DIABETES MELLITUS WHAT’S DIABETES? It’s a chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. ETIOLOGY When there isn’t enough insulin or cells stop responding to insulin, too much blood sugar stays in your bloodstream. Over time, that can cause serious health problems, such as heart disease, vision loss, and kidney disease. CLINICAL MANIFESTATIONS INCREASED THIRST (POLYDIPSIA) FREQUENT URINATION (POLYURIA) FATIGUE BLURRED VISION SLOW-HEALING SORES OR CUTS. UNEXPLAINED WEIGHT LOSS FREQUENT SKIN / VAGINAL YEAST INFECTIONS. TWO TYPES: NURSING DIAGNOSIS: Risk for unstable BLOOD GLUCOSE LEVEL related to Insuffi cient diabetes management or nonadherence to diabetes management plan; inadequate blood glucose monitoring; ineffective medication management as evidenced by polyuria, polydipsia, and slow-healing wounds. TYPE 1 DIABETES TYPE 2 DIABETES Once known as juvenile diabetes or insulin-dependent diabetes, is a chronic condition in which the immune system attacks and destroys insulin-producing cells in your pancreas, causing lack of insulin. The most common diabetes is type 2 diabetes. Also known as Non-insulin dependent diabetes, usually in adults, which occurs when the body becomes resistant to insulin or doesn't make enough insulin. NURSING INTERVENTIONS: •Determine individual factors that may contribute to unstable glucose as listed in risk factors. (e.g: Family History, poor glucose control, eating disorders, and obesity.) Ascertain whether client/SOs obtain accurate readings on their glucose-monitoring device and are adept at using the device Provide information on how to manage glucose level, balancing food intake, antidiabetic agents, and energy expenditure. Ask the patient to consult dietician as needed. DIscuss how the anti-diabetic medications work to patients Encourage the patient to have an active physical lifestyle and eat healthy foods DIAGNOSTIC TEST MEDICATION For Client Receiving Insulin • Fasting Plasma Glucose Test Emphasize the importance of (FPG) checking expiration dates of Oral Glucose Tolerance Test medications, inspecting insulin for (OGTT) cloudiness if it is normally clear, Random Plasma Glucose Test and monitoring proper storage and Hemoglobin A1c Test preparation (when mixing (HbA1c): required). These factors affect insulin absorbability. REFERENCES https://www.niddk.nih.gov/health-information/diabetes/overview/symptoms-causes https://www.cdc.gov/diabetes/basics/diabetes.html https://my.clevelandclinic.org/health/diseases/7104-diabetes https://www.who.int/news-room/fact-sheets/detail/diabetes NANDA 2015