test)
A1C level of 6.5 or more on two separate tests
Shows amount of glucose attached to hemoglobin molecule
Diagnostic test
Random Blood Sugar
Result of 11 mmol/L or greater and symptoms of diabetes
Fasting Plasma Glucose
normal: 5.6mmol/L prediabetes: 5.6 to 6.9 mmol/L diabetes: 7 mmol/L
Oral Glucose Tolerance Test
Two-hour OGTT level ≥11.1 mmol/L
Treatment
Drug therapy
Insulin Injections
Rapid Acting (Bolus)
Lispro
Onset: 10- 15 minutes Peak: 1-2 hours Duration: 3- 4.75 hours
Aspart
Onset: 9- 20 minutes Peak: Apart 1-1.5 Hours Duration: 3.5 hours
Intermediate Acting (Basal)
Onset: 1-3 hours Peak: 5-8 hours Duration: Up to 18 hours
Long Acting
Onset: 90 minutes Duration: 16 to 42 hours dependent on the drug No peak action
Short Acting (Bolus)
Onset: 30- 60 mins Peak: 2- 3 hours Duration: 6.5 hours to 24 hours
Problems with insulin therapy
Hypoglycemia
Lipodystrophy
Allergic reactions
Continuous Subcutaneous Insulin Infusion Therapy (CSIIT)/ Insulin Pump
Manually monitor glucose
Catheter inserted subcutaneously in abdomen, lower back, leg and arm
Convenient, small, accurate, adjustable
Closed Loop
Continuous glucose monitors (CGM) linked to insulin pump
Help monitors hypoglycemia
CGM’s can alert user when blood glucose level is above or below normal level
Delivers insulin when needed
Dependant on current glucose monitor readings
Treatment Complication
Bioinstability
Sensors can become unstable due to inflammatory and granuloma reaction
Lag time of 4-10 minutes for CGM’s blood glucose reading
Healthy Lifestyle
Nutritional Therapy
Nutritious low-fat high-fibre foods
Glycemic Index (GI)
Consume foods with lower GI (e.g. complex carbohydrates)
Sweet Potato
Carrots
Fats
Reduce saturated and trans-fat in diet; include food rich in omega-3 fatty acids
Balance with insulin and exercise patterns
Count Carbohydrates to identify the amount of insulin needed to metabolize it
Exercise
Regular Individualized physical activity
Increase of insulin receptor sites
Decreases blood glucose level
Monitor blood glucose level
Best done after meals
Aerobic exercise 150 minutes/week
Swimming
Walking
Maintain healthy weight
Other Treatment
Islet-cell Transplantation
Transplant new insulin-producing cells from donor pancreas
Treatment Complication: Islet cell rejection
Minimally invasive
Lower Morbidity
Pancreas Transplant
Greatest risk of complications
Chronic graft rejection
Pseudocyst
Fistula
Thrombosis
Pancreatitis
Gene Transfer using viral/non-viral vectors
Transform cells to have insulin secretory machinery
Stem Cell Transplant
Stem cells convert to beta cells to release insulin
Treatment Complication: Rejection of cells
Complications
Cardiovascular Diseases
Stroke
Heart Attack
Neuropathy
Nerve damage in legs & gastrointestinal tract
Nerve damage leading to erectile dysfunction
Nephropathy (Kidney Disease)
Kidney blood vessels damaged leading to kidney failture
Treatment
Dialysis
Kidney transplant
Increased susceptibility to bacterial and fungal infections (i.e. gum disease)
Retinopathy (Eye Damage)
Blindness
Pregnancy Complications
Ketoacidosis
Profound Insulin deficiency
Characteristics: Hyperglycemia Ketosis Acidosis Dehydration
Causes
Illness/Infection
Inadequate insulin dosage
Poor self-managemnt
Undiagnosed Type 1 Diabetes
The deficiency in insulin releases hormones that wouldn't otherwise be released, increasing the level of glucose.
Symptoms
Frequent urination
Excessive thirst
Confusion
Shortness of breath
Abdominal pain
Nausea and vomiting
Body produces high amount of ketones (blood acids)
Anxiety
Hypoglycemia
Low blood sugar
Blood glucose level <4 mmol/L
Treatment
Nursing Care
Monitor Physical Activity
Physical activity plus insulin causes blood sugar level to decrease significantly
Eat fewer carbohydrates
Avoid Skipping Meals
Manifestations
Diaphoresis
Hunger
Headache
Fatigue
Tremors
Irritability
Rapid irregular heart rate
Dizziness
Confusion
Somogyi Effect
Rebound hyperglycemia after Nocturnal hypoglycemia due to Stress hormones being released
By Chantalee Dunkley and Ashley Prasad
Media attachments
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