Predisposing factors: Age Race Obesity Diet Family History of DM Family History of HPN

Predisposing factors: Drinking alcohol Smoking Physical inactivity Pregnancy Stress

Insulin resistance or insufficient insulin secretion

Body compensates by further

insulin production

Insulin production

Hyperinsulinemia

Stimulation of beta-cells

Stimulation of alpha cells

Hyperglucagonemia

Inhibition of Insulin production

Production of Glucagon

Exhaustion of alpha and beta cells

Increased Blood glucose level

Protein utilization

Glucose utilization

Glucoheogenesis

CHON metabolism

Chronic elevation of blood glucose

Urea

Cellular starvation

Renal gluco threshold

e Muscle wasting Further in blood glucose Polyphagia Uric acid production Urea

Excretion of glucose in th urine

Weight loss Fatigue

Nausea & vomiting

Osmotic pressu

Reabsorption of wate electrolytes Sluggish blood flow Polyuria Hypoperfusion Fluid loss

Cellular dehydratio

Immune system

Eyes

Brain

Kidneys

Delayed wound healing

Affects retinal vein

Blurring of vision

Blockage in the minute capillaries

Damaged nephrons

Fibrosis Diabetic Peripheral Neuropathy Blockage in the optic nerve Decreased LOC

Diabetic Neuropathy Opacity of the lens

Diabetic Nephropathy

Cataract

Diabetic Retinopathy

EXAMINATIONS

Laboratories: 1. CBC 2 CBG 3. Glycosylated hemoglobin A1c 4. Urinalysis 5. Oral Glucose Tolerance Test (OGTT)-

Diagnostic: 1. Ultrasound 2. Opthalmologic examination

Diagnosis: DIABETES MELLITUS

MANAGEMENT

Medical Management: 1. Medications Insulin Oral Hypoglycemic agents 2. IV fluids

Surgical Management: 1. Transplant pancreatic cells 2. Amputation of

Nursing Management:

Administer medication Monitor VS, I & O Careful monitoring of blood glucose level Individualized meal plan to meet nutritional needs, with 50%CHON, 30%Fats, 20%CHO Weight reduction by exercise or regular physical activity program Psychological assessment to determine the impact of the disorder on the patient and family Stress the importance of complying with the prescribed treatment program, necessary lifestyle modifications such as improving food selection, increasing physical activity and smoking cessation. Meticulous foot care. Urge the patient to have regular ophthalmologic examinations to detect diabetic retinopathy. Stress the importance of regular screenings: FBS, Kidney (BUN and Creatinine) Need for self-examination of the skin including injection site.

PROGNOSIS

IF TREATED: 1. Good compliance of meds. 2. Good financial support 3. Good family support

IF NOT TREATED: 1. Poor compliance of meds. 2. Poor financial support 3. Poor family support

IF NOT TREATED

Chronic and uncontrolled elevation of blood glucose level

Damaged glomerulus

Acute Renal Failure Hyperosmolar Hyperglycemic Non-Ketotic Coma

Chronic Renal Failure

DEATH