Type 1 Diabetes Mellitus Type 2 Diabetes Mellitus
Acute Gradual
Autoimmune dysfunction Progressive
Destruction of beta cells that produce insulin Inability of cells to respond to insulin
Pancreas doesn’t make insulin Non-insulin dependent
Insulin dependent Insulin resistant
Mostly thin Body doesn’t use insulin effectively or
doesn’t produce enough
HYPOGLYCEMIA HYPERGLYCEMIA
“cold & clammy, need a candy” “hot & dry, sugar is high”
Low blood glucose < 70 High blood glucose > 250
Cold/clammy skin Polyuria ( urination)
Numbness of fingers, toes, mouth Polydipsia ( thirst)
HR/Palpitations Polyphagia ( hunger)
Irritable Hot & dry skin
Headache Weakness
Tremors/Nervousness/Shakiness Fatigue
Dizziness Headache
Faintness Glycosuria
Unsteady gait Nausea
Lack of coordination Vomiting
Hunger Abdominal cramps
Sweating Blurry vision
Blurry vision Fruity breath
Seizures Progression to DKA or HHS
Coma
, DIAGNOSTIC TESTS LAB TESTS
Self-Monitored Glucose Test (SMBG) Fasting Blood Glucose
Check accuracy of strips with the control solution Postpone antidiabetic medication until after levels are drawn
Use the correct code # in the meter to match strip bottle number Fast (no food or drink other than water) for the 8 hr. prior to blood test
Store strips in closed container in dry location Oral Glucose Tolerance Test
Obtain an adequate amount of blood sample when doing test Not used for routine diagnosis
Use appropriate hand hygiene A fasting blood glucose level is drawn at the start of the test
Use fresh lancets and avoid sharing equipment to prevent infection Client is then instructed to consume a specific amount of glucose
Keep a record of the SMBG (time, date, serum glucose level, insulin dose, Blood glucose levels are obtained Q 30 min for 2 hrs.
food intake, and other events that can alter glucose metabolism, such as Assess for hypoglycemia throughout the procedure
activity level or illness) Instruct client to consume a balanced diet for 3 days prior to test
Then instruct the client to fast for 10-12 hrs. prior to test
Only water may be taken during the testing period
Food or other liquids will affect the test results
Glycosylated hemoglobin (HbA1c)
Expected range: 4% to 6%
An acceptable range for diabetes: 6.5% to 8%, with a target goal of < 7%
Best indicator of the average blood glucose level for the past 120 days
It assists in evaluating treatment effectiveness & compliance
Recommended quarterly or twice yearly depending on the glycemic levels
Urine Ketones
Medical emergency
ketones in the urine = Hyperglycemia (> 300)
Diagnostic for diabetes include 2 findings (on separate days) of at least 1 of the following:
Manifestations of diabetes + Casual blood glucose concentration > 200 (without regard to time since last meal)
Fasting blood glucose > 126
2-hr glucose > 200 with oral glucose tolerance test
Glycosylated hemoglobin (A1C) > 6.5%
Acute Gradual
Autoimmune dysfunction Progressive
Destruction of beta cells that produce insulin Inability of cells to respond to insulin
Pancreas doesn’t make insulin Non-insulin dependent
Insulin dependent Insulin resistant
Mostly thin Body doesn’t use insulin effectively or
doesn’t produce enough
HYPOGLYCEMIA HYPERGLYCEMIA
“cold & clammy, need a candy” “hot & dry, sugar is high”
Low blood glucose < 70 High blood glucose > 250
Cold/clammy skin Polyuria ( urination)
Numbness of fingers, toes, mouth Polydipsia ( thirst)
HR/Palpitations Polyphagia ( hunger)
Irritable Hot & dry skin
Headache Weakness
Tremors/Nervousness/Shakiness Fatigue
Dizziness Headache
Faintness Glycosuria
Unsteady gait Nausea
Lack of coordination Vomiting
Hunger Abdominal cramps
Sweating Blurry vision
Blurry vision Fruity breath
Seizures Progression to DKA or HHS
Coma
, DIAGNOSTIC TESTS LAB TESTS
Self-Monitored Glucose Test (SMBG) Fasting Blood Glucose
Check accuracy of strips with the control solution Postpone antidiabetic medication until after levels are drawn
Use the correct code # in the meter to match strip bottle number Fast (no food or drink other than water) for the 8 hr. prior to blood test
Store strips in closed container in dry location Oral Glucose Tolerance Test
Obtain an adequate amount of blood sample when doing test Not used for routine diagnosis
Use appropriate hand hygiene A fasting blood glucose level is drawn at the start of the test
Use fresh lancets and avoid sharing equipment to prevent infection Client is then instructed to consume a specific amount of glucose
Keep a record of the SMBG (time, date, serum glucose level, insulin dose, Blood glucose levels are obtained Q 30 min for 2 hrs.
food intake, and other events that can alter glucose metabolism, such as Assess for hypoglycemia throughout the procedure
activity level or illness) Instruct client to consume a balanced diet for 3 days prior to test
Then instruct the client to fast for 10-12 hrs. prior to test
Only water may be taken during the testing period
Food or other liquids will affect the test results
Glycosylated hemoglobin (HbA1c)
Expected range: 4% to 6%
An acceptable range for diabetes: 6.5% to 8%, with a target goal of < 7%
Best indicator of the average blood glucose level for the past 120 days
It assists in evaluating treatment effectiveness & compliance
Recommended quarterly or twice yearly depending on the glycemic levels
Urine Ketones
Medical emergency
ketones in the urine = Hyperglycemia (> 300)
Diagnostic for diabetes include 2 findings (on separate days) of at least 1 of the following:
Manifestations of diabetes + Casual blood glucose concentration > 200 (without regard to time since last meal)
Fasting blood glucose > 126
2-hr glucose > 200 with oral glucose tolerance test
Glycosylated hemoglobin (A1C) > 6.5%
