Diabetic Neuropathy Blood Sugar Type Of Diabetes example essay topic

An Informative Essay On Diabetes Mellitus Diabetes is the seventh leading cause of death listed in the United States. Diabetes is the leading cause of blindness. "In 1996 diabetes contributed to more than 162,000 deaths" (Lewis 1367). "Diabetes is not a single disease but a group of disorders with glucose intolerance in common" (McCance 674).

Diabetes is a metabolic disorder characterized by hyperglycemia (increased blood sugar) and results from defective insulin production, secretion, and utilization. There are many forms of diabetes. "Diabetes increases the risk of heart and blood vessel disease, amputation, infections, kidney damage, eye problems (including blindness), and nerve malfunction" (Husain). I will briefly define the different forms of diabetes and then I will discuss diabetes in general.

1. Insulin dependent diabetes (IDDM) or type 1 is when the pancreas will produce little or no insulin, therefore requiring injections of insulin to control diabetes and prevent. All patients with this type of diabetes need insulin to survive (Deakins 34). Five to ten percent of all diabetic patients have IDDM.

Usual presentation is rapid with classical symptoms of polydipsia (increased thirst), polyphagia (increased hunger), (increased urination), and weight loss. IDDM is most commonly seen in patients under thirty, but can be seen in older adults. 2. Non-insulin dependent diabetes (NIDDM) or type 2 is caused by a defect in insulin manufacture and release from the beta cell or insulin resistance in the peripheral tissues. Approximately ninety percent of diabetic patients have NIDDM. Genetics play a big role in the etiology of NIDDM and is often associated with obesity.

Usually presentation is slow and often insidious with symptoms of fatigue, weight gain, poor wound healing, and recurrent infection. Primarily occurs in adults over thirty. 3. Gestational diabetes (GDM) is defined as carbohydrate intolerance, which occurs during pregnancy. Occurs in approximately three percent of pregnancies, and usually disappears after pregnancy. Women with GDM are at higher risk for having diabetes in the future.

GDM is associated with increased risk of morbidity. Women should be screened for GDM between the 24th and the 28th weeks of gestation. 4. Diabetic is a serious condition, which occurs primarily in IDDM during times of severe insulin deficiency or illness producing severe hyperglycemia (increased sugars in the blood), ketonuria (acetone bodies in urine), dehydration, and acidosis (PH balance of less than 7.35). According to McCance the diagnosis of diabetes is based on (1) more than one fasting plasma glucose level greater than 140 mg / dl, (2) elevated plasma glucose levels in response to an oral glucose test, and random plasma glucose levels above 200 mg / dl combined with classic symptoms of polydipsia, polyphagia, and (674).

The pancreas is located partially behind the stomach in the abdomen. The pancreas is a mixed gland composed of endocrine and exocrine gland cells. These cells are called aci nar cells. Aci nar cells, forming the bulk of the gland, produce an enzyme-rich juice that is ducted into the small intestine during food digestion. Scattered among the aci nar cells are approximately a million pancreatic islets (islets of Langerhans), minute cell clusters that produce pancreatic hormones. The islets contain two major populations of hormone-producing cells, the glucagon-synthesizing alpha cells and the more numerous insulin-producing beta cells.

Insulin and glucagons are intimately but independently involved in the regulation of the blood glucose levels. Their effects are opposite: Insulin is a hypoglycemic hormone (lowers blood sugar), whereas glucagon is a hyperglycemic hormone (increases blood glucose.) Islet cells also synthesize other peptides in small amounts. These include (secreted by the delta cells), which inhibits the release of insulin and glucagons; pancreatic polypeptide secreted by the F cells, which plays a role in regulating the exocrine function of the pancreas; and amyl in, a hormone co secreted with insulin by the beta cells that appears to antagonize some of the insulin's effects. That should explain the basic anatomy and physiology of the pancreas. Diabetes can affect the entire body. Two-thirds of adults with diabetes have high blood pressure, or hypertension.

This condition is serious because it leads to an increased risk of stroke, heart disease, kidney and eye problems. The disease may cause similar changes in the blood vessels of the kidneys. This condition, called diabetic, may lead to kidney failure. The nerves may also be affected by diabetes. This complication, known as diabetic neuropathy, can result in loss of feeling or abnormal sensations in different parts of the body. Diabetic neuropathy can occur with long-term diabetes, usually after several years of uncontrolled high blood glucose.

Glucose proteins, called glycoproteins, form in the nerves primarily those in the legs and feet. When the nerves in the feet are damaged, the brain cannot recognize pain in that area. Nerve damage from diabetic neuropathy can lead to weakness in the muscles in the legs and feet. Since the muscles work as a system, neuropathy can lead to other foot problems, such as hammertoes, calluses, bunions, and other foot deformities. These deformities are dangerous because of the risk of infection.

A simple blister from a tight shoe can spell disaster for a diabetic. Diabetic foot ulcers are crater-like depressions caused by neuropathy, poor circulation, or both. If bacteria are present infection can develop. When not treated properly, such ulcers can lead to diabetic gangrene or death of tissue (Harkreader 562). In gangrene the tissue is black and this alone should cause immediate concern. There are several treatments that can be prescribed by your doctor for diabetes.

Eating the right foods and the right amount can help to control diabetes. You would have to restrict the carbohydrates and saturated fats that you take in a day. Small frequent meals throughout the day; for example, six meals spaced out over the course of the day instead of the three traditional meals. Restrict the amount of sugar you take in throughout the day. The doctor would recommend that you use a sugar substitute of some sort. Exercise and maintaining your ideal body weight can also help to control diabetes.

Obesity is one of the leading precursors to NIDDM. Your physician, to maintain your blood sugar, may prescribe oral hypoglycemics. There are several oral hypoglycemics used to treat NIDDM. The two most commonly used are and. "Oral hypoglycemics lower blood sugar indirectly by enhancing the production and the rate of insulin release from the pancreas" (Deakins 35, 36). Monitoring your blood sugar is essential in managing diabetes.

Normal blood sugar should range from 70 to 120, which can vary from text to text. Working in the intensive care unit I've seen blood sugars as high as 900 and as low as 20. If your sugar is above 400 you are diagnosed with diabetic, which is treated with a continuous intravenous insulin drip and close observation in an intensive care unit. If your blood sugar is less than 60 but greater than 50 you would need to drink something high in sugar such as a glass of orange juice. If your blood sugar were less than 50 you would receive dextrose 50% (water high in sugar) intravenously to rapidly increase your blood sugar before you lose consciousness, which is called diabetic coma. If you are diagnosed with IDDM insulin may be prescribed for subcutaneous injections.

There are three types of insulin that act on the body differently these are: 1. Rapid or regular insulin when injected subcutaneous reach the bloodstream in thirty minutes, which is known as "time of onset". Regular insulin reaches its maximum strength or "peaks" about two to five hours later. It remains in the bloodstream for an additional eight to sixteen hours. 2.

NPH insulin has a slow onset about ninety minutes. It peaks between four and six hours. NPH remains in the bloodstream for about twenty-four hours. 3. Ultralente or long acting insulin usually takes about four to six hours to reach the bloodstream, but stays in the bloodstream for about thirty-six hours.

It peaks about fourteen to twenty-four hours after injection. Diabetes affects the entire body. It slowly deteriorates every one of the body's organs. You can live a long and prosperous life as a well-controlled diabetic, but a short and miserable life if noncompliant.

Bibliography

Deakins, Dee A. Oral Hypoglycemics. Nursing 92; The World's Largest Nursing Journal Nov. 1992: 34-39.
Doen ges, Marilynn E. Nursing Care Plans; Guidelines for Planning Patient Care. Philadelphia: F.A. Davis Company, 1989.
Dress, Janice. Insulin Injections. Nursing 92; The World's Largest Nursing Journal Nov. 1992: 40-43.
Harkreader, Helen. Fundamentals of Nursing; Caring and Clinical Judgment. Philadelphia: W.B. Saunders Company, 2000.
Husain, Rah at. The Diabetes Information Page. Undated. web Sharon M antik. Medical Surgical Nursing: Assessment and Management of Clinical Problems. St. Louis: Mosby, 2000.
McCance, Kathryn L. Pathophysiology; The Biologic Basis for Disease in Adults and Children. St. Louis: Mosby, 1994.