Diabetes

Module 3.2.2
Caring for people with
diabetes
Understanding diabetes,
supporting the individual and
planning care
Produced by The Alfred Workforce Development Team
on behalf of DHS Public Health -
Diabetes Prevention and Management Initiative
June 2005

Presentation purpose
DPMI Workforce Development – The Alfred Workforce Development Team June 2005
Target audience
 Grade 2 nurses, aged care workers and personal care assistants
Aim
 To provide best practice care for people with diabetes.
Objectives
 Provide an overview of diabetes and how it affects the body.
 Discuss what information people with diabetes require in order to
understand their condition and appropriate education strategies to
provide this information.
 Discuss best practice care for people with diabetes.
 Discuss role of carers in promoting best practice care.
 Discuss guidelines in relation to care planning for diabetes.

Overview of diabetes
 Diabetes means that blood glucose in
the body (often called blood sugar) is
too high
 Glucose comes from the food we eat
 Glucose is transported by the blood
stream to all the cells in the body.
G
G
G
G
G
Muscle
G
G
G G
Bloodstream

 Insulin helps the glucose from
food get into your cells.
 Insulin is a chemical (a
hormone) made in a part of the
body called the pancreas.
PANCREAS
Muscle
G
G
G
G
insulin

 If your body doesn't make
enough insulin or if the
insulin doesn't work the way
it should, glucose can't get
into cells.
 Glucose stays in the blood.
 Blood glucose levels get too
high, causing diabetes.
Muscle
Bloodstream

Common types of diabetes
Type 1 Type 2
Age of onset Usually <40 years Usually >40
years
Body weight Lean Usually obese
Prone to
Yes No
ketoacidosis
Medication Insulin essential Tablets and /or
insulin
Onset of
symptoms
Acute Gradual (may be
asymptomatic)

Complications of diabetes
 Diabetes can cause increased risk of:
 Heart Problems
 Stroke
 Eye sight problems
 Kidney problems
 Foot problems

Treatment goals
 Symptom free
 Prevent short term complications
 Prevent long term complications
 Quality of life =
Lifestyle focus

Cornerstones of treatment
Insulin/tablets
Physical activity
Diet

Healthy eating
 To help control blood glucose,
blood fats and adequate body
weight
 Healthy Eating
 Regular carbohydrate
 High in fibre
 Low in fat (particularly saturated
fat)
 Low in added sugar
 Adequate energy
/protein/fluids/vits and mins

Exercise / activity
 30 minutes moderate intensity most days
preferably all
 Helps to:
 Increased insulin sensitivity
 Decreased insulin requirements
 Weight reduction
 Lipid control
 Blood pressure control

Insulin and tablets
 Type 2 diabetes treatment may be
 Healthy eating
 Healthy eating + tablets (several different types of
tablets may be on combination of tablets
 Healthy eating + tablets + insulin
 Healthy eating and insulin
 Type 1 diabetes always require insulin
 May have long acting 1-2 times a day
 Short and long acting 1-4 times a day
 Continuous – insulin pump

Hypoglycaemia
June 2005

What you need to know!
 Blood glucose level that is considered low
 Signs and symptoms
 Causes
 Plan of action to treat
 Strategies to prevent hypoglycaemia

Definition of hypoglycaemia
 Blood glucose level below 3.5 mmol/L
in people with diabetes who are
treated with insulin or oral
hypoglycaemic agents

feeling dizzy/shaking profuse sweating
Symptoms
excessive hunger
headache
pins and needles
around mouth

Cognitive impairment
 Symptoms of cognitive impairment
Lack of concentration
Altered vision
Peculiar behaviour
Loss of consciousness

Nocturnal hypoglycemia
 Symptoms may include:
 Sweating
 Vivid dreaming
 Restlessness
 Incontinence
 Waking with a headache
 High or low fasting levels

Act quickly

Treatment
Treat hypoglycaemia with quickly absorbed
glucose (15 gm carbohydrate in total) eg.
100 ml Lucozade
150 ml lemonade
5 Jelly beans
4 Jelly babies
3 heaped teaspoons of sugar
3 glucose tablets

Treatment
 If symptoms have not resolved in 5-10
minutes treatment needs to be
repeated.
 Followed up initial treatment with
carbohydrate which is more slowly
absorbed
eg. Sandwich or fruit

Never
Never give food to an unconscious
person

Treatment if unconscious
 Position in the left lateral position and
withhold any food or fluids. Seek
further medical help.
 If glucagon is available it can be
administered subcutaneously,
intramuscularly or intravenously.

Causes of Hypoglycemia
Insufficient food or delayed
meal or snack
Extra physical activity
or exercise
Excess of
insulin and
some oral
hypogycemic
agents
insulin
Alcohol consumed without food or
excess alcohol

Hyperglycaemia
June 2005

What you need to know!
 What is hyperglycaemia
 Causes
 Describe the main principles of the
treatment
 Diabetic Ketoacidosis
 Hyperosmolar non ketotic coma

Hyperglycaemia
 Persistent BGL over 10 mmol/L
 Signs and symptoms of hyperglycaemia
 Polyuria
 Polydipsia
 Blurred vision
 Weight loss
 Infections, thrush
 Tired

Causes of Hyperglycaemia
 Increased weight
 Incorrect foods or amount of foods
 Forgetting or insufficient medication lack
of physical activity
 Stress
 Certain medications
 Illness /infections

Treatment
 Relieve symptoms
 Increase monitoring
 Identify cause treat accordingly
 Observe for signs of concurrent illness or
infection

Managing Type 2 if illness present
 BGLs
 Monitor 2-4 hourly, record BGLs
 Drink 1 glass of fluid per hour
 If on diet or metformin water or diet lemonade
 If on sulfonylureas/insulin - diet or regular
lemonade depending on BGL
 Contact Dr
 If becoming drowsy, vomiting or dehydrated
 If BGLs over 15mmol for 24 hours

Managing Type 1 if illness present
 Fluids
 Drink 1 glass of fluid per hour. Sweetened if BGL below 15mmol
- unsweetened if above 15mmmol
 Insulin
 Never omit even if not eating
 BGLs
 Test 2-4 hrly, may require extra short acting insulin
 Ketones
 Test for ketones if ill, BGL > 15 for 24 hours, or if vomiting
 Contact Dr
 If becoming drowsy or dehydrated
 If vomiting or ketones present

Diabetes

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