Tuesday, June 20, 2017

What about Diabetes

Diabetes is one of the diseases that I am very familiar with because my Mom has this.  With that, I paid attention to the lecture of my professor.  In this writing, I would like to define what is diabetes and insulin, differences of type one diabetes and type two diabetes, discuss screening methods of evaluating diabetes, identify modifications or preventions important to reduce the risk contributing to the development of diabetes. 

So what is diabetes? According to the book entitled Adult Medical-Surgical Nursing RN Edition 7.1, “diabetes mellitus is characterized by chronic hyperglycemia due to problems with insulin secretion”.   To understand it better, I would like to highlight the words chronic and hyperglycemia.  Chronic means an illness that is constantly recurring or persistent more than three months while hyperglycemia means high blood sugar.  This physical state or situation contributes to cardiovascular diseases, stroke, hypertension, renal failure, and blindness.

What are the signs and symptoms associated with diabetes mellitus? There are three P’s for hyperglycemic and three C’s for hypoglycemic or low blood sugar. The three P’s for hyperglycemic are Polyuria which means frequent urination, Polydipsia which means increased thirst and fluid intake, and Polyphagia which means increased appetite.  Weight loss, bed wetting, fatigue, vision changes, numbness and tingling in hands or feet, sores slow to heal, and recurrent infections are also included. The three C’s for hypoglycemic are Cool, Clammy skin, and Confused.  Also included are the characteristics of being lethargic, irritable, and experiencing seizure. To treat this, the goal is to consistently manage the blood glucose within the normal range which is 60-100mg/dL.  This means that as much as possible blood glucose should be near the normal level.

So what is Insulin?  Insulin is the hormone produced in the pancreas to control level of glucose in the blood.  This means that insulin is very important in regulating glucose.  For Type 1 Diabetes, insulin is no longer being produced by the pancreas that is why, type 1 diabetic patients are insulin dependents all their lives . Type 1 diabetic starts most often in childhood and characterized as rapid onset.  If type 1 diabetic patients do not produce any insulin at all, Type 2 diabetic produce insulin however it is insufficient. Also, type 2 diabetics are insulin resistance and characterized as slow onset.  It usually occurs in middle age and older adults.  Type 2 diabetic could lead to Type 1 diabetic if blood glucose is not maintained near to normal.

So what are the methods of evaluating diabetes mellitus? Before that, we have to know the manifestations of hyperglycemia and what is the glucose number to be considered hyperglycemia.  For casual plasma glucose, it is >200 mg/dL, for fasting plasma glucose it is >126mg/dL, and for two-hour plasma glucose>200mg/dL during an oral glucose tolerance test. Another method is the A1C also called as the glycosylated hemoglobin. This is a non-fasting blood test that shows average blood glucose over 1 to four months period.  A result between 5.7% and 6.49% is considered a high risk for developing diabetes.   6.5% or greater is considered diabetic.

So what are the modifications or preventions important to reduce the risk contributing to the development of diabetes? Self-Monitoring is very important in obtaining optimal blood glucose control especially in detection and prevention of hypo or hyperglycemia.  Meal planning, education in nutrition, and recording of blood glucose results will improve overall health in addition to medications/insulin prescribed by the doctor.  Consistent intervals between meals and moderation use of alcohol play a big part in achieving the goal. Bear in mind as well that exercise lowers blood glucose, improves insulin utilization, blood circulation, and overall contributes to good health.

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