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

2. Boston Globe – 10/27/2005 21 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.

3. 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.

4. 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

5. 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

6. 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

7. 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

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

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

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

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

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

13. 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

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

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

16. S&S of Type 1 DM Polydipsia – Excessive thirst

17. S&S of Type 1 DM Polyphagia – Excessive hunger

18. S&S of Type 1 DM Dehydration

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

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

22. 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.

23. 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?