Simple Nursing Mini Lesson: Type 1 and Type 2 Diabetes

Overview of Diabetes

• Diabetes is often thought of as "diet trees" where high sugar levels in blood make it syrupy, like mud.
• High blood sugar over time can damage vital organs and blood vessels.
• Insulin is released by the pancreas to help sugar and potassium enter cells.

Insulin and Its Role

• Insulin acts as a key for sugar and potassium entry into cells.
• Without enough insulin, glucose builds up in the blood, resulting in high blood sugar levels.
• Insulin issues are central to diabetes:
  • Type 1 Diabetes: No insulin production due to autoimmune destruction of the pancreas.
  • Type 2 Diabetes: Insulin resistance due to lifestyle factors; cells become lazy and ignore insulin.

Type 1 Diabetes

• Genetic and autoimmune disorder.
• Insulin-dependent as the body produces no insulin.
• Commonly diagnosed in childhood but can occur at any age.

Type 2 Diabetes

• Related to lifestyle factors: obesity, sedentary behavior, high cholesterol, smoking.
• Insulin resistance develops; cells become unresponsive to insulin.
• Increasingly seen in children due to rising obesity rates.

Risk Factors

• Type 1: Genetic; no lifestyle risk factors.
• Type 2: Lifestyle factors and some genetics (obesity, inactivity, high cholesterol, smoking, racial/ethnic disparities).

Lab Values

• Normal blood glucose: 70-115 (fasting < 100).
• Hemoglobin A1c < 6.5%.
• Diabetes indicators:
  • Blood glucose > 200 (random test).
  • Fasting glucose > 126.
  • Hemoglobin A1c > 6.5%.

Signs and Symptoms

• Three Ps:
  • Polyuria (excessive urination).
  • Polydipsia (excessive thirst).
  • Polyphagia (excessive hunger).
• Other symptoms: hot/dry skin, dehydration, abdominal pain, blurred vision, weight loss, recurrent infections.
• Type 1 Specific: DKA (fruity breath, Kussmaul respirations).
• Type 2 Specific: HHNS (extreme dehydration, very high sugar, slow onset).

Hypoglycemia

• Blood sugar < 70 is dangerous.
• Immediate treatment with sugar is crucial.
  • If awake, provide food/drink with sugar.
  • If asleep, use IV dextrose.
• Monitor blood sugar levels 15 minutes post-intervention.

Treatment

• Type 1: Insulin for life; must understand insulin peaks and administration safety.
• Type 2: Lifestyle modification first, followed by oral medications, and insulin as a last resort.

Insulin Considerations

• No peak insulin requires no mixing.
• Regular insulin can be given IV.
• Insulin pumps provide steady doses and fewer blood sugar swings.
• Always assess the client, not just the device.

Oral Anti-Diabetic Drugs

• Metformin
• Glipizide/Glimepiride
• Pioglitazone (TZD)
• Acarbose

Goals

• Aim for Hemoglobin A1c < 6.5 for controlled blood sugar.

Resources

• Simple Nursing provides study guides, in-depth videos, and quizzes for a comprehensive understanding of diabetes and other nursing topics.