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

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.