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Diabetes: Type 1 and Type 2 (Nursing)

by Rhonda Lawes, PhD, RN

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      Slides Diabetic Medications.pdf
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      Reference List Pharmacology Nursing.pdf
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    00:01 So let's look get type 1 diabetes and type 2 diabetes.

    00:06 Type 1 diabetes is that pancreas has really suffered some destruction, okay? So, the beta cells have taken a hit, and it's probably from some type of autoimmune disorder.

    00:16 Most people develop this as a pediatric patient or a child, but people can also develop type 1 diabetes as adults.

    00:22 But predominantly, Type 1 diabetes is identified as a child.

    00:27 Now this pancreas produces no insulin.

    00:31 Circle that really big.

    00:33 No insulin.

    00:35 These cells are destroyed.

    00:37 So the pancreas is no longer able to secrete insulin.

    00:41 All insulin that type 1 diabetic needs has to be taken as a medication.

    00:47 It's probably taken -- it can be taken SubQ, it can be taken from a pump, but all insulin has to be replaced by medication.

    00:54 We don't really have any oral medications for insulin replacement.

    00:58 Now there is 1 medication that we'll talk about in the Oral Medication's video that is showing some promise with Type 1 diabetics, but it's still not insulin.

    01:08 We have no oral forms of insulin that are reliable at this point.

    01:12 Okay, so that's why I wanted to highlight this.

    01:14 There has been some progress made, some research that really supports the use of one of the oral antidiabetics in conjunction with insulin replacement has been shown to be kind of effective for type 1 diabetics.

    01:27 So that's actually exciting news, that we might have the opportunity for diabetics that are type 1 type -- their pancreas isn't making any insulin -- to have another option for effective management.

    01:40 Now, type 1 diabetics and type 2, but type 1 diabetics particularly require frequent blood glucose monitoring.

    01:48 And then the titration means they'll adjust their insulin based on those readings.

    01:53 Many type 1 diabetics use a pump and that can help them with automatic adjustments, but every type 1 diabetic has to check their blood sugar frequently, monitor it, and then make sure they titrate their medication according to the plan they set up with their health care provider.

    02:10 Now, type 2 diabetes is a little bit different.

    02:13 This one, the pancreas just -- sometimes it's good, sometimes it's not, right? In type 1, we know for sure, that pancreas -- that function is gone.

    02:24 In type 2 diabetes, it's variable.

    02:27 The pancreas might be pushing out extra insulin, but they're resistant to it.

    02:31 The pancreas might be putting out just a little bit of insulin and it's not enough.

    02:35 But it is very likely in a type 2 diabetic that they have insulin resistance.

    02:41 Okay.

    02:41 So these guys also need regular and frequent monitoring, depending on what level the disease is.

    02:48 Now, progression of the disease impacts how you treat it.

    02:52 Initially, you might be able to treat it with just an oral medication, but if the patient is not able to control their blood sugar, then eventually, you're going to progress to the point where these patients will also need insulin.

    03:03 So we encourage everyone to improve their lifestyle to become more healthy, no matter what your diagnosis is, but it really matters in type 2 diabetes.

    03:12 My blood sugar was out of control and my weight was out of control.

    03:18 When I was able to lose half my body weight, I no longer had any more blood pressure or blood sugar issues.

    03:27 So, I don't say that to be judging because I know how hard it is to change your lifestyle, but what I want you to see here is if you can encourage a patient to even make small changes, it's going to have significant changes in their body.

    03:42 So lifestyle is key for any diagnosis, but particularly, for diabetes.

    03:46 We'll start with lifestyle and usually we start with oral meds.

    03:49 We'll talk about those in a little more detail.

    03:51 And then, if the disease progresses and we're not able to get that blood sugar under control, the pancreas may become worse and just tire out, and so, we have to start replacing the insulin too.

    04:03 So for type 2 diabetes, this i s developed usually in adulthood, but we're seeing with the rates of obesity in America, we're seeing it in our younger and younger and younger patients.

    04:14 So, this is 1 disease that is significantly impacted by lifestyle.

    04:20 As much as we can be positive role models for our patients, we can help them avoid, or at least, prolong the development of type 2 diabetes so they don't develop it right away.


    About the Lecture

    The lecture Diabetes: Type 1 and Type 2 (Nursing) by Rhonda Lawes, PhD, RN is from the course Endocrine Medications (Nursing).


    Included Quiz Questions

    1. Clients with diabetes type 1 do not produce any insulin
    2. Clients with diabetes type 1 produce a minimal amount of insulin
    3. Children with diabetes type 1 may use an oral replacement for insulin
    4. Children with diabetes type 1 should avoid oral medication when taking insulin because it may lead to hypoglycemia
    1. Clients with diabetes type 2 release variable amounts of insulin from their pancreas, whereas clients with diabetes type 1 release no insulin from their pancreas.
    2. Clients with diabetes type 2 release excessive amounts of insulin from their pancreas due to insulin resistance, whereas clients with diabetes type 1 release no insulin from their pancreas.
    3. Clients with diabetes type 2 release variable amounts of insulin from their liver, whereas clients with diabetes type 1 release no insulin from their liver.
    4. Clients with diabetes type 2 release variable amounts of glucagon from their pancreas, whereas clients with diabetes type 1 release no glucagon from their pancreas.
    1. Lifestyle modifications play an important role in the progression of the disease
    2. Lifestyle modifications do not have a significant impact on the progression of the disease
    3. Only the use of insulin slows progression of the disease
    4. Only oral antidiabetic medications are used to slow progression of the disease

    Author of lecture Diabetes: Type 1 and Type 2 (Nursing)

     Rhonda Lawes, PhD, RN

    Rhonda Lawes, PhD, RN


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