Diabetes Mellitus: Pathophysiology, Interventions, and Medications

This flashcard set covers the pathophysiology, assessment findings, nursing interventions, medication classes, and acute complications of Diabetes Mellitus as described in the lecture notes.

Diabetes Mellitus

Impaired glucose metabolism where glucose cannot reach cells, causing cells to starve and glucose to build up in the blood.

Type 1 Diabetes Mellitus (T1DM)

Autoimmune destruction of pancreatic beta cells resulting in no insulin production, typically with onset before early adulthood following a stressor.

Type 2 Diabetes Mellitus (T2DM)

Insulin resistance caused by chronic hyperglycemia overwhelming glucose transporters; the number one risk factor is obesity.

Metabolic Syndrome

A condition in clients with $\ge 3$ of the following: abdominal obesity, hyperglycemia, HTN, high triglycerides, or low HDL.

Polyuria

Excess urination occurring when glucose spills into the urine, causing osmotic diuresis.

Polydipsia

Excess thirst resulting from dehydration caused by diuresis.

Polyphagia

Excess hunger that occurs because cells are starving without glucose.

Hemoglobin A1C

A lab that represents average glucose levels for the past $3$ months; $\ge 6.5\%$ confirms a DM diagnosis, while the treatment goal is $\le 7.0\%$.

Ketonuria

The presence of ketones in the urine; a contraindication for exercise if present alongside severe hyperglycemia.

Hypoglycemia

A condition characterized by being 'cold and clammy,' displaying symptoms like confusion, irritability, tremor, diaphoresis, and tachycardia.

Rule of 15

Management for hypoglycemia: Give $15\,\text{grams}$ of carbohydrate and recheck glucose in $15\,\text{minutes}$, repeating if necessary.

Biguanides (Metformin)

First-line oral medication for T2DM that decreases glucose output from the liver; must be held for $48\,\text{hours}$ before IV contrast.

SGLT-2 inhibitors

Medications such as dapagliflozin that increase glucose excretion into urine; associated with increased risk for vaginal and urinary tract infections.

Sulfonylureas

Medications like glipizide that increase insulin secretion from the pancreas; can cause hypoglycemia and a disulfiram-like reaction with alcohol.

Insulin

A hormone that enables both glucose and potassium ($K^+$) to enter the cells.

Diabetic Ketoacidosis (DKA)

A life-threatening insulin deficiency characterized by hyperglycemia ($>300\,\text{mg/dL}$), dehydration, and the buildup of ketone bodies leading to metabolic acidosis.

Kussmaul respirations

Deep, rapid respirations seen in DKA that compensate for metabolic acidosis by 'blowing off' acidic $CO_2$.

Hyperosmolar Hyperglycemia Syndrome (HHS)

A T2DM complication with severe hyperglycemia ($>800\,\text{mg/dL}$) and dehydration, but which lacks ketosis and metabolic acidosis.