INTRODUCTION: TYPE 1 DIABETES & DKA
J.D. is a 16-year-old female with a medical history of Type 1 Diabetes. She presents to the Emergency Department, complaining of vomiting, excessive thirst, confusion and shortness of breath. Her mother states J.D. had been throwing up all night and was confused this morning, so her mother took her blood sugar and it was 380 mg/dL. At that point, her mother immediately brought her to the Emergency Department. At the ED, her blood sugar was taken again and it was 492mg/dL, her urine was checked and was positive for ketones, and her breath had a fruity scent. Arterial blood gases were drawn and showed metabolic acidosis. At this point the Emergency Room MD diagnosed her with Diabetic Ketoacidosis.
J.D.
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Adolescence is a time of increased independence, questioning authority, and continuously redefining one’s identify. Thus, it is no surprise that this can also be the scariest time in terms of managing one’s diabetes and glucose control. The primary concern and necessary intervention for this patient is immediate care for DKA, blood glucose control and appropriate psychosocial interventions and education with the family.
CASE STUDY DEMOGRAPHICS
J.D. is a 16-year-old female who lives in La Jolla in San Diego with her parents. She is the only child of her two parents who emigrated from Russia before she was born. They are an upper middle class family and are able to afford healthcare and education related costs for their child. J.D. is a junior at a public high school in La Jolla. She had to make up credits in summer school because she missed a significant portion of her sophomore year related to absences due to complications from her diabetes, including another hospitalization related to DKA.
ANATOMY AND PHYSIOLOGY OF TYPE 1 DIABETES AND DKA
Type 1 Diabetes typically presents initially in children under the age of 12. McCance and Huether (2010) explain that Type 1 Diabetes is an autoimmune disease, where the beta cells found in the islets of
Diabetes is a disease that can be devastating to some families, but it is not that bad as it seems. With the correct amount of exercise and moderation, it can be maintained with several different methods. A large part of the United States population has a form of diabetes. Today, there are many treatments that improve the lives of those living with this disease. With the correct understanding, it can be manageable and change the lives of the diabetic and his/her family. Some people may think of this as a bad thing for children to have but with the proper management and exercise, it can be maintained as well as bring a family closer to one another. As a brother of a type 1 diabetic, I know how hard it is to live with it and how to
There are a number of different healthcare professionals who treat diabetes. While many people work with their primary care physician to manage diabetes, others rely on one or more doctors and specialists to monitor their condition. Talk to your doctor about testing if you are at risk for diabetes or begin experiencing symptoms associated with the disease. The following sections discuss the different doctors and specialists who can assist in various aspects of diabetes diagnosis and care.
Diabetes one, and two revolve around the hormone insulin. Insulin is produced by the pancreas and its job is to help the cells in the body absorb glucose from the blood. Once the glucose is absorbed it signals beta cells from the pancreas to secrete insulin. Insulin enables glucose to enter cells of the liver and muscle. After the glucose has entered the cells, hormones that include insulin, decided if the glucose will be used as energy, or stored as glycogen for the future. The stored glycogen is important because if you haven’t eaten and your blood sugar is low, the body can take from the stored glycogen and use it as a source of energy.
Diabetes Mellitus is currently classified as type one and type two. Type one diabetes is characterized as a complete lack of insulin due to the destruction of the pancreatic cells. Type one is thought to come from an interaction between a genetic component or an acquired environmental component (auto immune). Type one diabetes, develops over the course of years. The peak age for diabetes is ten to fourteen years. With beta cells destruction happening before the disease is diagnosed.
Diabetes is one of the most prevalent diseases to this day. With over 171 million cases of diabetes all over the world, this disease is spreading exponentially fast. Lesser known as Diabetes Mellitus, this disease is all about the amounts of sugar in one's body. Glucose, in particular. Glucose is the powerhouse of the body. It helps run your body by transforming into the energy that we use to function on a daily basis. Whether or not one's diabetes is minor or even off the charts it can lead to terrible outcomes. These include stroke, blindness, vascular disease and heart disease. As mentioned before, the major symptom of diabetes is that too much sugar is in one's body. This is similar to a disease previously mentioned, hemochromatosis. However,
Diabetes is a very common disease around the world. If you treat it properly it will not create any future problems and you can live a healthy life. Diabetes has to do with a lack of insulin in the body which causes high blood sugar. There are several forms of diabetes, but type 1 forms when you body suddenly is unable to produce the insulin your body needs to function. Unlike other types, signs of type 1 develop very quickly leading to the disease forming within days or weeks.
During 2008-2009, 18,436 people younger than twenty years of age were diagnosed with type one diabetes. Because of diabetes, 18,436 people had to completely change their way of life for a disease that is currently incurable. Out of the U.S population, 9.3%, or 29.1 million people, currently live with diabetes. Each year, 40,000 new cases of diabetes are diagnosed in the U.S. Between 2001 and 2009, the number of cases of type one diabetes in people younger than twenty years of age increased by 21%. The annual healthcare costs associated with type one diabetes totals $14 billion. Diabetes is a life-altering disease whose affects can be seen at all stages of life. If it is not well managed, diabetes can result in blindness, nerve damage, loss of limbs, cardiovascular problems, and death.
Type I Diabetes was once referred to as Juvenile Diabetes or Insulin Dependent type Diabetes Mellitus (IDDM). Type 1 diabetes, is an incurable but treatable disease which can occur at any age but is mostly found in children. Couch et al. (2008) states, “Juvenile diabetes affects about 1 in every 400-600 children and more than 13,000 are diagnosed yearly” (pg. 1). A 2014 CDC fact sheet concerning diabetes, showed that, “In adults, type 1 diabetes accounts for approximately 5% of all diagnosed cases of diabetes in the United States.” It seems that we all know someone who is affected by diabetes; either type 1 or type 2. Diabetes seems to be such a common-place illness and is much more prevalent in today’s society. However, this hasn’t always been the case. Gale (2002), states, “At the start of the 20th century, childhood diabetes was rare… (pg. 3353).” In this paper, I will provide information about Juvenile or Type I diabetes in order to educate the reader about this illness.
People living with type 1 diabetes can have a difficult time self-management, especially because majority of the people with type 1 diabetes are young. In the review paper written by Deborah Wiebe, Vicki Helgeson, and Cynthia Berg (2016), they talk about people with type-1 and type 2 diabetes and how they self-manage having the disease and how they live their life. They go into depth on the social context on living with diabetes and living a long life span. They highlighted how young children and adolescent are diagnosed with type 1 diabetes and how parents with children that has type 1 diabetes have to teach their children how to control their blood pressure and all other things. It can take a stress on the parent because the child can be diagnosed at an early age when they do not know how to do complex task.
Type-1 diabetes is usually diagnosed in children and young adults. In Type-1 diabetes, the body does not produce insulin. Insulin is a hormone that is needed to convert sugar, starches, and other food into energy needed for daily life. With Type-1, the cells in the pancreas make little or no insulin. This means there is not enough insulin to help glucose get into the cells. Instead, it is dumped into the urine and the body gets rid of it. Because of this, those with Type-1 diabetes have to inject insulin to help move glucose into the cells.
In recent studies, Diabetes type 1 has been scientifically linked to a chronic autoimmune disorder. The immune system attacks the beta cells, in the Islets of Langerham, located in the pancreas. This leads to the insulin producing cells to be destroyed and damaged, which ultimately ends up with very limited blood glucose or no insulin production at all.
According to the given scenario and its manifestations, it is evident that the type of diabetes that RJ has is Type 1 Diabetes. The various signs and symptoms which help identify this type of diabetes as type 1 diabetes is through the fact that RJ was diagnosed with diabetes since the age of five. Type 1 diabetes also formerly known as juvenile-onset, most often occurs in younger individuals, predominantly those below the ages of 30 (Lewis, 2014, p.1431). Furthermore, individuals with Type 1 diabetes are dependent on insulin for their lifetime as without it their body is unable to maintain a hemostatic environment. This is evident in RJ’s case where due to her act of skipping her insulin medication, her blood glucose levels have tremendously
Diabetes and age: type 1 DM typically develops in children aged 4 years and older. And the peak incidence in children occur between the age of 11 and 13 years. Some cases of type 1 diabetes occur in adults. And cases of type 1 DM have been reported in people in the 8th and 9th decade of life. Almost all cases of type 1 DM are caused by autoimmune destruction of the pancreatic beta cells. But there are a small number of patients (mostly African-American or Asian) that develop idiopathic type 1 DM. this form of
Sometimes too much sugar really is a bad thing. Diabetes is a metabolism disorder that affects many people in today’s world. Diabetes can be many diseases that deal with the hormone called insulin, which is produced by the pancreas. The pancreas is a gland in the endocrine system that creates insulin and maintains the body’s glucose balance. Insulin regarding diabetes is important since people who are diagnosed with diabetes are in the stage where their body does not make enough insulin or their cells are not accepting the insulin, which leads to high levels of sugar in the blood. This problem leads to the two main types of diabetes: type 1 and type 2 diabetes.
Breathe in, breathe out. My lungs rattle as I gasp for air in the humid afternoon. The sun beats down on my forehead as sweat drips onto the blistering tar. My jersey sticks to my skin as I clench my fists. Breathe in, breathe out. My legs flood with lactic acid, but I march ahead. Coach’s voice interrupts the pounding of my feet, urging me to fight on. I feel a sudden burst of adrenaline rush through my body and I drive my legs up the hill. Breathe in, breathe out. Midway, my vision begins to blur. Numbness diffuses across my arms until I’m left paralyzed. I realize my blood glucose is dangerously low but I still push forward. My body stiffens and I collapse onto the dehydrated grass beneath me. I stare up at the sky and see the sun begin