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Denise Coffey MSN, RN American Diabetes Association:www.diabetes.org Nearly 26 million Americans have diabetes and an estimated 79 million U.S. adults have prediabetes‚ according to new estimates from the Centers for Disease Control and Prevention (CDC). The National Diabetes Fact Sheet for 2011 says that diabetes affects 8.3 percent of all Americans and 11.3 percent among those aged 20 and older. An estimated 7 million Americans with diabetes do not know they have the disease!! Insulin: what is it’s function?? Glucose: what is it’s function?? Type I –which is? Type 2 –which is? Gestational Diabetes (GDM) Other specific conditions resulting in hyperglycemia Hyperglycemia: what would you expect to see? Lab work Where do we want to see our patient’s lab values at? Hypoglycemia: what are some signs and symptoms? What are you going to do as the RN assigned to a patient experiencing hypoglycemia? Microvascular: you tell me! Macrovascular: you tell me! 3 P’s: polyuria, polydipsia, polyphagia Describe other assessment findings you would need to be on the look out for. Blood Glucose >110 Insulin Resistance Increased Free Fatty Acid Oxidative Stress Decreased Insulin Oxidative Stress Nitric Oxide Endothelin-1 Angiotensin ll Vasoconstriction hypertension Vascular smooth muscle cell growth Nitric Oxide Activation of activator protein -l Nitric oxide Tissue factor Plasminogen Activator Prostaccyclin Inflammation Thrombosis Angiotensin ll Release of chemokines Release of cytokines Expression of cellular adhesion molecules Hyper coagulation Platelet Activation Decreased Fibrinolysis Immune Dysfunction Infection Dissemination Increase in: Ketones Free Fatty Acids Lactate Cellular Injury Inflammation Tissue Damage Altered Tissue Healing Acidosis Thrombosis Global Infarction Ischemia Reactive 02 Species Increase Transcription Factors Leads to Secondary Meadiators Diet –what teaching would you provide to your patient? Exercise PO medications- what teaching would you provide to our patient Insulin therapies Insulin pumps Pancreas transplant Patient education: What education would you need to make sure you patient receives?