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Case study 3 diabetes mellitus type 1,airlines 4th january 2015 full episode,diabetic neuropathy treatment in pune india - How to DIY

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This case study describes the care plan that a doula may use to take care of a client who is planning a c-section and has gestational diabetes. Case Study 3Gestational DiabetesOccasionally I will be presenting case studies separate from the lesson to help you integratethe information you have learned as well as reinforce concepts taught. A 50-year-old male patient presented to the emergency department at 2 AM with vomiting and abdominal pain. 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.
Written birth plans are done to allow yourI have chosen to have a repeat c-section, but have some specific desires related to client to communicatethis. He had a 2-week history of polyuria and polydipsia, accompanied by a 20-pound weight loss and blurred vision.
Bloomgarden, MD Case 1 History A 50-year-old male patient presentedto the emergency department at 2 AM with vomiting and abdominal pain.
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. Her main need did not have to do withgestational diabetes, but this definitely played a role in her choices and her goals.
His medical history was unremarkable, except for being treated for hypertension with amlodipine 10 mg daily, which provided good control.
He had a2-week history of polyuria and polydipsia, accompanied by a 20-pound weightloss and blurred vision. 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. I beginwith my notes and assessment during the interview process, then move on to finding out herneeds and planning accordingly. His medical history was unremarkable, except for beingtreated for hypertension with amlodipine 10 mg daily, which provided goodcontrol. 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.
At the end of this, a birth plan was made that followed hergoals and ideas.Goals To understand how to apply knowledge of a specific medical diagnosis to your role as a doula. 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. To provide an example of how to incorporate the assessment and interview into the birth plan and your practice as a doula.
Make sure your clients have any medical questions answered by their chosen care providers and provide information they are unablet to obtain. It isAfter the birth, I would like to have my baby with me unless there is a medical reason based off of the plannot to. 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. 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).
Request warmed blanketsduring the operation and afterwards Request warm blankets while beingbefore, during, and after the surgery. The patient was seen as an outpatient 4 days afterhe is discharged from hospital.Table 1-1. These may not always be related to diabetes medications, but your doctor will need to investigate all possible causes. Lactic acidosis is especially likely to occur if you mix this medication with alcohol or have impaired kidney function.
If a woman already has a birthShe had a normal pregnancy and had a planned c-section at 39 weeks. Actions implemented: Research hospitals to find one that is committed to mom and baby staying together.
Antibody testing was not performed, presumably because of the typical type 1 presentation. Make sure the staff understands that your client wants her baby with her as much as possible. During his hospital stay, the patient received instructions regarding diet, medication schedule, and home glucose monitoring. She had difficulty breastfeeding because thoughts and ideasshe felt like she was not giving her baby enough milk. Action implemented: Allow your client to see as much as she desires of the c-section birth. The high HbA1c supports the existence of sustained hyperglycemia prior to hospitalization. There may be some peripheral neuropathy, but no evidence of nephropathy or retinopathy is found.
Over the next few weeks, the goal was to stabilize his insulin regimen to his diet and lifestyle.
Home glucose monitoring showed recurring lunchtimehypoglycemia and bedtime hyperglycemia (Table 1-4).

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