4570620
Description
Mind Map by natalieszabat, updated more than 1 year ago
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Created by natalieszabat
about 9 years ago
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Type 1 Diabetes
- Characterized by the destruction of pancreatic beta cells
- Genetic
- Human leukocyte antigen (HLA) types
- HLA DR3
- HLA DR4
- HLA DR3
- Human leukocyte antigen (HLA) types
- Environmental
- Viruses
- Toxins
- Viruses
- Immunological
- Antibodies against islet cells & endogenous insulin
- Antibodies against islet cells & endogenous insulin
- Genetic
- Clinical manifestations
- Polyuria
- Polydipsia
- Polyphagia
- Polyuria
- Assessment & diagnostic findings
- Fasting plasma glucose level (FPG)
- 7.0 mmol/L or more
- 7.0 mmol/L or more
- A1C lab test
- Normal A1C level is below 5.7 percent
- Normal A1C level is below 5.7 percent
- Fasting plasma glucose level (FPG)
- 5 components of diabetes management
- Nutrition
- Exercise
- Education
- 2 main types
- "Survival skills"
- In-depth, advanced continuing education
- "Survival skills"
- 2 main types
- Monitoring
- SMBG 4x daily
- Before meals
- At bedtime
- Before meals
- Urine testing for ketones
- If glucosuria present
- During illness
- In pregnancy
- Persistently elevated glucose levels
- If glucosuria present
- SMBG 4x daily
- Pharmacologic therapy
- Insulin therapy
- Conventional regimen
- Terminally ill
- Frail older adult w/ limited self-care capabilities
- Patients unwilling to engage in self-management activities
- Terminally ill
- Intensive regimen
- Allows for more control over blood glucose levels
- Ineligible candidates
- Nervous system disorders rendering them unaware of
hypoglycemia episodes
- Reoccurring severe hypoglycemia
- Irreversible diabetic complications
- Blindness
- ESRD
- Blindness
- Cerebrovascular and/or
cardiovascular disease
- Ineffective self-care skills
- Nervous system disorders rendering them unaware of
hypoglycemia episodes
- Allows for more control over blood glucose levels
- Conventional regimen
- Insulin therapy
- Nutrition
- Patient characteristics
- Onset any age, but usually young (younger than 30)
- Usually thin at diagnosis
- Onset any age, but usually young (younger than 30)
- Complications
- Acute
- Hypoglycemia (insulin reactions)
- Causes
- Too much insulin
- Too many hypoglycemic agents
- Too little food
- Excessive physical activity
- Too much insulin
- Description
- Blood glucose falls to <2.7-3.3 mmol/L
- Blood glucose falls to <2.7-3.3 mmol/L
- Clinical manifestations
- Mild hypoglycemia
- Sweating
- Tremor
- Tachycardia
- Palpitation
- Nervousness
- Hunger
- Sweating
- Moderate hypoglycemia
- Headache
- Inability to concentrate
- Light-headedness
- Confusion
- Memory lapses
- Slurred speech
- Numbness of lips & tongue
- Combative behaviour
- Impaired coordination
- Emotional changes
- Double vision
- Drowsiness
- Headache
- Severe hypoglycemia
- Disoriented behaviour
- Seizures
- Loss of consciousness
- Difficulty arousing from sleep
- Disoriented behaviour
- Mild hypoglycemia
- Treatment/interventions
- 15g of fast-acting concentrated
source of carbohydrate
- If unconscious/cannot swallow
- 1mg glucagon administered subcutaneously
- 1mg glucagon administered subcutaneously
- If unconscious/cannot swallow
- 15g of fast-acting concentrated
source of carbohydrate
- Causes
- Diabetic ketoacidosis
- Cause
- Absence or markedly inadequate amount of insulin
- Decreased or missed dose
- Illness or infection
- Undiagnosed/untreated diabetes
- Decreased or missed dose
- Absence or markedly inadequate amount of insulin
- Main clinical features
- Hyperglycemia
- Dehydration & electrolyte loss
- Acidosis
- Hyperglycemia
- Signs & symptoms
- Polyuria
- Polydipsia
- Blurred vision
- Weakness
- Headache
- Orthostatic hypotension
- Weak, thready pulse
- GI symptoms
- Anorexia
- Nausea
- Abdominal pain
- Vomiting
- Anorexia
- Kussmaul respirations
- Low pCO2 level
- 10-30 mm Hg
- 10-30 mm Hg
- Low pCO2 level
- Lethargy
- Polyuria
- Diagnostic findings
- Low serum bicarbonate
- 0-15 mmol/L
- 0-15 mmol/L
- Low pH
- 6.8-7.3
- 6.8-7.3
- Low serum bicarbonate
- Prevention
- Teach "sick day" rules
- Teach "sick day" rules
- Medical management
- Fluid resuscitation
- Avoidance of hypokalemia
- Insulin administration
- Avoidance of rapidly falling serum osmolality
- Search for cause
- Fluid resuscitation
- Cause
- Hyperglycemic hyperosmolar nonketotic
syndrome
- Not common in type I diabetes
- Not common in type I diabetes
- Hypoglycemia (insulin reactions)
- Chronic
- Microvascular disease
- Coronary artery disease
- Peripheral vascular disease
- Cerebrovascular disease
- Coronary artery disease
- Microvascular disease
- Retina
- Kidneys
- Retina
- Neuropathy
- Peripheral (sensorimotor) nerves
- Autonomic nerves
- Spinal nerves
- Peripheral (sensorimotor) nerves
- Retinopathy
- Nephropathy
- Microvascular disease
- Acute
- Foot & leg problems
- Neuropathy
- Peripheral vascular disease
- Immunocompromise
- Neuropathy
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