Diabetes Mellitus Management

Overview

Diabetes Mellitus is a chronic multisystem disease related to abnormal insulin production or utilization. It leads to hyperglycemia which, if uncontrolled, causes long-term damage to the vascular system and various organs. Nursing care involves monitoring glucose, administering medications, and providing extensive lifestyle education.

Key nursing concepts

• Type 1 diabetes involves absolute insulin deficiency due to beta-cell destruction.
• Type 2 diabetes involves insulin resistance and relative insulin deficiency.
• Hypoglycemia is defined as blood glucose less than 70 mg/dL.
• Diabetic Ketoacidosis (DKA) is a life-threatening complication of Type 1.
• Hyperglycemic Hyperosmolar State (HHS) typically occurs in Type 2 patients.
• Microvascular complications include retinopathy, nephropathy, and neuropathy.

Important nursing considerations

• Monitor blood glucose levels every 4 to 6 hours during acute illness.
• Assess the patient for signs of hypoglycemia including diaphoresis and tremors.
• Check for peripheral neuropathy and skin integrity especially on the feet.
• Rotate insulin injection sites to prevent lipodystrophy.
• Verify Hemoglobin A1c levels to evaluate long-term glucose control.
• Ensure the patient has a fast-acting carbohydrate source available at all times.

Patient teaching

• Teach the importance of daily foot inspections using a mirror if necessary.
• Instruct on the 'rule of 15' for managing hypoglycemic episodes at home.
• Explain the need for annual eye exams to screen for retinopathy.

Related practice questions

Real questions from the NursGuru bank, each with the answer and rationale.

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