Presentation about Knowledge and medical and nursing Management , Dm types , clinical features, complications of diabetes mellitus . King Saud university

1. Diabetes Mellitus
Supervisor Dr/ Ahmed Alsadoun
Prepared by / Ohoud Alalawi
May 17, 2022

2. Contents
Introduction
Types of diabetes mellitus
Signs and symptoms of diabetes mellitus
Pathophysiology of diabetes mellitus
Complications of diabetes mellitus
Diagnosis of diabetes mellitus
Medical Management of diabetes mellitus
Nursing Management of diabetic patients
Discharge plane
Reference

3. Introduction
Diabetes mellitus: is a chronic metabolic disorders
charaterised by high level of blood glucose
(hyperglycaemia).
Diabetes mellitus is now one of the most common
disease all over the world. This disease classified as
two types : DM type 1 which is due to insulin
insufficiency and DM type 2 wich is due to insulin
resistance and gestational DM wich is rare and come
withe some female during pregnancy period.
DM affect all body tissues and organs so diabetic
patients com with multiple clinical features involving
many systems.

4. Types of DM

5. DM Type 1
(Insulin dependent
diabetic)
results from failure
of pancreas to
produce insulin
hormone wich is
responsible for
blood glucose
regulation,
- this type onset
suddenly, most
commonly affect
children.

6. DM Type 1
- DM type 1 is
mandatory managed
by insulin therapy.
- The prevalence of
this type is 10% of
diabetic patient.

7. DM Type 2
( insulin independent
diabetes) results
from failure of body's
cells to respond to
insulin hormone
properly
(insulin resistance).

8. DM Type 2
DM Type 2: this type
onset gradully, most
commonly affect adult
person.
This is type managed by
oral drugs or nsulin
therapy when disease
uncontrolled with
previous drugs.
The prevalence of this
type is 90% of diabetic
patient.

9. Comparison of Type 1 and Type 2 DM

10. Symptoms of DM
The classic symptoms of diabetes mellitus are as follows:
* Polyuria ( excessive urination)
* Polydipsia( excessive thrist)
* Polyphagia (strong desire to eat)
* Unexplained weight loss
* Other symptoms may include fatigue, nausea, and
blurred vision.
Symptoms of type 1 DM developed rapidly during weeks or
month, However, many patients with type 2 diabetes are
asymptomatic, and their disease remains undiagnosed for
many years.

12. Pathophysiology of type 1 DM
The main isulin hormone function is to transport of
glucose from blood to body's tissues e.g: fat, muscles.
Insulin hormone produced by beta cells that lies in
langerhans's islets of pancrease and destruction of
insulin-secreting beta cells mass result in declines
insulin secretion until the available insulin is
unadequate to maintain normal blood glucose levels,
hyperglycemia develops and diabetes mellitus
diagnosed.

13. Pathophysiology of type 2 DM
Type 2 diabetes is characterized by peripheral
insulin resistance, which has been attributed
to elevated levels of free fatty acids and
proinflammatory cytokines in plasma, leads to
decreased glucose transport into muscle cells,
elevated hepatic glucose production, and
increased breakdown of fat.

14. Complications of DM
- Macrovascular complications including: increase
risks of cardiovascular diseases e.g:coronary artery
diseases and cerebrovasculare accident.
- Microvascular complications: diabeteic retinopathy,
nephropathy and neuropathy. a vasculopathy
and neuropathy is the leading cause of Diabeteic
Foot and occasionally requiring ambutation.

16. Diagnosis of DM
Diagnostic criteria by the American Diabetes
Association (ADA) include the following:
* A fasting plasma glucose (FPG) level of
126
mg/dL
or higher.
*
2
-
hour plasma glucose level of
200
mg/dL or
higher during a
75
-
tset ecnarelot esoculg laro g
(TTGO)
,
* A random plasma glucose of
200
mg/dL
or
higher
in a patient with classic symptoms of hyperglycemia
or hyperglycemic crisis.

19. Random blood glucose test

20. WHO DIABETES DIAGNOSTIC CRETERIA

21. Medical management of
DM
- Goals of medical management
- Nutritional management
- pharmacological therapy

22. Goals of DM treatment
- Microvascular risk reduction through control
of glycemia and blood pressure
- Macrovascular risk reduction through control
of lipids and hypertension, smoking cessation
- Metabolic and neurologic risk reduction
through control of
hyper-glycemia

23. Nutritional management

24. Pharmalogical therapy
* Exogenous insulin: In type 1 diabetes,
exogenous insulin must be administered for
life because the body loses the ability to
produce insulin.
* Oral antidiabetic agents may be effective for
patients who have type 2 diabetes.

25. Nursing Management of
DM
- nursing assessment
- nursing Diagnosis
- nursing priorities
- nursing interventions

26. Nursing Assessment
- Assess the patient’s history and physical condition,
assess the patient’s blood pressure 'Assess the body
mass index and visual acuity of the patient.
- Perform examination of foot, skin, mouth and
nervous system.
- Laboratory examinations: HgbA1C, fasting blood
glucose, lipid profile, microalbuminuria test, serum
creatinine level, urinalysis, and ECG must be
requested and performed.

27. Nursing Diagnoses
- Risk for unstable blood glucose level
- Risk for infection.
- Risk for disturbed sensory perception
- Impaired skin integrity related to delayed
wound healing.
- Ineffective peripheral tissue perfusion

28. Nursing Priorities
- Restore fluid/electrolyte and acid-base
balance.
- Correct metabolic abnormalities.
- Identify/assist with management of underlying
cause of disease process.
- Prevent complications.
- Provide information about disease process,
prognosis, self-care, and treatment needs.

29. Nursing Interventions
- Educate about home glucose monitoring.
- Discuss how client’s antidiabetic medications
work.
- Check viability of insulin.
- Review type of insulin used.
- Check injection sites periodically

30. Discharge and Home Care
Guidelines
- Simplify the treatment regimen if it is
difficult for the patient to follow.
- Adjust the treatment regimen to meet
patient requests.
- Educate client on wound care, insulin
preparation, and glucose monitoring
- Patient empowerment is the focus of
diabetes education.

32. Reference
- [Guideline] Diagnosis and classification of diabetes
mellitus. Diabetes Care. 2010 Jan. 33 Suppl 1:S62-9.
-American Diabetes Association. Standards of medical
care in diabetes--2012. Diabetes Care
- Complete Nurse’s Guide to Diabetes Care
- Medical-Surgical Nursing: Assessment and Management
of Clinical Problems
- Brunner & Suddarth’s Textbook of Medical-Surgical
Nursing