Diabetes Mellitus Nursing Care Plan & Management

 Description

  • Diabetes is a chronic disease, which occurs when the pancreas does not produce enough insulin, or when the body cannot effectively use the insulin it produces. This leads to an increased concentration of glucose in the blood (hyperglycaemia).
  • Type 1 diabetes (previously known as insulin-dependent or childhood-onset diabetes) is characterized by a lack of insulin production.
  • Type 2 diabetes (formerly called non-insulin-dependent or adult-onset diabetes) is caused by the body’s ineffective use of insulin. It often results from excess body weight and physical inactivity.
  • Gestational diabetes is hyperglycaemia that is first recognized during pregnancy.
Causes

The cause of diabetes depends on the type.

Type 1 diabetes
  • Is partly inherited, and then triggered by certain infections, with some evidence pointing at Coxsackie B4 virus. A genetic element in individual susceptibility to some of these triggers has been traced to particular HLA genotypes (i.e., the genetic “self” identifiers relied upon by the immune system). However, even in those who have inherited the susceptibility, type 1 DM seems to require an environmental trigger. The onset of type 1 diabetes is unrelated to lifestyle.
Type 2 diabetes
  • is due primarily to lifestyle factors and genetics.
The following is a comprehensive list of other causes of diabetes:
  • Genetic defects of β-cell function
    • Maturity onset diabetes of the young
    • Mitochondrial DNA mutations
  • Genetic defects in insulin processing or insulin action
    • Defects in proinsulin conversion
    • Insulin gene mutations
    • Insulin receptor mutations
  • Exocrine pancreatic defects
    • Chronic pancreatitis
    • Pancreatectomy
    • Pancreatic neoplasia
    • Cystic fibrosis
    • Hemochromatosis
    • Fibrocalculous pancreatopathy
  • Endocrinopathies
    • Growth hormone excess (acromegaly)
    • Cushing syndrome
    • Hyperthyroidism
    • Pheochromocytoma
    • Glucagonoma
  • Infections
    • Cytomegalovirus infection
    • Coxsackievirus B
  • Drugs
    • Glucocorticoids
    • Thyroid hormone
    • β-adrenergic agonists
    • Statins
TYPE I VERSUS TYPE 2 DIABETES
 PE I (IDDM)TYPE 2 (NIDDM)
 Age of onset Usually younger than 40 Usually older than 40
 Body weight Thin Usually overweight
 Symptoms Sudden onset Insidious onset
 Insulin producedNone Too little, or not effective
 Insulin requirements Exogenous insulin required May require insulin