Diabetes mellitus



Diabetes mellitus





Description



  • Chronic disease of absolute or relative insulin deficiency or resistance


  • Type 1 diabetes mellitus: most common childhood endocrine disorder


  • Type 2 diabetes mellitus: rising incidence due to childhood obesity and sedentary lifestyles



Pathophysiology



  • Diabetes mellitus is characterized by disturbances in carbohydrate, protein, and fat metabolism.


  • Insulin:



    • Allows glucose transport into the cells for use as energy or storage as glycogen.


    • Stimulates protein synthesis and free fatty acid storage in adipose tissues.


    • Deficiency compromises the body tissues’ access to essential nutrients for fuel and storage.


  • Two primary forms:



    • Type 1, characterized by absolute insulin insufficiency.


    • Type 2, characterized by insulin resistance with varying degrees of insulin secretory defects.


Causes



  • Autoimmune factors (type 1)


  • Genetic factors


  • Viral infection


  • Risk factors (type II): family history, obesity, sedentary lifestyle, hypertension, and dyslipidemia


Assessment findings



  • Polyuria


  • Polydipsia


  • Polyphagia


  • Nocturia


  • Weight loss and hunger


  • Weakness and fatigue


  • Dehydration



    • Dry mucous membranes


    • Poor skin turgor


  • Vision changes



    • Retinopathy or cataract formation


    • Possibly leading to blindness


  • Frequent skin and urinary tract infections



  • Skin changes



    • Dry, itchy skin (especially on the hands and feet)


    • Cool temperature


  • Numbness or pain in the hands or feet


  • Postprandial feeling of nausea or fullness


  • Nocturnal diarrhea


  • Decreased peripheral pulses


  • Diminished deep tendon reflexes


  • Orthostatic hypotension


  • Characteristic “fruity” breath odor in ketoacidosis


  • Possible hypovolemia and shock in ketoacidosis and hyperosmolar hyperglycemic state


  • Type 1 specific

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Jul 20, 2016 | Posted by in NURSING | Comments Off on Diabetes mellitus

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