Human Body structure: diabetes mellitus

DIABETES MELLITUS

DESCRIPTION:

Diabetes mellitus is a chronic disorder of impaired carbohydrate, protein, and lipid metabolism caused by a deficiency of insulin.
An absolute or relative deficiency of insulin results in hyperglycemia.
Type 1 diabetes mellitus is a nearly absolute deficiency of insulin (primary beta cell destruction); if insulin is not given, fats are metabolized for energy, resulting in ketonemia (acidosis).
Type 2 diabetes mellitus is a relative lack of insulin or resistance to the action of insulin; usually, insulin is sufficient to stabilize fat and protein metabolism but not carbohydrate metabolism.
obesity is a major risk for diabetes mellitus.
diabetes mellitus can lead to chronic health problems and early death as a result of complications that occur in the large and small blood vessels in tissues and organs.
Male erectile dysfunction can also occur as a result of this disease.

ASSESSMENT:

DIET:

The diabetic client's diet should take into account weight, medication, activity level, and other health problems.
Day-to-Day consistency in timing and amount of food intake helps to control the blood glucose level.
As prescribed by the doctor, the client may be advised to follow the recommendations of the American Diabetic Association diet or U.S. dietary guidelines issued by the U.S. departments of Agriculture and Health and Human services.
Carbohydrate counting may be a simpler approach for some clients; it focuses on the total grams of carbohydrates eaten per meal. The client may be more compliant with carbohydrate counting, resulting in better glycemic control; it is usually necessary for clients undergoing intense insulin therapy.
Incorporate the diet into individual client needs, lifestyle, and cultural and socioeconomic patterns.

EXERCISE:

Exercise lowers the blood glucose level, encourages weight loss, reduces cardiovascular risks, improves circulation and muscle tone, decreases total cholesterol and triglyceride levels, and decreases insulin resistance and glucose intolerance.
Instruct the client in dietary adjustments are individualized.
If the client requires extra food during exercise to prevent hypoglycemia, it need not be deducted from the regular meal plan.
If the blood glucose level is higher than 250 mg/dL (14.2 mmol/L) and urinary ketones (type 1 diabetes mellitus) are present, the client is instructed not to exercise until the blood glucose level is closer to normal and urinary ketones are absent.
The client should try to exercise at the same time each and should exercise when glucose from the meal is peaking, not when insulin or glucose lowering medications are peaking.
Insulin should not be injected into an area of the body that will be exercised following injection, as exercise speeds absorption.
Instruct the client with diabetes mellitus to monitor the blood glucose level before, during and after exercising.

INSULIN:

Insulin is used to treat type 1 diabetes mellitus and may be used to treat type 2 diabetes mellitus when diet, weight control therapy, and oral hypoglycemic agents have failed to maintain satisfactory blood glucose levels.
Illness, infection, and stress increase the blood glucose level and the need for insulin; insulin should not be withheld during times of illness, infection, or stress because hyperglycemia and diabetic ketoacidosis can result.
The peak action time of insulin is important to explain to the client because of the possibility of hypoglycemic reactions occuring during this time.
Regular insulin (U-100 strength) can be administered via IV injection (IV push). Regular insulin (U-100) and the short duration insulin. (lispro, aspart, and glulisine) can be administered via IV infusion.
Insulin increases glucose transport into cells and promotes conversion of glucose to glycogen, decreasing serum glucose levels.
Oral anti diabetic agents act in a number of ways; stimulate the pancreas to produce more insulin, increase the sensitivity of peripheral receptors to insulin, decrease hepatic glucose output, delay intestinal absorption of glucose, enhance the activity of incretins, and promote glucose loss through the kidney.