Diabetes Concept Map
Diabetes Mellitus
Type 1
Etiology
Genetic
Autoimmune Disease
Pancreas stops producing insulin
-Insulin: hormone that enables people to get energy from food
Beta cells destroyed by immune system
-Beta cells: insulin-producing cells in pancreas
Who is at risk?
Children and Adults at any age
Family history of Diabetes
Genetics
Geography: incidence increases the farther away from equator
Normal Ranges of Blood Glucose
70-100 mg/dL
Hyperglycemia
Blood Glucose Level: Hyperglycemia
Above 126 mg/dL
Hypoglycemia
Blood Glucose Level: Hypoglycemia
Below 70 mg/dL
Diabetic Ketoacidosis
Blood Glucose Level: Diabetic Ketoacidosis
Above 300 mg/dL
Symptoms of Hyperglycemia
Polydipsia
Polyuria
Polyphagia
Nocturia
Unintentional, sudden weight loss
Slow wound healing
Dry, itchy skin
Tingling in lower extremities
Blurred vision
Drowsiness or lethargy
Fruity odor on breath
Heavy or labored breathing
Stupor or unconsciousness
Symptoms of Diabetic Ketoacidosis
Blood Glucose: >300 mg/dL
Flushed face
Ketonemia & acidosis with blood pH: < 7.3
Serum bicarbonate level < 15 mEq/L
Kussmaul Respirations
Nausea
Vomiting
Polyuria
Abdominal Pain
Fruity Breath Odor (acetone)
Electrolyte imbalance
If DKA untreated:
Possibly Fatal
Treatment for DKA
IV fluids to treat dehydration & balance electrolytes
Insulin to lower blood glucose level & stop production of ketones
Treatment for Type 1 Diabetes
Medication
Insulin
Injections
Insulin Pump
Rapid-Acting
Onset: 15 minutes
Peak: 1 hour
Duration: 2-4 hours
Types: Humalog or Lispro, Novolog or Aspart, Apidra or Glulisine
Regular or Short-Acting:
Onset: 30 minutes
Peak: 2-3 hours
Duration: 3-6 hours
Types: Humulin R, Novolin R
Intermediate-Acting:
Onset: 2-4 hours
Peak: 4-12 hours
Duration: 12-18 hours
Types: NPH (Humulin N, Novolin N)
Long-Acting:
Onset: several hours
Peak: even level over 24 hours
Type 1
Etiology
Genetic
Autoimmune Disease
Pancreas stops producing insulin
-Insulin: hormone that enables people to get energy from food
Beta cells destroyed by immune system
-Beta cells: insulin-producing cells in pancreas
Who is at risk?
Children and Adults at any age
Family history of Diabetes
Genetics
Geography: incidence increases the farther away from equator
Normal Ranges of Blood Glucose
70-100 mg/dL
Hyperglycemia
Blood Glucose Level: Hyperglycemia
Above 126 mg/dL
Hypoglycemia
Blood Glucose Level: Hypoglycemia
Below 70 mg/dL
Diabetic Ketoacidosis
Blood Glucose Level: Diabetic Ketoacidosis
Above 300 mg/dL
Symptoms of Hyperglycemia
Polydipsia
Polyuria
Polyphagia
Nocturia
Unintentional, sudden weight loss
Slow wound healing
Dry, itchy skin
Tingling in lower extremities
Blurred vision
Drowsiness or lethargy
Fruity odor on breath
Heavy or labored breathing
Stupor or unconsciousness
Symptoms of Diabetic Ketoacidosis
Blood Glucose: >300 mg/dL
Flushed face
Ketonemia & acidosis with blood pH: < 7.3
Serum bicarbonate level < 15 mEq/L
Kussmaul Respirations
Nausea
Vomiting
Polyuria
Abdominal Pain
Fruity Breath Odor (acetone)
Electrolyte imbalance
If DKA untreated:
Possibly Fatal
Treatment for DKA
IV fluids to treat dehydration & balance electrolytes
Insulin to lower blood glucose level & stop production of ketones
Treatment for Type 1 Diabetes
Medication
Insulin
Injections
Insulin Pump
Rapid-Acting
Onset: 15 minutes
Peak: 1 hour
Duration: 2-4 hours
Types: Humalog or Lispro, Novolog or Aspart, Apidra or Glulisine
Regular or Short-Acting:
Onset: 30 minutes
Peak: 2-3 hours
Duration: 3-6 hours
Types: Humulin R, Novolin R
Intermediate-Acting:
Onset: 2-4 hours
Peak: 4-12 hours
Duration: 12-18 hours
Types: NPH (Humulin N, Novolin N)
Long-Acting:
Onset: several hours
Peak: even level over 24 hours
References: Atkinson, M. A., Eisenbarth, G. S., & Michels, A. W. (2014). Type 1 diabetes. The Lancet, 383(9911), 69-82. doi:http://dx.doi.org/10.1016/S0140-6736(13)60591-7 Bluestone, Jeffrey A, Atkinson, Mark,Arvan, Peter. (2012). Type 1 diabetes: A subject collection from cold spring harbor perspectives in medicine. Cold Spring Harbor, N.Y: Cold Spring Harbor Laboratory Press. Wolfsdorf, J., Craig, M. E., Daneman, D., Dunger, D., Edge, J., Warren Lee, W., Rosenbloom, A., Sperling, M. A. and Hanas, R. (2007), Diabetic ketoacidosis. Pediatric Diabetes, 8: 28 43. doi: 10.1111/j.1399-5448.2007.00224.x