MARYHILL COLLEGE INC.
LUCENA CITY
COLLEGE OF NURSING
TYPE II DIABETES MELLITUS
PRESENTED BY:
GLORY – IDEA – JABRICA
TYPE II DIABETES MELLITUS
It is a chronic metabolic disorder characterized by insulin resistance
and impaired insulin secretion, which leads to elevated blood
glucose levels (hyperglycemia).
Non-Insulin Dependent Diabetes Mellitus (NIDDM)
Onset is after age 30 years
ETIOLOGY
Genetics
Physical Inactivity
Age
Obesity
Insulin Resistance
Impaired Insulin Secretion
Diet
ASSESSMENT
Cardiovascular System
Hypertension
Atherosclerosis
Peripheral Arterial Disease (PAD)
Endocrine System
Insulin Resistance
Pancreatic Dysfunction
ASSESSMENT
Renal
Diabetic Nephropathy
Renal Impairment
Nervous System
Peripheral Neuropathy
Visual
Diabetic Retinopathy
CLINICAL MANIFESTATIONS
Polyuria, polydipsia, polyphagia
Slow wound healing
Weakness and paresthesia
Blurred vision
Hypertension
Numbness or Tingling in Hands and Feet
Weight loss
COLLABORATIVE MANAGEMENT
DIET
Low calorie diet
High fiber diet (especially vegetables)
Physical Activity
Weight Management
PHARMACOLOGICAL MANAGEMENT
Sulfonylureas Non-sulfonylureas
• Dymelor • Biguanides (Metformin) – first line treatment
• Amaryl • Alpha Glucosidase Inhibitors
• Glucotrol • Meglitinide
• Diabenese • Thiozolidinediones
• Orinase
• Tolinase
THANK YOU
QUIZ
1. The nurse is assigned to the care of a 64-year-old patient diagnosed with type 2 diabetes.
In formulating a teaching plan that encourages the patient to actively participate in
management of the diabetes, what should be the nurse's initial intervention?
a. Assess patient's perception of what it means to have diabetes.
b. Ask the patient to write down current knowledge about diabetes.
c. Set goals for the patient to actively participate in managing his diabetes.
d. Assume responsibility for all of the patient's care to decrease stress level.
QUIZ
2. Which statement by the patient with type 2 diabetes is accurate.
a. "I am supposed to have a meal or snack if I drink alcohol"
b. "I am not allowed to eat any sweets because of my diabetes."
c. "I do not need to watch what I eat because my diabetes is not the bad kind."
d. "The amount of fat in my diet is not important; it is just the carbohydrates that
raise my blood sugar."
QUIZ
3. Gary has diabetes type 2. Nurse Martha has taught him about the illness and
evaluates learning has occurred when the client makes which statement?
A. "My cells have increased their receptors, but there is enough insulin."
B. "My peripheral cells have increased sensitivity to insulin."
C. "My beta cells cannot produce enough insulin for my cells."
D. "My cells cannot use the insulin my pancreas makes."
QUIZ
4. Which of the following is accurate pertaining to physical exercise and type 2
diabetes mellitus?
A. Physical exercise can slow the progression of type 2 diabetes mellitus.
B. Strenuous exercise is beneficial when blood glucose is high.
C. Patients who take insulin and engage in strenuous physical exercise might
experience hyperglycemia.
D. Adjusting insulin regimen allows for safe participation in all forms of exercise.
QUIZ
5. The nurse is assisting a patient with newly diagnosed type 2 diabetes to learn
dietary planning as part of the initial management of diabetes. The nurse would
encourage the patient to limit intake of which foods to help reduce the percent of fat
in the diet?
a. Cheese
b. Broccoli
c. Chicken
d. Oranges
ANSWER
1. A. Assess patient's perception of what it means to have diabetes.
In order for teaching to be effective, the first step is to assess the patient. Teaching
can be individualized once the nurse is aware of what a diagnosis of diabetes means
to the patient. After the initial assessment, current knowledge can be assessed, and
goals should be set with the patient. Assuming responsibility for all of the patient's
care will not facilitate the patient's health.
ANSWER
2. A. "I am supposed to have a meal or snack if I drink alcohol"
Alcohol should be consumed with food to reduce the risk of hypoglycemia.
ANSWER
3. D. “My cells cannot use the insulin my pancreas makes.”
With type 2 diabetes mellitus, the pancreas produces insulin, but the cells cannot
use it. T2DM is an insulin-resistance condition with associated beta-cell dysfunction.
ANSWER
4. A. Physical exercise can slow the progression of type 2 diabetes mellitus.
Physical exercise slows the progression of type 2 diabetes mellitus because exercise
has beneficial effects on carbohydrate metabolism and insulin sensitivity.
ANSWER
5. A. Cheese
Cheese is a product derived from animal sources and is higher in fat and calories
than vegetables, fruit, and poultry. Excess fat in the diet is limited to help avoid
macrovascular changes