1. Alisa Foote
SDSU School of Nursing
10/14/11

2. Topics Diabetes Diabetic Emergencies Pathology & Insulin Interventions
Type I vs Type II
Signs & Symptoms
Interventions
Diabetic Emergencies

3. Facts 25.8 million people have DM. 7th leading cause of death
8% of US population.
7th leading cause of death
Leading cause of kidney failure, non-traumatic amputations, blindness.
Major cause of heart disease, stroke and nerve system damage.
$174 billion dollars (2007)
215,000 people under 20 lived with DM in 2010.

4. Definition Diabetes is:
Disease characterized by poorly regulated blood sugars
Caused by problem in insulin production, insulin action or both.
Not contagious
Definition

5. Insulin Insulin is: Hormone
Causes cells in the liver, muscles and other tissues to uptake glucose from the blood.
Allows our cell to eat and have energy for work.
Necessary to sustain life
Insulin

6. Unfortunately our cells can’t “eat” without the help of insulin.
Blood Sugar
Blood sugar is the “food” our bodies use to provide energy to our cells. -
Unfortunately our cells can’t “eat” without the help of insulin.

7. Types
Diabetes
Type 1
Insulin Dependent
Type 2
Non-insulin Dependent
Can often be minimized with Diet and Exercise
Note: there are other types of diabetes but they are either rare or conditional. If interested for more information!

8. Type 1 People’s bodies produce little to no insulin
Insulin Dependent
AKA Juvenile Diabetes
Body produces little to no insulin
Sudden onset
Usually seen in the young
Not weight related.
People’s bodies produce little to no insulin
Usually an autoimmune reaction
T-cells destroy pancreatic beta cells
Insulin is given through a pump or injection
Risk factors: autoimmune, genetic or environmental
Often has a trigger
Not preventable

9. Islets of Langerhans

10. Type II
People’s bodies either do not produce enough insulin or their bodies do not use it properly.
Often starts with usage problem  quantity problem as demand increases.
Risk factors: Age, weight,
lifestyle, medical history
Can be managed by
insulin, diet, exercise;
most often combo!
Not insulin dependent.
AKA Adult- onset DM.
90-95% of cases
DIET and EXERCISE help!

11. Common Symptoms

12. 3 “P’s”
Polydipsia
Polyuria
Polyphagia

13. Insulin Types Type Onset (h) Peak action (h) Rapid
Insulin lispro (Humalog) ¼ - ½ ½- 1 ¼
Insulin asparte (NovoLog) ¼ - ½ ½ -1 ¼
Short
Regular ½
Intermediate
NPH (isophane)
Long
Insulin glargine (Lantus)
Insulin Types

14. Pharmaceutical Treatment
DIET and EXERCISE can significantly DECREASE the need for insulin in people with DMII. Many people can STOP using insulin if they change their diet and exercise routine.

15. Diabetic Food Pyramid

16. Can be reversed with food.
Hypoglycemia
Blood sugar below 70 mg/dL.
Causes: no food, too much medicine or exercise
Onset: sudden, can progress to insulin shock
What to do?
Test blood sugar
Eat a snack: Milk, orange juice, crackers or yogurt are good choices.
Contact doctor if symptoms get worse or there is a change in consciousness.
Low blood sugar
< 70 mg/dL
Sudden onset
Can be reversed with food.
Call 911 if person starts acting really “strangely” or stops responding.

17. Hypoglycemia

18. Hyperglycemia Blood sugar elevated, often considered above 200 mg/dL.
High blood sugar
Often considered >200 mg/dL
Gradual onset.
Need insulin to reverse.
Call 911 if person starts acting really strangely or stops responding.
Blood sugar elevated, often considered above 200 mg/dL.
Causes: too much food, too little medicine, illness or stress
Onset: gradual, can progress to diabetic coma
What to do?
Test blood sugar
Take sliding-scale insulin dose
Recheck blood sugar
Call 911 if medical emergency.
Conditions: DKA (ketones present, bs>250, tx: insulin), HHNK (No ketones, dehydration, bs > 600, tx: fluids, insulin.)

19. Hyperglycemia

20. If a diabetic emergency is suspected; CALL 911!!!!