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Type 1 Diabetes

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In this type of diabetes, the body does not produce insulin. ... If you have any of the mentioned symptoms, contact your health care provider ... – PowerPoint PPT presentation

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Title: Type 1 Diabetes


1
Type 1 Diabetes
  • Pennington Biomedical Research Center
  • Division of Education

2
Types of Diabetes
  • Type 1 Diabetes mellitus (DM)
  • Type 2 Diabetes mellitus (DM)
  • Gestational Diabetes

3
Type 1 Overview
  • Usually diagnosed in children and young adults
  • Previously known as juvenile diabetes
  • In this type of diabetes, the body does not
    produce insulin.
  • Insulin is required in order for the body to
    properly use sugar, in the form
    of glucose.
  • Sugar is the basic fuel for the cells in the
    body.
  • Insulins role is to take the sugar from the
    blood and carry it into cells where it can be
    used to provide energy for the body to work.

4
About Insulin
  • Insulin is a hormone made from beta cells inside
    of the pancreas.
  • With each meal consumed, beta cells release
    insulin in order to help the body use or store
    the blood glucose it gets from foods.
  • With Type 1 Diabetes however, the pancreas no
    longer makes insulin.
  • These beta cells have been destroyed for some
    reason and insulin shots are thus required
    in order for the body to use the glucose coming
    from meals.

5
More on Insulin
  • Insulin cannot be taken in pill form.
  • If it were to be consumed orally, it would break
    down during digestion just like normal proteins
    in your food.
  • Insulin must be injected into the fat under your
    skin in order for it to get into
    your bloodstream.

6
Characteristics of Insulin
  • There are three characteristics of insulin
  • Onset is the length of time before insulin
    reaches the bloodstream
    and begins lowering blood glucose.
  • Peaktime is the time during which insulin is at
    maximum strength in terms of
    lowering blood
    glucose.
  • Duration is how insulin continues to lower blood
    glucose.

7
The Basics of Insulin 4 Types
  • Rapid-acting insulin
  • Regular or short-acting insulin
  • Intermediate-acting insulin
  • Long-acting insulin

8
Rapid-acting Insulin
  • Examples insulin lispro or insulin aspart
  • Onset Begins to work at about 5
    minutes
  • Peaktime Peak is about 1 hour
  • Duration Continues to work for about 2-4
    hours

9
Regular or Short-acting Insulin
  • Onset Reaches the bloodstream within 30
    minutes
  • after injection
  • Peaktime Peaks anywhere from 2-3 hours after
    injection.
  • Duration Effective for approximately 3-6
    hours.

10
Intermediate-acting Insulin
  • Onset Reaches the blood stream about 2
    to 4 hours
  • after injection
  • Peaktime Peaks 4-12 hours later
  • Duration Effective for about 12 to 18 hours

11
Long-acting Insulin
  • Onset Reaches the bloodstream 6-10 hours
    after injection
  • Duration Usually effective for 20-24 hours
  • There is also a very long-acting insulin, known
    as glargine insulin, which starts to lower blood
    glucose levels, on average, 1 hour after
    injection and keeps working evenly for 24 hours
    after injection.

12
Premixed Insulin
  • Premixed insulin is also an option for
    individuals with Type 1 Diabetes.
  • It is helpful for individuals who have trouble
    drawing up insulin out of two bottles or have
    difficulty in reading the correct directions and
    dosages.

13
Fine-Tuning Your Blood Glucose
  • There are many factors that influence your blood
    glucose levels, including
  • What you eat
  • How much and when you exercise
  • Where you inject your insulin
  • When you take your insulin injections
  • Illness
  • Stress

14
Information on Storage of Insulin
  • Manufacturers do recommend storing insulin in the
    refrigerator however, injecting cold insulin
    sometimes makes the injection more painful.
  • You can store insulin in use at room temperature.
  • Insulin stored at room temperature will last for
    1 month.
  • If purchasing several bottles at once, store your
    supply in the refrigerator for a longer shelf
    life.

15
Information on Storage of Insulin
  • Do not store insulin near extreme heat or extreme
    cold.
  • Never store in the freezer, direct sunlight, or
    in the glove compartment of a car.
  • Check expiration date- especially important if
    you have had the bottle for a while
  • Make sure the insulin looks normal before you
    draw it into the syringe
  • If there is any discoloration, particles,
    frosting, or crystals in the solution, do not
    use it. Return the unopened bottle to your
    pharmacy and exchange and/or refund it.

16
Conditions that can arise from Type
1 DM
  • Hypoglycemia
  • Hyperglycemia
  • Ketoacidosis

17
Hypoglycemia
  • A condition arising due to low blood glucose
  • Happens from time to time in everyone with
    diabetes
  • Sometimes referred to as an insulin reaction
  • Must be treated before immediately before
    symptoms worsen

18
Hypoglycemia The Symptoms
  • Shakiness
  • Dizziness
  • Sweating
  • Hunger
  • Headache
  • Pale skin color
  • Sudden moodiness or behavior changes, such as
    crying for no apparent reason
  • Clumsy or jerky movements
  • Seizure
  • Difficulty paying attention, or
    confusion
  • Tingling sensations around the mouth

19
How to Know When Your Blood Sugar is
Low?
  • Part of managing diabetes is to check your blood
    glucose often.
  • Ask your doctor how often you should check your
    blood sugar and what your
    levels should be.
  • Results from checking your level will indicate
    whether it is low or not.
  • It is important to follow your blood glucose
    monitoring schedule.
  • It is also important to check any time that you
    feel your blood sugar might be
    low and treat accordingly.
  • The basic rule is When in doubt, treat.

20
How to Treat Hypoglycemia?
  • The quickest way to raise your blood glucose and
    treat hypoglycemia is with some form of sugar.
    Either of the following would work
  • 3 glucose tablets
  • ½ cup of fruit juice
  • 5-6 pieces of hard candy

Tablets can be purchased at your local drug
store
21
How to Treat Hypoglycemia?
  • Once you have checked your blood glucose and
    treated the hypoglycemia, wait 15-20 minutes and
    check again.
  • If blood glucose is still low and symptoms have
    not went away, repeat the treatment.
  • After you feel better, continue eating your
    regular meals and snacks as planned to keep blood
    glucose levels up.

22
Treatment should be immediate!
  • It is very important to treat hypoglycemia
    quickly.
  • There is the potential of it getting worse if
    untreated, causing you to pass out.
  • If you pass out, you will need immediate
    treatment, such as an injection of glucagon or
    emergency treatment at the hospital.
  • Glucagon raises blood glucose. Like insulin, it
    too is injected. Your doctor can prescribe it to
    you and teach you to use it when needed.

23
Hypoglycemia Precautions!
  • If you pass out from hypoglycemia, people should
  • NOT inject insulin
  • NOT give you food or fluids.
  • NOT put their hands in your mouth
  • Inject glucagon
  • Call for emergency help

24
Hyperglycemia
  • A technical term for high blood glucose
  • Can be a serious problem if you dont treat it
  • Hyperglycemia can happen when the body has too
    little, or not enough insulin or when
    the body cant use insulin properly.

25
Hyperglycemia The Symptoms
  • High blood glucose
  • High levels of sugar in the urine
  • Frequent urination
  • Increased thirst

26
What Could Cause Hyperglycemia?
  • Eating more than planned
  • Exercising less than planned
  • Stress of an illness, such as the cold or flu
  • Other stresses, such as family conflicts or
    dating problems

27
How to Treat Hyperglycemia?
  • Often, you can lower your blood glucose level by
    exercising.
  • However, if your blood glucose level is above 240
    mg/dl, check your urine for ketones.
  • If there are ketones present, Do Not Exercise!

28
How to Treat Hyperglycemia?
  • Also, cutting down on the amount of food you eat
    may help.
  • If exercise and changes in diet do not help, talk
    with your doctor about possibly changing the
    amount of insulin or the timing of when you take
    it.

29
So, What are Ketones?
  • Ketones are acids that build up in the blood.
  • They appear in the urine when the body doesnt
    have enough insulin.
  • They can poison the body.
  • They are also an indicator that your diabetes is
    getting out of control or that you are getting
    sick.
  • They are present in high amounts in a condition
    known as Ketoacidosis.

30
Ketoacidosis
  • Results from a failure to treat hyperglycemia
  • Rarely occurs in individuals with type 2 diabetes
  • It is a serious condition that can lead to
    diabetic coma or even death.
  • Treatment for this condition usually takes place
    in the hospital.
  • You can prevent this by learning the warning
    signs and by checking blood and urine regularly.

31
Ketoacidosis Warning Signs
  • Thirst or a very dry mouth
  • Frequent urination
  • High blood glucose (sugar) levels
  • High levels of ketones in the urine
  • Constantly feeling tired
  • Dry or flushed skin
  • Nausea, vomiting, or abdominal
    pain
  • A hard time breathing (short, deep
    breaths)
  • Fruity odor on breath
  • A hard time paying attention or
    confusion

32
Possible Causes of Ketoacidosis?
  • Not getting enough insulin. Maybe you didnt
    inject enough or perhaps your body could need
    more insulin than usual because of illness.
    Without sufficient insulin, your body begins to
    break down fat for energy.
  • Not enough food. When people are sick, they often
    do not feel like eating. High ketones may result.
    This may also occur someone misses a meal.
  • An insulin reaction (low blood glucose). When
    blood glucose levels fall too low, the body must
    use fat to get energy. If testing shows high
    ketones in the morning, its likely that the
    person may have had an insulin reaction while
    asleep.

33
Ketoacidosis The bottom line
  • Ketoacidosis is dangerous and serious.
  • If you have any of the mentioned symptoms,
    contact your health care provider immediately or
    go to the nearest emergency room of your local
    hospital.
  • Another important note is that you never want to
    exercise when your urine test shows ketones and
    your blood glucose is high. High ketones and high
    blood glucose can mean that your diabetes is out
    of control.

34
Importance of Monitoring Blood Glucose
  • For those with diabetes, keeping blood glucose
    levels as close to normal as possible is very
    important.
  • Keeping blood glucose in your target range can
    help prevent or delay the start of diabetes
    complications, such as
  • Nerve, eye, kidney, or blood vessel damage.

35
Who Should Check?
  • Experts believe that anyone with diabetes can
    benefit from checking their blood glucose.
  • The American Diabetes Association recommends
    blood glucose checks if you have diabetes and are
  • Taking insulin or diabetes pills
  • On intensive insulin therapy
  • Pregnant
  • Having a hard time controlling your blood
    glucose levels
  • Having severe low blood glucose levels or
    ketones from
  • high blood glucose levels
  • Having low blood glucose levels without usual
    warning signs

36
Division of Education
  • Heli J. Roy, PhD, RDShanna Lundy, BSPhillip
    Brantley, PhDReviewed by

37
Sites
  • All diabetes-related information is from the
    American Diabetes Association. Available at
    http//www.diabetes.org
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