Eldridge H.

Esmalde, RN
Body does not make or properly use insulin:
– no insulin production
– insufficient insulin production
– resistance to insulin’s effects

No insulin to move glucose from blood into cells:

– high blood glucose means:
 fuel loss. cells starve
 short and long-term complications

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• Type 1 diabetes is a chronic (lifelong) disease
that occurs when the pancreas produces too
little insulin to regulate blood sugar levels
appropriately.

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 occur at any age, but it usually
starts in people younger than 30.
ONSET: Symptoms are usually severe and
occur rapidly.
• increased thirst •vomiting
• increased urination •abdominal pain
SYMPTOMS: •fatigue
• weight loss despite •absence of
increased appetite
menstruation
• nausea
CAUSE: uncertain, likely both genetic and
environmental factors

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• Visit your physician and/or diabetes educator.
• Have your glycosylated hemoglobin (HbA1c)
measured.
• Have your cholesterol and triglyceride levels and
kidney function evaluated.
• Visit your ophthalmologist.
• Every 6 months have a thorough dental cleaning
and examination.
• Monitor your feet every day.
• Stay up-to-date with all of your vaccinations.

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Emergency Complications
1. DIABETIC KETOACIDOSIS
2. HYPOGLYCEMIA
Long-term Complications
1. VASCULAR DISEASE
2. MICROVASCULAR DISEASE
3. EYE COMPLICATIONS
4. DIABETIC NEPHROPATHY (KIDNEY DISEASE)
5. DIABETIC NEUROPATHY(NERVE DAMAGE)
6. DIABETIC FOOT PROBLEMS
7. SKIN AND MUCUS MEMBRANE PROBLEMS

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• Type 2 diabetes is a chronic, life-long disease
that results when the body's insulin does not
work effectively. Insulin is a hormone released
by the pancreas in response to increased levels
of blood sugar (glucose) in the blood.

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 ONSET: usually occurs gradually.

•frequent and/or
• increased thirst slow-healing
• increased urination infections (including
SYMPTOMS: • increased appetite bladder, vaginal,
• Fatigue skin)
•erectile dysfunction
• blurred vision in men

CAUSE: a problem in the way your body makes or

uses insulin.

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• Fasting blood glucose level
• Random (non-fasting) blood glucose level
• Oral glucose tolerance test

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• SOME SKILLS TO LEARN
• SELF-TESTING
• DIET AND WEIGHT CONTROL
• REGULAR PHYSICAL ACTIVITY
• MEDICATION
• FOOT CARE
• CONTINUING CARE

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• Emergency Complications:
1. include diabetic coma.
• Long-term Complications:
1. diabetic retinopathy (eye disease)
2. diabetic nephropathy (kidney disease)
3. diabetic neuropathy (nerve damage)
4. peripheral vascular disease (damage to blood
vessels/circulation)
5. high cholesterol, high blood pressure,
atherosclerosis, and coronary artery disease

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• Blood glucose check
• Maintain a healthy body weight and keep an
active lifestyle

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Eldridge H. Esmalde, RN
Any condition that causes swelling or a change
in position of the tissue within the carpal
tunnel can squeeze and irritate the median
nerve. Irritation of the median nerve in this
manner causes tingling and numbness of the
thumb, index, and the middle finger – this is
the “carpal tunnel syndrome.”

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A condition where sensory nerve that passes
through the tarsal tunnel is irritated by
pressure in the tunnel, numbness and tingling
of the foot and the toes can be felt. This is
analogous to, but far less common, than the
carpal tunnel syndrome.

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Numbness and tingling of the hand/ankle.

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• Examination of the neck, shoulder, elbow,
pulses, and reflexes. (Phalen’s maneuver)
• Electromyogram (EMG)
• Blood Test

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Eldridge H. Esmalde, RN
• Meniere’s Disease is a disorder of the inner ear
that can affect hearing and balance to a
varying degree. It can range from being a mild
annoyance to a chronic, lifelong disability.
• It is idiopathic.

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• Endolymphatic fluids bursts from its normal
channels in the ear, causing damage to the
area.
• Membranous labyrinth in the ear containing
endolymph dilate and blocked the drainage.

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• Increased prevalence of migraine.
• Presence of a middle ear infection, head trauma, or an
upper respiratory tract infection, triggered by using
aspirin, smoking cigarettes, and drinking alcohol.
• Presence of:
• Cogan’s syndrome
• Autoimmune disease of the inner ear
• Dysautonomia
• Perilymph fistula
• Multiple sclerosis
• Acoustic neuroma
• Hypo- and hyperthyroidism

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• Complaints from patients
• Patients’ medical history
• Otolaryngological examination
• Audiometry
• Head MRI scan

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Because Meniere’s Disease cannot be cured,
treatments focus more on treating and
preventing symptoms.

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• Lipoflavonoids
• Environmental and dietary changes
• Treatments aimed at lowering of the inner ear
includes:
– Antihistamines
– Anticholinergics
– Steroids
– Diuretics
• Acyclovir (antiherpes virus drug)
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• Antihistamines
• Antiemetic drugs
• Antivertigo/antianxiety
• Herbal remedies
• Cannabis

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• Nondestructive Surgery
– Do not actively remove any functionality.
– Chemical labyrinthectomy

• Destructive Surgery
– Irreversible
– Involve entire functionality of most, if not all, of the
affected ear.
– Labyrinthectomy
– Vestibular neurectomy

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