1. Diabetes Mellitus
Nursing Management

2. Characteristics of Type I and II
Type II
More common in youth
Abrupt onset
Absent or minimal insulin
Thin, catabolic state
Thirst, polyuria, polyphagia, fatigue, weight loss
Prone to ketosis
Nutritional therapy essential
Insulin required for all
Frequent vascular and neurologic complications
35 yoa or older
Insidious
Insulin resistance
Obese or possibly normal
Frequently none, fatigue, recurrent infections
Ketosis resistant except during infection or stress
Nutritional therapy essential
Insulin required for some
Frequent vascular and neurologic complications

3. Insulin Therapy Types of insulin Insulin regimens
Mealtime insulin
Long acting basal insulin
Combination therapy
Problems with insulin therapy
Allergic reactions
Lipodystrophy
Somogyi effect and dawn phenomenon

4. Drug Therapy: Oral Agents
Sulfonylureas
Meglitindes
Biguanides
Alpha glucosidase inhibitors
Thiazolidinediones (glitazones)

5. Nutrition Therapy
Type I: Meal planning is based on usual food intake and balanced with insulin and exercise patterns
Type II: Emphasis is based on achieving glucose, lipid and blood pressure
Food composition
Carbs: 50%
Protein: 20% or less
Fats: 30%

6. Metabolic Complications
DKA
HHNS
Hypoglycemia