Recommended
More Related Content
What's hot
What's hot (20)
Similar to Diabetes Care in Nursing Homes
Similar to Diabetes Care in Nursing Homes (20)
More from Gerinorth
More from Gerinorth (20)
Recently uploaded
Recently uploaded (20)
Diabetes Care in Nursing Homes
- 1. Tele-Continuing Nurse Education conducted by GeriCare@North Topic: Diabetes Care in Nursing Home Date: 12-March, 2018 Presentors: SN Lara Joven & SN Pauline Magpoc of Sree Narayana Mission Home
- 2. Diabetes • Also known as Diabetes Mellitus (DM). • An endocrine disorder in which there is insufficient amount or lack of insulin secretion to metabolize carbohydrates. • Caused by a complex interaction of genetics and enviromnetal factors. • Long term illness characterized by a high sugar (glucose) in the blood.
- 3. Statistics of DM in Singapore: • It has been on the rise in Singapore, while Singaporeans are becoming more affluent, the lifestyles are more sedentary and our population is ageing rapidly. • Malay and Indian women and Indian men were at higher risk, with 14.3, 14.9 and 16.7% prevalence rates, respectively. • Diabetes was a factor in 39.7% of strokes and in 9.3% of all deaths in Singapore, and is the sixth most common cause of death.
- 4. DM Signs and Symptoms: • Frequent urination • Increased thirst • Rapid weight loss • Constant Hunger • Fatigue • Blurred vision • Numbness in hands or feet • Itchy skin, especially in the genital areas • Slow healing of cuts and wounds
- 5. 3 Types of DM: • Type 1 Diabetes (Insulin-Dependent) • Type 2 Diabetes (Non-insulin-Dependent) • Gestational Diabetes
- 6. Type 1 Diabetes • High blood glucose levels because the pancreas is not able to produce sufficient insulin. • Triggered by exposure to the environment such as an unidentified virus, stimulating an immune attack against the beta cells of the pancreas (that produce insulin) in some genetically pre-disposed people. • Common in Children.
- 7. Type 2 Diabetes • Able to produce some insulin. However, the insulin produced may not be effective in keeping the blood glucose at a healthy level. • Strongly influenced by genes and lifestyle factors. • Common in Adults.
- 8. Risk Factors for DM: • Age • Race / Ethnicity • Family history of Diabetes / Genes • Physical inactivity • Obesity • Impaired glucose tolerance • Sedentary Lifestyle • Stress
- 9. Diagnostics for DM: • Blood Tests o FBS / RBS o OGTT o HBA1C • Urine Tests
- 10. Complications of DM: • Stroke • Heart disease • Infections • Neuropathy • Nephropathy • Retinopathy • Diabetic Ketoacidosis • Hyperosmolar Hyperglycemic Nonketotic Syndrome
- 11. Treatment for DM in Nursing Home: • Dietary Management • Physical Activity • Insulin Therapy There are four major types of insulin: • Rapid-acting • Short-acting • Intermediate-acting • Long-acting
- 12. Nursing Management for DM in Nursing Home: • Oral Medications - Oral hypoglycemic agents • Frequent Blood Glucose Testing and Monitoring - Once a week / as per NH protocol • Health Education – Skin and foot care – Eye examinations – Diet and fluids
- 13. Nursing Management for DM in Nursing Home: • Weekly monitoring of BGL. • 2 monthly review of resident including medications and HbA1c or other nececssary blood test. • Ensure proper skin care to prevent cut and wounds. • Provide Low sugar diet. • Ensure compliance to medication.
- 14. Hypoglycaemia – Management • Assess the condition of the resident. • Check BGL. • BGL < 4mmol to give Glucoline Powder 1 packet mix with 1 cup of water. • Recheck BGL after 10-15 mins.
- 15. Hypoglycaemia – Management • If stabilized after Glucoline – to monitor BGL and review for next doctor rounds. • If still low and resident LOC change – refer to A&E.
- 16. Hyperglycaemia – Management • Assess the condition of the resident. • Check BGL. • BGL > 20mmol/L to call and inform Nursing home doctor about BGL reading: Carry out doctors’ advise
- 17. Hyperglycaemia – Management • If resident have sliding scale to administer insulin as prescribed. • If BGL don’t improve to refer to A&E for further management.
- 21. Thank you!
Editor's Notes
- During digestion, our body transforms the food particles into simple sugar form known as glucose. The glucose is then absorbed into the blood for our body to be utilised as energy. Hormones known as insulin, produced by the pancreas, will then help glucose in the blood to enter the body cells where they will be converted into energy stored for future use. The insulin released in a diabetic patient, however, is either insufficient or unable to absorb glucose from the patient’s blood well. As such, the unabsorbed glucose are accumulated and stored in the blood.
- It is important to note that symptoms can sometimes appear mild. In some cases, patients with diabetes do not even experience the above symptoms until it has reached the final stage of diabetes. It is therefore crucial for those who are at risk of getting diabetes to have regular medical checks of their blood glucose level.
- Untreated or uncontrolled diabetes can lead to serious complications. Diabetes can affect the blood vessels and the heart, causing heart disease and stroke due to poor blood circulation. A persistent high blood glucose level damages the small vessels in the body, particularly in the areas such as the eyes, kidneys and nerves. Without proper control of the disease, diabetes can lead to blindness, kidney disease, numbness in the hands and feet and impotence. Diabetic patients may find that they often injure themselves easily without realising it. In addition, wounds or infections from these injuries will tend to take a long time to heal. Good control of diabetes, however, helps to reduce the risk or delay the onset of these complications.
- Routine for Residents with DM at SNM
- Asses: Physical appearance. Pale Cold clammy
- Asses: Physical appearance. Pale Cold clammy
- Drs’ advise: To give insulin and monitor. KIV A&E