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1. DIABETES MELLITUS
Ms. Rohini Patil [Bsc Nursing]
Nursing Tutor
P D Bharaesh college of Nursing
belagavi

2. DIABETES MELLITUS
Diabetes Mellitus is a group of metabolic disease in which there are high
blood sugar levels over a prolonged period.
Diabetes is due to either the pancreas not producing enough insulin or the
cells of the body not responding properly to the insulin produced.

3. TYPES OF DM
• 1. Type I Diabetes mellitus [ Insulin dependent DM]
• 2. Type II Diabetes mellitus[Non Insulin dependent DM]
• 3. Type III Gestational Diabetes

4. 1.TYPES I DM –INSULIN DEPENDENT DM
• Also called as a Juvenile diabetes mostly seen is the children.
• Its results from the pancreas failure to produce enough insulin .
• Insufficient insulin
• Exact cause is unknown

5. 2 TYPE II DIABETES MELLITUS[NON
INSULIN DEPENDENT DM]
• Also called as a “ Adult onset diabetes” mellitus mostly seen in
adults above 30 yrs.
• Its condition in which cells fail to respond to insulin properly
• Insulin resistance
• Cause primary is excessive body weight,
Not enough exercise

6. 3 TYPE III GESTATIONAL DIABETES
• Its occurs in pregnant women without a previous history of
diabetes.

7. PATHOPHYSIOLOGY
Due to etiological factors
Decrease insulin secretion
Hyperglycaemia
Increase glucose
in tissue
Increase risk of
infection
Glucose splits in urine
glycosuria
decrease water reabsorption
Polyuria Polydipsia
Decrease glucose available to cells
Fat metabolism
Production of ketone
bodies
Ketoacidosis
Coma
Weight
loss
Hyperlipidaemia
Cardiovascular disease
Heart disease
[cardiopathy]
Kidney damage
[ nephropathy]
Retinopathy
Ulcer and
gangrene

8. CLINICAL MANIFESTATION
POOR WOUND HEALING
RECURRENT INFECTION
POLYPHAGIA
VOMITING
DEPRESSION
NAUSEA
POLYURIA
LETHARGY
BLURRED VISION
HEDACHE
WEAKNESS
 BREATH SMELL OF ACETONE
WEIGHT LOSS
 HPERGLYCEMIA

9. DIAGNOSTIC EVALUATION
• History Collection
• Physical Examination
• Blood Test – Fasting Blood Sugar, Random Blood Sugar,CBC
• Oral Glucose Tolerance Test
• Lipid Profile
• HbA1c [GLYCOSYLATED Hb]
• ECG
• Urine analysis

10. MEDICAL MANAGEMENT
ORAL ANTI-DIABETIC AGENTS
1 1st generation : Tolbutamide 500mg-2000mg/day
:Chloropromide 100- 500 mg/day, od
: Tolasamide 100mg/day, od or bd
[Stimulates beta cell of pancreas to secret insulin.]
2nd generation :Glipizide 2.5 to 40 mg/day ,bd
:Glyburide 1.5 to 12mg/day, bd
[ Increase tissue response to insulin]
3rd generation: Alpha glucosidase inhibitors 75to 100 mg/day
[ Increase tissue response to insulin and decrease production of glucose]

11. INSULIN THERAPY
The administration of synthetically produced
insulin extract
From the pancreas of pigs and cows.
It’s a given to person who do not have
adequate insulin and
Administered through subcutaneously route to
lower blood
Glucose level.

12. Types of insulin
Short acting / Rapid Acting –Humalog , inj Lispro,Actrapid Humulin-s
Intermediate Acting–Lente, Humulin-I, Novolin etc.
Long acting – Lantus ,Levemir, Humulin-U, Humulin-Zn

13. NURSING MANAGEMENT INSULIN THERAPY
• Right dose
• Proper filling insulin in the syringe
• Proper method.
• Safety and storage of insulin
• Timing of insulin
• Patient should not miss meals after taking insulin

14. SITES OF INSULIN THERAPY

15. INSULIN THERAPY PEN

16. NURSING MANAGEMENT
• Assessment of sign and symptoms
• Physical examination
• Monitoring blood glucose level
• Educating about exercise
• Checking feet and legs for skin sensation ,dryness, swealing ,gangrene
• Administering insulin therapy right dose and time
• Caring of wound
• Provide diabetes diet
• Monitoring daily weight and managing weight.

17. DIET MANAGEMENT
• Providing small amount of food for more frequency
• Avoiding more glucose and lipid food
• Provide good glucose and low lipid level diet

18. COMPLICATION DM
• Acute: Hypoglycaemia
: Diabetic ketoacidosis
:Cataract
• Chronic :Retinopathy
:Nephropathy
:Cardiopathy
:Diabetic foot ulcer