Simple Nursing Mini Lesson: Type 1 and Type 2 Diabetes

Overview

• Diabetes: Referred to as "diet trees" due to thick, sugary blood turning blood into "mud."
• Insulin Role: Acts as a key to help sugar and potassium enter cells, keeping blood sugar levels normal.
• Types of Diabetes:
  • Type 1 Diabetes: No insulin due to autoimmune destruction of pancreas.
  • Type 2 Diabetes: Insulin resistance; cells stop responding to insulin.

Type 1 Diabetes

• Cause: Autoimmune; body attacks pancreas, leading to no insulin production.
• Characteristics:
  • Genetic: Can be passed on.
  • Insulin-dependent for life.
  • Generally diagnosed in childhood, but can occur at any age.

Type 2 Diabetes

• Cause: Linked to lifestyle and diet; obesity and sedentary lifestyle leading to insulin resistance.
• Characteristics:
  • More common in adults, but increasing in children.
  • Cells become "lazy," ignore insulin.

Risk Factors

• Type 1: None; genetic.
• Type 2: Includes obesity, sedentary lifestyle, high cholesterol, smoking, genetics, racial and ethnic disparities.

Laboratory Values

• Normal Blood Glucose: 70 to 115 mg/dL.
• Fasting Glucose: Less than 100 mg/dL.
• Hemoglobin A1c: Less than 6.5%.
• Diabetes Indicators:
  • Random Blood Glucose: Over 200 mg/dL.
  • Fasting Blood Glucose: Over 126 mg/dL.
  • Hemoglobin A1c: Over 6.5%.

Signs and Symptoms

• High Blood Sugar: "Three P's"
  • Polyuria (excessive urination)
  • Polydipsia (excessive thirst)
  • Polyphagia (excessive eating)
• Other Symptoms: Hot, dry skin, dehydration, abdominal pain, blurred vision, weight loss, recurrent infections.
• Type 1 Specific: DKA with fruity breath, Kussmaul respirations.
• Type 2 Specific: HHNS with extreme dehydration but no ketones.

Hypoglycemia (Low Blood Sugar)

• Significance: More dangerous than high blood sugar.
• Treatment:
  • If awake: Provide sugar (juice, soda, crackers, low-fat milk).
  • If asleep: Administer IV dextrose.
  • Reassess sugar levels after 15 minutes.

Treatment

• High Blood Sugar:
  • Insulin for Type 1 (lifelong dependency).
  • Focus on diet and exercise for Type 2; oral medications if needed.
• Insulin Key Points:
  • "Peaks and Plates": Give food during insulin peaks.
  • Regular insulin can be given IV.
  • Draw up insulin "clear to cloudy."
  • Insulin pumps provide steady insulin levels.
• Oral Medications for Type 2:
  • Metformin
  • Glipizide, Glyburide
  • Pioglitazone (TZD)
  • Acarbose, Precose

Goal

• Aim for Hemoglobin A1c less than 6.5% for effective blood sugar control.

Additional Resources

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