NUR 265 Exam 3 (last parts)/13
Complete Questions and Answers
Lesson Outcome 51.1: Differentiate between types of
diabetes - -- *Type 1 diabetes*
- *Type 2 diabetes*
- Latent autoimmune diabetes of adults (LADA)
- Gestational diabetes (onset during pregnancy, doesnt necessarily mean
they have type 1 or type 2, but does increase risk of having it with other
pregnancies or developing type 2 in later life)
Diabetes associated with other conditions or syndromes
Focus on Table 51-1
pg. 1458
TYPE 1 -
- Insulin-producing beta cells in the pancreas are destroyed by a combination
of genetic, immunologic, and environmental factors
- Results in decreased insulin production, unchecked glucose production by
the liver and fasting hyperglycemia
- Affects 5% of adults with diabetes
- Onset any age, but usually young (<30 years)
- Usually thin at diagnosis; recent weight loss
- Etiology includes genetic, immunologic, and environmental factors (e.g.,
virus)
- Often have islet cell antibodies
- Often have antibodies to insulin even before insulin treatment
- Little or no endogenous insulin
- Need exogenous insulin to preserve life
- Ketosis prone when insulin absent
- Acute complication of hyperglycemia: diabetic ketoacidosis
TYPE 2 -
- Insulin resistance and impaired insulin secretion
- Affects 95% of adults with diabetes, onset over age 30 years, increasing in
children r/t obesity
- Slow, progressive glucose intolerance and may go undetected for years
- Onset any age, usually >30 years
- Usually obese at diagnosis
- Causes include obesity, heredity, and environmental factors
- No islet cell antibodies
- Decrease in endogenous insulin, or increased with insulin resistance
, - Most patients can control blood glucose through weight loss if obese
- Oral antidiabetic agents may improve blood glucose levels if dietary
modification and exercise are unsuccessful
- May need insulin on a short- or long-term basis to prevent hyperglycemia
- Ketosis uncommon, excep
-Lesson Outcome 51.2: Describe the etiologic factors associated with
diabetes. - -Type 1: early-onset, familial, genetic predisposition, possible
immunologic or environmental (viral or toxins) factors
Type 2: obesity, age, previous identified impaired fasting glucose or impaired
glucose tolerance, hypertension ≥140/90 mm Hg, HDL ≤35 mg/dL or
triglycerides ≥250 mg/dL, history of gestational diabetes or babies over 9
pounds
- 45 or greater, older you get the more at risk you are
trademark manifestations of hyperglycemia pg.1460
Classic manifestations of diabetes or hyperglycemia (do not differ between
the two types of diabetes)
- polyuria - increased urination
- polydypsia - increased thirst
- polyphasia - increased hunger
Normal hemoglobin A1C for a nondiabetic - 6.5% or less, most handle less
than 6%
children: below 7%
Depends on the level of hyperglycemia
"Three Ps" Polyuria Polydipsia Polyphagia
Other symptoms include fatigue and weakness, sudden vision changes,
tingling or numbness in hands or feet, dry skin, skin lesions or wounds that
are slow to heal, and recurrent infections.
The onset of type 1 diabetes may also be associated with sudden weight loss
or nausea, vomiting, or abdominal pains, if DKA has developed.
Diabetes RISK FACTORS
- Family history of diabetes (e.g., parents or siblings with diabetes)
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