Introduction

Type 2 diabetes is a lifelong (chronic) disease in which there is a high level of sugar

(glucose) in the blood. Type 2 diabetes is the most common form of diabetes. (Medline Plus,

2021)

When you have type 2 diabetes, your fat, liver, and muscle cells do not respond correctly to

insulin. This is called insulin resistance. As a result, blood sugar does not get into these cells to

be stored for energy. When sugar cannot enter cells, a high level of sugar builds up in the blood.

This is called hyperglycemia. The body is unable to use the glucose for energy. This leads to the

symptoms of type 2 diabetes. (Medline Plus, 2021)

People with type 2 diabetes often have no symptoms at first. They may not have symptoms

for many years. Early symptoms of diabetes caused by a high blood sugar level may include:

Bladder, kidney, skin, or other infections that are more frequent or heal slowly, Fatigue,

Increased thirst, Increased urination and Blurred vision. After many years, diabetes can lead to

serious health problems, and as a result, many other symptoms. (Medline Plus, 2021)

Risk factors on developing this disease includes family history (genetics), physical

inactivity, old age, abnormal cholesterol and triglyceride levels, and individuals diagnosed with

Polycystic ovary syndrome. Family history and genes play a role in type 2 diabetes. Low activity

level, poor diet, and excess body weight around the waist increase your chance of getting the

disease. (Medline Plus, 2021)

At first, the goal of treatment is to lower your high blood glucose level. Long-term goals are

to prevent complications. These are health problems that can result from having diabetes. The
most important way to treat and manage type 2 diabetes is by being active and eating healthy

foods. Everyone with diabetes should receive proper education and support about the best ways

to manage their diabetes. (Medline Plus, 2021)

Type 2 diabetes affects many major organs, including your heart, blood vessels, nerves, eyes

and kidneys. Potential complications of diabetes and frequent comorbidities include heart and

and blood diseases (macrovascular diseases such as MI, CAD and microvascular diseases such as

nephropathy and retinopathy), damage to nerves of the heart that can contribute to irregular heart

rhythms, nerve damage in the digestive system that can cause problems with nausea, vomiting,

diarrhea or constipation, obstructive sleep apnea, and also dementia. (Mayoclinic org, 2021)

Amputation is a major complication of diabetes. In some cases, diabetes can lead to

peripheral artery disease (PAD). PAD causes your blood vessels to narrow and reduces blood

flow to your legs and feet. It may also cause nerve damage, known as peripheral neuropathy.

This could prevent you from feeling pain. (HealthLine, 2016)

If you can’t feel pain, you may not realize you have a wound or ulcer on your feet. You may

continue putting pressure on the affected area, which can cause it to grow and become infected.

Reduced blood flow can slow wound healing. It can also make your body less effective at

fighting infection. (HealthLine, 2016)

As a result, your wound may not heal. Tissue damage or death (gangrene) may occur, and

any existing infection may spread to your bone. If the infection cannot be stopped or the damage

is irreparable, amputation may be necessary. The most common amputations in people with

diabetes are the toes, feet, and lower legs. (HealthLine, 2016)
 Like any type of operation, an amputation carries a risk of complications. It also carries a

risk of additional problems directly related to the loss of a limb. The risk of serious

complications is lower in planned amputations than in emergency amputations. Complications

associated with having an amputation includes deep vein thrombosis (DVT), slow wound healing

and wound infection, stump and "phantom limb" pain. (nhk.uk, 2019)

According to the Philippine society of Endocrinology, Diabetes and Metabolism, Inc. 2020

statistics data, 85% of diabetes-related amputations are preceded by foot ulcers.

The purpose of this case presentation is to report pertinent findings, generate reasonable

differential nursing diagnoses, and develop fitting management plans by strategically asking

questions and suggestions from the clinical instructors and classmates.