produces many hormones to stimulate pituitary lobes
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What are the other key hormones?
Melatonin
Adrenaline and noradrenaline
Cortisol
Aldosterone
Oestrogen
Insulin
Glucagon
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What does insulin and glucagon do?
Regulate blood glucose
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What gland releases these hormones?
Pancreas
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What is diabetic ketoacidosis (DKA) and what is the cause?
a serious complication of diabetes
caused by raised metabolic rate during infection, or non-compliance with diabetic regimes
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What 3 things are present to make a diagnosis of DKA?
D - blood glucose concentration >11.0mmol/L or known to have diabetes
K - capillary or blood ketone concentration of >3.0mmol/L
A - a bicarbonate concentration of <15.0mmol/L or venous pH <7.3
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What are 3 common symptoms of DKA?
Hyperglycaemia
Metabolic acidosis
Large urine output
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What are other symptoms of DKA?
polyuria - dehydration and hypovolaemia
polydipsia
nausea, vomiting and abdominal pain
pH <7.30 (ketoacidosis)
kussmaul respirations
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What are Kussmaul respirations, seen in DKA?
Deep, rapid breathing, indicating that organs have become too acidic
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What are some important nursing interventions for DKA patients?
replace volume IV with isotonic saline
monitor/replace electrolytes
administer sliding scale insulin
monitor serum ketone levels
monitor blood pH
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What effect does insulin have on potassium levels in blood?
Lowers potassium
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How does hyperglycaemic hyperosmolar syndrome state present?
Blood glucose >33.3mmol/L
polyuria - dehydration
polydipsia
vomiting
pH <7.3 but no ketoacidosis
absence of ketones in urine
bicarbonate >15mmol/L
loss of consciousness
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How would you treat a patient with hyperglycaemic hyperosmolar syndrome?
monitor for seizures
replace fluids if sodium is increased with hypotonic saline
monitor/replace electrolytes
administer sliding scale insulin
monitor serum ketone levels
monitor blood pH
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Describe type 1 diabetes
an autoimmune condition causing an increase of hormone glucagon
it is characterised by hyperglycaemia (not enough insulin being produced)
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Why does this happen?
Person's own immune system DESTROYS beta cells used to produce insulin in the pancreas
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Why is polyuria common in type 1 diabetes?
Glucose is not secreted by the kidney
However, if there is too much glucose, it exceeds the renal threshold, and glucose enters urine
this causes dehydration
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Why is polydipsia common in type 1 diabetes?
because the concentration of plasma is decreased due to dehydration, due to polyuria
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How does hypoglycaemia present?
blood glucose <3mmoL/L
sweating, anxiety, nausea
loss of consciousness
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What nursing interventions are important in hypoglycaemia?
monitor consciousness
administer oral dose of glucagon, eg: glucogel
if severe, give glucose IV
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Which 2 diabetic drug groups are more likely to result in hypoglycaemia?
insulin therapy
sulfonylurea therapy
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Which patient group is most likely to experience hypoglycaemia in hospital?
Type 1 diabetes
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Describe type 2 diabetes
It is insulin RESISTANT, the pancreas doesn't produce enough, and so blood sugars are high (too much glucose)
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