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1、Diabetes Mellitus 1糖尿病（全英文版）DiabetesMellitusTeaching objectivesgrasp the definition and types of diabetes mellitus realize etiology and pathogenesisrealize diagnosis and classification grasp the clinical manifestation for the patient with diabetes mellitusbe aware of the main lab examinationrealize
2、the treatment for the patient with diabetes mellitus2糖尿病（全英文版）DiabetesMellitusIntroductionThere are more and more people suffer from diabetes with the development of society, population aging and changes of life style. 3糖尿病（全英文版）DiabetesMellitusDiabetes mellitus is a group of metabolic disorders cha
3、racterized by chronic hyperglycemia which results from the defects of insulin secretion or function, or both.4糖尿病（全英文版）DiabetesMellitusLong-standing diabetes may lead to multisystem damage such as eye, kidney, nerve, heart, blood vessels and so on.5糖尿病（全英文版）DiabetesMellitusEtiology Etiology and path
4、ology are complex, and still unknown. But it is a syndrome results from compound etiological factor and has relation to inheritance, autoimmune and environment. 6糖尿病（全英文版）DiabetesMellitusFactors associated with diabetes include obesity, aging, and ethnic group. 7糖尿病（全英文版）DiabetesMellitusClassificati
5、onnType 1 diabetesuStage 1: genetics emotivityuStage 2: start autoimmuneuStage 3: immunology abnormality 8糖尿病（全英文版）DiabetesMellitusuStage 4: progressive dysfunction of beta cellsuStage 5: clinical diabetesuStage 6: beta cells of the clients who have longtime diabetes are damaged thoroughly, blood in
6、sulin level is very low9糖尿病（全英文版）DiabetesMellitusnType 2 diabetesugenetics emotivityuhyperinsulinism and (or) insulin resistanceuimpaired glucose tolerance (IGT)uclinical diabetes 10糖尿病（全英文版）DiabetesMellitusnOther types uinclude beta cell genetic defects, endocrinopathies, and drug or chemical-induc
7、ed diabetesugestational diabetes mellitus11糖尿病（全英文版）DiabetesMellitusClinical manifestation nMetabolic disorders syndrome: polyuria, polydipsia, polyphagia and weight loss12糖尿病（全英文版）DiabetesMellitusnAcute complications of diabetes: DKA, hyperosmolar nonketotic diabetic coma, infection13糖尿病（全英文版）Diabe
8、tesMellitusDKA uevocation factors surgery, stress, infection, deficiency of insulin dosage, pregnancy, delivery, anesthesia, or illness may trigger DKA14糖尿病（全英文版）DiabetesMellitusuClinical featuresClassic symptoms of hyperglycemia (polyuria, polyphagia, polydipsia) precede DKA. Other symptoms: nausea
9、, vomiting, abdominal pain, headache, weakness, fatigue, hyperpnea15糖尿病（全英文版）DiabetesMellitusuLab test Laboratory values will reveal blood glucose from 300 to 600 mg/dl(16.7-33.3mmol/l), and metabolic acidosis. Urine will be positive for glucose and ketones.16糖尿病（全英文版）DiabetesMellitushyperosmolar no
10、nketotic diabetic comauevocation factors include illness or other stressor such as infection, cerebrovascular events, or some drugs.17糖尿病（全英文版）DiabetesMellitusuClinical features lethargy, illusion, disorientation, seizure and coma.18糖尿病（全英文版）DiabetesMellitusuLab test blood glucose is higher than 33.
11、3 mmol/l, usually 33.3-66.6 mmol/l and serum osmolality 350 mmol/l19糖尿病（全英文版）DiabetesMellitusinfectionuSkin infection, septicaemia, pulmonary tuberculosis,infection of urinary system20糖尿病（全英文版）DiabetesMellitusnChronic complications of diabetes: cardiovascular diseases, nephropathy, diabetic neuropat
12、hy, retinopathy, diabetic foot infection21糖尿病（全英文版）DiabetesMellitusCardiovascular diseasespain, paresthesia of lower extremeties and intermittent claudicationheart failure, arrhythmia, cardiogenic shock,and sudden death22糖尿病（全英文版）DiabetesMellitusNephropathynephrosclerosis edema, proteinuria, hyperte
13、nsion23糖尿病（全英文版）DiabetesMellitusdiabetic neuropathy numbness, pain and paresthesia of extremeties, muscular atrophy24糖尿病（全英文版）DiabetesMellitusretinopathy : microangiopathydiabetic foot infection: gangrenous 25糖尿病（全英文版）DiabetesMellitus26糖尿病（全英文版）DiabetesMellitus27糖尿病（全英文版）DiabetesMellitusLab test nur
14、ine glucose nblood glucose nIGT28糖尿病（全英文版）DiabetesMellitusTreatment nDiet maintain as near-normal blood glucose level as possible, achieve optimal serum lipid levels, provide adequate energy.29糖尿病（全英文版）DiabetesMellitusnActivity: aerobic exercisenOral glucose-lowering agents: sulfonylurea, biguanides
15、, glucosidasenInsulin therapy 30糖尿病（全英文版）DiabetesMellitusInsulin Therapynoticeadminister insulin as ordered, inject insulin on time with correct type and precise dosagetime, position and method of injectionside effects of insulin therapy: hypoglycemia, insulin allergy, subcutaneous fat atrophy or pr
16、oliferation31糖尿病（全英文版）DiabetesMellitusnTransplantation of pancreas and islet nTreatment for gestational diabetes nTreatment for DKA : intravenous infusion, insulin therapy, keep balance of electrolyte and acid-base, prevent and manage complicationsnHyperosmolar nonketotic diabetic coma32糖尿病（全英文版）Dia
17、betesMellitusNursing process nAssessment uSubjective datauObjective data33糖尿病（全英文版）DiabetesMellitusNursing diagnosis 1: Deficient Knowledge: Diabetes, medical regimen, diet, exercise, self-care management skills (insulin injection, SMBG) related to new diagnosis or changes in treatmentNursing diagno
18、sis 2: Imbalanced Nutrition: Less than body requirements related to imbalance between insulin, diet, and activity34糖尿病（全英文版）DiabetesMellitus Nursing diagnosis 3: risk for infection related to hyperglycemia, fat metabolism disorderNursing diagnosis 4: potential complications hypoglycemia Nursing diagnosis 5: potential complications DKA, hyperosmolar coma35糖尿病（全英文版）DiabetesMellitus36糖尿病（全英文版）DiabetesMellitus
