1. What is Diabetes? Definition: A disorder of metabolism where the pancreas produces little or no insulin or the cells do not respond to the insulin produced. Glucose, or sugar, builds up in blood, overflows and is lost into urine. Meanwhile the cells are denied their source of energy.

2. Diabetes Mellitus (DM) Diabetes Mellitus affects about 6.3% of the U.S. population (18.2 million people); 5.2 million people are unaware that they have the disease. Diabetes is the 5 th leading cause of death in the U.S.

3. Diabetes

5. How Insulin Moves Glucose to Cells

6. Three Types of Diabetes Type 1 – autoimmune. Immune system attacks and destroys the insulin producing cells of the pancreas. Insulin must be taken daily to survive.  Why does this happen? Genetic, viruses, environment  When does this happen? Mostly children, young adults but can happen at any age.

7. Type 1 Diabetes Video http://www.youtube.com/user/JNJhealth?v=IS So2RfCcmA

8. Three Types of Diabetes Type 2 – most common form. 90-95% of people with DM have this type.  Associated with older age, obesity, lack of physical activity, family history, ethnicity.  80% of people with Type 2 are overweight!  Pancreas produces insulin but body cannot utilize the insulin called insulin resistance. Production also decreased over time.  More gradual onset over several years.

9. Teen’s journey with Type 2 Diabetes http://www.youtube.com/user/lillyhealth?v=h MPc_y5kNpU&feature=pyv&ad=1657425226 0&kw=diabetes

10. Three Types of Diabetes Gestational Diabetes – Some women develop in late pregnancy. Usually disappears after birth of baby.

11. How does this happen? Normally, insulin allows glucose to travel into cells. It acts as the “key” to unlock cells to let glucose in. There, it is used for energy and stored as glycogen. It also stimulates protein synthesis and stores fat in adipose tissue. When people lack the “key” (insulin) to unlock their cells to let glucose in, it builds in the bloodstream.

12. Signs and Symptoms of Diabetes Polyuria – increased urination Polydipsia- increased thirst Polyphagia- increased hunger Weight Loss Extreme Fatigue  If Type 1 not diagnosed a person can lapse into a life-threatening diabetic coma also called diabetic ketoacidosis

13. Hyperglycemia

14. Treatment of Diabetes Exercise Medicine PO/Insulin Diet Control Glucose Monitoring Continuous

15. Glucose Testing - Glucometer May be checked q daily bid qid Make take “Sliding Scale” Insulin doses based on readings Normal Blood Glucose 70-120 Also called blood sugar. Diabetes is fasting (not haven eaten) over 126 or random over 200.

16. Insulin http://www.youtube.com/watch?v=0PX4 R14N68Y

17. Insulin Injection Sites 25G needle, special U- 100 insulin syringes only. Give SQ Sites must be rotated.

18. Insulin Pump

19. Diet Therapy

21. Effects of Diabetes

22. Diabetic Neuropathy – damaged nerves decrease sensation or give dysfunctional sensation especially in lower extremities.

23. Diabetic Retinopathy – leads to blindness.

24. Diabetic Nephropathy-leads to renal failure. Many end up on dialysis.

25. Arteriosclerosis – leads to coronary and peripheral vascular disease. Many will have MI’s and lack of blood flow to extremities.

26. Diabetic Ulcers

28. What is Hypoglycemia? Below normal blood sugar levels  Symptoms include:  Nervousness,  Sweating,  Intense hunger, nausea  Trembling, shaking  Weakness  Palpitations (heart pounding)  Possible trouble speaking  The person needs sugar!!! – cola, OJ, candy…

29. hypoglycemia