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Adult Health Nursing (NURSNG310) Exam 3

John Marsh
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University of Massachusetts Boston

Adult Health Nursing (NURSNG310)

NU 310 Exam 3

NU 310 Exam 3
Diabetes Mellitus
 More than 25.8 million people in the US have diabetes
 DM is the leading cause of nontraumatic amputations, blindness in working-age adults, and endstage
kidney disease
o DM is a leading cause of death from disease mainly because of high rate of
cardiovascular disease
 Hospitalization rates for people with diabetes are 2.4 times greater for adults
Review of Pathophysiology

Classification of Diabetes: Type 1 and 2
 Type 1 only 5-10% of people have it
o Common in younger adults and it is characterized by destruction of the pancreatic beta
cells that lead to the decrease in insulin production
o Fasting and postprandial hyperglycemia
 Type 2 is about 90-95% of people
o Common in adult 30 years and older with obesity
o This is characterized by insulin resistance and impaired insulin secretion
o May lead to metabolic syndrome: HTN, hypercholesterolemia, abdominal obesity and
 Diabetes associated with other conditions, gestational diabetes, prediabetes
Risk Factors for Diabetes
 Family history of diabetes
 Obesity (> 20% over desired body weight)
 Race/ethnicity
 Age >45 years
 Previously identified impaired fasting glucose or impaired glucose tolerance
 Hypertension (>140/90)
 HDL level <35 mg/Dl (0.90 mmol/L) and/or triglyceride level > 250mg/Dl (2.8 mmol/L)
 History of gestational diabetes or delivery of a baby over 9lb
Clinical Manifestations
 3 P’s which is the manifestation of hyperglycemia
o Polyuria, polydipsia, and polyphagia
 Other symptoms
o Fatigue and weakness
o Sudden vision changes
o Tingling or numbness in hands and feet
o Dry skin or slow healing wounds
o Recurrent infections
o Sudden weight loss, nausea, vomiting, abdominal pain
Diagnosis of Diabetes
 Four criteria for diagnosing diabetes are
o 1. HbA1C > 6.5%
o 2. Fasting plasma glucose (FPG) > 126 mg/Dl (7.0 mmol/L) usually fast for 8 hr
o 3. 2 hour plasma glucose > 200mg/Dl (11.1 mmol/L) during an OGTT (using a glucose
load containing the equivalent of 75 g anhydrous glucose dissolved in water and blood
levels are tested 2hrs later)
o 4. A random plasma glucose >200 mg/Dl (11.1 mmol/L), in patients with classic
symptoms of hyperglycemia or hyperglycemic crisis
Medical Management of Diabetes
 The Goal is to
o Normalize insulin activity and blood glucose levels, reduce development of vascular and
neuropathic complications, and maintaining high quality of life
 Components of treatment include
o Nutritional therapy
o Physical activity and exercise
o Monitoring
o Pharmacologic therapy
o Patient and family education
Nutritional Therapy



Adult Health Nursing (NURSNG310) Exam 3

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