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Denise Coffey MSN, RN
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American Diabetes Association:www.diabetes.org
Nearly 26 million Americans have diabetes and an estimated 79 million U.S. adults have prediabetes‚ according to new estimates from the Centers for Disease Control and Prevention (CDC).
The National Diabetes Fact Sheet for 2011 says that diabetes affects 8.3 percent of all Americans and 11.3 percent among those aged 20 and older. An estimated 7 million Americans with diabetes do not know they have the disease!!
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Insulin: what is it’s function??Glucose: what is it’s function??
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Type I –which is?Type 2 –which is?Gestational Diabetes (GDM)Other specific conditions resulting in
hyperglycemia
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Hyperglycemia: what would you expect to see?
Lab workWhere do we want to see our
patient’s lab values at?
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Hypoglycemia: what are some signs and symptoms?
What are you going to do as the RN assigned to a patient experiencing hypoglycemia?
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Microvascular: you tell me! Macrovascular: you tell me!
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3 P’s: polyuria, polydipsia, polyphagia
Describe other assessment findings you would need to be on the look out for.
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Blood Glucose >110
InsulinResistance
DecreasedInsulin
IncreasedFree Fatty
Acid
OxidativeStress
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OxidativeStress
Nitric Oxide
Endothelin-1
Angiotensin ll
Vasoconstriction
Nitric Oxide
Angiotensin ll
Activation of activator protein -l
InflammationhypertensionVascular smoothmuscle cell growth
Release of chemokinesRelease of cytokinesExpression of cellular adhesion molecules
Nitric oxideTissue factorPlasminogen ActivatorProstaccyclin
Thrombosis
Hyper coagulationPlatelet ActivationDecreased Fibrinolysis
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Increase in:Ketones
Free Fatty AcidsLactate
ImmuneDysfunction
Reactive 02Species
InfectionDissemination Increase
TranscriptionFactorsLeads to
SecondaryMeadiators
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Diet –what teaching would you provide to your patient?
ExercisePO medications- what teaching
would you provide to our patient Insulin therapies
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Insulin pumpsPancreas transplant
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Patient education: What education would you need to
make sure you patient receives?