Diabetes: Types and Treatment Goals – NCLEX Review (Nursing)

by Prof. Lawes

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    00:00 Type 1 diabetes, complete absence of insulin, something happened in an autoimmune way that destroyed that pancreas of the beta cells so they have to have insulin replacement.

    00:11 You can't use oral medications at this point for a type 1 diabetic.

    00:15 For a type 2 diabetic, they're resistant to insulin often times so we can use some oral hypoglycemics and/or insulin but you can also help with diet and exercise.

    00:27 I know. Everyone benefits from diet and exercise but with type 2 diabetes, we can maybe treat it with just diet and exercise before we have to move forward to medications.

    00:40 Also, diet and exercise can really help with insulin resistance.

    00:44 We're finding that excess fat kind of acts like another organs so if you can minimize that, you can actually see phenomenal changes and that patient's ability who has type 2 diabetes to maintain their own blood sugar without medications.

    01:01 Now, these are the treatment goals that we're looking for.

    01:03 Now, the blood pressure guidelines there, there's a lot of debate about those.

    01:07 Those are basically right now a combination of what the diabetic experts and the heart experts say is okay for diabetics to keep it below 130/80. I know.

    01:18 A lot of people, we've changed the other requirements that say if your blood pressure is to be considered normal, it has to be lower than 120/80 but in this case for diabetics, right now, that's the standard.

    01:32 But you can always keep up with guideline changes.

    01:35 There's a normal for LDL, triglycerides, and HDL.

    01:39 So if those aren't ringing a bell for you, make sure that you come back and review those.

    01:44 Those are numbers you're gonna want to commit to memory cuz you can see, really easy to give you a test question on some of this type of information.

    01:52 So our goal is to prevent long-term complications.

    01:55 We wanna keep the blood sugar under tight control.

    01:58 Now, I've got pre-meal, peak post-meal, and hemoglobin A1C.

    02:03 Those are 3 really important areas when you're looking at test questions, the timing of the blood sugar and the results matter.

    02:11 So you look at pre-meal or a fasting glucose.

    02:14 That might be first thing in the morning or right before a meal.

    02:19 So before a meal, we're shooting for 90-130.

    02:21 Peak post-meal, that's postprandial, is less than 180.

    02:27 That means 2 hours after the first bite is when you do postprandial.

    02:33 Hemoglobin A1C is a test that when it came out, diabetic patients hated it.

    02:39 Why? Because it tells you what the example, what their blood sugar average has been over the past 2-3 months.

    02:47 So before, they could kinda just shape up for, you know, a week or so before their test.

    02:51 Now, a week before isn't gonna make any difference.

    02:55 It's the 2-3 month average that it'll tell you.

    02:58 Now, we're shooting below 7%. That's actually pretty generous.

    03:03 A lot of people can be much lower than that.

    03:05 They really get after their diet and lifestyle but you have to adjust that target based on that individual patient.

    About the Lecture

    The lecture Diabetes: Types and Treatment Goals – NCLEX Review (Nursing) by Prof. Lawes is from the course NCLEX Pharmacology Review (Nursing).

    Included Quiz Questions

    1. Complete absence of insulin
    2. Autoimmune destruction of pancreas beta cells
    3. Only treated with insulin replacement
    4. Cellular resistance to insulin
    5. Treated with oral hypoglycemics and/or insulin
    1. < 7%
    2. < 10%
    3. < 6%
    4. < 4%

    Author of lecture Diabetes: Types and Treatment Goals – NCLEX Review (Nursing)

     Prof. Lawes

    Prof. Lawes

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