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Class Progress
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Chapter Listing

Diabetes Management and Insulin Pumps - DEMO


Type 2 diabetes is a much more complex disease and involves several organs in addition to the pancreas. Insulin resistance occurs at the cellular level, there is an overproduction of glucose by the liver, leptin resistance occurs due to obesity, and a deficiency occurs in the gut hormone GLP1. Over many years, with the pancreas working hard to produce enough insulin to overcome all these obstacles in an attempt to maintain glucose control, there is a decrease in the amount of insulin the pancreas is able to produce until corrections in the underlying problems are resolved. For that reason, people with Type 2 diabetes may also require insulin. People with Type 2 may also need insulin and if they need  MDI of insulin, the insulin pump may be  prescribed to provide the needed exogenous insulin.
It is important to know which type of diabetes your patient has. This should be documented on the admission medical history. Type 1 patients are extremely prone to the rapid onset of ketoacidosis, a medical emergency, if their insulin requirements are not adequately met. Type 2 patients, on the other hand, are much less prone to ketoacidosis, although the same interventions need to be taken to assure adequate insulin delivery. An important caveat to remember is that just because a patient is currently using insulin does not tell you what type of diabetes they have. A person with Type 2 will always make some endogenous insulin, even though they may also require exogenous insulin to maintain glycemic control. Type 2 patients will usually be on diet and exercise when first diagnosed, pills are added as time goes on, and eventually insulin may be added. Type 1 patients do not make any endogenous insulin and, therefore, their lives depend on exogenous insulin. They go on insulin at the time of diagnosis.
Q: [Insulin resistance] - Body tissues have a decreased response to insulin resulting in the pancreas producing high levels of insulin in attempt to maintain glucose.
Q: [Leptin resistance] - Excess fat tissue produces excess leptin that leads to a decreased signal to brain for weight and appetite control and other metabolic effects.
Q: [Type 2 diabetes] - A multi-factorial disorder of carbohydrate metabolism that results in hyperglycemia.
Q: [MDI] - Multiple Daily Injections of insulin with syinge or insulin pen.
Q: [Exogenous] - Insulin supplied by a source other than the body such as from injections with a syringe or insulin pen or an insulin pump.
Q: [Ketoacidosis] - A metabolic emergency created by an inadequate amount of insulin available to utilize carbohydrates for energy. Type 1 are very prone.
Q: [Endogenous] - Originating or developing from within
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