Glucose Control in Diabetes Clients (Nursing)

00:01 So what's different about glucose control in diabetic clients? That's what we're here to talk about.

00:08 Now in type 1 diabetes, that's a probable autoimmune destruction of the pancreas.

00:13 So you can see why that is problematic.

00:16 So an autoimmune disorder means the body kind of turns on itself.

00:21 Auto (self) immune.

00:23 And it starts attacking its own cells.

00:25 When it attacks the cells in the pancreas, specifically those beta cells, the patient is not going to be able to produce insulin.

00:33 That's the definition of type 1 diabetes.

00:36 No insulin is produced by the pancreas.

00:38 All of the insulin for a patient who has type 1 diabetes has to be taken as medication.

00:44 This is where it becomes kind of problematic.

00:47 The pancreas is really efficient at it when it's functioning at optimum level.

00:52 But after autoimmune destruction, it can no longer do that.

00:55 So we do our best to try to supply insulin at the level the patient needs it as medication.

01:02 We don't have any oral medications that will completely replace insulin.

01:06 But we have made some progress with oral antidiabetics along side the insulin.

01:11 So this patient is going to need frequent monitoring and titration of their medications and closely watching their blood sugar.

01:19 Now, type 2 diabetes kind of start out a little different.

01:23 Now these beta cells can kind of secrete insulin, right? So there may be a lot of insulin, a little insulin, but the problem starts with insulin resistance.

01:34 See the insulin released by a type 2 diabetic pancreas can kind of be variable.

01:39 Usually the patient is resistant to that insulin, that means they've got insulin, but their body can't use it.

01:45 It's not opening those receptors to allow glucose into the cells.

01:49 These patients also require frequent monitoring and titration of their medications.

01:54 Now, progression of the disease impacts the treatment.

01:58 That's why lifestyle is so very important to any patient, but particularly to type 2 diabetes.

02:06 If we can help them change eating habits toward healthier choices, we can help them become more active, then we can slow the progression of the type 2.

02:15 So we can probably treat it with oral meds, but eventually, they may even end up needing insulin, depending on how quickly the disease progresses.

02:24 Now we're back to talking about that food and what it does in your body.

02:27 We know that the postprandial blood sugar two hours after the start of the meal, likely less than 140 for a nondiabetic, we want it to be less than 180 for a diabetic client, but notice that their blood sugar is higher.

02:41 And you know why? That's because they just don't have the insulin available, or usable in their body due to insulin resistance.

02:50 So the blood glucose rises after you eat it, right? You eat the food, the blood glucose rises, the beta cells in the pancreas would normally secrete the insulin into the bloodstream.

03:00 then the body cells would take up the glucose and the blood glucose would return to normal and there's no more stimulus for insulin.