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4731133
Diabetes Mellitus Type II
Description
Mind Map on Diabetes Mellitus Type II, created by oliviayinli on 03/03/2016.
Mind Map by
oliviayinli
, updated more than 1 year ago
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Created by
oliviayinli
about 8 years ago
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Resource summary
Diabetes Mellitus Type II
Pathophysiology
Risk Factors
Pre-diabetes
Impaired glucose tolerance (IGT)
2h OGTT: 7.8-11.1 mmol/L (ADA, 2004)
Impaired fasting glucose (IFG)
FPG 5.6-6.9 mmol/L (ADA, 2004)
Genetics
Obesity
Aging
Metabolic Syndrome (Grundy et al., 2004)
Dyslipidemia
Abdominal obesity
Diagnosis
CLINICAL MANIFESTATIONS
MANAGEMENT
PHARMACOLOGICAL
Insulin
Preparations
rapid-acting: peak 1.5-2.5h
short-acting (regular): peak 2-4h
Intermediate (NPH - cloudy): peak 6-8h
Long-acting: no peak
Admin
self-admin
subcutaneous
abdomen, buttocks, thigh, deltoid
rotate injection sites
intravenous
Oral Anti-hyperglycemic Agents
α-glucosidase inhibitors
mech: slow carb digestion
DPP-4 inhibitors
mech: slow incretin hormone inactivation
Biguinides (i.e. metformin)
FIRST-LINE OHA TREATMENT! (Nathan et al., 2009; Inzucchi et al., 2012)
Thiazolidinediones
mech: decrease insulin resistance
sulphonylureas
metglitinides
mech: increase insulin production by β cells
STRESS MANAGEMENT (Surwit et al., 2002)
Muscle Relaxation
Cognitive Behavioural
Recognizing stressors
Guided imagery
EXERCISE
150 min/week moderate intensity
Mechs
↓ blood glucose
↑ insulin sensitivity
weight loss
NUTRITION
Diet Teaching
Personalized diet planning (Inzucchi et al., 2012)
Fat <7% of daily intake
Carbs < 10% of daily intake from sucrose
Protein: 15-20% of daily intake
Nursing Considerations
Nursing Process
1. Assessment
Learning needs, motivation and the ability to learn
Physical history
BMI, height, weight, vital signs
Current medication
Past surgical procedure
History of infection
Lifestyle
Stress
Exercise
2. Plan
Determine goals and expected outcome with the patient
Setting priorities
Learning objectives
Selecting teaching methods
3. Implementation
Home care
Importance of medication adherence
Travel
Adequate medication
Diabetic medical bracelet
Health promotion
Patient education
Diet
Define the disease
Purposeful factiities that can control the disease
Self monitoring blood glucose
Important resources
4. Evaluation
Patient understanding
Up-to-date immunizations
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