Diabetes Mellitus
I. What is Diabetes?
Insulin dependent diabetes mellitus (IDDM), type 1 diabetes or juvenile diabetes, is a condition caused by the lack of insulin. Insulin is a hormone made in the body by the pancreas. without insulin the body cannot use sugar for energy. as a result, the sugar level in the blood becomes very high.
II. What does Insulin do?
Insulin is necessary for the body to use food for energy. In all people, food is broken down into sugar by the body. Insulin is the "key" which allows sugar to enter the cell for energy. In diabetes, becasue there is not enough insulin, sugar cannot be used to make energy and the body cannot function in the way that it should. When this happens, two things occur:
A. The sugar, which cannot be used for energy, accumulates in the blood and then spills in to the urine. if there is much sugar in the urine, large amounts of water are needed to carry the suagr from the body. Thus, the amount of urine and frequency of urination increases. This leads to a loss of water from the body and increased thirst. A high level of sugar in the blood is called hyperglycemia. The symptoms of high sugar or hyperglycemia are:
1. Urinating frequently in large amounts
2. Being very thirsty
3. Being very hungry
4. Losing weight
5. Bed-wetting or waking at night to urinate
B. If insulin deficiency persists, body fat and protein (instead of sugar) are used to make energy. Using fat for energy produces acetone (or ketones), which appear in the urine. When acetone builds up in the blood it causes acidosis. The symptoms of acidosis are:
1.Vomiting
2. Weight
3. Stomach Ache
4. Deep, fast breathing
5. Fruity odor to the breath
6. Coma
III. What are the types of Diabetes?
The are two major types of diabetes. Type 1 diabetes is the type of diabetes that commonly occurs in children; type 2 diabetes is the type of diabetes that commonly occurs in adults. they are different diseases. A child with type 1 diabetes will NOT grow up to have type 2 diabetes. The major differences between the two diseases are:
Type 1 Diabetes
1. Usually occurs in children
2. Pancreas stops making insulin
3. Must be treated with insulin injections for remainder of one's life. Because the pancreas is no longer making insulin, it cannot be stimulated with pills to produce more insulin, such as type 2 diabetes. Insulin cannot be given orally because it is broken down in the stomach.
B. Type 2 Diabetes
1. Usually occurs in adults but may occur in some children
2. Body makes some insulin, but not enough, or the insulin does not work well
3. Often controlled with diet and pills (Pills are not insulin pills stimulate the pancreas to produce more insulin)
IV. What is the cause of Type 1 Diabetes?
The exact cause of diabetes is not fully understood. It is due to the destruction of the insulin producing cells (beta cells) of the pancreas by one's own body. This process is called autoimmunity. The reason the body attacks its own beta cells in the pancreas is unclear. However, a combination of environmental factors and genetics appears to play a role. The important thing to remember is - nothing you did caused diabetes, there is nothing you could have done to prevent the diabetes. Diabetes is not caused by eating sweets.
V. What is the Management of Diabetes?
There is no cure for type 1 diabetes at this time. However, it can adequately controlled with a combination of insulin, diet and exercise. People with type 1 diabetes are able to lead normal, productive lives as evidenced by scientists, athletes, actors, and musicians who have type 1 diabetes. Children with diabetes are able to participate in all activities that children without diabetes can and, as adults, are able to marry, have children and have a normal life-span.
However, when the blood sugar is not generally maintained in the near range, children with type 1 diabetes may be at risk for a long-term complications involving the eye, kidney, heart, and nervous system. Their growth and pubertal development may also be affected.
1.Goals of Treatment:
A. To lead a normal, productive life
B. To prevent complications of diabetes by maintaining near normal blood sugars (80-180 mg/dl)
2.Components of Treatment
A. Insulin
B. Blood tests
C. Urine tests
D. Record keeping
E. Exercise
F. Diet
G. Regulation of insulin dose
H. Recognition and Treatment of hypoglycemia
These subjects in more detail.
A. Insulin
1. Source of Insulin: as mentioned before, insulin is a hormone secreted from the beta cells of the pancreas. Until recently, insulin was extractred from the pancreas of cows and pigs. Today, owever, human insulin can be easily made in the laboratory in large amounts.
2. Types of Insulin: Several types of insulin are available. These differ mainly in the speed and duratin of their action in lowering blood sugar. The two types of insulin described below are ones of the most commonly used.
A Rapid Acting Insulin- (regular): Its action begins within 20-30 minutes
after injection, reaches a peak in 2-4 hours and usally finished in 6-8
hours. Rapid insulin is water-clear in appearance.
B.Intermediate Acting Insulin-(NPH, Lente): This for of insulin has an
onset of action in 1-2 hours, reaches its peak activity in 8-12 hours,
but continues to have some action for approximately 24 hours.
The bottle of intermediate acting insulin shold be rolled gentle before
use and then will have a cloudy white or grey appearance.
The plan of insulin therapy for a child with diabetes in 2 injections per day. Each injection consists of regular and NPH. Two injections mixed insulin cover the peaks of blood sugar that occur after meals.
3. Storage of Insulin: The currently used bottles of insulin may be kept at room temperature in a cool, dark place. extra bottle should be stored in a portion of the refrigerator where they will not freeze. The exception is that refrigeration is also recommended for those taking very small amounts of insulin of the bottle should be changed for a new one on a monthly basis. To make the injections less painful,the insulin should be removed form the refrigerator 10-15 mins before use and rolled in the hands to warm. Insulin should be kept away from direct sunlight, heaters, radiators or freezing temperatures.
4. Insulin Strength: Insulin is measured in units. Unit is abbrevaited as U. Insulin comes in U-100 strength. This means there is 100 units of insulin in a 1 cc volume. Some younger children may be on U-50 insulin. The insulin is diluted to be half as strong as U-100 and to allow us to change the insulin does by smaller amounts in younger children. Two units of U-50 is the same as one unit of U-100.
5 Syringes: There are 4 kinds of plastic disposable syringes that can be used with U-100 insulin:
A. a 25- unit syringe (1/4 cc)
B. a 30- unit syringe (3/10 cc)
C. a 50- unit syringe (1/2 cc)
D. a 100- unit syringe (1 cc)
6. Sites of Injecton: Insulin is injected under the skin into the fat tissue of the front and sides of the thighs and the upper outer sides of the thighs and the upper.
This page
hosted by 
Get your own Free Home Page
This page hosted by 
Get your own Free Home
Page