Diabetes
Lauren is 65 years old and has been a diabetic for the last five years. Lauren enjoys walking in the park but is now finding it difficult to walk. On inspection, the nurse notices that the skin on Lauren’s feet is discolored and dry. The toenails also look gnarled and a different colour.
1. Describe the condition;
2. Explain the anatomical and or physiological changes which may occur and;
3. Give details of any medication and or therapeutic intervention which may be required.
My suggestion
Introduction
Description?
High carb diet, frequent meals, damaged insulin receptors, sedentary lifestyle – High levels of sugar in the blood – Chronic condition
Type 2 – insulin resistance – cells not responding
Type 1 – No insulin or little insulin (brief introduction)
Normal range – 4-7mmol before eating
Risk factors – People over 40 years of age, Overweight and obese, south asian, afro caribbean, smoking, diet and lifestyle, family history
Symptoms – Polyphagia, Polydipsia, Glycosuria, fatigue, Polyuria, Blurried vision, cuts/wounds take longer to heal, Hyper/hypoglcaemia
Complications – stroke, hypertension, heart disease, retinopathy – blindness, neuropathy, miscarriages, AKI, Foot problems – sores, infections
Pathophysiology
Insulin resistance – we eat a meal (high in sugar/ carbs) the pancreas has to release insulin
Pancreas – Beta cells of islets of langerhans
Insulin levels rise – high blood sugar
Cells cannot uptake glucose – insulin receptors are damaged so glucose channels will not open
Pancrease will release more insulin
High levels of insulin and high level of blood sugar
Excess glucose – stored away as fat
High glucose – damage walls of arteries – artherosclerosis – plaque ruptures – MI and stroke
Damaging Blood vessels in the retina – retinopathy
Damaging nerve endings – foot issue
Medications and therapeutic interventions
Treatment!
Metformin
Sulfonylureas – help the body secrete more insulin
Insulin
Diet and lifetyle management
Blood sugar monitoring
Chiropodist,
Foot care – Elaborate
Weight loss surgery
