Diabetes Mellitus Management

1. Diabetes Mellitus Management Reynel Dan L. Galicinao

2. Diagnostic Evaluation FBS ≥ 126 mg/dL Random blood glucose ≥ 200 mg/dL with classic symptoms (polyuria, polydipsia, polyphagia, weight loss) OGTT ≥ 200 mg/dL on the 2-hour sample Tests for glucose control over time are glycated hemoglobin and fructosamine assay.

3. Diet Dietary control with caloric restriction of carbohydrates and saturated fats to maintain ideal body weight. The goal of meal planning is to control blood glucose and lipid levels. Weight reduction is a primary treatment for type 2 diabetes.

5. Consistency in timing of meals and amounts of food eaten on a day-to-day basis help regulate blood glucose levels.

6. Increase the intake of soluble and insoluble fiber.

7. Avoid salt whenever possible.

8. Prepare foods to retain vitamins and minerals and reduce fats.

9. Distribute snacks in the meal plan depending on insulin/medication regimens, physical activity, and lifestyle.

10. Use alcohol only in moderation.

13. Glyburide, micronized (Glynase)

14. Glipizide (Glucotrol)

15. Glipizide (Glucotrol XL)

20. Glipizide/metformin (Metaglip)

23. Monitor serum glucose and urine acetone levels.

24. Monitor patient for acute complications of diabetes therapy, especially hypoglycemia (vagueness, slow cerebration, dizziness, weakness, pallor, tachycardia, diaphoresis, seizures, and coma).

26. Monitor diabetic effects on the cardiovascular system (such as cerebrovascular, coronary artery, and peripheral vascular impairment) and on the peripheral and autonomic nervous systems.

27. Provide meticulous skin care, especially to the feet and legs.

29. Observe the patient for signs of urinary tract and vaginal infection.

30. Encourage adequate fluid intake.

31. Monitor the patient for signs and symptoms of diabetic neuropathy (numbness or pain in the hands and feet, footdrop, and neurogenic bladder).

33. Offer emotional support and a realistic assessment of his condition.

34. Stress that with proper treatment he can have a near-normal lifestyle and life expectancy.

35. Help the patient develop coping strategies.

36. Refer him and his family to a counselor, if necessary. Encourage them to join a support group.