DIABETES MELLITUS (DM)BY

SUDIP DASFACULTY OF I.N.S.

DEFINITION:-It is the condition in which carbohydrates

metabolism disturbed due to insufficient secretion of insulin hormones.

It is characterized by triad features, e.g. Polyuria, polyphagia, polydypsia.

TYPES :-1. IDDM ( Insulin dependent diabetes

mellitus ) or type-1 diabetes mellitus:- In this condition patient is unable to

produce endogenous insulin due to destruction of pancreatic beta cells by genetic immunologic and environmental factors.

It is also known as Juvenile diabetes mellitus because it usually occur before the age of 30 years.

Insulin therapy is necessery.

2. NIDDM ( Non insulin dependent diabetes mellitus or type-2 diabetes mellitus:-

It results from a decreased sensitivity to insulin or from a decreased amount of insulin production.

About 90-95% pf patient have type-2 DM. About 80% cases occur due to obesity. There is no need of exogenous insulin.3. Gestational Diabetes Mellitus :- It is characterized by any degree of glucose

intolerance with onset during pregnancy.

ETIOLOGY/ RISK FACTORS :- Heredity. Obesity. Old age ( Pancreatic function become slow) Renal disease. Other systemic disease like heart disease-

MI, Stroke. Virus ( Streptococcus). Asians people are more susceptible.

CLINICAL MANIFESTATION:- Early 3P’s Symptoms are-1. Polyuria. 2. Polydypsia. 3. Polyphagia. Later symptoms are:-1. Blurred vision.2. Weight loss.3. Hypotension.4. Skin infections.5. Fatigue.6. Dry skin.7. Leg cramps.

DIAGNOSTIC EVALUATION :-a. History collection.b. Physical examination.c. Blood glucose level test.d. Detection of complication.

Managementa) Pharmacological management:-1. Insulin injection should be given according to blood

sugar level.2. Hypoglycemic drugs, e.g. Metformin, Glipizide.b) Dietary management :- 1. Sufficient quantity of diet is very necessary which

satisfy the appetite.2. About ½ energy should be get from carbophydrates

and 1/3 energy get from fat and 15-20% from protein.3. Meal should be taken at regular time. If meal will be

late it may cause hypoglycemic attack.4. Total calories-2200/8800 KJ should be taken.

Nursing Management :- Nursing Assessment. Nursing Diagnosis :-1. Fluid volume deficit related to hyperglycemia.2. Imbalanced nutrition less than body requirement

related to loss of appetite.3. Sleeping pattern disturbance related to leg

cramps.4. Knowledge deficit related to disease condition.5. Self care deficit related to lack of understanding

and fatigue. Nursing Intervention :-

Complication :- Edema in legs. high B.P. Pain in legs. Albuminuria. Sweating. Muscles damage. Tonsilitis.

PREVENTION :- Nutritional management. Exercise. Monitoring. Pharmacological therapy. Education.

DIFFERENCE BETWEEN TYPE-1 AND TYPE-2 DIABETES MELLITUS:-

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