Diabetes mellitus type 2 or type 2 diabetes (formerly called non-insulin-

dependent diabetes mellitus (NIDDM), or adult-onset diabetes) is a disorder that is

characterized by high blood glucose in the context of insulin resistance and relative
insulin deficiency. While it is often initially managed by increasing exercise and
dietary modification, medications are typically needed as the disease progresses.

The symptoms of DM II are excessive urine production, excessive thirst and

increased fluid intake, blurred vision, unexplained weight loss, lethargy.

Pathophysiology

Insulin resistance means that body cells do not respond appropriately when insulin
is present. Unlike type 1 diabetes mellitus, the insulin resistance is generally "post-
receptor", meaning it is a problem with the cells that respond to insulin rather than
a problem with production of insulin.

Other important contributing factors:

• increased hepatic glucose production (e.g., from glycogen -> glucose

conversion), especially at inappropriate times (typical cause is deranged
insulin levels, as those levels control this function in liver cells)
• decreased insulin-mediated glucose transport in (primarily) muscle and
adipose tissues (receptor and post-receptor defects)
• impaired beta-cell function—loss of early phase of insulin release in response
to hyperglycemic stimuli

Diabetes mellitus type 2 is presently of unknown etiology.

Diabetes mellitus type 2 is often associated with obesity, hypertension, elevated

cholesterol (combined hyperlipidemia), and with the condition often termed
Metabolic syndrome (it is also known as Syndrome X, Reavan's syndrome, or
CHAOS). It is also associated with acromegaly, Cushing's syndrome and a number of
other endocrinological disorders. Additional factors found to increase risk of type 2
diabetes include aging, high-fat diets and a less active lifestyle.

Treatment

Diabetes mellitus type 2 is a chronic, progressive disease that has no established

cure, but does have well-established treatments which can delay or prevent entirely
the formerly inevitable consequences of the condition.
Lay, Alfonso Rafael L. BSN
303

Group VIIIB

JOURNAL WRITING

1st day – August 17, 2009

The 1st day in the hospital, it was nerve racking. The hospital isn’t that large,
though it was very civilized not too mention the fast food chains inside it. Our
professor Ma’am Delen is our C.I. in MS Ward 3b. The first thing we did is orientation
and settling our things. There are a lot of things that we talked about, how to chart,
NCP, SOAPIE, discharge planning, and many more.

We also had a quiz about things that we should have known a long time ago.
I learned a new lesson, that I should never forget important things like that! It was
very upsetting; my score didn’t even reach half. If only I reviewed.

2nd day – August 18, 2009

So the 2nd day is very stressful, for me it was very different from other duties I
went through. Though my patient wasn’t present that time I spent a lot of energy.
Making a Nursing care plan to someone I know nothing about because her chart is
currently not available. So I made a NCP that has a diagnosis that is potential. I
learned to think well, to critically think through cracks and every inch of detail.

3rd day- August 19, 2009

The third day so far is the hardest, I got a new patient and he was on bed
almost all shift. Took his vital signs and regulated his almost defective IV line. I
received him with a D5NSS 1L that should have been over. I made a mistake in
saying it out loud in the patient’s room and now I think I will really avoid doing
clumsy things like that.

Maybe I should study more? I’ve experienced so far a lot of things and it was
very exciting even though it’s hard. Well, the future will be hard to predict I should
be ready for it.