detail description

2. JUVENILE
DIABETICST

3.  Diabetes mellitus is a group of metabolic
diseases in which a person has high blood
sugar, either because the body does not
produce enough insulin, or because cells do
not respond to the insulin that is produced.

4.  Diabetes mellitus is a chronic disease caused
by inherited and/or acquired deficiency in
production of insulin by the pancreas, or by
the ineffectiveness of the insulin produced.
Such a deficiency results in increased
concentrations of glucose in the blood, which
in turn damage many of the body's systems,
in particular the blood vessels and nerves.
(Acc. To WHO)


5.  Also called as insulin-dependent
diabetes, insulin-dependent diabetes
mellitus, type 1 diabetes mellitus.

7. CLASSIFICATION-

8.  Also known as type 1 diabetes:
type 1 diabetes is also referred
to as juvenile diabetes. It
results from destruction of
pancreatic ß cells which
produce insulin, leading to
absolute insulin deficiency.

9.  The person becomes completely dependent
on exogenous insulin absolute insulin
injections. Its onset is typically in childhood
and adolescence but can be at any age.

10.  Type 2 Diabetes results from insulin
resistance, a condition in which cells of the
body fail to use insulin properly. The onset in
usually after 40 years of age so it is also
known as “Adult-onset Diabetes” .

11.  When pregnant women
who have never had
diabetes before , have
high blood glucose level
during pregnancy , it is
also known as gestational
diabetes . It may precede
development of type -2
diabetes mellitus.

12.  The exact cause of diabetic
mellitus type 1 is still unknown.
In type 1 diabetes genetic
factors are very important. It
appears that certain
histocompatibility locus antigen
(HLA) patterns on 6th
chromosome predispose an
individual to develop type 1
diabetes.

13.  It has been suggested that in genetic early
susceptible individuals exposed to
environmental factors (such as viruses or
chemicals) the immune system begins T-
lymphocyte mediated process that damages
and destroy the ß cells of pancreas
resulting in complete deficiency of
insurance. By the time symptoms are
evident approximately 90% of ß cells have
been destroyed.

14.  Also known as juvenile diabetes or insulin-
dependent diabetes, Is a chronic condition
in which the pancreas produces little or no
insulin.

19.  Pharmacology management
TYP OF INSULIN ONSET PEAK EFFECT
RAPID ACTING 5-15 MIN 30-90 MIN 5 HOURS
SHORT ACTING 20-60 MIN 2-3 HOURS 5-8 HOURS
INTERMEDIATE
ACTING
2-4 HOURS 4-10 HOURS 10-14HOURS
LONG ACTING 3-5 HOURS 10-16HOURS 18-24 HOURS

20.  A meal plan is developed that
will help the child to attend
and maintain ideal weight,
maintain proper nutrition,
attend normal growth and
development and achieve
diabetic control so as to
prevent or delay acute or
chronic complications of
diabetes.

21.  The family is explained
that should contain 55%
carbohydrate, 30% fat and
15% protein. American
diabetes association
exchange system is
nutritionally adequate not
only for the child but also
for his family.

22. Food items are classified into
one of the six categories of
the exchange list according
to their composition-
 Group 1-milk exchange
 Group 2- vegetable exchange
 Group 3 -Fruits exchange
 Group 4- bread exchange
 Group 5- meat exchange
 Group 6- fat exchange

24. NURSING DIAGNOSIS
 Knowledge Deficient related to
Unfamiliarity with insulin injection
as evidenced by Inadequate follow-
through of instructions.

25.  To increase knowledge level regarding the
treatment procedure.

26.  Explain that long-acting insulin only need to
be injected once or twice daily.
 Teach patient to follow a diet that is low in
simple sugars, low in fat, and high in fibber
and whole grains.

27.  Knowledge provided to the client regarding
medication.
 Explained all regarding the treatment
procedure to the client.

28.  Client got knowledge regarding the
treatment procedure little bit .

29.  Risk for Infection
may include high
glucose levels,
decreased leukocyte
function .

30.  To reduce chances of risk for
infection.

31.  Assess the condition of patient.
 Observe for the signs of infection
and inflammation.
 Provide catheter or perineal care.
Teach female patients to clean
from front to back after
elimination.

32.  Regularly patient condition is assessed.
 Signs of infection and inflammation is
observed.
 Catheter care is also provided according to
patient need.

33.  Chances of risk for infection is reduced
some extent.

34.  Risk for Deficient Fluid
Volume as evidence by
Restricted intake.

35.  Assess patients history
regarding vomiting and
excessive urination.
 Monitor vital sign.
 Maintain fluid intake of at least
2500 mL/day within cardiac
tolerance when oral intake is
resumed.

36.  To increase fluid volume.

37.  Patients history of vomiting and excessive
urination is assessed.
 Vital sign monitored.
 Fluid intake maintained during oral intake.

38.  Chances of fluid volume deficient
may reduced some extent.

39.  Imbalanced Nutrition: Less than
Body Requirements related to
decreased oral intake: anorexia,
nausea, gastric fullness,
abdominal pain as evidenced by
Increased urinary output, dilute
urine.

40.  To maintain nutritional level as
body required.

41.  Discuss eating habits and
encourage diabetic diet
(balanced diet) as prescribed
by the doctor.
 Consult dietician and/or
physician for further
assessment and
recommendation regarding
food preferences and
nutritional support.

42.  A balanced diet prescribed by
the doctor.
 According to the nutrition
requirement to body, physician
recommndated a new diabetic
dietary pattern to the patient.

43.  Some amount of nutrition level
may maintained as body required.

44. Educate the child’s family about-
 Involving school personnel in
management plan for insulin
administration ,exercise and meal
time.
 Monitoring child’s blood glucose level
, maintain insulin coverage and notify
health care providers when child is ill.

45.  Recognizing symptoms of
insulin shock and diabetic
acidosis and related
emergency management.
Prevention of infection-
 Attend to regular body
hygiene with special attention
to foot care.
 Report any breaks in skin and
treat them promptly.

46.  Properly fitted shoes should be used.
 Child should receive regular dental
checkups , every six months.
 Child should be vaccinated as per the
schedule.

47.  The child should carry an identification
card. Which states that the child is a
diabetic and includes the child's name
address telephone number and the
treating physicians name and telephone
number.
 The child suit always carry some sugar
source like sugar cubes or glucose
powder that can be consumed in case of
hypo-glycaemia occurs.

48.  All forms of diabetic in fetes
risks of long term
complications.

49. Diabetes also causes micro vascular
complications that results in
 Diabetic retinopathy
 Reduced vision and potential blindness
 Diabetic nephropathy and chronic renal
disease resulting in protein urea

50.  Diabetic neuropathy causing numbness
tingling and pain in the feet
 Skin damage
 Diabetic foot which may required
amputation.

51.  Diabetes mellitus (DM) is the most common
endocrine metabolic disorder of childhood
and adolescent with long term effects on
Childs physical and psychological growth and
development.

53.  Diabetes mellitus is a group of metabolic
diseases in which a person has high blood
sugar, either because the body does not
produce enough insulin, or because cells do
not respond to the insulin that is produced.

55.  Sharma rimple, “Essential of pediatric nursing”
jaypee brothers medical publishers,first
edition,2013,page no-504-505.
 Data parul, “pediatric nursing” jaypee brother
medicalpublishers,4th edition,page no-353-354.
 Beeves assuma “text book of pediatric nursing”
reed Elsevier india private limited,1st dition,page
no-258-259.
 Wong’s “nursing care of infants and children”
Elsevier publication,9th edition,page no-403-405.
 Gupta piyush”essential pediatric nursing” CBS
publishers,4th edition,page no-422-423.