• Decreased metabolic energy production
• Altered body chemistry: insufficient insulin
• Increased energy demands: hypermetabolic state/infection

• Overwhelming lack of energy, inability to maintain usual routines, decreased performance, accident-prone
• Impaired ability to concentrate, listlessness, disinterest in surroundings

• Osmotic diuresis (from hyperglycemia)
• Excessive gastric losses: diarrhea, vomiting
• Restricted intake: nausea, confusion

• Increased urinary output, dilute urine
• Weakness; thirst; sudden weight loss
• Dry skin/mucous membranes, poor skin turgor
• Hypotension, tachycardia, delayed capillary refill

• Insulin deficiency (decreased uptake and utilization of glucose by the tissues, resulting in increased protein/fat metabolism)
• Decreased oral intake: anorexia, nausea, gastric fullness, abdominal pain; altered consciousness
• Hypermetabolic state: release of stress hormones (e.g., epinephrine, cortisol, and growth hormone), infectious process

• Increased urinary output, dilute urine
• Reported inadequate food intake, lack of interest in food
• Recent weight loss; weakness, fatigue, poor muscle tone
• Diarrhea
• Increased ketones (end product of fat metabolism)

• Long-term/progressive illness that is not curable
• Dependence on others

• Reluctance to express true feelings; expressions of having no control/influence over situation
• Apathy, withdrawal, anger
• Does not monitor progress, nonparticipation in care/decision making
• Depression over physical deterioration/complications despite patient cooperation with regimen

• Endogenous chemical alteration: glucose/insulin and/or electrolyte imbalance

• High glucose levels, decreased leukocyte function, alterations in circulation
• Preexisting respiratory infection, or UTI

Diabetes is a chronic disease, which occurs when the pancreas does not produce enough insulin, or when the body cannot effectively use the insulin it produces. This leads to an increased concentration of glucose in the blood (hyperglycaemia).

• Type 1 diabetes (previously known as insulin-dependent or childhood-onset diabetes) is characterized by a lack of insulin production.
• Type 2 diabetes (formerly called non-insulin-dependent or adult-onset diabetes) is caused by the body’s ineffective use of insulin. It often results from excess body weight and physical inactivity.
• Gestational diabetes is hyperglycaemia that is first recognized during pregnancy.