3. Outlines
Define Diabetes Mellitus
Know the symptoms of Diabetes Mellitus
Understand diagnostic process of Diabetes Mellitus
Enumerate complication of Diabetes Mellitus
Understand facts and figures of Nursing workforce
Explain role and responsibilities of nurse to diabetes care
Understand five components of diabetes management.
4. Is a group of metabolic diseases characterized by
elevated levels of glucose in the blood
(hyperglycemia) resulting from defects in insulin
secretion, insulin action, or both.
(American Diabetes Association [ADA] 2003)
Diabetes mellitus
5.
6. Diagnostic Tests
Random blood sugar test.
200 milligrams per deciliter (mg/dL) — 11.1 millimoles
per liter (mmol/L) or higher suggests diabetes.
Fasting blood sugar test.
level less than 100 mg/dL (5.6 mmol/L) is normal.
level from 100 to 125 mg/dL (5.6 to 6.9 mmol/L) is
considered pre-diabetes.
If it's 126 mg/dL (7mmol/L) or higher on two
separate tests, is diabetes.
7. Diagnostic Tests
Glycated hemoglobin (A1C) test.
Indicates average blood sugar level for the
past two to three months
level of 6.5 percent or higher on two
separate tests indicates that is diabetes
A1C between 5.7 and 6.4 percent indicates
prediabetes
Below 5.7 is considered normal.
8. Diagnostic Tests
Oral glucose tolerance test:
Level less than 140 mg/dL (7.8 mmol/L) is
normal
More than 200 mg/dL (11.1 mmol/L) after
two hours indicates diabetes.
Between 140 and 199 mg/dL (7.8 mmol/L
and 11.0 mmol/L) indicates pre-diabetes.
9.
10. FACTS AND FIGURES NURSING
Nurses account for 59% of health professionals.
The global nursing workforce is 27.9 million, of which 19.3 million
are professionals.
Pakistan Nursing workforce is103777.
The global shortage of nurses is estimated to be 5.9 million
89% is in low and lower middle-income countries
Nursing graduates need to increase by 8% a year to overcome
the predicted global shortfall by 2030.
Approximately 90% of the nursing workforce is female
11. Nurse role in caring diabetes
patient
Educate about using behavior change and
health coaching techniques
Screening, prevention and early detection of type 2
diabetes
Promoting self-care
An awareness of how mental health issues can
affect people with diabetes
12. Cont…
Assessing and meeting the patient’s
nutritional needs
Urine & Blood glucose monitoring
Oral therapies & Injectable therapies
Identifying and treating hypoglycaemia
Identifying and treating hyperglycaemia
13. Nursing Planning
Overall goals:
Active patient participation
No episodes of acute hyperglycemic
emergencies or hypoglycemia
Maintain normal blood glucose levels
Lifestyle adjustment with minimal stress
15. Nutritional management
Nutrition, diet, and weight control are the
foundation of diabetes management.
Nutritional management Goals:
Providing all the essential food (eg, vitamins,minerals)
Meeting energy needs
Achieving and maintaining a reasonable
weight
Preventing wide daily fluctuations in blood glucose
levels (close to normal )
Decreasing serum lipid levels.
16.
17. Exercise
Benefits of Exercise
Lowers blood glucose
Decrease Cardiovascular risk factors.
Psychological well being
Improvement in insulin secretions.
Decrease weight, decrease stress
18. Recommendations
Exercise at the same time each day.
Exercise the same amount of time each day.
Start slow and gradually increase exercise
If patient has diabetic complications, alter the
exercise type and amount as necessary.
19. Monitoring
Blood glucose monitoring is a cornerstone
in diabetes management.
Self-monitoring of blood glucose (SMBG) is
recommended by the ADA.
Many types of glucometers . Pick the one that best
suits the patient.
Consider ease of use, skill level, cost of strips, visual
numbers etc….
20. Monitoring
According to the ADA patients on insulin
should test at least four times a day, usually
before meals and at bedtime.
Persons not receiving insulin and on orals
should test two-three times a day.
Important to keep a Diabetic chart.
21. Drug Therapy: Oral Agents
Not insulin
Work to improve the mechanisms in which
insulin and glucose are produced and used
by the body.
Increase insulin production by pancreas
Reduce glucose production by liver
Enhance glucose transport into cell
22. Drug Therapy: Insulin
Types of insulin
Rapid-acting: Lispro
• Onset 10 – 15 min. Peak 1 hours. Effects last 2 hrs – 6 hrs
Short-acting: Regular
• Onset 30 min – 1 hr, Peak 2 – 3 hr, Effects last 4 – 6 hrs
Intermediate-acting: NPH or Lente
• Onset 2 – 4 hrs, Peak 6 – 12 hrs, Effects last 16 – 20 hrs
Long-acting: Ultralente, Lantus
• Onset 6-8hrs, Peak 12 – 16 hrs, Effects last 20 – 30 hrs
25. Education
Basic definition of diabetes (having a high blood
glucose level)
Normal blood glucose ranges and target
blood glucose levels
Effect of insulin and exercise (decrease
glucose)
Effect of food and stress, including illness
and infections (increase glucose)
Basic treatment approaches
Administration of insulin or/and oral antidiabetes
medications
26. Education
Take insulin or oral antidiabetic agents as usual.
Diet information (food groups, timing of meals)
Monitoring of blood glucose and ketones
Recognition, treatment, and prevention of acute
complications,(Hypoglycemia, Hyperglycemia)
Report nausea, vomiting, and diarrhea.
Where to buy and store insulin, syringes, and
glucose monitoring supplies
When and how to reach the physician
27. Conclusion
Nurses play a key role in:
Diagnosing diabetes early to ensure timely
treatment.
Providing self-management training and
psychological support for people with diabetes to
help prevent complications.
Tackling the risk factors for type 2 diabetes to help
prevent the condition
Nurses can make the difference for people
affected by diabetes