Introduction to Nursing Care: Altered Glucose Regulation
Blood glucose is a source of energy for all cells and is essential for brain
function and cell formation. If insufficient glucose is available for use, the
body will break down fat into fatty acids for energy. However, this process is
incomplete and results in the buildup of ketone bodies, resulting in ketosis,
which leads to acid-base imbalances in the body.
As a nurse, you will care for clients who have altered glucose regulation.
Whether the problem is an inadequate dietary supply of carbohydrates or
the inability of the body to use blood glucose efficiently, altered glucose
regulation creates significant problems.
Nursing care for altered glucose regulation involves understanding the
pathophysiology of diabetes mellitus that causes the disruption of
homeostasis in the body.
Glycosylated hemoglobin (A1C) is used to assess blood glucose control
over the previous 3 months.
A fasting blood glucose will measure the current blood glucose result.
An oral glucose tolerance test is used to diagnose diabetes mellitus when
abnormal fasting blood glucose levels do not clearly indicate diabetes.
A water deprivation test is used to differentiate causes of diabetes insipidus.
The main function of carbohydrates in the body is to provide energy. Simple
carbohydrates are digested quickly and enter the bloodstream for
immediate use; therefore, causing blood glucose to increase (not maintain a
stable level). Complex carbohydrates are digested much slower. When
entering the bloodstream, if glucose is not needed it can be converted to
glycogen and stored in the liver until it is needed later for a surge of
energy. When the body is deficient of carbohydrates for energy, fat will be
broken down for energy. In the absence of carbohydrates or sufficient fat,
the body will break down protein for energy. Excessive fat breakdown leads
to ketosis (not hypoglycemia), which can cause ketoacidosis.
,The client must fast for at least 8 hours prior to the test. Water intake is
allowed.
Endocrine Hormone Refresher
The pancreas secretes hormones through the islets of Langerhans. There
are 4 types of hormone-secreting cells: alpha, beta, delta, and F cells.
Alpha cells make and secrete glucagon.
Beta cells make and secrete insulin and amylin.
Delta cells make and secrete somatostatin.
F cells secrete pancreatic polypeptide.
Pancreas
Hormone Target Tissue Function
Amylin (from Liver Decreases gastric motility
beta cells) Decreases glucagon secretion
Stomach
Decreases endogenous glucose
release from the liver
Increases satiety
Glucagon (from General Stimulates glycogenolysis and
alpha cells) gluconeogenesis
Insulin (from General Promotes glucose transport from
beta cells) the blood into the cells
Pancreatic General Influences regulation of pancreatic
polypeptide function and metabolism of
(from F cells) absorbed nutrients
Somatostatin Pancreas Inhibits insulin and glucagon
(from delta secretion
cells)
, Insulin and Glucagon
Insulin and glucagon function in a reciprocal manner to maintain normal
blood glucose levels. Let’s discuss glucagon and insulin in more detail.
Select each tab to learn more!
Glucagon
Pancreatic alpha cells release glucagon when blood glucose levels are low,
protein is ingested, or the client is exercising. Glucagon increases blood
sugar by stimulating glycogenolysis, gluconeogenesis, and ketogenesis.
Blood glucose is a source of energy for all cells and is essential for brain
function and cell formation. If insufficient glucose is available for use, the
body will break down fat into fatty acids for energy. However, this process is
incomplete and results in the buildup of ketone bodies, resulting in ketosis,
which leads to acid-base imbalances in the body.
As a nurse, you will care for clients who have altered glucose regulation.
Whether the problem is an inadequate dietary supply of carbohydrates or
the inability of the body to use blood glucose efficiently, altered glucose
regulation creates significant problems.
Nursing care for altered glucose regulation involves understanding the
pathophysiology of diabetes mellitus that causes the disruption of
homeostasis in the body.
Glycosylated hemoglobin (A1C) is used to assess blood glucose control
over the previous 3 months.
A fasting blood glucose will measure the current blood glucose result.
An oral glucose tolerance test is used to diagnose diabetes mellitus when
abnormal fasting blood glucose levels do not clearly indicate diabetes.
A water deprivation test is used to differentiate causes of diabetes insipidus.
The main function of carbohydrates in the body is to provide energy. Simple
carbohydrates are digested quickly and enter the bloodstream for
immediate use; therefore, causing blood glucose to increase (not maintain a
stable level). Complex carbohydrates are digested much slower. When
entering the bloodstream, if glucose is not needed it can be converted to
glycogen and stored in the liver until it is needed later for a surge of
energy. When the body is deficient of carbohydrates for energy, fat will be
broken down for energy. In the absence of carbohydrates or sufficient fat,
the body will break down protein for energy. Excessive fat breakdown leads
to ketosis (not hypoglycemia), which can cause ketoacidosis.
,The client must fast for at least 8 hours prior to the test. Water intake is
allowed.
Endocrine Hormone Refresher
The pancreas secretes hormones through the islets of Langerhans. There
are 4 types of hormone-secreting cells: alpha, beta, delta, and F cells.
Alpha cells make and secrete glucagon.
Beta cells make and secrete insulin and amylin.
Delta cells make and secrete somatostatin.
F cells secrete pancreatic polypeptide.
Pancreas
Hormone Target Tissue Function
Amylin (from Liver Decreases gastric motility
beta cells) Decreases glucagon secretion
Stomach
Decreases endogenous glucose
release from the liver
Increases satiety
Glucagon (from General Stimulates glycogenolysis and
alpha cells) gluconeogenesis
Insulin (from General Promotes glucose transport from
beta cells) the blood into the cells
Pancreatic General Influences regulation of pancreatic
polypeptide function and metabolism of
(from F cells) absorbed nutrients
Somatostatin Pancreas Inhibits insulin and glucagon
(from delta secretion
cells)
, Insulin and Glucagon
Insulin and glucagon function in a reciprocal manner to maintain normal
blood glucose levels. Let’s discuss glucagon and insulin in more detail.
Select each tab to learn more!
Glucagon
Pancreatic alpha cells release glucagon when blood glucose levels are low,
protein is ingested, or the client is exercising. Glucagon increases blood
sugar by stimulating glycogenolysis, gluconeogenesis, and ketogenesis.
