Week 5 | Diabetes Update (17181-SP)
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- Group of metabolic disorders of carbohydrate metabolism. Fifth most common cause of death in developed world.
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
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
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:
- Discuss categories of diabetes as identified today.
- Review updated diagnostic approaches to identify people with diabetes.
- State current recommended blood glucose ranges.
- Explain correct method for performing Semmes-Weinstein monofilament test.
- Compare types of neuropathy seen in the patient with a diabetic foot ulcer.
Betty Hanrahan, MSN, CNS, ARNP-BC, CWCN-AP, CWS, FACCWS, CFCN
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