Mellitus Type 2
SIGNS AND SYMPTOMS
Polyuria(excessive urination)
Polydipsia(excessive thirst)
Tom Hanks Polyphagia(excessive hunger)
Poor wound healing/recurrent infections
Brownish skin thickening of neck and
armpits
Weakness/fatigue
PATIENT EDUCATION
PATHOPHYSIOLOGY
Healthy diet
Physical activity and exercise
Pancreatic cells quit responding to insulin
Signs/symptoms of hypo/hyperglycemia
due to overuse
Oral medications
Decreased sensitivity to insulin
RISK FACTORS Should see ophthalmologist and podiatrist every 6
months
Always keep sugary snack or beverage nearby in
Diet high in fat/sugar case blood sugar levels drop too low
Sedentary lifestyle Insulin(last line)
HTN
Obesity/waist size(BMI >27) **CRITICAL**
Age(>45) HYPOGLYCEMIA HYPERGLYCEMIA
Race/ethnicity(Hispanic, Asian, African
Americans, Native Americans, Pacific
Islanders) HHNS/HHNK
Hyperlipidemia
Low BS: <50-60 mg/dL High BS: >600 mg/dL
PMH of gestational diabetes
DIAGNOSTICS Causes: too much Causes: lack of effective
insulin, too little food, or insulin
excessive exercise Manifestations:
Cholesterol panel(high LDL and low HDL Manifestations: hypotension, dehydration,
levels) sweating, tremors, tachycardia, ketones in
HbA1c test: >6.5% tachycardia, hunger, urine/blood, fruity breath,
Random blood sugar test: >200 mg/dL confusion, HA, seizures, Kussmaul respirations
Fasting blood sugar test: >126 mg/dL LOC, disoriented, death Treatment: rehydrate w/
TREATMENT Treatment: must be isotonic IV fluid, IV
immediate(if pt is continuous infusion of
Metformin: 1st choice(hold before procedure) conscious-> source of regular insulin, reverse
Glipizide & Glyburide: stimulate pancreas to release sugar, unconscious-> acidosis and restore
insulin(slow position changes) subQ or IM 1 mg electrolyte imbalance(don't
Thiazolidinedion(TZD) & Pioglitazone: treats insulin glucagon; 25-50 mL 50% treat initial hyperkalemia->
dextrose solution IV) may lead to hypokalemia)
resistance
Acarbose & Precose: digest food
SIGNS AND SYMPTOMS
Polyuria(excessive urination)
Polydipsia(excessive thirst)
Tom Hanks Polyphagia(excessive hunger)
Poor wound healing/recurrent infections
Brownish skin thickening of neck and
armpits
Weakness/fatigue
PATIENT EDUCATION
PATHOPHYSIOLOGY
Healthy diet
Physical activity and exercise
Pancreatic cells quit responding to insulin
Signs/symptoms of hypo/hyperglycemia
due to overuse
Oral medications
Decreased sensitivity to insulin
RISK FACTORS Should see ophthalmologist and podiatrist every 6
months
Always keep sugary snack or beverage nearby in
Diet high in fat/sugar case blood sugar levels drop too low
Sedentary lifestyle Insulin(last line)
HTN
Obesity/waist size(BMI >27) **CRITICAL**
Age(>45) HYPOGLYCEMIA HYPERGLYCEMIA
Race/ethnicity(Hispanic, Asian, African
Americans, Native Americans, Pacific
Islanders) HHNS/HHNK
Hyperlipidemia
Low BS: <50-60 mg/dL High BS: >600 mg/dL
PMH of gestational diabetes
DIAGNOSTICS Causes: too much Causes: lack of effective
insulin, too little food, or insulin
excessive exercise Manifestations:
Cholesterol panel(high LDL and low HDL Manifestations: hypotension, dehydration,
levels) sweating, tremors, tachycardia, ketones in
HbA1c test: >6.5% tachycardia, hunger, urine/blood, fruity breath,
Random blood sugar test: >200 mg/dL confusion, HA, seizures, Kussmaul respirations
Fasting blood sugar test: >126 mg/dL LOC, disoriented, death Treatment: rehydrate w/
TREATMENT Treatment: must be isotonic IV fluid, IV
immediate(if pt is continuous infusion of
Metformin: 1st choice(hold before procedure) conscious-> source of regular insulin, reverse
Glipizide & Glyburide: stimulate pancreas to release sugar, unconscious-> acidosis and restore
insulin(slow position changes) subQ or IM 1 mg electrolyte imbalance(don't
Thiazolidinedion(TZD) & Pioglitazone: treats insulin glucagon; 25-50 mL 50% treat initial hyperkalemia->
dextrose solution IV) may lead to hypokalemia)
resistance
Acarbose & Precose: digest food
