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So, You are a Diabetic!

Written by kimmel52 on November 11, 2008 – 11:00 pm

By Nancy Kimmel R.N. Ph.D. C.H.M.M.

So, you are a diabetic. If you have just been recently diagnosed, then there is much to learn. Be careful where you get your information. The doctor should be your first source. Your doctor should prepare you with literature and other teaching material, as well as give you referrals to help groups. Being a diabetic doesn’t mean your life is going to change. It does mean that you will have to make important decisions about your health maintenance. If your diagnoses requires that you take oral hypoglycemics then you need to know how they work, when to take them, and the signs and symptoms of hypoglycemia and hyperglycemia. For those who are required to take injections of insulin, they must learn how to give themselves injections, and take their blood glucose level. The best idea is to take it slow. All of this information may seem overwhelming at the beginning. No one expects you to know everything. Most of all be patient with yourself.

It is important to understand why you have diabetes. Diabetes whether Type I or Type II has been determined to have certain genetic links. Genetically speaking, Type I Diabetes risk to offspring from the mother is 1%-3%, risk to offspring of diabetic fathers is 4 %-6%, with identical twin concordance between 30%-50%. (1) In regards to Type II Diabetes the genetic predisposition of risk to first degree relatives is 10%-15% and identical twin concordance can exceed 90%. (1)

In Type I Diabetes the autoimmune system of the individual gradually destroys the beta cells within the pancreas. Signs and symptoms of diabetes do not begin to manifest until 80%-90% of the beta cells are destroyed. Beta cells are important because they are responsible for the production of insulin. Insulin is a hormone that controls the amount of glucose in the blood stream at any particular time. For instance, when a person indulges in a meal that is high in sugar content, there will be large amounts ofo circulating glucose in the blood. To protect the body from excessive amounts of glucose, there is cascade of hormonal signals that stimulate the pancreas to produce insulin and put the unused glucose back into the cell where it will stay until the body requires it. High glucose levels can put the person in danger of diabetic ketoacidosis. Excessively low levels of blood glucose can be just as dangerous as in hypoglycemia. The acceptable range of blood glucose levels considered optimum range between 90-120 mg/dl. The diagnoses of diabetes require blood tests for confirmation. Usually one of the following blood tests are done;

1. Fasting Plasma glucose level exceeding 126 mg/dl

2. Random, or casual, plasma glucose exceeding 200mg/dl, with the inclusion of the signs and symptoms of Type I Diabetes.

3. Two hour Oral Glucose Tolerance Test level exceeding 200mg/dl using a glucose load of 75mg.

Type II Diabetes is by far the most prevalent in those people diagnosed with diabetes. Also, certain populations have a predisposition to diabetes more so than others. Native Americans, Hispanics and African Americans appear to have higher rates of Type II diabetes than their non-Hispanic white counterparts.

The signs and symptoms of diabetes can differ depending on whether the person is Type I or Type II. For Type I diabetics, the symptoms include, polyuria (frequent urination), polydipsia (excessive thirst), and polyphagia (excessive hunger) as well as weight loss, weakness and fatigue. The signs and symptoms of Type II Diabetes are not as obvious as Type I. In Type II Diabetics, the onset is later in life. Also, their pancreas is still producing some endogenous insulin. Therefore, their symptoms are not as detectable. Symptoms include, delayed wound healing, peripheral neuropathy (decreased sensation or pain in extremities), fatigue and visual changes. or Diabetes, just like hypertension is a disease that must be treated for life. Diabetics who take proper care of themselves can live long healthy lives into their nineties.

References:

1. http://en.wikipedia.org/wiki/Beta_cell

2. Lewis, Heitkemper, Dirksen, Medical surgical Nursing 6th ed., Mosby, copyright 2004, pg. 1270-1273.


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