The article "Diabetes mellitus and ...

The article "Diabetes mellitus and its chronic complications" is the basis for this AORN Journal independent reflection The behavioral objectives and examination for this program were prepared by way of Barbara K. Bailes, RN, EdD C NP-C with consultation from Susan Bakewell, RN M education program professional, Center for Perioperative Education.

A minimum score of 70% onward the multiple-choice examination is necessary to earn 35 contact hours for this independent inquiry Participants receive feedback on incorrect answers. Each applicant who fortunately completes this study will receive a certificate of completion. The deadline for submitting this studious mood is August 31, 2005.

forward the completed application form, multiple-choice examination, learner evaluation, and appropriate absolute title [i]or[/i] posession to

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BEHAVIORAL OBJECTIVES

After reading and studying this article in succession diabetes mellitus and its complications, the foster will be able to

(1) compare and contrast symbol 1 and type 2 diabetes mellitus,

(2) define the pathogenesis of emblem 2 diabetes as it evolves

(3) explain the major complications of diabetes mellitus,

(4) discuss fresh findings regarding the pathogenesis of vascular disease and its major complications,

(5) describe the clinical manifestations of peripheral neuropathy,

(6) discuss management of patients with impressed sign 2 diabetes, and

(7) identify possible complications associated with representation 2 diabetes.

This program come togethers criteria for CNOR and CRNFA recertification, as well as other continuing education requirements.

Diabetes Mellitus and its Chronic Complications

Diabetes mellitus ofttimes is referred to as a silent killer because it annually contributes to approximately 18% of all deaths in the United States among patients who are age 25 and older Diabetes is a significant risk factor for early storm of atherosclerotic vascular disease and coronary heart disease. The rate of heart disease in patients with diabetes is double that of the general population. Heart disease is the leading cause of death in patients with diabetes and has a mortality rate that is six times greater among male patients with diabetes and four times greater among female patients with diabetes. (1) Other complications of diabetes are retinopathy, nephropathy, and neuropathy. (2)

each day, patients with diabetes meet with scheduled or emergency surgical conducts Perioperative nurses often are aware of the chronic complications that fret patients with diabetes, but they may not be familiar with now passing findings and treatment goals. The drift of this article is to provide a brief overview of the pathogenesis of emblem 1 and type 2 diabetes mellitus; the chronic complications and underlying pathophysiology of diabetes mellitus; various treatment protocols being investigated to obstruct reverse, or alleviate chronic complications of diabetes; treatment protocols; and nursing interventions that can be used to provide intraoperative care for patients with diabetes undergoing surgery

EPIDEMIOLOGY

The prevalence of diabetes mellitus worldwide has increased dramatically during the past small in number decades, and it is look fored to increase even more in the time to come In the United States, approximately 16 million Americans have diabetes mellitus, and more than 90% of these have exemplar 2 diabetes mellitus. Each year, approximately 800000 Americans are diagnosed with diabetes mellitus, and many others remain undiagnosed. In addition, there are countles populace with impaired glucose tolerance (ie, prediabetic condition) or insulin resistance. Diabetes mellitus is confirmed when an individual has a fasting plasma grape-sugar of 126 mg per dL or higher. (3) Table 1 lists major risk factors for shadow 2 diabetes mellitus. (4)

The incidence of diabetes mellitus essentially is the same for males and females, and it increases with age. The prevalence of known cases rises from about 6% in tribe age 45 to 64 years to approximately 12% in those age 65 and old In the older age collection more women than men are diagnosed with diabetes each year. High-risk clusters include African Americans, Hispanics, Native Americans, Asian Americans, and Pacific Islanders. Regardless of race or ethnicity, however, obesity and advancing age the two are correlated to the increased incidence of diabetes mellitus. (5) Table 2 lists criteria for the diagnosis of diabetes mellitus. (6)

CATEGORIZING DIABETES MELLITUS

Diabetes mellitus is a cluster of metabolic diseases caused from a complex interaction of genetic, immunological, and environmental factors, as well as life-style choices. These diseases also feature chronic hyperglycemia. Chronic hyperglycemia is associated with microvascular and macrovascular changes that accrue in organ damage, dysfunction, or failure. apts believe that microvascular changes begin when the diabetic state becomes open (ie, fasting blood glucose is at or higher than 126 mg by dL), and macrovascular changes begin many years earlier. (7)