Endocrine system: Diabetes mellitus

In diabetes mellitus, the body has trouble moving glucose from your blood into the cells, so blood sugar levels are constantly high.

This is called hyperglycemia. A hormone made by the pancreas, called insulin, stimulates the movement of glucose into the cells after meals.

So, in type 1 diabetes, the blood glucose stays high because of an autoimmune destruction of the pancreas, which leads to low insulin levels.

In type 2 diabetes, on the other hand, the body makes insulin, but the cells are insulin resistant, meaning they don’t “respond” to insulin by taking glucose in.

In time, constantly high blood sugar levels can cause long-term complications, like cardiovascular disease, kidney problems, neurological disease, eye conditions, slower healing, and increased risk of infections.

Lack of insulin or cells’ inability to use it translates in classical symptoms of diabetes, like polyuria, which means that individuals pee a lot; polydipsia, which means they drink a lot of water; sometimes polyphagia, which is a fancy way to say they eat a lot; and unexplained weight loss.

Both type 1 and type 2 diabetes get these symptoms. However, with type 1, the onset is usually abrupt and usually affects people under 30.

With type 2, the symptoms gradually worsen over a few months, and individuals usually have risk factors, like being over 45 years old or having a first degree relative with type 2 diabetes mellitus; a body mass index, or BMI over 25; a sedentary lifestyle; or cardiovascular disease, like hypertension.

People with risk factors for type 2 diabetes can develop something called “prediabetes.” That’s when their blood sugar levels are higher than normal but not high enough to meet the criteria for diabetes.

The good news is that lifestyle changes, like exercising, adopting a healthy diet, and losing weight, can delay or even prevent type 2 diabetes altogether!

There are three key focuses for the management when caring for people with type 2 diabetes: diet, exercise, and antidiabetic medications.

Diet-wise, people with diabetes should limit their carbohydrate and fat intake and eat an overall well-balanced diet. But then again, that’s true for all of us!

When caring for people with diabetes, it’s important to bring their meals and snacks at the designated time in order to help them maintain a steady blood sugar level.People with diabetes also eat a fixed amount of macronutrients, which are carbohydrates, protein, and fats, so pay attention to their meals and how much they’ve consumed of the meal to make sure that their blood sugar won’t become too low when they take their medication or too high if they overeat.

Make sure to tell the nurse if the person is only partially eating their meal or not eating at all. Also, bear in mind that some people with diabetes may find it hard to refrain from eating sweets, so if you notice they’re hoarding and sneaking candy or chocolate into their diet, you should inform the nurse.

Now, regarding exercise: It’s a well-known fact that exercise helps improve our overall health; reduces blood pressure; and, in people with diabetes, it also helps lower blood sugar levels as muscles use the glucose for energy.

Exercise also helps reduce the risk of cardiovascular disease, which is higher in people with diabetes. Some people, especially elderly people or people with other diseases, may have special exercise requirements in their care plan, so take note of that and encourage them to fulfill their exercise requirements.

Also, bear in mind that exercising, especially when starting a new exercise routine, can cause hypoglycemia, which is low blood sugar.

Conversely, if people take a break from their normal activity level, that can cause hyperglycemia. Next up, antidiabetic medications fall under one of two categories: insulin or non-insulin medications.

For all people with type 1 diabetes and some people with type 2 diabetes, the only medication that maintains normal blood sugar levels is insulin, and it’s usually administered in multiple shots per day.

Some clients may have an insulin pump that will automatically administer a set amount of insulin at regular intervals. For other people with type 2 diabetes, oral medications are effective.

There are a lot of oral medications available, and while they work in slightly different ways, they all try to keep blood sugar at a normal level.

Monitoring blood sugar levels in people with both type 1 and type 2 diabetes is done with the help of a glucometer. This device is used to lightly prick the person’s finger, and then the drop of blood is placed on a strip.

A few seconds later, the glucometer tells you the blood sugar level! That’s pretty easy to do, so most people with diabetes do it themselves.

However, some people may need your help with this, and because we’re working with blood, it can increase the risk of transmission for bloodborne diseases.

So, if your facility allows you to assist in monitoring a client’s blood sugar, make sure to wear gloves!Now, we’ve mentioned hypoglycemia and hyperglycemia a few times, so let’s briefly go over their causes and possible manifestations.

Hypoglycemia, or low blood sugar levels, can be caused by a delayed or skipped meal or snack; eating too little; vomiting; exercising too much; administering too much diabetes medication; or not being allowed to have any food or fluids per by mouth, which is known as an “NPO status.” Symptoms of hypoglycemia include hunger; headaches; shaking; sweating; cold, clammy skin; altered mental status to the point of losing consciousness altogether; blurry vision; restlessness; and a rapid heart and breathing rate.Hyperglycemia, on the other hand, can be caused by eating too much, decreased physical activity, insufficient diabetic medication, as well as physical and emotional stress.

Symptoms of hyperglycemia include altered mental status and loss of consciousness, and blurry vision and headaches, but more specific symptoms include weight loss; dehydration; excessive urination; thirst and hunger; dry, flushed skin; sweet-smelling breath; and seizures.

Both hypoglycemia and hypoglycemia are serious acute complications of diabetes mellitus, so make sure to inform the nurse immediately if you notice signs and symptoms.

Other situations when you should inform the nurse include vomiting, any changes in normal activity level, and changes in eating habits.

All of these other causes can cause either hypoglycemia or hyperglycemia, so they should be easy to remember! All right, as a quick recap… With diabetes mellitus, blood sugar levels are consistently much higher than normal.

In type 1 diabetes, there’s high blood sugar because of low insulin levels. In type 2 diabetes, the body makes insulin, but the cells are insulin-resistant.

Risk factors for type 2 diabetes include being over 45 years old or having a first degree relative with type 2 diabetes mellitus; a body mass index, or BMI over 25; a sedentary lifestyle; or cardiovascular disease, like hypertension.

When blood sugar levels are higher than normal but not enough to qualify for type 2 diabetes, that’s called prediabetes, and in this case, lifestyle changes can help delay or prevent the onset of diabetes.

When caring for people with diabetes, pay close attention to their diet, activity levels, and medications. Changes in any of these three factors can cause either hypoglycemia or hyperglycemia.

Both hyper- and hypoglycemia are serious complications about which you