1. What is Type I DM?
    • autoimmune disease
    • Juvenile DM, IDDM (insulin dependent DM). Both terms are no longer used. 
    • Immune disorder response attacks Beta cells-->Loss of Beta cells-->NO insulin
    • Emergent levels ~500-800.
  2. What is type II DM?
    • insulin resistance or insufficiency
    • Adult onset, NIDDM (Non-Insulin-Dependent DM). Again, neither one is really used anymore. 
    • More common than Type 1
    • Obesity, esp abdominal/visceral; genetic
    • Insufficient insulin production &/or poor utilization (e.g. insulin resistance)
    • Emergent levels ~800-1600.
  3. What labs are necessary to diagnose DM?
    • Hgb A1C >6.5
    • FPG >126 mg/dL
    • 2o PG >200 mg/dL 
    • w/classic hyperglycemia (3 Ps & wt. loss), or crisis, random PG >200 mg/dL

    • FPG=Fasting Plasma Glucose
    • 3 P's=Polydipsia, polyurea, polyphagia.
  4. Treatment of DM
    • Lifestyle modification, ie v sugar intake and ^exercise. 
    • Insulin, esp with type I. 
    • Oral agents
    • Prevent/tx complications
  5. SnSs of Type I DM
    • Polyuria, Polydipsia, Polyphagia
    • DKA (Diabetic Ketoacidosis): Hyperglycemia, ketosis, acidosis, dehydration
  6. SnSs of type II DM
    • Nonspecific, asymptomatic, fatigue, and possibly 3p's. 
    • HHS (Hyperosmolar Hyperglycemic Syndrome): Hyperglycemia and severe neurologic changes
  7. What are some Nursing Intervensions for pts w/
    • DKA (type I), HHS/HHSK (hyperosmolar hyperglycemic syndrome/hyperosmolar hyperglycemic nonketotic) syndrome.) 
    • Fluid resuscitation, e-lyte replacement, insulin, glucose
    • Vitals
    • Labs
    • Cardiac monitor
  8. What is the emergency response for hyperglycemia?
    • In emergent situations, it does not matter if pt is hyperglycemic due to type I or type II. Treatment will be the same either way. 
    • Large bore (16-18gauge) IV fluid, ie .9% NS
    • CMP
    • CBC
    • Hbg A1C value
    • Slow IV insulin admin, as glucose levels approach normal, can switch NS to 5DW to help prevent hypoglycemia. 
    • Possibly antibiotic
    • Cardiac monitoring
  9. Possible DM complications
    • Angiopathy (blood vessel damage)
    • Micro/macrovascular damage
    • Diabetic retinopathy
    • Nephropathy
    • Neuropathy
    • Feet/LE 
    • Foot care
  10. Tx for hypoglycemia?
    • Give sugar, ie 15-20 g simple carbs
    • Glucose check
    • Recheck glucose after giving sugar
    • More complex carbs and proteins.
Card Set
Diabetes Melitis Type I and II