Nursing Assessment, Management and Treatment of Autoimmune Diseases
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than, or equal to, two pancreatic autoantibodies. ● Stage 2 : Stage 2 diagnostic criteria include the presence of greater than or equal to 2 pancreatic autoantibodies and dysglycemia (glucose of 100 to 125 mg/dl), impaired glucose tolerance (2- hour PG of 140 to 199 mg/dL), or a hemoglobin A1C between 5.7% to 6.4%. Patients remain asymptomatic. ● Stage 3 : In Stage 3 the patient has hyperglycemia with clinical symptoms and two or more pancreatic autoantibodies. Etiology The exact cause of T1D is unknown. How- ever, several risk factors and possible trig- ger factors have been identified, includ - ing the following: ● Genetics : Having a family history of T1D puts people at greater risk of developing the disease. However, the majority of diagnoses are found in people who have no family members with the disease (JDRF, n.d.). ● Viral infections : Viral infections may be triggers for T1D development (JDRF, n.d.). ● Geography : The further away from the equator a person lives, the greater the incidence of T1D (Mayo Clinic, 2021c). ● Age : Although T1D can occur at any age, it seems to peak at two specific age ranges. The first peak appears in children between the ages of 4 and 7 years old. The second peak is in children between the ages of 10 and 14 years old (Mayo Clinic, 2021c).
| NURSING CONSIDERATION
Unlike type 2 diabetes, no dietary changes can be made to prevent the onset of T1D. Likewise, lifestyle fac- tors such as exercise and weight do not contribute to T1D development (JDRF, n.d.). Some insulin regimens can be very expensive, so this should be discussed with patients to help them avoid skipping doses. Complications Maintaining a normal blood glucose level can significantly reduce the occur - rence of complications. Such compli- cations may be disabling or even fatal. Without insulin to facilitate the entry of glucose into the cells, blood glucose lev- els increase and complications may be likely (Mayo Clinic, 2021c). Complications linked to T1D include the following (Mayo Clinic, 2021c): ● Cardiac and vascular diseases : T1D radically increases the risk of cardiovascular diseases such as coronary artery disease (CAD), angina, heart attack, stroke, atherosclerosis, and hypertension. ● Neuropathy : Excessive blood glucose levels may injure the capillaries that nourish the nerves. Symptoms of neuropathy include tingling, numbness, and burning or pain that typically starts at the tips of the toes or fingers and spreads gradually. If blood glucose levels are not controlled, all sensation may be lost in the affected limbs. If the nerves of the gastrointestinal tract are damaged, patients may suffer from nausea, vomiting, diarrhea, or constipation. In men, erectile dysfunction may occur.
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