DISEASE/CAUSE RISK FACTORS PATHOPHYSIOLOGY SIGNS AND

SYMPTOMS
DIAGNOSTIC TEST TREATMENT MEDICAL MGT NURSING MGT
DIABETES type II

Causes

About 90% to 95%
of patients with
diabetes have type
2 diabetes.

It results from a
decreased
sensitivity to insulin
(insulin
resistance)or from a
decreased amount
of insulin
production.

Type 2 diabetes is
rst treated with
diet and exercise,
and then with oral
hypoglycemic
agents as needed.
African, American
Indian, Asian,
Hispanic, and
Pacific Islander
descent.
whites usually
develop type 2
diabetes after the
age of 40,
Type 2 diabetes
tends to occur at
an earlier age in
nonwhite
populations,
and about 25% of
the diabetes that
occurs in youth in
nonwhite
populations is type
2.
Type 2 diabetes
mellitus is a chronic
disease caused by one
or more of the
following factors:

impaired insulin
production,
inappropriate
hepatic glucose
production,
or peripheral
insulin receptor
insensitivity.

Genetic factors are
significant, and onset is
accelerated by

obesity and a
sedentary lifestyle.
Again, added stress
can be a pivotal
factor.

polyuria and
polydipsia due to
high serum
osmolality caused
by high serum
glucose levels
anorexia (common)
or polyphagia
(occasional)
headaches, fatigue,
lethargy, reduced
energy levels, and
impaired school
and work
performance due
to low intracellular
glucose levels
muscle cramps,
irritability, and
emotional lability
due to electrolyte
imbalance
vision changes,
such as blurring,
due to glucose-
induced swelling
numbness and
tingling due to
neural tissue
damage
abdominal
discomfort and
pain due to
autonomic
neuropathy,
causing
gastroparesis and
constipation
nausea, diarrhea,
or constipation due
to dehydration and
24 hours apart,
using the same test
twice or any
combination:
Fasting Plasma
Glucose level of
126 mg/dl or more
on at least two
occasions
typical symptoms
of uncontrolled
diabetes and
random blood
glucose level of 200
mg/dl or more
blood glucose level
of 200 mg/dl or
more 2 hours after
ingesting 75 g of
oral dextrose.

Diagnosis may also be
based on:
diabetic
retinopathy on
ophthalmologic
examination
urinalysis for
acetone and
glycosylated
hemoglobin
(reflects
glycemic control
over the past 2 to 3
months).
Oral Antidiabetic
Drugs to stimulate
endogenous insulin
production,
increase insulin
sensitivity at the
cellular
level,suppress
hepatic
gluconeogenesis,
and delay GI
absorption of
carbohydrates
(drug combinations
may be used)

Exogenous Insulin,
alone or with

Oral Antidiabetic
Drugs, to optimize
glycemic control.

The main goal of
diabetes treatment is to
normalize insulin
activity and blood
glucose levels to reduce
the development of
vascular and
neuropathic
complications.
Providing Patient
Education

Diabetes mellitus is a
chronic illness that
requires a lifetime of
special self-
management
behaviors. Nurses play
a vital role
in identifying patients
with diabetes, assessing
self-care skills,
providing basic
education, reinforcing
the teaching provided
by the specialist, and
referring patients for
follow-up care afte
discharge.















Source: brunner and
sudsarths medical surgical
nursing 12
th
edition &
Handbook of
Pathophysiology (January
15, 2001): by Springhouse
electrolyte
imbalances or
autonomic
neuropathy.