Lecture Notes: Diabetes Mellitus - Key Points for NCLEX

Introduction

• Speaker: Nurse Mike from Simple Nursing.com
• Focus: Breakdown of Diabetes Mellitus (DM) - Type 1 and Type 2
• Objective: Key points for NCLEX exam, including memory tricks

Understanding Diabetes Mellitus

• DM: High blood sugar levels impact vital organs
  • Leads to kidney failure, nerve damage, blindness, high blood pressure
• Different from Diabetes Insipidus: A diuretic issue, not sugar-related

Blood Sugar Regulation

• Insulin from pancreas helps cells absorb sugar & potassium
• Glucagon from pancreas increases blood sugar when low
• Type 1 Diabetes: No insulin production (autoimmune/genetic)
  • Insulin-dependent for life
• Type 2 Diabetes: Insulin resistance due to diet/lifestyle
  • Diet, obesity, and sedentary lifestyle as contributing factors

Risk Factors & Metabolic Syndrome

• Type 1: Primarily genetic
• Type 2: Lifestyle, diet, and some genetic influence
• Metabolic Syndrome: Increased risk of diabetes, heart disease, stroke
  • BOL Acronym: Blood Pressure, Obesity, Lipids
  • Blood pressure >130, fasting glucose >100, waist size >35 (females), >45 (males), high cholesterol

Diagnosis and Key Labs

• Normal glucose: 70-115
• Fasting glucose: <100
• Hemoglobin A1C: <6.5
• A1C test: Long-term sugar control indicator
• Hypoglycemia: Sugar <70 is dangerous (brain death risk)
  • Signs: Cool, pale, sweaty

Causes and Symptoms of Imbalance

• High sugar symptoms (3 Ps): Polyurea, Polydipsia, Polyphagia
• Causes of high sugar: Sepsis, stress, skipping insulin, steroids
• Low sugar causes: Exercise, alcohol, insulin peak times
• Treatment: Insulin, sugary foods for low sugar

Insulin Management

• 7 Rules of Insulin:
  1. Peaks = Plates (food during peaks)
  2. Low sugar management
  3. Long-acting insulins: No peaks, no mix (e.g., Glargine)
  4. Regular insulin: IV usage
  5. Clear to cloudy when drawing insulin
  6. Rotate injection sites, best on abdomen
  7. Insulin during sickness, stress, infection

Oral Agents for Type 2

• Used after exercise/diet fail
• Avoid with iron, calcium, antacids
• Common Drugs: Metformin, Glyburide, Pioglitazone, Acarbose
  • Metformin: Minimal hypoglycemia, liver/kidney caution

Patient Education

• Diet: Low sugar/simple carbs, focus on whole grains, high fiber
• Diabetic Foot Care: Regular inspection, proper footwear, avoid injuries
  • Foot care acronym "FOOT": No flip-flops, OTC corn removal, test bath water with thermometer, daily inspection

Practice Questions and Memory Aids

• Emphasis on memorization techniques for peak times and symptoms
• Use of acronyms and memory tricks to aid retention
• Encourage frequent review before exams

Conclusion

• Importance of consistent review using provided study guides
• Simple Nursing membership offers additional resources and practice questions