The Procedural Work For Diabetes Patients

- Prepared by

Inpatient guide

- Oath of Nursing Professionals

"I swear by Almighty God
That I will be sincere in my work, fear God in my profession, respect its laws and regulations, and perform my duties with competence and dedication.
I will rely on knowledge derived from nursing sciences in my practice and exert my utmost effort in caring for those entrusted to me.
I will preserve their dignity, keep their secrets, defend their rights, and protect them from any harm.
I will not fear criticism in speaking the truth, and I will provide a safe environment for the patient, their family, and the community.
I will continue to develop myself, honor those who have taught me, and respect them.
I will cooperate with my colleagues in the profession in righteousness and piety.
And I bear witness to God on what I say."

- Vision and Mission of Nursing Care

Vision of Nursing Care in the Internal Patient Care Unit

- Definition

Diabetes is a chronic disease that occurs when the pancreas is unable to produce enough insulin or when the body is unable to use the insulin it produces effectively (known as "insulin resistance"). Insulin is a hormone that regulates blood glucose levels.

- Causes

• Dysfunction in the pancreas.
• Insulin resistance in body cells (insulin resistance).

- Types of Diabetes

1. Type 1 Diabetes: An autoimmune condition in which the immune system attacks insulin-producing beta cells in the pancreas.
2. Type 2 Diabetes: A metabolic disorder characterized by high blood glucose levels and insufficient insulin production.
3. Gestational Diabetes: A temporary condition that occurs during pregnancy, increasing the risk of the mother and child developing chronic diabetes later.

- Signs and Symptoms of Diabetes

• Persistent hunger
• Increased urination
• Unexplained weight loss or weight gain
• Weakness and fatigue
• Blurred vision
• Slow healing of wounds and bruises
• Numbness or tingling in hands and feet
• Skin infections
• Vaginal or bladder infections
• Smell of acetone (DKA)

- Prevention

• Maintaining a healthy weight
• Regular physical activity (30 minutes daily)
• Healthy diet, low in sugars and saturated fats
• Avoiding smoking

- Complications of Diabetes

• Damage to blood vessels, which can lead to a variety of complications such as stroke, blindness, heart disease, chronic kidney disease, neuropathy, and diabetic foot ulcers.
• Increased susceptibility to bacterial and fungal infections.

- Diagnosis of Diabetes

1. Clinical Examination and Symptom Evaluation.
2. Blood Glucose Tests:
• Fasting Blood Glucose: ≥126 mg/dL (7.0 mmol/L).
• Random Blood Glucose: ≥200 mg/dL (11.1 mmol/L).
• HbA1c: ≥6.5% indicates diabetes, 5.7-6.4% indicates prediabetes.

- Treatment of Diabetes

• Diet and Exercise: Healthy eating, regular physical activity, and weight control.
• Medications: Insulin injections for Type 1 diabetes and oral medications (sometimes insulin) for Type 2 diabetes.

- Nursing Care for Diabetic Patients

• Regular monitoring of blood glucose levels.
• Monitoring weight and physical activity.
• Educating patients on diet, exercise, and medication use.
• Teaching proper insulin injection techniques and rotating injection sites to avoid tissue damage.
• Providing health education on foot care, wound care, and the importance of regular checkups.

- Nursing Care for Diabetic Foot

• Regular Assessments: Examine feet for any changes, including skin color, temperature, swelling, or sores.
• Skin Care: Moisturize feet regularly to avoid dryness and cracks. Avoid moisturizing between toes to prevent fungal infections.
• Wound Care: Clean and dress wounds properly.
• Footwear: Ensure that shoes are comfortable and suitable for diabetic patients.
• Monitor Blood Sugar: Maintain blood glucose levels within normal ranges.
• Education and Guidance: Teach patients how to check their feet daily and recognize any potential issues early.

- Nursing Intervention in Hyperglycemia (High Blood Sugar) and Hypoglycemia (Low Blood Sugar)

Nursing Intervention in Hyperglycemia (High Blood Sugar)

- Nursing Care for Diabetic Coma

• Check the patient’s responsiveness and glucose levels.
• Administer fluids and insulin based on the type of coma (e.g., diabetic ketoacidosis or hypoglycemic coma).
• Monitor vital signs and oxygen saturation.
• Provide continuous support and adjust treatment as necessary.

- Nursing Care for Diabetic Ketoacidosis (DKA)

• Fluid and Electrolyte Balance: Administer IV fluids (e.g., saline) and correct electrolyte imbalances.
• Insulin Therapy: Administer insulin intravenously to reduce blood glucose and ketone levels.
• Monitoring pH Levels: Monitor acid-base balance and provide necessary treatments (e.g., bicarbonate) if needed.
• Continuous Monitoring: Keep track of vital signs, glucose levels, and the patient's clinical status.
• Education: After stabilization, educate patients and families about diabetes management to prevent recurrence.

- References

·       American Diabetes Association (ADA): https://diabetes.org/

·       International Diabetes Federation (IDF): https://idf.org/

·       Joslin's Diabetes Manual: A classic reference for healthcare professionals.  

·       Diabetes: A Complete Guide: A comprehensive guide for patients and their families.

National Institutes of Health (NIH): https://www.niddk.nih.gov/