T1DM
What are the acute symptoms of T1DM?
Polyuria (frequent urination)
Polydipsia (increased thirst)
Polyphagia (increased hunger)
Weight loss
Fatigue
Nausea
Blurred vision
Mood changes
what is T2DM
T2DM is a progressive metabolic disorder characterized by a combination of insulin resistance and impaired insulin secretion from dysfunctional beta cells in the pancreas.
What happens in the absence of insulin?
Hyperglycaemia
Lipolysis → increased free fatty acids → ketone production
Muscle protein breakdown
Gluconeogenesis and glycogenolysis are upregulated
what is the target BGL
4-8mmols
under 10mmols 2 hrs after meals
What is T1DM
Diabetes mellitus is a chronic metabolic disorder characterized by impaired carbohydrate, protein, and fat metabolism due to a deficiency in insulin secretion (Type 1).
Who is most commonly diagnosed with T2DM?
People over the age of 45, although it is increasingly being diagnosed in adolescents due to lifestyle factors.
What shifts in energy usage occur in the fasting state?
Most tissues stop using glucose and switch to fatty acids or ketones
Brain and red blood cells continue to use glucose, so blood glucose must be maintained
What are signs of hypoglycaemia a patient should be taught?
What are signs of hypoglycaemia a patient should be taught?
A:
Shakiness
Sweating
Confusion
Dizziness
Hunger
Seizures (if severe)
what causes T1DM
An autoimmune response destroys the insulin-producing beta cells in the pancreas, resulting in absolute insulin deficiency. The exact cause is unclear, but genetic, viral, toxic, and environmental factors are implicated.
What are modifiable risk factors for T2DM?
Obesity (especially abdominal)
Sedentary lifestyle
Poor diet
Smoking
How is glucose handled in the absorptive state?
Used by most tissues for energy
Stored as glycogen in the liver and muscles
Converted to triglycerides in adipose tissue for long-term fat storage
explain "rule of 15" for a hypoglyceamia managment
consuming 15 grams of fast-acting carbohydrates, waiting 15 minutes, and then rechecking your blood glucose
How does the onset of T1DM differ between children and adults?
In children: Rapid onset with symptoms developing over weeks.
In adults: Slower onset.
What happens to insulin secretion over time in T2DM?
There is delayed, prolonged, and depressed insulin release, and eventually, insulin production may decline to the point where exogenous insulin is needed.
What are the liver’s key roles in maintaining blood glucose during fasting?
Glycogenolysis: Breaks down glycogen into glucose
Gluconeogenesis: Produces glucose from glycerol, lactate, and amino acids
Ketogenesis: Produces ketone bodies from fatty acids
What complications does good BGL management help prevent?
For Type 1: Hypoglycaemia, DKA
For Type 2: Heart disease, kidney failure, vision loss, nerve damage
What causes fruity breath (halitosis) in T1DM?
Ketone production due to fat metabolism releases acetone, which gives a fruity smell to the breath.
How can progression from prediabetes to T2DM be prevented?
Through lifestyle changes: improved diet, increased exercise, smoking cessation, and weight loss.
What happens to glucose when insulin is secreted?
Tissues take up glucose
Liver stores it as glycogen
Muscles store it as glycogen
Adipose tissue converts it to fat
What is the nurse’s role in insulin administration for patients with Type 1 diabetes in a healthcare setting?
The nurse is responsible for ensuring that insulin is administered safely, correctly, and on time as prescribed. They must also monitor the patient’s response, reassess blood glucose levels as needed, and be prepared to manage complications such as hypoglycaemia or hyperglycaemia.