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Diabetes Mellitus and Chronic Renal Failure

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Yvonne B

on 5 December 2013

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Transcript of Diabetes Mellitus and Chronic Renal Failure

insulin pen
insulin pump
Insulin therapy
inhibit glucose production
insulin sensitivity
insulin production
block carb digestion

For Diabetes Mellitus
Patient History
Case Study #11
Monitor blood sugar
Eat right
Lifestyle Changes
Peritoneal dialysis
Kidney Transplants
Must be same blood & tissue type
No age requirement
For Chronic Kidney Failure
Statins: inhibit cholesterol absorption
Erythropoietin supplements
Calcium & Vitamin D supplements
Cannot be cured/reversed
Symptoms shown by Patient
Excessive thirst and urination
Weight loss despite extra eating
Patient Outline
Cindy Mallon
8 years old
Previously healthy
Has been experiencing strange symptoms recently.
impaired quality of life
dialysis for the rest of her life
maintain insulin therapy
possible further complications
The doctor orders several tests.
Blood glucose test
Blood pH
Urinalysis for glucose and ketone bodies
Blood Glucose Level
This test measures the concentration of glucose found in blood.
Typically only used for patients suspected of diabetes or prediabetes.
High levels, especially after fasting, indicate risk of diabetes.
Normal: 50 - 170 mg/dL
Cindy's results: 545 mg dL
Blood pH Test
Respiratory conditions causing a buildup of carbon dioxide and a low pH.
Buildup of acidic ketone bodies from lack of glucose, such as in diabetes.
Lactic acid buildup
Normal pH: 7.35 - 7.45
Cindy's pH: 7.23
Blood pH may be tested for many reasons.
Urinalysis for Glucose and Ketones
Glucose is normally filtered out of urine by the kidneys.
It is only present if there is so much glucose in the blood that not all can be filtered or the kidneys are not functioning properly.
Ketone bodies normally are not present in blood or urine.
Their presence indicates not enough glucose is reaching cells, a sign of diabetes or of a diet low in carbohydrates.
Cindy tests positive for both ketones and glucose in her urine.
Time goes by
In her mid-forties, Cindy begins to show early signs of kidney disease, but feels fine.
At 55, though, she begins to feel worse
Nausea and vomiting
Edema in ankles
Difficulty breathing
Low responsiveness
Testing Overview
The doctor orders two tests to determine the extent of kidney disease.
Blood urea nitrogen test
Urinary output
Blood Urea Nitrogen (BUN) Test
This test determines how much urea, a waste product is present in the blood.
The kidneys normally filter out urea, leaving a concentration of 10-20 mg/dL
This test determines whether the kidneys are functioning optimally.
Cindy's level is 56 mg/dL
Urine Output
This test simply measures how much urine a patient produces.
It can be used to test hydration or kidney function by how much urine is excreted.
Normal urine output: 25 cc/hour
Cindy's urine output: 50-60 cc/hour
High blood glucose levels
Ketones and glucose in the urine
AV fistula
AV graft
venous catheter
Physical symptoms that point to diabetes
excessive urination and thirst
weight loss despite increased appetite
Tests for renal failure
blood urea nitrogen test
normal 10-20 mg/dl
results 56 mg/dl
urinary output test
normal 50-60 cc/hour
results 25 cc/hour
Full transcript