NURSES RESEARCH PUBLICATION DIABETES MELLITUS

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Nurses Research Publication for Continuing Education

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NURSES RESEARCH PUBLICATION jklzxcvbnmqwertyuiopasdfghjklzxcvbnmDqwIAertByuEioTpaEsdSfghMjklEzxLcvLbnImTqUweSrtyuiopasdfghjklzxcvbnmqwertyuiopasdf

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Author: Deborah Brown, R.N., BSN Copyright? Nurses Research Publications

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NURSES RESEARCH PUBLICATION

DIABETES MELLITUS

HOW TO USE THIS COURSE

Thank you for choosing Nurses Research Publication home study for your continuing education. This course may be completed as rapidly as you desire. However there is a one-year maximum time limit.

If you have downloaded this course from our website you will need to log back on to pay and complete your test. After you submit your test for grading you will be asked to complete a course evaluation and then your certificate of completion will appear on your screen for you to print and keep for your records. Satisfactory completion of the examination requires a passing score of at least 70%. No part of this course may be copied or circulated under copyright law.

Instructions:

1. Read the course objectives. 2. Read and study the course. 3. Log back onto our website to pay and take the test. If you have already paid for the

course you will be asked to login using the username and password you selected when you registered for the course. 4. When you are satisfied that the answers are correct click grade test. 5. Complete the evaluation. 6. Print your certificate of completion.

If you have a procedural question or "nursing" question regarding the materials, call (510) 888-9070 for assistance. Only instructors or our director may answer a nursing question about the test.

Thank you again for choosing our course

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NURSES RESEARCH PUBLICATION

DIABETES MELLITUS

TABLE OF CONTENTS

How to Use This Course

2

Course Objectives

4

Chapter I Introduction to Diabetes Mellitus

5

Chapter II Diabetes Mellitus

8

Chapter III Laboratory Tests and Monitoring

20

Chapter IV Insulin and Oral Antidiabetic Agents

25

Chapter V The Diabetic Diet

41

Chapter VI Diabetic Foot and Wound Conditions and Treatment 55

Chapter VII Complications of Diabetes Mellitus

59

Chapter VIII The Family and Diabetes

72

Chapter IX Coping With Diabetes

75

References

77

Course Test

79

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NURSES RESEARCH PUBLICATION

DIABETES MELLITUS

COURSE OBJECTIVES

At the end of this course, each nurse will be able to:

1. Define diabetes mellitus as a genetically determined disorder of metabolism.

2. Identify the manifestations of insulin deficiency and the inability to tolerate carbohydrates.

3. Identify diabetes mellitus in its completely developed state characterized by fasting hyperglycemia, microangiopathic and arteriosclerotic vascular disease and neuropathy.

4. Identify the various types of lesions that may lead to insulin insufficiency.

5. Discuss and identify insulin as a hormone that regulates the amount of glucose in the blood.

6. Identify and discuss Type I, Type 2, and Gestational diabetes and their respective goals.

7. Identify the factors that increase the risk of diabetes.

8. Identify the factors in the development of DKA and its treatment.

9. Discuss the pathogenesis of diabetic ketoacidosis.

10. Identify the pathophysiology of hypersosmolar coma and its treatment

11. Identify and discuss hypoglycemia.

12. Identify the laboratory procedures used in the diagnosis and treatment of diabetes mellitus.

13. Identify the different types of insulin and their use.

14. Understand blood sugar monitoring and blood sugar fluctuations.

15. Identify oral hypoglycemic agents and their use.

16. Identify the diabetic diet as a well-balanced meal plan tailored to the individual needs, tastes, activity level and life-style.

17. Understanding the variety of complications associated with diabetes mellitus and their treatment.

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NURSES RESEARCH PUBLICATION

DIABETES MELLITUS

CHAPTER I INTRODUCTION TO DIABETES MELLITUS

INTRODUCTION

Diabetes is a condition that affects the way the body uses food. A genetically determined disorder of metabolism, it is manifested by insulin deficiency and the inability to tolerate carbohydrates.

Diabetes in a completely developed state is characterized by Fasting hyperglycemia Microangiopathic and arteriosclerotic vascular disease Neuropathy

The incidence of diabetes is high, with more than 16 million Americans having some form of the disease. More than 700,000 new cases are diagnosed each year.

The term diabetes covers a wide spectrum of disability ranging from the elderly, a symptomatic individual with glucose intolerance, to the young patient dependent on exogenous insulin.

The manifestation of diabetes mellitus can be divided into two main groups: The acute diabetic syndrome characterized by hyperglycemia, ketoacidosis, and if untreated, death. The chronic diabetic characterized by diffuse microangiopathy involving vital tissue.

Diabetes has a heterogeneous etiology. Different types of lesions may lead to insulin insufficiency along with environmental factors, causing an alteration in the function and integrity of the beta cells in the pancreas. The factors include pregnancy, diet, obesity, and infective agents such as the mumps virus.

THE ROLE OF INSULIN

Insulin is a hormone produced by the pancreas. The pancreas either produces no insulin, too little insulin, or the body does not respond to the insulin produced. This causes a build-up of glucose in the blood, creating high glucose levels in the body since the body is unable to utilize the glucose for energy. This high concentration of glucose in the blood is called hyperglycemia.

During the normal digestive process, the body converts food into glucose to be used by the body's cells as an energy source.

Foods eaten are made of carbohydrates, proteins, and fats. These foods are broken down to provide fuel for the cells, which are converted into glucose, a simple sugar.

Glucose enters the cells through receptor sites that accept insulin, which facilitates the passage of glucose to the cell. Excess glucose is stored in the liver and muscles in the form of glycogen. When the body is low on fuel and the blood sugar is low, glycogen, stored in the liver, is released

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