Type 1 diabetes is an autoimmune disorder in which insulin producing cells are destroyed. Insulin is a hormone produced by the pancreas, that controls the level of glucose in the blood. Without insulin present glucose can not enter into the cells. There is no definite cause of type 1 diabetes; it is thought to stem from a combination of genetic, immunologic, and environment factors. Diabetes type 1 is also called juvenile diabetes because the onset is usually during childhood.
The symptoms include:
- increased urination
- increased thirst
- blurred vision
- weight loss
The primary treatment for type 1 diabetes will be insulin injection. The insulin injections could range from 1-7 times a day with a combination of short and long acting insulin. This is important because if insulin is not available for energy consumption the body will burn fats. When fat breakdown occurs, the result is ketone production. If ketones are present in the body; clients are at risk for diabetic ketoacidosis.
Diabetic Ketoacidosis (DKA) is a life threatening condition that occurs when not enough insulin is present. The three main symptoms are:
- Dehydration/electrolyte loss
The ketone production will create an acidotic state in the body. Dehydration will be caused by excessive urination, clients may lose up to 6 liters a day. Hyperglycemia is caused due to a lack of insulin.
Other signs of DKA: fruity breath, abdominal pain, nausea, vomiting, hyperventilation
Treatment for DKA will be IV fluid + electrolytes and Regular Insulin IV. The Insulin will reverse both the acidosis and hyperglycemia.
NCLEX Review Questions:
What is the primary way type 1 diabetes is controlled?
What is the life threatening condition that can occur if type 1 diabetes is uncontrolled?
If ketones are present in the body should the client exercise?
What is the treatment for diabetic ketoacidosis?
**Remember if insulin injection is the primary mode of treatment for type 1 diabetes education will be the key.
On NCLEX remember to teach about:
- blood glucose monitoring
- different types of insulin
- giving insulin with meals
- prevention of diabetic complications
No-will cause more fat to be consumed for energy leading to more ketone production
IV fluids and insulin