糖尿?。ㄈ⑽陌妫〥iabetesMellitus課件

1、糖尿?。ㄈ⑽陌妫〥iabetesMellitusDiabetes Mellitus 糖尿病（全英文版）DiabetesMellitusTeaching objectives grasp the definition and types of diabetes mellitus realize etiology and pathogenesis realize diagnosis and classification grasp the clinical manifestation for the patient with diabetes mellitus be aware of the m

2、ain lab examination realize the treatment for the patient with diabetes mellitus糖尿病（全英文版）DiabetesMellitusIntroduction There are more and more people suffer from diabetes with the development of society, population aging and changes of life style. 糖尿?。ㄈ⑽陌妫〥iabetesMellitusDiabetes mellitus is a group

3、 of metabolic disorders characterized by chronic hyperglycemia which results from the defects of insulin secretion or function, or both.糖尿?。ㄈ⑽陌妫〥iabetesMellitusLong-standing diabetes may lead to multisystem damage such as eye, kidney, nerve, heart, blood vessels and so on.糖尿病（全英文版）DiabetesMellitusE

4、tiology Etiology and pathology are complex, and still unknown. But it is a syndrome results from compound etiological factor and has relation to inheritance, autoimmune and environment. 糖尿病（全英文版）DiabetesMellitusFactors associated with diabetes include obesity, aging, and ethnic group. 糖尿?。ㄈ⑽陌妫〥iabe

5、tesMellitusClassificationnType 1 diabetesuStage 1: genetics emotivityuStage 2: start autoimmuneuStage 3: immunology abnormality 糖尿?。ㄈ⑽陌妫〥iabetesMellitusuStage 4: progressive dysfunction of beta cellsuStage 5: clinical diabetesuStage 6: beta cells of the clients who have longtime diabetes are damage

6、d thoroughly, blood insulin level is very low糖尿?。ㄈ⑽陌妫〥iabetesMellitusnType 2 diabetesugenetics emotivityuhyperinsulinism and (or) insulin resistanceuimpaired glucose tolerance (IGT)uclinical diabetes 糖尿病（全英文版）DiabetesMellitusnOther types uinclude beta cell genetic defects, endocrinopathies, and dru

7、g or chemical-induced diabetesugestational diabetes mellitus糖尿病（全英文版）DiabetesMellitusClinical manifestation nMetabolic disorders syndrome: polyuria, polydipsia, polyphagia and weight loss糖尿?。ㄈ⑽陌妫〥iabetesMellitusnAcute complications of diabetes: DKA, hyperosmolar nonketotic diabetic coma, infection糖

8、尿?。ㄈ⑽陌妫〥iabetesMellitusDKA u evocation factors surgery, stress, infection, deficiency of insulin dosage, pregnancy, delivery, anesthesia, or illness may trigger DKA糖尿病（全英文版）DiabetesMellitusuClinical featuresClassic symptoms of hyperglycemia (polyuria, polyphagia, polydipsia) precede DKA. Other symp

9、toms: nausea, vomiting, abdominal pain, headache, weakness, fatigue, hyperpnea糖尿病（全英文版）DiabetesMellitusuLab test Laboratory values will reveal blood glucose from 300 to 600 mg/dl(16.7-33.3mmol/l), and metabolic acidosis. Urine will be positive for glucose and ketones.糖尿?。ㄈ⑽陌妫〥iabetesMellitushyperos

10、molar nonketotic diabetic comauevocation factors include illness or other stressor such as infection, cerebrovascular events, or some drugs.糖尿病（全英文版）DiabetesMellitusuClinical features lethargy, illusion, disorientation, seizure and coma.糖尿?。ㄈ⑽陌妫〥iabetesMellitusuLab test blood glucose is higher than

11、 33.3 mmol/l, usually 33.3-66.6 mmol/l and serum osmolality 350 mmol/l糖尿?。ㄈ⑽陌妫〥iabetesMellitusinfectionuSkin infection, septicaemia, pulmonary tuberculosis,infection of urinary system糖尿病（全英文版）DiabetesMellitusnChronic complications of diabetes: cardiovascular diseases, nephropathy, diabetic neuropat

12、hy, retinopathy, diabetic foot infection糖尿病（全英文版）DiabetesMellitusCardiovascular diseases pain, paresthesia of lower extremeties and intermittent claudication heart failure, arrhythmia, cardiogenic shock,and sudden death糖尿?。ㄈ⑽陌妫〥iabetesMellitusNephropathy nephrosclerosis edema, proteinuria, hyperten

13、sion糖尿?。ㄈ⑽陌妫〥iabetesMellitusdiabetic neuropathy numbness, pain and paresthesia of extremeties, muscular atrophy糖尿病（全英文版）DiabetesMellitusretinopathy : microangiopathydiabetic foot infection: gangrenous 糖尿?。ㄈ⑽陌妫〥iabetesMellitus糖尿病（全英文版）DiabetesMellitus糖尿?。ㄈ⑽陌妫〥iabetesMellitusLab test nurine glucose

14、 nblood glucose nIGT糖尿?。ㄈ⑽陌妫〥iabetesMellitusTreatment nDiet maintain as near-normal blood glucose level as possible, achieve optimal serum lipid levels, provide adequate energy.糖尿病（全英文版）DiabetesMellitusnActivity: aerobic exercisenOral glucose-lowering agents: sulfonylurea, biguanides, glucosidasenI

15、nsulin therapy 糖尿病（全英文版）DiabetesMellitusInsulin Therapy noticeadminister insulin as ordered, inject insulin on time with correct type and precise dosagetime, position and method of injectionside effects of insulin therapy: hypoglycemia, insulin allergy, subcutaneous fat atrophy or proliferation糖尿?。ㄈ?/p>

16、英文版）DiabetesMellitusnTransplantation of pancreas and islet nTreatment for gestational diabetes nTreatment for DKA : intravenous infusion, insulin therapy, keep balance of electrolyte and acid-base, prevent and manage complicationsnHyperosmolar nonketotic diabetic coma糖尿?。ㄈ⑽陌妫〥iabetesMellitusNursing

17、 process nAssessment uSubjective datauObjective data糖尿?。ㄈ⑽陌妫〥iabetesMellitus Nursing diagnosis 1: Deficient Knowledge: Diabetes, medical regimen, diet, exercise, self-care management skills (insulin injection, SMBG) related to new diagnosis or changes in treatment Nursing diagnosis 2: Imbalanced Nutrition: Less than body requirements related to imbalance between insulin, diet, and ac