Nursing 212

Health Differences Across the Lifespan 2 Study Guide

4.3 Metabolic Disorders in Response to Inadequate Production or Utilization of Secretions Diabetes Insulin Dependent Diabetes Mellitus (type 1) is a chronic disorder of carbohydrate metabolism with subsequent alteration of protein and fat metabolism. This may be caused by genetics, hyperpituitarism, Cushing’s syndrome, hyperthyroidism, infection, stress, or pregnancy. Type I results from the beta cells in the islets of langerhans of the pancreas not producing adequate endogenous insulin. Type 1 results from autoimmune destruction of beta cells, has a genetic predisposition, is more common in males, occurs at any age (but usually occurs in children and adolescents), and is also characterized by hyperglycemia and ketosis (ketones in blood resulting from gluconeogenesis from fats). Type 2 diabetes has several proposed causes including compromised ability of beta cells to respond to hyperglycemia, abnormal insulin receptors on cells, and peripheral insulin resistance. It has a genetic predisposition, can occur at any age, and is more common in obese, older adults, African Americans, Hispanic Americans, and Native Americans. Acute complications include hypoglycemia, diabetic ketoacidosis, and hyperglycemic hyperosmolar nonketotic (HHNK) coma, also called hyperosmolar coma (HOC) in type 2. Signs and symptoms: • Type 1: polyuria, polydipsia, polyphagia, weight loss, malaise and fatigue • Type 2: polyuria, polydipsia, blurred vision, fatigue, paresthesia (numbness, tingling, and sensitivity) and skin infections; elevated random and/or fasting blood sugar (BG); abnormal oral glucose tolerance test; elevated glycosylated hemoglobin (HgbA1c); positive serum ketones and possible urine ketones or acetone with ketoacidosis

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