Year: 1991
Type: article
Abstract: he patient with insulin-dependent diabetes mellitus (IDDM) presents a chal-T lenge to the surgical and nursing staff.In addition to providing general perioperative care, the staff must administer glucose and insulin to maintain serum glucose levels within a delicate range.With appropriate knowledge, the staff can assist the patient in maintaining metabolic stability during this challenging time. Pa tho physiologynsulin-dependent diabetes mellitus is a chronic illness for which there is no known I cure.Also referred to as type I diabetes, IDDM occurs annually in 15 of 100,000 people under 20 years of age.Although often considered to be a disease that primarily affects children, IDDM also occurs each year in five of 100,000 people over 20 years of age.'The pathology of this disorder lies in the failure of the pancreatic beta cells to produce insulin.Consequently, exogenous insulin is necessary to maintain the body in a normoglycemic state.Insulin is required for the passage of glucose through the cell wall.Without adequate insulin, the body is unable to metabolize glucose for energy.The body compensates by breaking down fats, which produces byproducts known as ketones.In large amounts, ketones can cause metabolic acidosis.In diabetics, this is referred to as diabetic ketoacidosis (DKA).The symptoms of DKA are polyuria, polydipsia, hyperventilation, dehydration, fruity breath odor, abdominal pain, and altered con-sciousness ranging from lethargy to coma.Diabetic ketoacidosis is a medical emergency that requires intensive treatment.When diagnosed early, it is a reversible condition.Long-term complications of diabetes include macrovascular disease, as well as microvascular disorders (ie, nephropathy, retinopathy, autonomic and peripheral neuropathy).Microvascular complications occur more frequently in individuals with histories of poor metabolic control.Treatment of vascular complications may include surgical intervention. Znsulin Therapyreatment for the IDDM patient includes diet, exercise, and insulin administra-T tion.The physician specifies a diet in accordance with the patient's growth needs and
Source: AORN Journal
Authors: Juliette U. Kelly, Timothy J. Kelly
Language: French
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W1968488340