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Classification
Pathophysiology
Insulin could not bind with the special receptors so insulin becomes
less effective at stimulating glucose uptake and at regulating the
glucose release.
Epidemiology
Diabetes mellitus is now one of the most common disease all over the world.
Here are some quick facts and numbers on diabetes mellitus.
More than 23 million people in the United States have diabetes, yet
almost one-third are undiagnosed.
People who are 65 years and older account for 40% of people with
diabetes.
Causes
The exact cause of diabetes mellitus is actually unknown, yet there are factors
that contribute to the development of the disease.
Clinical Manifestations
Fatigue and weakness. The body does not receive enough energy
from the food that the patient is ingesting.
Sudden vision changes.The body pulls away fluid from the eye in an
attempt to compensate the loss of fluid in the blood, resulting in
trouble in focusing the vision.
Symptoms of Diabetes Mellitus.
Prevention
Appropriate management of lifestyle can effectively prevent the development of
diabetes mellitus.
Complications
If diabetes mellitus is left untreated, several complications may arise from the
disease.
Electrolytes:
Urine: Positive for glucose and ketones; specific gravity and osmolality
may be elevated.
Medical Management
Here are some medical interventions that are performed to manage diabetes
mellitus.
Nutritional Management
The foundations. Nutrition, meal planning, and weight control are the
foundations of diabetes management.
Weight loss. This is the key treatment for obese patients with type 2
diabetes.
Meal Planning
Criteria in meal planning. The meal plan must consider the patients
food preferences, lifestyle, usual eating times, and ethnic and cultural
background.
A person with diabetes should exercise at the same time and for the
same amount each day or regularly.
Blood glucose readings are analyzed after 72 hours when the data has
been downloaded from the device.
The longer the amount of glucose in the blood remains above normal,
the more glucose binds to hemoglobin and the higher the glycated
hemoglobin becomes.
Pharmacologic Therapy
Oral antidiabetic agents may be effective for patients who have type
2 diabetes that cannot be treated by MNT and exercise alone.
Half of all the patients who used oral antidiabetic agents eventually
require insulin, and this is called secondary failure.
Primary failure occurs when the blood glucose level remains high 1
month after initial medication use.
Nursing Management
Nurses should provide accurate and up-to-date information about the patients
condition so that the healthcare team can come up with appropriate
interventions and management.
Nursing Assessment
The nurse should assess the following for patients with Diabetes Mellitus:
Assess the patients history. To determine if there is presence of
diabetes, assessment of history of symptoms related to the diagnosis
of diabetes, results of blood glucose monitoring, adherence to
prescribed dietary, pharmacologic, and exercise regimen, the patients
lifestyle, cultural, psychosocial, and economic factors, and effects of
diabetes on functional status should be performed.
Assess the body mass index and visual acuity of the patient.
Diagnoses
The following are diagnoses observed from a patient with diabetes mellitus.
Homeostasis achieved.
Complications prevented/minimized.
Nursing Priorities
4. Prevent complications.
Nursing Interventions
Evaluation
The responsibility of the healthcare team members does not end when the
patient is discharged. The following are guidelines that should be discussed
before the patient is discharged from the hospital.
Patient empowerment is the focus of diabetes education.