【优质】DIABETESUPDATE-DIABETESOVERVIEWANDUPDATE.pptVIP

DIABETES OVERVIEW AND UPDATE Barb Bancroft, RN, MSN, PNP BBancr9271@ Historical highlights…in the old days… Diabetes—”to siphon” Mellitus—”sweet” Nurse… “Taste thy patient’s urine, for if it be sweet…” ---Dr. Thomas Willis When I was in Nursing School…it was called “sugar diabetes”…the evolution of the name… Definition of Diabetes Mellitus Chronic disorder of carbohydrate, lipid, and protein metabolism characterized in its fully expressed clinical form by an absolute deficiency of insulin (Type 1 diabetes) or a relative insulin deficiency (Type 2 diabetes). Huh? Type 1—no insulin Type 2—insulin resistance PLUS…it’s a PROthrombotic, PROinflammatory, and PROatherosclerotic disease! So be PRO-active in DX and RX! Is this a cardiovascular disease? Type 2 diabetes—the numbers 1.5 million new cases diagnosed per year in the U.S. Over 20 years of age: 20.8 million Americans (9.6%); 1/3 have no clue Over 60 years of age: 10.3 million or 20.9% of all people Usual onset after 40; 70% increase in incidence under 40 in last decade Under 20 years of age: 176,500 or 0.22% of the population; 1 in every 400-600 kids with Type 1 2 million adoloescents (1 in 6 overweight adolescents) aged 12-19 have prediabetes 50% of all new cases of Pediatric diabetes are TYPE 2…not Type 1… Who’s at risk? Who’s sitting in YOUR waiting room? Genetic risk for Type 1 and for Type 2 diabetes—family history, sibling or parent How many genes? Family history Family history of early coronary artery disease What is meant by early? Hypertension Greater than 140/90 increases the risk of diabetes 50-60% of newly diagnosed patients also have HTN at diagnosis An interesting note: A family history of hypertension in a child with Type 1 diabetes increases their risk of developing nephropathy High risk ethnic groups African American Native American Asian American Hispanic American Pacific Islander Indian (from India) Impaired glucose tolerance Gestational diabetes Baby weighing greater than 9 lbs.