Insulin shock type 2 diabetes quizlet,natural healing for diabetic ulcers cause,s63 amg us - You Shoud Know


Diabetes mellitus is a condition in which the pancreas no longer produces enough insulin or cells stop responding to the insulin that is produced, so that glucose in the blood cannot be absorbed into the cells of the body. The most common form of diabetes is Type II, It is sometimes called age-onset or adult-onset diabetes, and this form of diabetes occurs most often in people who are overweight and who do not exercise.
The causes of diabetes mellitus are unclear, however, there seem to be both hereditary (genetic factors passed on in families) and environmental factors involved. In Type II diabetes, the pancreas may produce enough insulin, however, cells have become resistant to the insulin produced and it may not work as effectively. Diabetes mellitus is a common chronic disease requiring lifelong behavioral and lifestyle changes.
Several blood tests are used to measure blood glucose levels, the primary test for diagnosing diabetes. Random blood glucose test — for a random blood glucose test, blood can be drawn at any time throughout the day, regardless of when the person last ate. Fasting blood glucose test — fasting blood glucose testing involves measuring blood glucose after not eating or drinking for 8 to 12 hours (usually overnight). Oral glucose tolerance test — Oral glucose tolerance testing (OGTT) is the most sensitive test for diagnosing diabetes and pre-diabetes. Oral glucose tolerance testing is routinely performed at 24 to 28 weeks of pregnancy to screen for gestational diabetes; this requires drinking a 50 gram glucose solution with a blood glucose level drawn one hour later. When diet, exercise and maintaining a healthy weight aren’t enough, you may need the help of medication.
The most widely used form of insulin is synthetic human insulin, which is chemically identical to human insulin but manufactured in a laboratory. Advice patient about the importance of an individualized meal plan in meeting weekly weight loss goals and assist with compliance.
Assess patients for cognitive or sensory impairments, which may interfere with the ability to accurately administer insulin.
Review dosage and time of injections in relation to meals, activity, and bedtime based on patients individualized insulin regimen. Instruct patient in the importance of accuracy of insulin preparation and meal timing to avoid hypoglycemia.
Advise patient to assess blood glucose level before strenuous activity and to eat carbohydrate snack before exercising to avoid hypoglycemia. Assess feet and legs for skin temperature, sensation, soft tissues injuries, corns, calluses, dryness, hair distribution, pulses and deep tendon reflexes.
Advice patient who smokes to stop smoking or reduce if possible, to reduce vasoconstriction and enhance peripheral flow. Type 1 diabetes is one of the most common chronic diseases for children and its becoming more common, but doctors say it can be managed with care and discipline. This story is part of Inside Jersey's Top Doctors for Children's Health Package.Find all of our Top Doctors for 2013 here. Rutherford High School sophomore Sarah Kirkpatrick, 16, recalls a similar experience when she was 12.
After seeing a doctor, Kirkpatrick was sent to the emergency room, the same thing that happened to Ally Carman. Type 1 diabetes, which affects more than 250,000 young people in the United States, is increasing at an annual rate of about 3 percent and impacts one in every 300 to 400 children by age 18, according to Andrew Calabria, attending physician at the Children’s Hospital of Philadelphia and CHOP at Virtua in Voorhees. Why Type 1 is on the rise remains unknown, though theories range from susceptibility due to decreased exposure to allergens (hygiene hypothesis) to changes in the environment that encourage kids to grow faster and gain more weight earlier (accelerator hypothesis).
Patients with Type 2 diabetes, often associated with obesity, suffer from insulin resistance, which prevents the body from processing insulin effectively, leading to a build up of glucose. Insulin is a protein hormone produced in the pancreas and secreted into the bloodstream that delivers glucose, the body’s main source of energy, to all cells in the body.
Once tests reveal high glucose levels in the bloodstream (the norm is 80 to 120 milligrams per deciliter), along with clinical symptoms for Type 1 diabetes, patients are rehydrated and started on an IV insulin drip. While genes and family history can play a strong part in the development of Type 2 diabetes, this isn’t necessarily the case with Type 1.
Sarah Kirkpatrick, whose older brother was found to have Type 1 Diabetes a year before her own diagnosis, was at least familiar with the disease.
But when the Willingboro teen left home to become a Rutgers freshman, the lifestyle change landed him in the hospital in May when his blood sugar level jumped to more than 300 and he was unable to bring it down for nine hours. Davis, the Rutgers student, says that while he doesn’t want the condition, it has helped shape his personality. Insulin itself is ineffective orally, but several groups of medications given orally can lower the blood glucose levels of some clients with type 2 diabetes. Four major mechanisms cause blood glucose levels to elevate in clients with type 2 diabetes.
Several major categories of oral antidiabetic agents act to interfere with one or more of these mechanisms (Fig.
The actions of the sulfonylureas (Diabinese, Glucotrol, DiaBeta, Micronase) are not fully understood. Nursing Alert Advise clients receiving oral hypoglycemic agents or insulin about the use of alcohol; alcohol can exaggerate the hypoglycemic effect of these drugs. FIGURE 79-5 · Oral hypoglycemic drugs use various mechanisms to lower blood glucose levels. Metformin (Glucophage), a biguanide, works by preventing the liver from overproducing glucose. Acarbose (Precose), an alpha-glucosidase inhibitor, blocks enzymes that break down dietary starches so that starches can be absorbed more slowly in the small intestine. Clients can use oral antidiabetic medications alone or in combination with each other or with insulin. Experimentation with pancreas transplantation in clients with diabetes has been under way for many years. Doses of insulin (or oral diabetes medications) are calculated to control blood glucose levels.
Key Concept All persons with diabetes who use insulin or oral hypoglycemic medications should wear a MedicAlert tag at all times. Nursing Alert Avoid chocolate bars and whole milk as treatment for a hypoglycemic reaction because the high fat content prevents quick release of glucose. Hypoglycemia requires emergency treatment, followed by adjustment of the client’s carbohydrate intake and insulin dosage to regulate the disturbed metabolism. If medical assistance is unavailable, the client may use a substance called Instant Glucose, which contains 25 g of pure glucose and is packaged in a tube for squeezing into the client’s mouth. The Somogyi phenomenon occurs when hypoglycemia is followed by a compensatory period of rebound hyperglycemia as the body attempts to correct the initial problem by increasing glucose production. Diabetic ketoacidosis (DKA) results from a lack of effective insulin, causing hyperglycemia.
Continuous IV infusion of low-dose regular insulin, with a controlled-flow mechanism, is used.
Following the initial emergency, test blood specimens for sugar hourly and keep a record of fluid I&O.
Nursing Alert If you are outside the healthcare facility and do not know whether a person is having a hypoglycemic or hyperglycemic reaction, give sugar Rationale: If you give sugar, and it is incorrect, an already high blood glucose level will only increase slightly. Diabetic-ShockAlarmingly low level of blood sugar leads to Diabetic Shock or Insulin shock. Diabetic-CareDiabetic Care involves- regular exercise, foot care, controlled diet, avoidance of alcohol and cigarette, and regular monitoring of blood glucose level. HypoglycemiaHypoglycemia is the indication of decline in the blood sugar level below normal. Complications-of-diabetesComplications-of-diabetes include- Hypoglycemia, Hyperglycemia, Diabetic, Cardiomyopathy, Diabetic Nephropathy, Diabetic Neuropathy, Diabetic Retinopathy. Diabetes MellitusAn imbalance in the blood glucose level may indicate low blood sugar or high blood sugar. Diabetes-and-DepressionDiabetes leads to Depression and sometimes even more complications.
Causes-of-DiabetesVarious Causes of Diabetes can be-genetic, obesity, abnormal functioning of pancreas and liver, unhealthy Food and lifestyle and certain infections. Diabetic-DietDiabetic-Diet should incorporate plenty of greens and vegetables, no-sugar,colocasia,rice or potato and chicken, mutton should be consumed sparingly.


Tingling in hands and feet, Sudden weight loss, Always hungry, Always thirsty, Wounds take time to heal, Blurry Vision.
Prevent-DiabetesDiabetes can be successfully prevented by leading healthy lifestyle, less intake of sugar and avoiding alcohol consumption and cigarette smoking.
Risk-factors-for-diabetesModifiable Risk Factors Of Diabetes-Lifestyle, Eating Habits, Existing Health Problems. Is-Diabetes-HereditaryPeople with diabetes heredity have higher chances of getting this metabolic disorder.
Diabetes MellitusWhen the blood sugar is either below or above the normal level then it may lead to a disorder called diabetes mellitus.
Nephrogenic-Diabetes-InsipidusNephrogenic Diabetes Insipidus is caused by insufficient amount of antidiuretic hormone in the body. Generally, people tend to associate diabetes as having high blood glucose level in the blood that circulates the body.  But do we really know if this increased amount of blood glucose level in blood is due to the high carbohydrates or sugar consumption we take daily?  Or is it really due to the communal norms that obese people tend to have more glucose deposits in their body?
Genetic Vulnerability:  Study shows heredity plays a vital role in the development of type 1 diabetes.
Type 2 diabetes develops when the pancreas does not produce enough amount of insulin to compensate for the glucose ingested into the body. Obesity: Obesity coupled with physical inability is a significant among the causes of diabetes Type 2. Insulin Resistance:  As long as the pancreas, through its beta cells, function normally by producing enough insulin, blood glucose level will remain normal. Type II is considered a milder form of diabetes because of its slow onset (sometimes developing over the course of several years) and because it usually can be controlled with diet and oral medication. Symptoms of Type II diabetes can begin so gradually that a person may not know that he or she has it. It is best managed with a team approach to empower the client to successfully manage the disease. The body’s primary energy source is glucose, a simple sugar resulting from the digestion of foods containing carbohydrates (sugars and starches). It is used to monitor blood glucose control in people with known diabetes, but is not normally used to diagnose diabetes. However, the OGTT is not routinely recommended because it is inconvenient compared to a fasting blood glucose test. The person then drinks a 75 gram liquid glucose solution (which tastes very sweet, and is usually cola or orange-flavored). For women who have an abnormally elevated blood glucose level, a second OGTT is performed on another day after drinking a 100 gram glucose solution.
These medications, such as repaglinide (Prandin), have effects similar to sulfonylureas, but you’re not as likely to develop low blood sugar. Metformin (Glucophage, Glucophage XR) is the only drug in this class available in the United States. These drugs block the action of enzymes in your digestive tract that break down carbohydrates. These drugs make your body tissues more sensitive to insulin and keep your liver from overproducing glucose. By combining drugs from different classes, you may be able to control your blood sugar in several different ways. All rights reserved (About Us).The material on this site may not be reproduced, distributed, transmitted, cached or otherwise used, except with the prior written permission of New Jersey On-Line LLC. These agents are not oral forms of insulin and are not to be regarded as insulin substitutes.
These medications are thought to stimulate the pancreas to produce more insulin, to improve the use of insulin at the cell’s receptor sites, or to increase the effectiveness of endogenous insulin. There are several categories of oral hypoglycemic agents: sulfonylureas, biguanides (metformin), alpha-glucosidase inhibitors (acarbose), and thia-zolidinediones.
However, when they are combined with drugs that do, dramatic lowering of blood glucose levels can occur. Success has been limited because of the high rate of transplant rejection, but with new antirejection medications, results are improving. In hypoglycemia, the client experiences symptoms of excess adrenaline, which the body releases in response to a low blood glucose level.
Hypoglycemia can develop so rapidly that a client may be having seizures or may become unconscious before anyone knows what is wrong. If the client is conscious, give sugar in some form (4 oz orange juice, 4 oz regular soft drink, 6 to 8 Lifesavers, honey, or Karo syrup). Glucagon is not glucose; it is a hormone that causes the liver to release glucose into the bloodstream. Adjusting these factors is difficult in the first 24 hours after the reaction; the client requires close observation for symptom recurrence. If a client is unconscious, place the glucose between the lower lip and front teeth to prevent aspiration. By lowering the body’s production of ketones, insulin makes more carbohydrate available to the tissues and builds up the liver’s glycogen supply.
Monitor blood levels of potassium, chlorides, and bicarbonates hourly and sodium levels every 8 hours.
However, if you give insulin and the blood glucose is already too low, the reaction is faster, more severe, and more long lasting.
This condition primarily starts in the extremities (lower and upper) that is arms and legs.
In this case pancreas is able to produce insulin, however, it is not sufficient enough to stabilize the glucose level in the blood.
People with too much body fats result in insulin resistance as well as other potentially complicated diseases. The problem arises when insulin production is not enough to level up for our sugar consumption.  Body tissues such as muscle and fats, as well as liver cells may dysfunction in response to insulin content that will lead to overwork of the pancreas. Their only aim is to share their opinion on the concerned topic, and help the reader understand it better. The treatment includes changes in diet, oral medications, and in some cases, daily injections of insulin. The consequences of uncontrolled and untreated Type II diabetes, however, are the just as serious as those for Type I. In Type I diabetes, the immune system, the body’s defense system against infection, is believed to be triggered by a virus or another microorganism that destroys cells in the pancreas that produce insulin. As part of the team the, the nurse plans, organizes, and coordinates care among the various health disciplines involved; provides care and education and promotes the client’s health and well being. Glucose from the digested food circulates in the blood as a ready energy source for any cells that need it.
The blood glucose level is measured before, and at one, two, and three hours after drinking the solution.
Everyone with type 1 diabetes and some people with type 2 diabetes must take insulin every day to replace what their pancreas is unable to produce. One of its chief failings is that it doesn’t mimic the way natural insulin is secreted. It works by inhibiting the production and release of glucose from your liver, which means you need less insulin to transport blood sugar into your cells. That means sugar is absorbed into your bloodstream more slowly, which helps prevent the rapid rise in blood sugar that usually occurs right after a meal. Side effects of thiazolidinediones, such as rosiglitazone (Avandia) and pioglitazone hydrochloride (Actos), include swelling, weight gain and fatigue. While she admits to being nervous the first time she had to give herself an injection, she ultimately got a pump and is open about her condition with her friends and teachers.
It is produced by the pancreas in response to increased glucose levels in the blood. Hypoglycemia is relatively common in persons with diabetes. These categories include sulfonylureas, biguanides, alpha-glucosidase inhibitors, and thiazolidinediones.
Because they stimulate the pancreas to produce more insulin, they are useful only for people with type 2 diabetes who still produce their own (endogenous) insulin. The client’s participation through self-monitoring of blood glucose (SMBG) level is important in determining which pills or combinations to use and how effectively the medication regimen controls blood glucose levels.


Research has also shown some success in implanting only the beta cells from the islets of Langerhans.
Individually packaged glucose tablets are available in pharmacies; give such glucose to individuals who use Precose. During this time, the body continues to absorb insulin from the injection site, although not sufficient glucose is available for the insulin to act on it. To make up for the loss of sugar as a source of energy, the body uses more fats and proteins, which it breaks down into ketones and sends to the muscles.
The client experiences weakness, drowsiness, vomiting, thirst, abdominal pain, and dehydration. While laboratory examination of blood and urine specimens is being completed, apply blankets to the unresponsive client to support warmth and combat shock. Good or bad, Right or wrong is solely readers decision and should be taken under the guidance of a medical expert. This form is also called noninsulin-dependent diabetes, a term that is somewhat misleading. Other symptoms may include sudden weight loss, slow wound healing, urinary tract infections, gum disease, or blurred vision.
Insulin is a hormone or chemical produced by cells in the pancreas, an organ located behind the stomach.
Unfortunately, insulin can’t be taken in pill form because enzymes in your stomach break it down so that it becomes ineffective.
But newer types of insulin, known as insulin analogs, more closely resemble the way natural insulin acts in your body. Second-generation sulfonylureas such as glipizide (Glucotrol, Glucotrol XL), glyburide (DiaBeta, Glynase PresTab, Micronase) and glimepiride (Amaryl) are prescribed most often. One advantage of metformin is that is tends to cause less weight gain than do other diabetes medications.
Most doctors prescribe two drugs in combination, although sometimes three drugs may be prescribed.
She even participates in online support groups and helps other teens manage their diagnoses through a peer program at HackensackUMC. Another category is the insulin secretagogues or nonsulfonylurea hypoglycemic agents (meglitinides), which help the pancreas to make more insulin. Rationale: The enzymatic action of Precose blocks the absorption of sucrose, which is found in table sugar and fruit juice. If the client shows no response within 5 to 10 minutes after the injection, administer 50 mL of 50% glucose IV. As a result, the body secretes glucagon, norepinephrine, and corticosteroids to correct the hypoglycemia, but exceeds the necessary amounts. If too many ketones accumulate (ketosis), body fluids become imbalanced, and a condition called ketoacidosis follows. All these tests are necessary to evaluate the client’s progress and to assist the physician in determining how much insulin to prescribe and which electrolytes to replace.
Many people with Type II diabetes can control the condition with diet and oral medications, however, insulin injections are sometimes necessary if treatment with diet and oral medication is not working. It is not unusual for Type II diabetes to be detected while a patient is seeing a doctor about another health concern that is actually being caused by the yet undiagnosed diabetes.
Insulin bonds to a receptor site on the outside of cell and acts like a key to open a doorway into the cell through which glucose can enter. For that reason, many people inject themselves with insulin using a syringe or an insulin pen injector,a device that looks like a pen, except the cartridge is filled with insulin. The most common side effect of sulfonylureas is low blood sugar, especially during the first four months of therapy. Possible side effects include a metallic taste in your mouth, loss of appetite, nausea or vomiting, abdominal bloating, or pain, gas and diarrhea. Although safe and effective, alpha-glucosidase inhibitors can cause abdominal bloating, gas and diarrhea. The thiazolidinedione troglitzeone (Rezulin) was taken off the market in March 2000 because it caused liver failure. Newer medications, such as Glucovance, which contains both glyburide and metformin, combine different oral drugs in a single tablet. Babies born to mothers with diabetes may have severe hypoglycemia. Idiopathic hypoglycemia is hypoglycemia that occurs without a known cause.
An injectable medication in a class of drugs known as incretin mimetics called exenatide (Byetta) is available; it is designed to lower blood glucose levels primarily by increasing insulin secretion. The client trembles and perspires and may also experience headache, drowsiness, nausea, and vomiting. In ketoacidosis, the body produces a volatile substance called acetone, which has a characteristic sweetish odor (like nail-polish remover) that can be detected on the client’s breath in late stages of ketoacidosis. The breath may have the sweetish odor mentioned earlier; breathing and pulse may become rapid and deep and blood pressure low. When the client’s metabolism is in balance again, the physician prescribes a regimen specifically designed for that client.
Some of the glucose can be converted to concentrated energy sources like glycogen or fatty acids and saved for later use. Others may use an insulin pump, which provides a continuous supply of insulin, eliminating the need for daily shots.
You’re at much greater risk of low blood sugar if you have impaired liver or kidney function.
These effects usually decrease over time and are less likely to occur if you take the medication with food.
If your doctor prescribes these drugs, it’s important to have your liver checked every two months during the first year of therapy. Without treatment, other symptoms develop, such as dizziness, confusion, combative behaviors, and speech loss. When there is not enough insulin produced or when the doorway no longer recognizes the insulin key, glucose stays in the blood rather entering the cells.
A rare but serious side effect is lactic acidosis, which results when lactic acid builds up in your body. Contact your doctor immediately if you experience any of the signs and symptoms of liver damage, such as nausea and vomiting, abdominal pain, loss of appetite, dark urine, or yellowing of your skin and the whites of your eyes (jaundice). Sometimes, the unresponsive client who is admitted to the healthcare facility is unaware that he or she has diabetes. These may not always be related to diabetes medications, but your doctor will need to investigate all possible causes. Vision is double or blurry; if the condition is still untreated, seizures, loss of consciousness, and permanent brain damage may develop, sometimes causing death. Or, a person may have a diabetic condition that is hard to control, even when he or she follows the regimen faithfully. Lactic acidosis is especially likely to occur if you mix this medication with alcohol or have impaired kidney function.
This can cause high blood sugar and weight gain. Persons with severe hypoglycemia are treated with glucose injections or the hormone glucagon. Immediate treatment is needed to prevent serious complications or death. Preventing low blood sugar is better than having to treat it.
Make sure you have snacks with you if you take insulin or other medicines that lower your blood sugar. Ask your doctor or nurse if you need a bedtime snack to prevent low blood sugar overnight. If you do drink, have only one or two drinks at the most. Your doctor may tell you to change your diet so that you get more even amounts of glucose into your body throughout the day. Severe hypoglycemia is a medical emergency that may result in seizures and permanent damage to the nervous system if not treated.



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