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Classification
Pathophysiology
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.
By 2030, the number of cases is expected to increase more than 30
million.
Diabetes is especially prevalent in the elderly; 50% of people older
than 65 years old have some degree of glucose intolerance.
People who are 65 years and older account for 40% of people with
diabetes.
African-Americans and members of other racial and ethnic groups are
more likely to develop diabetes.
In the United States, diabetes is the leading cause of non-traumatic
amputations, blindness in working-age adults, and end-stage renal
disease.
Diabetes is the third leading cause of death from disease.
Costs related to diabetes are estimated to be almost $174 billion
annually.
Causes
The exact cause of diabetes mellitus is actually unknown, yet there are factors
that contribute to the development of the disease.
Clinical Manifestations
Prevention
Complications
If diabetes mellitus is left untreated, several complications may arise from the
disease.
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.
Consult a professional. A registered dietitian who understands
diabetes management has the major responsibility for designing and
teaching this aspect of the therapeutic plan.
Healthcare team should have the knowledge. Nurses and other
health care members of the team must be knowledgeable about
nutritional therapy and supportive of patients who need to implement
nutritional and lifestyle changes.
Weight loss. This is the key treatment for obese patients with type 2
diabetes.
How much weight to lose? A weight loss of as small as 5% to 10%
of the total body weight may significantly improve blood glucose levels.
Other options for diabetes management. Diet education,
behavioral therapy, group support, and ongoing nutritional counselling
should be encouraged.
Meal Planning
Criteria in meal planning. The meal plan must consider the patients
food preferences, lifestyle, usual eating times, and ethnic and cultural
background.
Managing hypoglycemia through meals. To help prevent
hypoglycemic reactions and maintain overall blood glucose control,
there should be consistency in the approximate time intervals between
meals with the addition of snacks as needed.
Assessment is still necessary. The patients diet history should be
thoroughly reviewed to identify his or her eating habits and lifestyle.
Educate the patient. Health education should include the importance
of consistent eating habits, the relationship of food and insulin, and the
provision of an individualized meal plan.
The nurses role. The nurse plays an important role in communicating
pertinent information to the dietitian and reinforcing the
patients for better understanding.
Pharmacologic Therapy
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:
The following are diagnoses observed from a patient with diabetes mellitus.
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.