Diabetes Mellitus

Prepared by:

Dumpa, Baylon, Shi, Abueva, Gulfan

What is Diabetes Mellitus 2 (DM 2)

– Type 2 diabetes is a lifelong disease that keeps your body from using insulin the
way it should. People with type 2 diabetes are said to have insulin resistance.
– Type 2 diabetes, the most common type of diabetes, is a disease that occurs
when your blood glucose, also called blood sugar, is too high. Blood glucose is
your main source of energy and comes mainly from the food you eat. Insulin, a
hormone made by the pancreas, helps glucose get into your cells to be used for
energy. In type 2 diabetes, your body doesn’t make enough insulin or doesn’t
use insulin well. Too much glucose then stays in your blood, and not enough
reaches your cells.
Who is more likely to develop type 2 diabetes?

– Type 2 is the most common type of diabetes. There are about 29 million people in the U.S.
with type 2. Another 84 million have prediabetes, meaning their blood sugar (or blood
glucose) is high but not high enough to be diabetes yet.
– You can develop type 2 diabetes at any age, even during childhood. However, type 2
diabetes occurs most often in middle-aged and older people. You are more likely to develop
type 2 diabetes if you are age 45 or older, have a family history of diabetes, or are
overweight or obese. Diabetes is more common in people who are African American,
Hispanic/Latino, American Indian, Asian American, or Pacific Islander.
– Physical inactivity and certain health problems such as high blood pressure affect your
chances of developing type 2 diabetes. You are also more likely to develop type 2 diabetes
if you have prediabetes or had gestational diabetes when you were pregnant.
 Pathophysiology

– Type 2 diabetes is the most common form of diabetes. The causes of type 2 diabetes are multi-factorial
and include both genetic and environmental elements that affect beta-cell function and tissue (muscle,
liver, adipose tissue, and pancreas) insulin sensitivity. In type 2 diabetes, either the body does not produce
enough insulin or the cells ignore the insulin. It usually begins as insulin resistance, a disorder in which the
cells do not use insulin properly. As the need for insulin rises, the pancreas gradually loses its ability to
produce it.
– When glucose builds up in the blood instead of going into cells, it can cause far-reaching health
implications like heart disease, nerve damage and kidney damage. Diabetes is the leading cause of kidney
failure, non-traumatic lower-limb amputations, and new cases of blindness among adults in the United
States.
– You can prevent or delay the onset of type 2 diabetes through a healthy lifestyle such as changing your
diet, increasing your level of physical activity, maintaining a healthy weight... with these positive steps, you
can stay healthier longer and reduce your risk of diabetes.
Signs and Symptoms

Early signs and symptoms of DM 2 includes:

• Frequent urination
• Increased thirst
• Always feeling hungry
• Feeling very tired
• Blurry vision
• Slow healing of cuts and wounds
• Tingling, numbness, or pain in the hands or feet
• Patches of dark skin
• Itching and yeast infections
Diagnostic Tests

– Random blood sugar test

– Fasting blood sugar test
– Oral glucose tolerance test
– Blood sugar screening
Treatment
Management of type 2 diabetes includes:

4. Insulin Therapy
Table of Insulin Action
 Pharmacologic Therapy

– Metformin (Fortamet, Glumetza, others) is generally the first medication prescribed for
type 2 diabetes. It works primarily by lowering glucose production in the liver and
improving your body's sensitivity to insulin so that your body uses insulin more effectively.
– Sulfonylureas help your body secrete more insulin. Examples include glyburide (DiaBeta,
Glynase), glipizide (Glucotrol) and glimepiride (Amaryl).
– Glinides stimulate the pancreas to secrete more insulin. They're faster acting than
sulfonylureas, and the duration of their effect in the body is shorter. Examples include
repaglinide and nateglinide.
– Thiazolidinediones make the body's tissues more sensitive to insulin. Examples include
rosiglitazone (Avandia) and pioglitazone (Actos). 
Others:
– DPP-4 inhibitors, GLP-1 receptor agonists, SGLT2 inhibitors
 NCP
– 1. Imbalanced Nutrition: Less Than Body Requirements related to insulin deficiency.
 NCP
2. Risk for Fluid volume deficit related to increased glucose level in the blood as
evidenced by excessive urination.
References

– https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/diagnosis-treatment/dr
c-20351199#:~:text=Metformin%20(Fortamet%2C%20Glumetza%2C%20others,body%20u
ses%20insulin%20more%20effectively
.
– https://
www.mayoclinic.org/diseases-conditions/type-2-diabetes/diagnosis-treatment/drc-20351
199
– https://nursestudy.net/diabetes-nursing-diagnosis-care-plan /
– https://
www.betterhealth.vic.gov.au/health/conditionsandtreatments/diabetes-and-insulin
– https://my.clevelandclinic.org/health/drugs/13902-injectable-insulin-medications
– https://dtc.ucsf.edu/types-of-diabetes/type2/treatment-of-type-2-diabetes/medications-
and-therapies/type-2-insulin-rx/types-of-insulin/