1. Diabetes Mellitus Ch 13 ~ Endocrine System Med Term

2. 18.8 million adults & children diagnosed 7.0 million diagnosed 79 million are prediabetic

3. History of the Disease 1500 BC ~ Egyptian physician Hesy-Re described disease with polyuria 1 st century AD ~ described as ‘melting down of flesh & limbs into urine’ Up to 11 th century ~ diagnosed by ‘water tasters’ who tasted the urine of suspected diabetics. Latin for ‘honey’ is ‘mellitus’

4. Dec. 1921 ~ insulin discovered by Dr. F. Banting 1940s ~ advances made in understanding of diabetes and better use of insulin 1950s ~ oral preparations discovered

5. What is diabetes? Chronic disorder characterized by high blood glucose levels Body is not able to utilize insulin to aid with the absorption of glucose into the cells May be due to a deficiency in the amt of insulin or due to the individual’s resistance to their own insulin

6. What is insulin? A hormone secreted by the pancreas Functions to ‘carry’ glucose through the cell wall so the cell can produce energy Released after a meal when glucose is absorbed into the bloodstream

7. What is normal blood sugar? Narrow range of 70 – 110 mg/dl of blood BS naturally remains elevated aprox. 2 hrs after a meal or drink then returns to normal

8. Signs & Symptoms of DM If insulin is deficient and sugars in blood are not utilized by the cells for energy then the following S&S will appear: Extreme fatigue Blurred vision Polyuria *dehydration * polydipsia Polyphagia Unexplained weight loss Slow healing

9. Types of Diabetes Type I Diabetes ~ (insulin deficiency) * it’s all about lack of insulin * formerly known as ‘juvenile diabetes’, an autoimmune insulin deficiency * treated with insulin (injected), diet, exercise

10. Etiology of Type I * autoimmune onset triggered by an event such as viral illness * insulin in not produced in type I

11. Type I Signs & Symptoms Extreme weakness/fatigue Extreme thirst - dehydration (polydipsia) Increased urination (polyuria) Abd. Pain N & V Blurred vision Slow healing wounds Mood changes Amenorrhea Unexplained weight loss

12. Treatment of Type I DM Obtaining ideal body wt. Close monitoring of blood sugar levels Following a diabetic diet with prescribed calories (16 cal/lb per day) Regular exercise Insulin injections

13. Type II Diabetes Formerly known as ‘adult onset diabetes’ Usually develops in middle age but more children & young adults are now susceptible Associated with insulin resistance or lack of insulin Usually hereditary tendency

14. Predisposed by obesity & hi caloric intake As obesity rates increase in the US, the diabetic rate increases in ALL age groups

15. Type II Signs & Symptoms Come on more gradually than Type I Polyphagia Polydipsia Polyuria Weight loss Extreme fatigue Slow healing

16. Treatment of Type II DM Diet Exercise Oral hypoglycemic agents Insulin (injections, pump)

17. Long Term Complications of Diabetes Mellitus Chronic elevated blood sugars →→ Microvascular Complications due to atherosclerosis →→ arteriostenosis →→ Coronary artery diseasediabetic retinopathy Chronic kidney diseasediabetic neuropathy

18. Complications cont Slow wound healing Decreased ability to fight infection Decrease sensation leads to increased injury

19. Diabetic Foot Ulcers

20. Gestational Diabetes Cause is unknown; probably insulin resistance Mother not using available insulin Hyperglycemia apparent at aprox. 28 weeks Extra glucose from mother crosses placental barrier

21. Baby can’t utilize all the extra glucose and stores it as fat. Baby likely to be higher birth weight May be complications at birth due to ↑ size

22. Gestational Diabetes Babies of mothers with GD may have ‘macrosomia’ Higher risk of obesity as they grow Moms with GB at higher risk of developing DM as they get older

23. Diabetic Testing Blood sugars = finger sticks FBS = done with pt. fasting and at least 2 hrs postprandial Hemoglobin A1C = measures average bld sugars for past 2-3 months