Diabetes Mellitus: General information CDC 14.7 million Americans diagnosed (2004) Est. 5 million not diagnoses

Boston Globe – 10/27/ million Americans have diabetes, CDC says WASHINGTON -- Almost 21 million Americans have diabetes, most of them the type-2 variety associated with poor diet, too little exercise, and being overweight, the Centers for Disease Control and Prevention said yesterday.

Boston Globe – 10/27/2005 This represents about 7 percent of the population -- and more than 6 million of these people do not know they have the condition, the CDC said in a statement.

Boston Globe – 10/27/2005 ''Another 41 million people are estimated to have pre-diabetes, a condition that increases the risk of developing type-2 diabetes -- the most common form of the disease -- as well as heart disease and stroke," the CDC said

Diabetes Mellitus: 6 th leading cause of death in US 3 rd leading cause of death by disease Assoc. with many complication Heart disease is the leading cause for a diabetic 65% of diabetics have hypertension

Diabetes Mellitus: Risk of heart attack or stroke 3 times great if you have DM DM leading cause of blindness in adults DM leading cause of new cases of renal failure 50% of all people with non-traumatic leg amputation have DM

Diabetes Mellitus: DM shortens peoples life span DM creates disabilities DM is an economic burden 12% of all health care expenditures are for diabetic care/treatment Seen in all age groups and races 1/3 of diabetics are over the age of 60

What is diabetes mellitus? Group of disordered characterized by chronic hyperglycemia Due to faulty insulin production (Not Diabetes Insipidus)

Classification of Diabetes Type 2 – Adult onset – Non-insulin dependent diabetes mellitus (NIDDM) Type 4 – Gestational Diabetes Mellitus

Type 1 – Diabetes Mellitus Old names – Juvenile diabetes – Insulin dependent diabetes mellitus (IDDM) Destruction of the Beta cells Result – NO insulin production – Insulin dependent

Etiology Type 1 DM #1: Auto-immune disease #2: Idiopathic Genetic susceptibility

Function of Insulin Need insulin for glucose to cross cell membrane No insulin  no glucose in the cell Glucose stays in the blood

S&S of Type 1 DM Hyperglycemia –↑ blood glucose levels – No insulin  – Glucose stays in the blood stream What effect does insulin have on glycogen? – Inhibits the conversion of glycogen to glucose

S&S of Type 1 DM Glycosuria – Glucose in the urine

S&S of type 1 DM Polyuria – Osmotic diuresis Nocturia – Urinating during the night Nursing diagnosis – Fluid Volume Deficit

S&S of Type 1 DM Polydipsia – Excessive thirst

S&S of Type 1 DM Polyphagia – Excessive hunger

S&S of Type 1 DM Dehydration

S&S of Type 1 DM Ketonuria – No insulin – Burn fats – Byproduct  ketones – ↑ ketone in the blood – Metabolic Acidosis

– Liver can not excrete all of the ketones  – spill into the urine  – Ketonuria

Small Group Questions 1.Why would a person with high glucose levels have polyphagia? 2.Explain why polyuria is a common symptom of diabetes Mellitus Type 1. 3.What is hyperglycemia? 4.Why does hyperglycemia happen in Type 1 diabetes mellitus? 5.Explain why Ketonuria occurs in uncontrolled diabetics.

Small Group Questions 6. What is a normal level for a FBS, 2h-PPG and GTT? 7. Define the following terms: Glucose, glycogen, glucagon, Glycogenolysis, Glycogenesis, Glycosuria. 8. What does an Hgb A1c measure? What are normal values for a diabetic and non- diabetic?