Diabetes Mellitus

Chapter II Diabetes Mellitus

TYPE 2 DIABETES (NIDDM)
NON-INSULIN DEPENDENT DIABETES MELLITUS

TYPE 2

Approximately 85% to 90% of all diabetics have Type 2 diabetes, or non-insulin dependent diabetes mellitus, (NIDDM). Type 2 diabetics are usually over 40 and usually overweight. Type 2 diabetes often goes undetected for long periods of time, since symptoms are usually not pronounced. Insulin is produced, but it is not enough, or it does not work properly to transport glucose through the receptor cells. Type 2 diabetics can often be controlled with a carefully planned diet, an exercise program, oral medication, or insulin, used as necessary.

Uncontrolled Type 2 diabetes results in hyperglycemia. Since symptoms have an insidious onset, the patient may not recognize that there is any difficulty. Some of the following symptoms that may be experienced include: polydipsia, polyuria, increased fatigue, blurred vision, slow-healing cuts or sores, dry, itchy skin, numbness and tingling feet.

Left uncontrolled for a long period of time, Type 2 diabetics develop more serious symptoms such as severe hyperglycemia, dehydration, confusion, and shock. This is called “hyperglycemic hypersosmolar non-ketotic coma.”

These symptoms are most common in the elderly population and people suffering from illness or infection.

TREATMENNT GOALS FOR TYPE 2 DIABETES

Nursing Implications

Diet control helps regular=te weight, which is extremely important in Type 2 diabetes. Eating healthy food and following a diet program if overweight, is essential and should be stressed in diabetic teaching.

Exercise burns calories, which helps control weight. It also stimulates insulin function to allow the body’s production of insulin to work more efficiently.

Oral hypoglycemic agents simulate the beta cells in the pancreas to produce more insulin and help the insulin work more effectively.

Monitoring blood glucose is essential for all diabetics.

PERSONAL GOALS FOR TYPE 2 DIABETES

Learn about your disease and how to manage it.

Balance diet, exercise and medication

Maintain appropriate blood sgar levels

Maintain body weight within normal range

Table 2: TYPE I VERSUS TYPE 2 DIABETES

TYPE I (IDDM)

TYPE 2 (NIDDM)

Age of onset

Body weight

Symptoms

Insulin produced

Insulin requirements

Usually younger than 40
Thin

Sudden onset

None

Exogenous insulin required

Usually older than 40

Usually overweight

Insidious onset

Too little, or not effective
May require insulin

Table 3: WARNING SIGNS OF DIABETES

Type I (IDDM)	Type 2 (NIDDM)
Sudden onset	Insidious onset
Polyurea	Fatigue
Polydipsia	Blurred vision
Polyphagia	Tingling or numbness in hands and feet
20 pound weight loss	Itching
Irritability	Any symptoms of IDDM or hard to heal wounds
Weakness and fatigue	Frequent bladder infections
Nausea, vomiting

Next: GESTATIONAL DIABETES