Author Archives: admin

Psychological Aspects Of Type 1 Diabetes In Adults

  By admin | November 3, 2011 - 1:02 pm | Type 1 diabetes
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When considered from an experiential perspective, type 1 diabetes (Type 1 diabetes mellitus) represents a significant stressor for individuals and their families. A comprehensive understanding of psychological factors related to Type 1 diabetes mellitus requires investigation of (/) the impact of Type 1 diabetes mellitus upon psychological adjustment and (ii) the impact of psychological adjustment upon medical outcomes for diabetes mellitus 1. Both of these directions of influence are reviewed below regarding each of the most prevalent and/or problematic psychological adjustment problems for adults with Type 1 diabetes mellitus. When comparing with other chronic health conditions, from an experiential perspective, it is important to consider: •   disease factors, including … Continue reading →

Depression

  By admin | November 3, 2011 - 1:01 pm | Type 1 diabetes
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A well-developed literature has investigated the comorbidity between Type 1 diabetes mellitus and depression, and the relationship of depression to medical outcomes among those with Type 1 diabetes mellitus. It has been shown that individuals with diabetes mellitus have a disproportionately higher rate of psychiatric disorders, with affective and anxiety disorders being more commonly diagnosed than in the general population. In one study of Type 1 diabetes mellitus and type 2 (type 2 diabetes mellitus) inpatients, 52% presented with at least one lifetime psychiatric disorder, and 41.3% presented with a diagnosis within the past 6 months. In this sample, affective and anxiety disorders represented 83% of … Continue reading →

Anxiety

  By admin | November 3, 2011 - 12:59 pm | Type 1 diabetes
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A significant literature has addressed the prevalence of anxiety comorbid to Type 1 diabetes mellitus. A meta-analysis of 2584 individuals with either Type 1 diabetes mellitus or type 2 diabetes mellitus, found that 14% of the sample showed symptoms of generalized anxiety disorder, and 40% of the sample reported elevated symptoms of anxiety. Although these studies included participants with both types of diabetes, the rates of anxiety were similar for Type 1 diabetes mellitus and type 2 diabetes mellitus. Thirteen percent of young individuals developed an anxiety disorder during the 10 years following their diagnosis of Type 1 diabetes mellitus. Additionally, … Continue reading →

Dysregulated Eating

  By admin | November 3, 2011 - 12:58 pm | Type 1 diabetes
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Approximately 5 % of women and 1 % of men suffer from anorexia nervosa, bulimia nervosa, or binge eating disorder. An estimated 1 in 100 American women binges and purges to lose weight and 15 % of young women have significantly disordered eating attitudes and behavior. Although eating disorders can strike anyone, the most common demographic affected is adolescent, Caucasian females, of middle to upper middle class socioeconomic status. At particular risk, however, may be people who modify their diet because of an illness such as diabetes or celiac disease. When considering the development, prevalence, … Continue reading →

Insulin Therapy In Adults With Type 1 Diabetes Mellitus

  By admin | November 3, 2011 - 12:50 pm | Type 1 diabetes
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Insulin is the cornerstone of pharmacotherapy for the estimated 0.73 to 1.46 million persons with type 1 diabetes mellitus in the United States. While the peak incidence … Continue reading →

Potential Complications Of Insulin Therapy

  By admin | November 3, 2011 - 12:48 pm | Type 1 diabetes
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Potential complications directly related to insulin itself which both the health-care provider and the patient should be aware of are hypoglycemia, weight gain, exacerbation of retinopathy, insulin allergy, and lipodystrophy, each of which will now be discussed. Hypoglycemia The normal physiologic response to hypoglycemia includes early suppression of insulin secretion, release of glucagon and catecholamines, and later release of cortisol and growth hormone. It is important to understand that persons with Type 1 diabetes mellitus have alterations in the physiologic suppression of insulin and release of glucagon expected in response to low blood glucose, which impairs ability to return blood glucose levels to normal. … Continue reading →

Physiologic Replacement Therapy Insulin Regimens

  By admin | November 3, 2011 - 12:47 pm | Type 1 diabetes
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Conventional Insulin Therapy Conventional insulin therapy is used to describe simpler, usually fixed dose insulin regimens, such as single daily injections, or two injections per day of regular and NPH insulin, either mixed together in the same syringe or provided as a premix of insulins, which are given in prespecified doses before breakfast and dinner. Such regimens are based on the concept that each of the insulin components in the two doses is covering insulin needs for … Continue reading →

Insulin Dosing Adjustments And Pattern Management

  By admin | November 3, 2011 - 12:45 pm | Type 1 diabetes
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With experience and close observation of blood glucose results and insulin doses, the health-care provider and the patient can identify patterns that will suggest a need for adjustment in insulin doses to enable attainment of blood glucose targets and Ale goals in the adult Type 1 diabetes mellitus patient who is on an intensive insulin therapy regimen, whether it be with multiple daily insulin or CSII. Pattern management refers to the practice of reviewing a patient’s blood glucose logs, identifying patterns, and/or trends where blood glucose is outside or might be expected to deviate from designated target ranges, and taking … Continue reading →

Guidelines For Dosing Correction/Supplemental Insulin

  By admin | November 3, 2011 - 12:44 pm | Type 1 diabetes
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Correction or supplemental doses of insulin are administered to correct hyperglycemia that results in spite of the patient having taken the usual prescribed basal and prandial insulin doses. Correction or supplemental doses of insulin is taken in addition to the usual basal and/or bolus insulin dose(s) to be administered at the time when the finger-stick blood glucose is checked and found to be high. The Correction or supplemental doses of insulin should not be large enough to cause, nor taken so frequently that overlapping peaks (insulin stacking) will result in hypoglycemia. Typically, approximately 1U of short-or rapid-acting insulin will lower blood glucose by 40 to 50 mg/dL in the patient with … Continue reading →

Diabetes Education, Nutrition, Exercise, And Special Situations

  By admin | November 3, 2011 - 12:35 pm | Type 1 diabetes
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EDUCATION Diabetes education is required for all who are diagnosed with diabetes regardless of kind of diabetes or the age of the patient. Diabetes education does not ensure that patients will follow instructions and do everything that they are asked to do. Education is necessary but patients should be able to make the decision as to what they are willing to do to maintain or improve their health. Educators need to remember that just because someone decides that they will not follow directions for care, education was wasted. Everyone deserves to make an informed decision. … Continue reading →