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    Diabetes 2023

    Uploaded by

    o.adereti

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pptx, pdf, or txt
    of 18

    WHAT IS DIABETES?

    Diabetes is a chronic disease that occurs either when the


    pancreas does not produce enough insulin or when the body
    cannot effectively use the insulin it produces (WHO, 2020)

    Why control blood glucose?


     Symptom relief; improved quality of life
     To reduce morbidity and mortality
     To reduce risk of acute and chronic complications
     To reduce economic burden

    ‘short will be the life of the man in whom the disease is


    fully developed’
    Aretaeus, 120 AD
    TYPES OF DIABETES?

    Users must ensure that they do not share or allow other staff members to use their password in line with
    Information Governance Policy.
    Normal Values
    Variable rate IV insulin infusion (VRIII – Sliding Scale)

    • Monitor CBG hourly, frequency can be reduced to 2-hourly if levels are stable
    VRIII (Sliding Scale) Titration Values
    • Administer long-acting insulin i.e Glargine/levemir
    alongside a VRIII (Sliding scale).
    • Unused insulin should be stored IN A REFRIGERATOR (4°C-
    8°C)
    • After first usage, an insulin vial/pen should be
    discarded after 3 months if kept at 2°C to 8°C or 4
    weeks if kept at room temperature.
    DID YOU KNOW:
    • Patients with type 1, type 2 and gestational diabetes should have their blood glucose tested within 1 hour of
    admission.

    • In adults, blood glucose monitoring frequency should be stepped up to every 15 minutes following an episode of
    hypoglycaemia until there are two blood glucose levels greater than 6mmol/L.

    • Capillary blood ketone testing should ONLY be used in patients with established Type 1 diabetes and ketosis-
    prone Type 2 diabetes.

    • Make sure that the sampling site is clean and dry before lancing. Cleaning should only be with soap and water or
    with cotton wool/gauze dampen with water.

    • For patient’s comfort, avoid pricking thumbs or index fingers. Prick sides of the fingers only and rotate test
    sites

    • Ketone test strips should be kept in a locked drawer, not in the BM box.

    • Do not take BM box to the bedside – gather and prepare required equipment on a blue tray.

    • Meter must be cleaned between patients with clinell wipes.

    • The meter is programmed to request 2 levels of ketone QC testing every week – Monday and Thursday
    INSULIN ADMINISTRATION with vial & syringe
    INSULIN ADMINISTRATION via insulin pen

    Sharp bin
    COMPLICATIONS OF DIABETES MELLITUS

    ACUTE CHRONIC
    Hypoglycaemia Cerebrovascular disease
    Diabetic ketoacidosis (DKA) Retinopathy
    Hyperosmolar non - ketotic hyperglycaemia (HONK) Coronary Heart Disease
    OR Nephropathy
    Hyperosmolar hyperglycaemic state (HHS) Erectile Dysfunction
    Neuropathy
    Blood glucose with Blood glucose with

    Food intake (carbohydrates) Omission of, or inadequate, carbohydrate intake when


    insulin and sulphonylureas given
    Steroids Exercise
    Stress (surgery, investigations, illness, GLP – 1 analogues
    infection, post epileptic fit)

    Total Parenteral Nutrition Excessive alcohol

    Pregnancy Diarrhoea and Vomiting

    Enteral Feeds Hypothermia

    Inadequate glucose lowering agents e.g. insulin, Sepsis


    OHAs, GLP-1
    What is Insulin?

    Insulin is a hormone that regulates


    blood sugar.
    The amount of sugar in the blood is
    controlled by insulin, which is
    produced by the pancreas.
    Why and when do we need to refer to diabetic team?

     Newly diagnosed diabetes


     On insulin which needs adjustment
     Patient with uncontrolled diabetes
     When blood are abnormal
     Any medication regime changes
     To prevent complications of DM
     For health education
    Email: imperial-diabetes@nhs.net

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