Week 5 | Diabetes Update (16181-SP)

Photo of patient checking blood sugar level.

►Click Continue to go to the course activities


Diabetes Mellitus

  • Group of metabolic disorders of carbohydrate metabolism. Fifth most common cause of death in developed world.

Resource: http://www.diabetes.org/home.jsp

Common Types of Diabetes

  • Type 1 DM – Beta cell destruction – absolute insulin deficiency
  • Type 2 DM – Progressive insulin secretory defect with insulin resistance
  • Gestational DM – diabetes during pregnancy that is clearly not overt diabetes
  • Others

Most Common Types of DM

  • Type 2 - Genetic disorder with cells in pancreas producing properly
  • Type 1 - Autoimmune, genetic disorder

Diagnosing Diabetes Mellitus

  • Hemoglobin A1C of 6.5 or greater
  • Fasting BG of 126 or greater
  • 2 hour Oral Plasma Glucose level
  • In symptomatic person random BG equal or greater than 200

Who Needs to be Tested

  • Asymptomatic people
    • Any overweight (BMI of 25 or more) adult with one or more risk factors
    • Adults without risk factors at age 45
    • Pregnant females at 6-12 weeks
    • Screen children starting at age 10 – every 2 years (When overweight and 2 risk factors - ADA Clinical Practice Guidelines, 2012)

Risk Factors for Diabetes

  • Overweight individuals with
    • Physical inactivity
    • First degree relative with DM
    • High risk ethnic populations
    • Females delivering babies over 9 pounds, or with GDM
    • Those with HTN, Hyperlipids, polycystic ovary disease, hx CVD

Self Monitoring of Blood Glucose

Medical Team Monitoring of Blood Glucose

Diabetics Who Smoke

  • Need to STOP
  • Causes day to day variation in insulin absorption
  • Many other risk factors

Diabetic Foot Wounds

  • Leading cause of hospitalization for diabetic patients in the U.S. and abroad
  • Costs 4 time that of non-diabetics

Understanding Foot Ulcer Etiology

  • Vascular
  • Neuropathic
    • Sensory
    • Autonomic
    • Motor

Testing in Diabetic Foot Ulcers

  • Use of Semmes-Weinstein Monofilament
  • Laboratory Tests

Foot Care Needs of the Diabetic Patient 

Objectives for Learning Outcomes

After completing this session, you will be able to:

  1. Discuss categories of diabetes as identified today. 
  2. Review updated diagnostic approaches to identify people with diabetes. 
  3. State current recommended blood glucose ranges. 
  4. Explain correct method for performing Semmes-Weinstein monofilament test. 
  5. Compare types of neuropathy seen in the patient with a diabetic foot ulcer. 
Course summary

Certified Wound Care Nurse; Co-Director, Wound Management Education Program (WMEP) and Wound Management Fundamentals Course (WMFC), Continuing Nursing Education, University of Washington School of Nursing, Seattle; Fellow, College of Certified Wound Specialists

Please login or create account to take this course.