Diabetes Mellitus Pathophysiology & Nursing | Diabetes Nursing Lecture NCLEX | Type 1 & Type 2

Summary

This educational video by a registered nurse delves into the intricacies of diabetes, covering its pathophysiology, types, complications, and nursing assessments. It aims to provide insights into the roles of glucose, insulin, glucagon, and the liver in diabetes management. The speaker promises a series of videos, including discussions on nursing interventions, education for diabetic patients, and mnemonic devices to aid in memorizing crucial information for nursing exams and clinical practice.

Takeaways

• 😀 Diabetes Mellitus involves the body's inability to properly use glucose due to issues with insulin.
• 📚 The video covers the pathophysiology, types, complications, and nursing assessment of diabetes.
• 🧬 Key players in diabetes are glucose, insulin, glucagon, and the liver, all of which work together to regulate blood sugar levels.
• 🚨 Glucose requires insulin to enter cells, and without insulin, high blood sugar levels can cause damage to the body.
• 💉 Insulin is a hormone produced by the pancreas that helps regulate glucose levels by facilitating its entry into cells.
• 🔄 Glucagon works in opposition to insulin, increasing blood sugar levels by converting stored glycogen in the liver back into glucose.
• 🔍 The liver plays a crucial role in glucose storage and release, responding to insulin levels to maintain blood sugar balance.
• 🔑 There are three types of diabetes: Type 1, where the body does not produce insulin; Type 2, where the body is resistant to insulin; and Gestational, which occurs in pregnant women.
• ⚠️ Complications of diabetes include hypoglycemia, organ problems, diabetic ketoacidosis (DKA), and hyperosmolar hyperglycemic state (HHS).
• 🩺 Signs of diabetes include the '3 Ps': polyuria (frequent urination), polydipsia (increased thirst), and polyphagia (increased hunger).
• 📋 The video script also mentions mnemonic devices to help remember the symptoms and complications of diabetes, such as 'I'm sweaty cold and clammy, give me some candy' for hypoglycemia treatment.

Q & A

What is the main focus of the video by the registered nurse?

The main focus of the video is to cover the pathophysiology of diabetes, its complications, different types, and the nursing assessment. It is part of an in-depth review series on diabetes.

What are the key players in diabetes according to the script?

The key players in diabetes are glucose, insulin, glucagon, and the liver. These components work together to help the body use glucose effectively.

Why is glucose unable to enter cells without insulin?

Glucose cannot enter cells without insulin because insulin acts as a key that allows glucose to attach to it and be transported into the cell where it can be used as fuel.

What is the role of insulin in the body?

Insulin is a hormone that helps regulate blood sugar levels by allowing glucose to enter cells. It is secreted by the pancreas and is crucial for the body's ability to use glucose for energy.

How does glucagon differ from insulin in its function?

Glucagon works in opposition to insulin. While insulin helps lower blood sugar levels by facilitating glucose uptake into cells, glucagon raises blood sugar levels by promoting the conversion of stored glycogen in the liver back into glucose.

What is the liver's role in glucose metabolism?

The liver plays a crucial role in glucose metabolism by storing excess glucose as glycogen and releasing it back into the bloodstream as glucose when needed, thus helping to maintain normal blood sugar levels.

What are the different types of diabetes mentioned in the script?

The script mentions three types of diabetes: Type 1, where the body does not produce insulin; Type 2, where the body is resistant to insulin; and Gestational diabetes, which occurs in pregnant women and usually resolves after birth.

What is the main difference between Type 1 and Type 2 diabetes?

Type 1 diabetes is characterized by the body not producing any insulin, often due to autoimmune destruction of the beta cells in the pancreas. Type 2 diabetes involves the body's cells becoming resistant to insulin, leading to high blood sugar levels despite the presence of insulin.

What are some of the complications of diabetes discussed in the script?

The script discusses complications such as hypoglycemia, organ problems, diabetic ketoacidosis (DKA), and hyperosmolar hyperglycemic nonketotic syndrome (HHS).

How does the body respond to low blood sugar (hypoglycemia) in a non-diabetic individual?

In response to low blood sugar, the pancreas releases glucagon, which stimulates the liver to convert stored glycogen back into glucose, thereby increasing blood sugar levels.

What is the significance of the 'three Ps' in the context of diabetes?

The 'three Ps' refer to polyuria (frequent urination), polydipsia (increased thirst), and polyphagia (increased hunger), which are common symptoms experienced by individuals with diabetes, particularly Type 1 diabetes.

What mnemonic is provided in the script to remember the symptoms of diabetes?

The mnemonic 'SUGAR' is provided to remember the symptoms of diabetes: Slow wound healing, Urinary issues, Glucose in urine, Acetone breath, Rash on skin, and Repeated yeast infections in women.

Outlines

00:00

📚 Overview of Diabetes Mellitus

In this introductory video on diabetes mellitus, the presenter, a registered nurse from RN.com, discusses the pathophysiology, complications, types, and nursing assessments related to diabetes. This video is part of an NCLEX review series and aims to provide a comprehensive understanding of diabetes for nursing exams. Viewers are encouraged to visit the website for quizzes and to access related videos in the endocrine playlist.

05:01

🔬 Understanding Glucose and Insulin

This section explains the roles of glucose and insulin in the body. Glucose is essential for cellular energy, but it requires insulin to enter cells. Without insulin, glucose remains in the bloodstream, causing high blood sugar levels. The liver stores excess glucose as glycogen, which can be converted back to glucose when needed. Insulin is secreted by the pancreas and is crucial for regulating blood sugar levels.

10:05

🧬 Role of Glucagon and the Liver

Glucagon, which works opposite to insulin, helps increase blood sugar levels by prompting the liver to release stored glycogen. The liver plays a vital role in maintaining blood sugar balance by storing and releasing glucose based on insulin levels. This feedback loop ensures normal blood sugar levels in healthy individuals, but is disrupted in diabetes.

15:07

🩺 Normal Blood Sugar Regulation vs. Diabetes

In a healthy individual, the pancreas releases insulin to manage high blood sugar after eating, and glucagon to manage low blood sugar. In diabetes, either the pancreas doesn't produce insulin (Type 1) or the body's cells are resistant to insulin (Type 2), leading to hyperglycemia. This section describes the differences between Type 1 and Type 2 diabetes, including their causes, presentations, and complications.

20:09

🏋️‍♂️ Causes and Characteristics of Type 1 and Type 2 Diabetes

Type 1 diabetes is characterized by the destruction of pancreatic beta cells, leading to no insulin production and requiring insulin therapy. It is not lifestyle-related and often presents in young, thin individuals. Type 2 diabetes is marked by insulin resistance and is often associated with lifestyle factors like obesity. Treatment typically involves lifestyle changes and possibly oral medications.

🚑 Management and Treatment of Type 2 Diabetes

Type 2 diabetes management often starts with lifestyle changes, such as diet and exercise, and may progress to oral medications or insulin injections during periods of high stress or illness. This section highlights the importance of addressing lifestyle factors to manage blood sugar levels effectively.

⚠️ Complications and Nursing Assessments of Diabetes

Diabetes can lead to severe complications like hypoglycemia, organ damage, diabetic ketoacidosis (DKA), and hyperosmolar hyperglycemic nonketotic syndrome (HHNS). Hypoglycemia results from too much insulin and presents with symptoms like sweating, dizziness, and confusion. Organ problems arise due to the sticky nature of excess glucose, leading to issues like heart disease, strokes, hypertension, neuropathy, and poor wound healing.

🔥 Diabetic Ketoacidosis (DKA) and HHNS

DKA is a life-threatening condition common in Type 1 diabetes, caused by the breakdown of fats into ketones due to a lack of insulin. Symptoms include high blood sugar, excessive thirst, and Kussmaul breathing. HHNS typically occurs in Type 2 diabetes and is marked by severe dehydration and high blood sugar without ketone breakdown. Understanding the differences between DKA and HHNS is crucial for proper diagnosis and treatment.

🧠 Recognizing and Assessing Diabetic Symptoms

Key symptoms of diabetes include the three Ps: polyuria (frequent urination), polydipsia (excessive thirst), and polyphagia (extreme hunger). These symptoms result from the body's inability to use glucose properly, leading to excessive glucose in the blood and urine. Additional signs include slow wound healing, blurry vision, acetone breath, and skin rashes, particularly in Type 1 diabetes.

🔎 Summary and Call to Action

The video concludes with a reminder to take the free quiz available on the website to test knowledge on diabetes. Viewers are also encouraged to watch the next video in the series, which will cover nursing interventions and pharmacological treatments for diabetes. The presenter thanks viewers and invites them to subscribe to the YouTube channel for more educational content.

Keywords

💡Diabetes Mellitus

Diabetes Mellitus is a chronic condition characterized by high blood sugar levels. In the video, it is the central theme, with a focus on understanding its pathophysiology, types, complications, and nursing assessment. The script discusses how the body normally processes glucose and how this process is disrupted in diabetes, leading to hyperglycemia.

💡Insulin

Insulin is a hormone produced by the pancreas that regulates blood sugar levels by allowing glucose to enter cells. The video emphasizes insulin's role in diabetes, explaining that in type 1 diabetes, the body does not produce insulin, while in type 2 diabetes, the body's cells become resistant to it. The script mentions that insulin is secreted by beta cells in the pancreas.

💡Glucagon

Glucagon is a hormone that has the opposite effect of insulin, raising blood sugar levels by promoting the conversion of glycogen to glucose in the liver. The video script explains that glucagon is important for counteracting low blood sugar, which is a state that insulin helps to prevent.

💡Glucose

Glucose, a simple sugar, is the primary source of energy for the body's cells. The video discusses how glucose enters cells with the help of insulin and how its accumulation in the bloodstream due to diabetes can lead to hyperglycemia, causing damage to various organs.

💡Liver

The liver plays a critical role in glucose metabolism by storing excess glucose as glycogen and releasing it when needed to maintain blood sugar levels. The script explains how the liver responds to both high and low insulin levels, affecting glucose storage and release.

💡Type 1 Diabetes

Type 1 Diabetes is an autoimmune condition where the body's immune system attacks and destroys the insulin-producing beta cells in the pancreas. The video script describes this type of diabetes as not related to lifestyle and usually presents in children with symptoms like ketones in the urine and sudden weight loss.

💡Type 2 Diabetes

Type 2 Diabetes is often related to lifestyle factors such as obesity and poor diet, although genetic factors also play a role. The script explains that in type 2 diabetes, the body's cells become resistant to insulin, leading to high blood sugar levels. Treatment may involve lifestyle changes, oral medications, and sometimes insulin injections.

💡Gestational Diabetes

Gestational Diabetes is a form of diabetes that occurs during pregnancy and typically resolves after birth. The script mentions that it is similar to type 2 diabetes, with the body's cells not being receptive to insulin, but it is unique in that it affects pregnant women.

💡Hypoglycemia

Hypoglycemia refers to low blood sugar levels, which can be a side effect of too much insulin or diabetes medication. The video script provides a mnemonic to remember the symptoms (sweaty, cold, clammy) and treatment (simple carbs like candy) for this condition.

💡Diabetic Ketoacidosis (DKA)

Diabetic Ketoacidosis is a life-threatening complication of diabetes, particularly in type 1 diabetics, where the body starts breaking down fats into ketones due to a lack of insulin. The script describes the symptoms, such as high blood sugar, thirst, deep breathing, and a fruity smell on the breath due to ketones.

💡Hyperosmolar Hyperglycemic Syndrome (HHS)

Hyperosmolar Hyperglycemic Syndrome is a complication of diabetes, usually seen in type 2 diabetics, characterized by very high blood sugar levels without ketosis. The script explains that patients with HHS present with dehydration, mental status changes, and extremely high blood sugar, but without the ketone production seen in DKA.

Highlights

Introduction to a series on diabetes, covering pathophysiology, complications, types, nursing assessment, interventions, and education.

Key players in diabetes: glucose, insulin, glucagon, and the liver, and their roles in glucose metabolism.

Glucose's necessity for the body and its entry into cells facilitated by insulin.

Insulin's role in lowering blood sugar levels and its secretion by the pancreas.

Glucagon's function in increasing blood sugar levels and its interaction with the liver.

The liver's sensitivity to insulin levels and its dual role in glucose storage and release.

Feedback loop explanation in a non-diabetic body and the contrast in diabetic conditions.

Differences between type 1 and type 2 diabetes in terms of insulin presence and resistance.

Causes of diabetes, including genetic, autoimmune, and lifestyle factors.

Presentation of type 1 diabetics with symptoms like ketones in urine and weight loss.

Characteristics of type 2 diabetics, often related to obesity and sedentary lifestyle.

Gestational diabetes as a unique type affecting pregnant women and resolving postpartum.

Complications of diabetes such as hypoglycemia, organ problems, DKA, and HHNS.

Hypoglycemia treatment mnemonic 'I'm sweaty, cold, and clammy, give me some candy'.

Effects of high glucose levels on blood vessels leading to various organ complications.

Diabetic ketoacidosis (DKA) as a life-threatening condition in type 1 diabetics.

Hypoglycemic hyperosmolar non-ketotic syndrome (HHNS) in type 2 diabetics characterized by extreme dehydration.

Assessment of diabetic patients focusing on symptoms like polyuria, polydipsia, and polyphagia.

Mnemonic 'SUGAR' for remembering symptoms of slow wound healing, blurry vision, acetone breath, and rashes.

Invitation to take a free quiz and subscribe for further educational content on diabetes nursing.

Transcripts

hey everyone it's s register nurse

rn.com and in this video I'm going to be

going over diabetes malius this is part

of a inlex review series on diabetes and

what I'm want to be doing in this video

is I'm going to be hitting the patho

physiology and diabetes the

complications the different types and

the nursing assessment in the next video

I'm going to be going over the nursing

interventions and I'm going to hit

really hard on the phological aspects of

um taking care of a diabetic patients

the education and the teaching and I'm

going to give you some clever pneumonics

on how to remember that stuff because

it's a lot of stuff that you need to

know for the inlex and your nursing

lecture exams and then I'll be having

some more videos coming out about dka

hhns syndrome and all those things you

need to know about diabetes so make sure

you access the playlist the enderin

playlist so you can get access to those

videos now after this lecture be sure to

go to my website register nurse rn.com

and take the free quiz says a card

should be popping up to test your

knowledge on Diabetes okay so let's get

started okay first let's talk about the

key players in diabetes because if you

understand what's going on normally in

the body you're going to understand why

the diabetic patient is having all of

these issues so the big key players in

diabetes is glucose insulin glucagon and

the liver and all of these work together

to help your body use glucose because

the big issue with diabetes is an issue

with insulin and um here in a second

you'll see why that's an issue okay so

first let's talk about glucose what is

glucose glucose is sugar and your body

loves sugar because your body needs it

to survive and what sugar does is it

enters into the cell or the glucose

enters into the cell and fuels those

cells so they can work but the catch is

is that glucose cannot enter into your

cell without the help of insulin so in

order you eat all this sugar you take it

in it enters your bloodstream but for

glucose to actually go into yourself or

your cell to use it has to have the help

of insulin and if you don't have any

insulin at all then you're not going to

have the ability to use the glucose and

the glucose is just going to hang out in

your bloodstream and cause high blood

sugars which reeks havoc on havoc on the

body now um glucose is mainly stored in

the liver in the form of

glycogen which we'll go over in depth

here in a second okay insulin what is

insulin insulin is a hormone and it

plays a huge role in helping us bring

those blood sugar levels down because

like I said it regulates the amount of

glucose in your body it attaches lets

glucose attach to it and it takes it

inside that cell so you can use it and

the big thing that you want to remember

is that insulin is secreted by your

pancreas by the beta cells of the

pancreas in the insulates of the

langerhan cell so if this area of the

body the beta cells and the pancreas get

damaged then you're in trouble you're

not going to have any insulin production

now let's talk about glucagon what is

glucagon it works in the opposite of

insulin insulin helps us bring our

sugars down glucagon helps us increase

our blood sugar so it helps with low

blood sugar level lels and um what it

does is it causes the liver because your

liver will store this glucose um if you

have extra glucose in the body the liver

will take it and store it and turn it

into

glycogen and whenever glucagon is

released it will cause that liver to

release that glycogen that it's stored

up and turn it into glucose so you can

get that glucose in your body and

increase your blood sugar levels now the

liver that's our last key player the

liver is very sensitive to insulin

levels in your body it's whenever it

senses that you have too high of insulin

levels and you have high blood sugar

levels it starts doing its job but if

you have low insulin levels you have low

blood sugar it also helps with that so

it's very vital in helping us keep those

levels nice and um normal so whenever

you have high blood sugar and a high

insulin level the liver will cause the

body to absorb that extra glucose and

will turn it into glycogen so you can

use it later on but then say all of a

sudden your glucose drops and your

insulin levels will drop as well the

liver will sense that and this will

cause the liver to release those stores

of the glycogen which will turn into

glucose and increase your blood sugar so

it helps with that now let's

recap about the feedback loop what

happens normally in the body and someone

who does doesn't have diabetes and then

let's talk about what's happening in

someone with diabetes okay so you have

high blood sugar you ate and drank a

bunch of sugary stuff so what does your

body do the pancreas says hey there's a

lot of blood there's a lot of glucose in

our body so we need to use that so the

pancreas releases insulin and the

insulin causes the glucose to enter into

the cells and there may be some leftover

and the leftover will go into the liver

and the liver will store it for later

and turn it into glycogen and then use

it whenever you need it now say you have

low blood sugar you've been working all

day as a nurse and you have an eight so

your blood sugar is level low is um

level is low so what will your body do

because it wants to help protect you the

pancreas will release glucagon now

remember glucagon works in the opposite

of insulin and this will cause the liver

to release glycogen remember all those

stores that stored up from all that

extra glucose and this will turn into

glue glucose which will increase your

blood sugar so that is what's happening

in someone who doesn't have diabetes who

has a normal healthy pancreas and they

don't have insulin issues but what is

happening to someone with

diabetes okay what's happening is that

the B you're eating all your sugar

you're eating your food but the body

cannot get to that sugar that glucose

that you're eating and this is either

due to there's no insulin present either

those um beta cells in the pancreas were

damaged or the body is resistant to

insulin you um you're secreting insulin

perfectly but those cells are like we

don't want that and they're not

receptive to that insulin so you can't

use it and in type one there's no

insulin present in type two the body is

resistant to insulin which we'll go over

in depth here in a second and whenever

that happens because your body is not

using glucose you get

hyperglycemia where you have an elevated

blood sugar in the body and it just

hangs out now when glucose hangs out in

your body this is not good it's not

meant to do that so it starts to affect

major organs of the body and the body

says hey we need some energy these cells

need to be able to work since we can't

get the glucose we've got to burn energy

some other way so it will start to burn

fats ketones which are acids and this

happens in your type one diab diabetics

and whenever you're burning those fats

and those acids it's throwing the whole

body out of whack it's going to cause

some major acid and base imbalances

which we talked about in depth in

metabolic acidosis and alkalosis or with

the type 2 diabetics what's happening is

that there is enough insulin there's

just enough where your body is not

receptive to it so it doesn't burn those

fats but instead it doesn't use the carb

so they're having issues with carbo

carbohydrate metabolism

now what causes diabetes malius the

causes are separated into three

different types you have type one type

two and gestational so let's talk about

type one okay type one remember this is

where the patient does not have any

insulin and what's happened is that

those beta cells in the insulet of the

langerhan which is in your pancreas have

been destroyed they're not working

properly at all so there is no insulin

for this for this patient so in order

for treatment they have to take

insulin now this is not related to

Lifestyle like with your type two

diabetics this is either genetic

autoimmune for instance um they got a

virus that went in wed havoc on havoc on

the body and the body attacked itself

specifically those beta cells in the

pancreas and it just doesn't work

anymore now how do these patients

present I would remember this this is

important um these patients are going to

be thin because they're burning all that

fat off because the body needs energy so

they're burning all those fats and

ketones they're going to be young uh

normally this happens in children and

it's going to happen all of a sudden and

there's going to be ketones present in

the urine where the body is breaking

down those fats now type two diabetics

What's Happening Here the cells have

quit responding to insulin so it's

insulin resistant they don't care about

the insulin and you can secrete insulin

all day and they're not going to have

anything to do with it and so what

happens the glucose just hangs out in

the body but it's like a catch 22 all

this insulin is is being produced it's

nice and fine but the cells just don't

want anything to do with it but you

still have all this glucose and the

pancreas thinks you need more insulin

because it senses that you have all this

glucose still in the body so it starts

to over secrete insulin and you start

getting the condition called hyper

insulin emia which will lead to

metabolic syndrome so not good and

treatment for this is normally the

patient um they will the doctor will

order diet and exercise that normally

helps with that but if that's not

successful they will start them on oral

medications which we will cover in the

next video in depth and um these

patients normally don't take insulin but

they may need insulin injections if um

they're having lost stress on the body

like with surgery or with infection so

that's something just to keep in mind

and this is generally type two diabetes

is related to Lifestyle either due to

being obese having a sanitary lifestyle

a poor diet lots of colas things like

that and genetic now how do these

patients present what do they typically

look like they're typically overweight

um it happens over time they're usually

adult age teenage age and um it's very

rare for them to have ketones in the Y

because remember back to this they don't

have an issue with metabolizing the fats

because there's just enough insulin but

they have issues with metabolizing those

carbohydrates now gestational just

wanted to throw that in that is a that's

another type and it's similar to your

type 2 diabetes and this is where the

cells are not receptive and it happens

in pregnant women and it will usually go

away after birth now let's look at the

complications of diabetes and the

nursing

assessment first let's talk about

complications okay complications with

diabetes you can have hypogly cmia organ

problems diabetic keto acidosis also

called dka or hypoglycemic hyper osmolar

non-ketotic syndrome which we will refer

to as hhns so let me go over these in

detail okay hypoglycemia this is the

opposite of hyper glycemia hypo means

low gly means glucose and emia means

blood so we have low blood glucose in

the blood usually it's around less than

60 milligram per Des

now whenever patients have this this is

usually a side effect from too much

insulin or too much oral diabetic

medication which we'll go over in the

next video but they're going to present

as being sweaty and clammy confused Li

headed dizzy and double vision now to

help you remember how to treat someone

with hypoglycemia because you want to

treat it fast and remember this saying

I'm sweaty cold and clammy give me some

candy so these patients who are H having

hypoglycemia need a simple carb remember

that um I remember a test question from

nursing school and it gave us the

glucose and it said what would be a

treatment and what the option was simple

carb complex carb and listed all these

things but it's a simple carb of what

they need and simple carbs are like your

hard candies like Lifesavers um fruit

juice graham crackers honey things like

that that can hit the body body can

absorb and take in and use now if the

patient's unconscious they can't eat um

normally in the hospital setting

whatever the doctor orders you will give

them a IV

D50 okay now let's look at organ

problems okay glucose think about it in

our real life sugar if you get sugar on

your hands it's really sticky the same

concept can apply to whenever it gets

you get way too much in the blood what

it does is it causes AOS scerotic um

issues where you're having um hardening

of the vessels now what this does is

this glucose enters into the blood

glucose is naturally sticky so it's

going to start to stick to those

proteins of the vessels and they become

hard and they form plaes and normally

your vessels are nice and um pliable and

they're not hard and when they're hard

they don't work properly so let's think

of all the systems in the body that are

affected by hard vessels your heart you

can get heart disease it's going to on

those coronary arteries make them hard

blood flow is going to be narrow and

there's also some plaques that can form

can cause an MI my cardial infarction

Strokes um a lot of strokes happen with

that weakening of those vessels um

hypertension again you have stiff hard

vessels that's going to increase um

resistance on your vessels causing

hypertension

neuropathy um decrease wound healing

again that is because um you're you have

decreased compromis circul

from those hardening of those vessels

you can't get all that um all those

cells there to work to help heal that

wound so they will have slow wounds on

their feet especially on their feet eye

trouble and infections okay let's look

at diabetic keto acidosis dka now in the

other videos coming up in this series

we're going to go in depth about dka

treatments and all that and we're going

to actually compare it with

hhns because people get these two

conditions confused but let me help

break it down for you so you can

understand a little bit okay dka this

happens in your type one diabetics it's

super rare to happen in type two it's

type one so keep that in mind and

another issue with this is they are

burning ketones let the name help you

out diabetic keto acidosis okay remember

what we were talking about diabetes type

one they don't have any insulin insulin

helps glucose go into the cell for

energy so the body's like hey we don't

have anything for energy so we've got to

start burning fats ketones so what

happens is that the body is burning

those ketones like crazy and this is

causing um acids to iner into the blood

whenever those ketones break down and

then you're getting some acid base

imbalances this is lifethreatening they

need to be treated and how your

patient's going to present they're going

to have extremely high blood sugars and

they're going to be very thirsty and

they're going to have the cosmal

breathing remember that that's because

all that acid build up in the body

respiratory system is trying to blow

blow off that acid by those deep long um

breaths rapid breaths and they can also

have the acetone breath which is like

that fruity smell in their breath and

that's just because of all those ketones

breaking out now let's let's look at

hhns okay this happens typically in your

type 2 diabet

diabetics and part of HHS the n stands

for non-ketotic so there is no breakdown

of ketones in this because remember with

type two diabetes they have just just

enough insulin where they don't have to

break down the fats instead they have

carbohydrate issues so um what you're

going to have is no burning of the

ketones you're just going to have um

dehydration the patient going to be very

dehydrated they're going to be thirsty

and they're going to have mental status

changes and their blood sugars are going

to be crazy high but there's going to be

no Ketone issues now how is a patient

going to present to you um whenever

you're assessing them what signs and

symptoms are they going to have okay you

want to remember for this these are

typically test questions okay the three

PS for hypoglycemia because the issue

with diabetes is they have high blood

sugars so the three PS which are

polyuria polydipsia and

polyphasia okay what's polyura polyurea

is where poly means many um Uria means

urine so they're having frequent

urinations they are peeing a lot they're

getting a lot of um urine output why is

this happening okay this happen happens

because of the rule of Osmosis remember

in our hyperonic isotonic hypotonic

video and we talked about osmosis this

is where water likes to be where there's

a higher concentration so it's going to

move to higher concentration lower

concentration higher concentration and

what's happened is there's all this

glucose in your blood and the cells in

inside the cells there's water and the

water's like hey all the glucose is in

the blood let's move out of the cell and

go into the bloodstream so you have all

this water shifting into the blood that

causes a lot of fluid so what system of

the body gets rid of extra fluid the

kidneys so the kidneys start putting out

all this extra fluid you have but also

whenever the kidneys is doing that one

of the roles is that it reabsorbs

glucose but there's way too much glucose

in the blood so the kidneys can't cope

with this so they start leaking glucose

so you're going to see glycose uad that

means you're going to see glucose in

their urine next they're going to have

poly dipsia and this plays into the

polyurea all these play off of each

other so poly dipsia poly means many

dipsia means thirst drinking so um

they're going to be very thirsty and

this is because of the polyera because

they're putting out all this fluid the

body's like hey we got to keep drinking

to keep hydrating ourselves because

we're putting out all this water and

then the polyphasia that means they're

very hungry they're just constantly

craving food and this ties back to

burning all the fats all those ketones

um the body needs the energy because it

can't get to the glucose so the body's

like hey we've got to eat keep eating

food so we can keep burning this energy

and these three PS are mainly seen in

your type one diabetics okay now let's

look at another pneumonic remember the

word sugar this is what you're going to

see in both the type one and the type

two okay s for slow wound healing again

that's because of that glucose being

sticky hardening those vessels so you

have decreased per Fusion to help heal

those wounds the U blurry blurry vision

again that's because the damage to the

eyes with all that glucose a glyco Uria

that's where the kidneys can't cope with

all that extra glucose so it leaks into

the um urine a for acetone breath that

is mainly seen in your type ones and

that's because of the burning of the

ketones it gives off that fruity smell

of the breath R for rashes on the skin

and repeated yeast uh infe

in women because yeasts love glucose if

you have too much glucose yeast is going

to build up and they have repeated

vaginal infections of yeese okay so that

is about diabetes malius now don't

forget to take that free quiz a um you

should get the card or it's down in the

description below and be sure to check

out that other video where I'm going

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covering covering the phological aspects

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