Insulin‐Dependent Diabetes

作者：Juliette Urtis Kelly, Timothy Kelly · 发表于：AORN Journal · 年份：1991 · DOI：10.1016/s0001-2092(07)67005-7 · 被引用次数：61 · 研究领域：Clinical practice guidelines implementation、Diabetic Foot Ulcer Assessment and Management、Hyperglycemia and glycemic control in critically ill and hospitalized patients

he patient with insulin-dependent diabetes mellitus (IDDM) presents a chal-T lenge to the surgical and nursing staff.In addition to providing general perioperative care, the staff must administer glucose and insulin to maintain serum glucose levels within a delicate range.With appropriate knowledge, the staff can assist the patient in maintaining metabolic stability during this challenging time. Pa tho physiologynsulin-dependent diabetes mellitus is a chronic illness for which there is no known I cure.Also referred to as type I diabetes, IDDM occurs annually in 15 of 100,000 people under 20 years of age.Although often considered to be a disease that primarily affects children, IDDM also occurs each year in five of 100,000 people over 20 years of age.'The pathology of this disorder lies in the failure of the pancreatic beta cells to produce insulin.Consequently, exogenous insulin is necessary to maintain the body in a normoglycemic state.Insulin is required for the passage of glucose through the cell wall.Without adequate insulin, the body is unable to metabolize glucose for energy.The body compensates by breaking down fats, which produces byproducts known as ketones.In large amounts, ketones can cause metabolic acidosis.In diabetics, this is referred to as diabetic ketoacidosis (DKA).The symptoms of DKA are polyuria, polydipsia, hyperventilation, dehydration, fruity breath odor, abdominal pain, and altered con-sciousness ranging from lethargy to coma.Diabetic ketoacidosis is ...