Mind map

Diabetes Type 1 Mind Map

Kari Gaffney English

Map content

What is it?
- No insulin production (Mayo Clinic, 2016)
  - The role of insulin
    - Pancreas secretes insulin into the bloodstream (Mayo Clinic, 2016)
      - Insulin circulates, allowing sugar into the bloodstream (Mayo Clinic, 2016)
        Insulin decreases the amount of sugar in the bloodstream (Mayo Clinic, 2016)
        As blood sugar levels drop, so does the secretion of insulin from the pancreas (Mayo Clinic, 2016)
  - The Role of Glucose
    - 2 major sources: food, liver
      - Sugar is absorbed into the bloodstream, where it enters cells with the help of insulin
        The liver stores glucose as glycogen
        When glucose decreases, liver converts stroed glycogen into glucose to keep the glucose levels at and within a normal range
- Due to autoimmune disorder: destruction of beta cells int he pancreas. (Mayo Clinic, 2016)
  - Insulin Pump: worn outside of body, tube connects to reservoir of insulin that's inserted under the skin the abdomen (Mayo Clinic, 2016)
  - Needles, insulin pens
    - Regular insulin: Humalin 70/30, Novolin 70/30, Novolin N, Humolog R (Mayo Clinic, 2016)
      - Long acting: Lantus, Levemir (Mayo Clinic, 2016)
- Exact cause unknown (Diabetes Association of Canada, 2016)
Symptoms
- Increased thirst (Mayo Clinic, 2016)
- Frequent urination (polyuria) (Mayo Clinic, 2016)
- Bedwetting in children with no previous history of bedwetting (Mayo Clinic, 2016)
- Extreme hunger (Mayo Clinic, 2016)
- Unintended weight loss (Mayo Clinic, 2016)
- Blurred vision (Mayo Clinic, 2016)
- Irritability, fatigue/weakness (Mayo Clinic, 2016)
Risk Factors
- Family history - parent/sibling (Mayo Clinic, 2016)
- Genetics: certain genes increase risk (Mayo Clinic, 2016)
- Geography: the more further away from the equator (Mayo Clinic, 2016)
- Age: two notable peaks - 4-7yrs old & 10-14yrs old (Mayo Clinic, 2016)
- Virus exposure: Epstein Barr, Coxsackie virus, mumps. cytomegalovirus (Mayo Clinic, 2016)
Tests for Diagnosing
- Islet cell cytoplasmic autoantibodies (American Diabetes Association, 2016)
- A1C: glycated hemoglobin, takes average blood sugar levels for the past 2-3 months. An A1C level of 6.5 percent or higher on two separate tests indicates you have diabetes.(American Diabetes Association, 2016)
- Random blood sugar test: random blood sugar level of 200 mg/dL (11.1 mmol/L) or higher suggests diabetes (American Diabetes Association, 2016)
  - Checking blood sugar: before meals/snacks, before bed, before exercising and driving (American Diabetes Association, 2016)
    - Daytime sugars before meals: 70-130 mg/dL (3.9-7.2 mmol/L) (American Diabetes Association, 2016)
    - After meals no higher than 180 mg/dL (10mmol/L) (American Diabetes Association, 2016)
- Fasting blood sugar test: blood sugar level from 100 to 125 mg/dL (5.6 to 6.9 mmol/L) considered prediabetes. 126 mg/dL (7 mmol/L) or higher on two separate occasions, have diabetes. (American Diabetes Association, 2016)
- Presence of ketones: byproduct from the break down of fat in urine (American Diabetes Association, 2016)
Complications
- Pregnancy complications: high risk for birth defects if poorly controlled first 6-8 wks of pregnancy (Canadian Diabetes Association, 2016)
- Hyperglycemia: sustained blood sugar over 7 mmol/l or 126 mg/dL is diagnostic (Canadian Diabetes Association, 2016)
  - Freq. urination, increased thirst, blurred vision, fatigue, hunger, irritability, difficulty concentrating (Canadian Diabetes Association, 2016)
- Hypoglycemia: 3.9 mmol/L or 70 mg/dL) is diagnostic (Canadaian Diabetes Association, 2016)
  - Early signs: sweating, shaking, hunger, dizziness, rapid/irregular HR, fatigue, headache, blurred vision (Canadaian Diabetes Association, 2016)
    - Late signs: mistaken for alcohol intoxication - lethargy, confusion, behavior changes, poor coordination, convulsions (Canadaian Diabetes Association, 2016)
- Diabetic Ketoacidosis: increased ketones in urine. (Canadaian Diabetes Association, 2016)
  - Nausea, vomiting, abdominal pain, sweet/fruity breath smell, weight loss (Canadaian Diabetes Association, 2016)
    - Check urine with OTC ketones test kit: if large amounts of ketones are in urine, seek emergency care (Canadaian Diabetes Association, 2016)
- Heart disease, stroke, diabetic retinopathy, celiac disease, diabetic peripheral neuropathy
Treatment
- NO CURE!!! (Canadian Diabetes Association, 2016)
- Pancreas Transplant: life time of potent immune suppressing drugs to prevent organ rejection. Usually reserved for those with difficult to manage diabetes (Mayo Clinic, 2016)
- Stem cell transplant (Mayo Clinic, 2016)
- Exercise: 30 mins anaerobic activity (Canadian Diabetes Association, 2016)
- Nutrition: decrease fat, increase fibre (Canadian Diabetes Association, 2016)
- Maintaining a healthy weight (Canadian Diabetes Association, 2016)
- Managing stress (Canadian Diabetes Association, 2016)
  - Schedule yearly physical exam and regular eye exams (Canadian Diabetes Association, 2016)
  - Identify yourself, wear an ID medical bracelet (Canadian Diabetes Association, 2016)
  - Keep immunizations up to date - increased blood sugar weakens the immune system (Canadian Diabetes Association, 2016)
  - Pay attention to feet - daily wash with luke warm water and moisturize. Check for any cuts, blisters, sores, redness (Canadian Diabetes Association, 2016)
  - Get BP/cholesterol under control to decrease kidney damamge (Canadian Diabetes Association, 2016)
  - quit smoking
Nursing Interventions
- Stress of acute illness/surgery
  - Check BG (blood glucose) q4h if BG >14 mmol/L – urine test for ketones. Continue with meds administration as prescribed. Continue with regular meal plan Extra insulin may be required (Michel, 2014)
- Diabetic Ketoacidosis (DKA)
  - Monitor patient closely for: BG, urine for output/ketones, lab tests, IV fluids to correct dehydration. Insulin therapy, Electrolytes therapy: Potassium imbalance. (ECG) Assess: VS-for fever, hypovolemic shock, tachycardia and Kussmaul’s breathing. Renal status, cardiovascular (related to hydration), electrolyte levels , LOC (Michael, 2014)
- Hypoglycemia (BG <4 mmol/L)
  - Mild/moderate: Administer 15—20 g of simple carb, repeat in 15 min Administer complex carbs with protein or fat if next meal 1h away Notify physician immediately is symptoms do not subside (Michael, 2014)
  - Severe hypoglycemia: Subcutaneous or intramuscular injection of 1 mg glucagon IV of 20-50 ml of dextrose 50% in water given over 1-3min (Michael, 2014)
Figure 4. Illustration of main symptoms of Diabetes type 1. Adapted from “Diabetes Mellitus type 1” by Wikipedia, 2016, Wikipedia.org. Retrieved October 27, 2016, from https://en.wikipedia.org/wiki/Diabetes_mellitus_type_1
Figure 5. Illustration of diabetic needle. Adapted from “Insulin Needles & Syringes” by Bandageer, 2016, bandager.info. Retrieved October 27, 2016, from http://bandageer.info/insulin-needles-and-syringes/
Figure 1. Illustration of Healthy Diet. Adapted from “Five best tips for breast cancer prevention” by E. Woods, 2013, EzineMark.com. Retrieved October 27, 2016 from http://health.ezinemark.com/five-best-tips-for-breast-cancer-prevention-7736346520c2.html. Copyright (c)2005-2013 by EzineMark.com.
Figure 2. Illustration of physical activity. Adapted from “Five best tips for breast cancer prevention” by E. Woods, 2013, EzineMark.com. Retrieved October 27, 2016, from http://health.ezinemark.com/five best-tips-for-breast-cancer-prevention-7736346520c2.html. Copyright (c)2005-2013 by EzineMark.com.
Figure 3. Illustration of anti-smoking. Adapted from “Need to quit smoking” by Wordpress, 2016, Needtostopsmoking.com. Retrieved October 27, 2016, from http://needtoquitsmoking.com/great-tips-quit-smoking/