A group of metabolic disease characterized by elevated level of glucose in the blood resulting from defects in insulin secretion, insulin action or both. It is a chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin. Basic pathology is Insulin Problem (either deficiency or impaired action). Insulin is a hormone secreted by the Beta cells of the pancreas it promotes entry of glucose into the body cells by binding to the insulin receptor in the cell. Risk factors for diabetes are Family history of diabetes, Race/ethnicity, Age ≥45 y/o, Previously identified impaired fasting glucose or impaired glucose tolerance, Hypertension, HDL cholesterol level ≤35 mg/dL (0.90 mmol/L) and/or triglyceride level ≥250 mg/dL (2.8 mmol/L).
Classification of diabetes includes:
1. Type 1 (IDDM) insulin dependent diabetes mellitus or child onset 2. Type 2 (NIDDM) non-insulin dependent diabetes mellitus 3. Secondary diabetes – diabetes associated with other conditions or syndromes The most common form of diabetes is Type II, It is sometimes called age-onset or adult-onset diabetes, and this form of diabetes occurs most often in people who are overweight and who do not exercise. Type II is considered a milder form of diabetes because of its slow onset. In Type II diabetes, the pancreas may produce enough insulin, however, cells have become resistant to the insulin produced and it may not work as effectively. Symptoms of Type II diabetes are signs of lethargy, extreme thirst, and frequent urination. Other symptoms may include sudden weight loss, slow wound healing, or blurred vision. Management of diabetes mellitus includes five components they are the nutritional therapy, exercise, monitoring, pharmacologic therapy and education.
Over 346 million people worldwide have diabetes. According to the Department of Health, an estimated five million Filipinos suffer from diabetes and expected to increase ten times in five years if not properly addressed. Among the ten leading causes of mortality here in the Philippines, diabetes ranked number 6 with a percentage of 34%. Among males, diabetes ranked number 8 with 20.8% while in females it ranked number 5 with 22.5%. As nursing students we chose this case because it is the number 6 among the ten leading cause of mortality here in the Philippines. We as students would like to how we can manage patients with diabetes mellitus to still have a healthy lifestyle. That is why we made this problem as our case.
Ten leading cause of mortality in the Philippines:
1. Heart disease| 79.3%|
2. Stroke| 57.9%|
3. Cancer| 45.4%|
4. Chronic obstructive pulmonary disease| 41.2%|
5. Accidents| 38.8%|
6. Diabetes| 34.0%|
7. Dengue fever| 28.6%|
8. Maternal deaths| 17.0%|
9. Kidney failure| 18.2%|
10. Perinatal conditions| 11.5%|
Name: Mr. R. Z
Address: Canlalay,Biñan, Laguna
Birth Date: November 25, 1965
Age: 45years old
Civil Status: Single
Date Admitted: July 30, 2011
Admitted in: Hospital x
Chief complaint: weight loss
Diagnosis: DM2, poorly controlled
Admitting Physician: Dra. S
History of Present Illness:
1 week PTA - Patient experience polydypsia and polyuria associated with loss of weight, no medications taken, no consultation done. Few hours prior to PTA - Still with above symptoms, patient sought consult to a private attending physician, where blood sugar determined and revealed elevated result (430mg/dL), hence advised admission.
Past Medical History
Patient has hypertension since 2004 with...