Nursing Diagnosis for Diabetes

Nursing Diagnosis for Diabetes

The American Diabetes Association recommends that all adults over forty-five be screened for type 2 diabetes at least every three years, and that people with several risk factors be screened yearly. Diabetes is diagnosed by the results of blood tests. There are several different types of blood tests that may be used.

• Fingerstick. This type of test is often used as a screener in the doctor’s office. The doctor pricks the patient’s fingertip with a needle and touches a test strip attached to a small handheld glucometer to the drop of blood, which provides a blood sugar reading within a few seconds. This method is used by diabetic patients at home to monitor their blood sugar levels.
• Fasting blood glucose test. The patient has blood drawn first thing in the morning after having eaten nothing since midnight of the previous night. A score over 126 milligrams per deciliter (mg/dL) indicates possible diabetes.
• Glucose tolerance tests. In this test, the patient has blood drawn twice, the first time after fasting for eight hours and the second time two hours later, after drinking a very sweet drink. A score over 200 mg/dL suggests diabetes.
• Hemoglobin A1c test. This test is used to monitor blood sugar control in people known to have diabetes. It measures the amount of blood sugar attached to the hemoglobin in red blood cells. If more than 7 percent of the hemoglobin has excess sugar attached to it, the person needs to get better control over their blood sugar levels.

There is no cure for diabetes. Treatment is based on a combination of diet and weight control; physical exercise; injected insulin or oral medications to reduce blood sugar levels; and home monitoring of blood glucose levels. The goal of treatment is to control blood sugar levels and to lower the patient’s risk of blindness, frequent infections, heart disease, and other complications of diabetes:

• Diet: Patients with type 2 diabetes usually need to lower their weight. In addition, they must learn to eat roughly the same size meals at the same times each day so that their insulin doses will not lower their blood sugar level too quickly or too far.
• Exercise: Exercise reduces the patient’s risk of leg ulcers, stroke, heart disease, kidney failure, and other complications of diabetes.
• Insulin and oral medications: Patients with type 1 diabetes must use injected insulin. Type 2 diabetics can be treated with oral medications that increase the body’s sensitivity to insulin, stimulate the pancreas to produce more insulin, or decrease the amount of glucose produced by the liver. They may need insulin injections in addition to these oral medications.
• Home monitoring. Patients with either type of diabetes must check their blood sugar levels four times a day—before each meal and at bedtime—and keep a careful record of the test results.

Prognosis
The prognosis of diabetes depends on the type and the patient’s willingness to take responsibility for their health. Patients who do not take their insulin or other medications regularly or fail to monitor their blood sugar at home run the risk of severe complications. According to the American Diabetes Association, people with diabetes are at risk for the following complications:

• Diabetics are two to four times more likely to develop heart disease than those without diabetes.
• Between 12,000 and 24,000 diabetics lose their eyesight each year.
• About 48,000 diabetics develop end-stage kidney disease each year.
• Around 71,000 amputations of legs and feet are performed each year in people with diabetes.
• Thirty-five percent of people with diabetes have periodontal disease.
• About 60–70 percent of diabetics have some degree of damage to the nervous system

 Nursing Diagnosis for Diabetes

1. Risk for Impaired skin integrity

2. Impaired physical mobility

3. Acute Pain

4. Imbalanced nutrition: less than body requirements

5. Risk for infection

6. Sleep disorders

7. Deficient knowledge

8. Anxiety