DIABETES MELLITUS

Presented by: Ivy Rose Duhilag

BLOOD PRESSURE is created by the force of blood pushing against the
walls of blood vessels (arteries) as it is pumped by the heart. The
higher the pressure the harder the heart has to pump.

SYSTOLIC PRESSURE
blood pressure is highest when the heart beats, pumping the blood.

DIASTOLIC PRESSURE
When the heart is at rest, between beats, the blood pressure falls.
RISK FACTORS: OTHER CONTRIBUTING FACTORS:
• Age • Physical inactivity
• Race • Salt-rich diet (processed, fatty foods)
• Family History • Low K+ diet
• Sex • Alcohol and tobacco use
• Overweight/Obese
• Existing Health conditions
• Stress
PRIMARY (ESSENTIAL) HPN
there's no identifiable cause of high blood pressure.
It can result from multiple factors and may develop over time.
It is also influenced by environmental factors, such as stress and lack of exercise.

SECONDARY HPN
has specific causes and is a complication of another problem.
• Diabetes Mellitus • Congenital Adrenal Hyperplasia
• Kidney Disease, CKD • Hyperthyroidism
• Pheocromocytoma • Pregnancy
• Cushing Syndrome • Obesity
If the reading shows a hypertensive crisis, wait 2 or 3 minutes and retake.
If the reading is the same or higher, this is a medical emergency.
Seek for immediate medical attention!
A person with hypertension may not notice
any symptoms, and it is often called the
"silent killer"
 STROKE Arteriosclerosis Arrhythmias

HEART FAILURE ANEURYSM Pulmonary Edema

Hypertensive Retinopathy

Preeclampsia and Eclampsia

TIA (Transient Ischemic Attacks)

 HYPERTENSIVE ENCEPHALOPATHY
- a change in mental status, frequently accompanied by headache and nausea, that
results from swelling in the brain caused by alterations in blood flow at very high blood
pressure.

KIDNEY DISEASE – Blood is filtered through the kidneys, and when the small blood
vessels of the kidney are damaged by chronic uncontrolled hypertension, the body becomes unable
to filter waste.

DEMENTIA - Narrowed or blocked arteries can limit blood flow to the brain,
leading to vascular dementia.
 SEXUAL DYSFUNCTION
• MALE – high blood pressure damages the lining of the blood vessels and causes arteries
to harden and narrow (atherosclerosis), limiting blood flow – erectile dysfunction.

• FEMALE – high blood pressure reduces blood flow to the vagina that results to a decrease
in sexual desire or arousal, vaginal dryness, or difficulty achieving orgasm

BONE LOSS - high blood pressure results in excessive elimination of calcium through urine.
This may lead to loss of bone density (osteoporosis), and may progress to broken bones.

SLEEP APNEA - a condition in which the throat muscles relax causing to snore
loudly — occurs in more than half of those with high blood pressure.
 BETA-BLOCKERS
• slowers heart beat with less force.
• This reduces the amount of blood pumped through your arteries with each beat, which
lowers blood pressure.

DIURETICS
• High sodium levels and excess fluid in the body increase blood pressure.
• As the sodium leaves, extra fluid in the bloodstream moves in a form of urine, thus lowers blood
pressure.

ACE Inhibitors Angiotensin is a chemical that causes blood vessels and artery
walls to tighten and narrow. ACE (angiotensin converting enzyme) inhibitors prevent the
body from producing as much of this chemical. This helps blood vessels relax and
reduces blood pressure..
 ARBS
• ANGIOTENSIN II RECEPTOR BLOCKERS
• block angiotensin from binding with receptors. Without the chemical, blood vessels won’t
tighten. That helps relax vessels and lower blood pressure.

CALCIUM CHANNEL BLOCKERS

• block some of the calcium from entering the cardiac muscles that leads to less forceful heartbeats
and a lower blood pressure.

ALPHA 2 AGONIST
• changes the nerve impulses that cause blood vessels to tighten.
 • Developing a healthy diet
• Increasing Physical Activity
• Reaching a healthy weight
• Managing stress
• Adopting a cleaner lifestyle

DIETARY RECOMMENDATIONS:
• Eat less meat, more plants
• Reduce dietary Na+
• Cut back on sweets
• Complex disease
• Digestion breaks down
carbohydrates  sugar
(glucose)
• Sugar bloodstream
• Insulin moves sugar into
cells for energy
• is a chronic disorder of carbohydrate, protein, and
fat metabolism resulting from insulin deficiency or
abnormality in the use of insulin
 Body
Function
Without
Diabetes
No insulin (key) means that sugar Insulin (key) cannot unlock the cell
cannot enter the cell. door. Insulin resistance or inability of
body to use insulin.
 • Insulin – Dependent Diabetes
• Juvenile – onset Diabetes.
- it is an autoimmune condition. The body is attacking its own pancreas with
antibodies.
- destruction of beta cells  little or no insulin production
- may be caused by a genetic predisposition
- may occur at any age, usually appears below age 15
 • Adult - onset Diabetes
• Non-insulin-dependent Diabetes
probably caused by:
• disturbance in insulin reception in the cells
• Decreased number of insulin receptors
• loss of beta cell responsiveness to glucose leading to slow or decreased
insulin release by the pancreas

• occurs over age 40 but can occur in children

• common in overweight or obese
• w/ some circulating insulin present, often do not require insulin
• Obesity
• Race
• History of CVD
• HTN
• Physical inactivity
• Familial history
• Polycystic Ovary Syndrome
• Gestational Diabetes
• Polyuria weakness
• Polydipsia fatigue
• Polyphagia inc blood sugar / glucose level
• weight loss (+) glucose in urine (glycosuria)
• nausea / vomiting
• changes in LOC (severe hyperglycemia)
• recurrent infection, prolonged wound healing
• altered immune and inflammatory response, prone to infection
• genital pruritus – (hyperglycemia and glycosuria favor fungal
growth : candidal infection – resulting in pruritus, common
presenting symptom in women)
• Fasting Plasma Glucose Tolerance Test

• Oral Glucose Tolerance Test

• Glycoselated Hemoglobin (HbA1c)

HbA1c is a test that measures the amount of glycated hemoglobin in
your blood. Glycated hemoglobin is a substance in red blood cells that is
formed when blood sugar (glucose) attaches to hemoglobin.

• Urinalysis – Glycosuria, ketone bodies

1. Follow individualized meal plan and snacks as scheduled.
- balanced diabetic diet
2. Pt. must have adequate CHO intake to correspond to the time when insulin is most
effective
3. Routine blood glucose testing
4. Less added fat, fewer fatty foods and low-cholesterol
5. Advise use of complex carbohydrates to help stabilize blood sugar. Meal should include
more fiber and starch and fewer simple or refined sugars.
6. Avoid concentrated sweets, high in sugar (jellies, jams, cakes, ice cream)
7. If taking insulin, eat extra food before periods of vigorous exercise
8. Avoid periods of fasting and feasting
9. Keep weight at normal level, obese diabetics should be on a strict weight control
program and should lose weight.
By: Ivy Rose Duhilag