Type 2 Diabetes
- Describe the pathophysiology of Type 2 Diabetes Mellitus.
Type 2 diabetes refers to a heterogeneous syndrome condition that results in abnormalities in fat metabolism and carbohydrates. Environmental and genetic elements are the fundamental causes of type 2 diabetes. The elements affect the functioning of beta-cell and the sensitivity of insulin(Tamarai et al., 2019). Several factors link dysfunction of beta-cell and resistance of insulin with type 2 diabetes pathogenesis—for example, central visceral adiposity.
- List the signs and symptoms of hyperglycemia.
Hyperglycemia is a health condition that occurs when the sugar content in the blood is too high. Having hyperglycemia for an extended period can cause damage to blood vessels, nerves, and other body organs. The signs and symptoms of hyperglycemia include the following, increased hunger, blurred vision, numbness in the feet, and increased thirst. Other additional early signs include weight loss, vaginal and skin infections, fatigue, slows-healing sores, and cuts(Duarte et al., 2019). When not treated, hyperglycemia can lead to an emergency condition known as ketoacidosis.
- List the signs and symptoms of hypoglycemia?
The condition occurs with the diabetes patient have low sugar content in the blood, but the insulin level is too high. Hypoglycemia’s early signs and symptoms include sweating, anxiety, dizziness, hunger, shakiness, headache, and moodiness. Diabetic hypoglycemia nighttime symptoms include nightmares and dam sheets (Kapoor et al., 2017). For severe hypoglycemia, signs and conditions include drowsiness, muscle weakness, unconsciousness, jerky movements, and convulsions.
- What are the target blood glucose ranges for a diabetic patient with reasonable control? List both fasting and when checking their blood sugar 2 hours after eating.
For a diabetic patient with reasonable control, the recommended blood glucose ranges between 70 mg/dl and 130 mg/dl (American Diabetes Association, 2018). However, according to the International Diabetes Federation and American College of Endocrinologists, the range is between 110 mg/dl and 100 mg/dl. The blood glucose should fall within the target ranges; any level below or above the fields will lead to complications or damages to the body.
- What does a hemoglobin A1C indicate? What is the target goal? Why?
Hemoglobin A1C can be used to measure the hemoglobin percentage of an individual. Hemoglobin refers to the protein contained in the red blood cells that transmits oxygen. A1C is glycated, coated with sugar. When the A1C level is high, the blood sugar control ability is likely to be low, thus exposing an individual to a high risk of diabetes complication(Qaseem et al., 2018) Recommended A1C goal should be below 7 percent. The main target of A1C is to identify hemoglobin percentage to reduce diabetes complication risk.
- How often should a diabetic patient monitor their blood sugar?
According to National Institute for Health and Care Excellence (NICE) guidelines, the recommended blood glucose testing period for individuals with type 1 diabetes should be at least four times daily; this includes before retiring to bed and before every meal(Starr, 2019). The doctor should also support the patient more often to ensure the test is conducted in the following circumstances; at least once after every two hours if the patent is a long journey and every time before driving., before and after exercise, during illness period and pregnancy or breastfeeding.
- What are the predisposing factors for developing Type 2 Diabetes?
The predisposing factors include weight, inactivity, age, fat distribution, race, prediabetes, family history, and gestational diabetes.
- Describe the comorbidities associated with diabetes, and what do they mean for the patient?
According to a study conducted by the Medical Expenditure Panel Survey, about 98 percent of adults who have type 2 diabetes have a high risk of contracting the chronic disease. About 90 percent have a chance of contracting at least two chronic conditions, and about 40 percent have at least three chronic diseases (Hermans and Dath, 2018). The same study also reveals that approximately 75 percent of diabetic patients are suffering from hypertension.Other diabetes comorbidities include cardiovascular disease, nonalcoholic fatty liver, obesity, hyperlipidemia, and kidney disease.
- What are the results/complications of uncontrolled diabetes with hyperglycemia?
When hyperglycemia is not treated in time, toxic acids known as ketones may build in the patient’s blood and urine. This is a condition known as ketoacidosis. Some of the complications of untreated hyperglycemia include nerve damage, retinal blood vessel damage, cardiovascular diseases, and kidney damage or kidney failure.
- What is involved in diabetes self-management?
Diabetes self-management refers to a critical care element for all diabetes patients. It is necessary because it improves the outcome of patients. Diabetes self-management includes healthy eating habits, regular monitoring of blood glucose level, physical activities, taking medication as prescribed by the health provider, solving problems related to diabetes self-care, and reducing the risk of chronic and complications for persons living with diabetes.
- Why would the nurse encourage diabetic patients to perform daily foot care and exams?
Performing daily foot care and exams assist in the early detection and prevention of diabetes. Foot examination helps the patient to monitor any changes that have occurred to the foot; this will help the nurse to take a prior precaution to reduce the risk of diabetic neuropathy and improve the patient’s quality of life. Furthermore, it helps the patient take care of the fit for physical fitness.
- Identify three (3) nursing diagnoses and a goal for each for Mr. B.
Three nursing diagnoses for Mr. B include risk of infection, unstable glucose risk, and unbalanced nutrition.
- List 3-4 nursing interventions for each nursing diagnosis(Whitehead et al., 2017)
The risk for unstable blood glucose
- Assessing the hyperglycemia signs
- Treating hypoglycemia using 50 percent dextrose
- Evaluate the patient’s tremors, anxiety, and slurring speech.
Risk of infection
- Observe whether Mr. B has any infection and inflammation signs
- Teaching Mr. B on how to promote good hand hygiene
- Maintaining asepsis during activities medicine administration and IV insertion.
Imbalanced Nutrition
- Advising Mr. B to keenly comply with a meal plan to meet weekly weight loss target
- B should weigh daily
- Ascertaining the dietary program of Mr. B
References
American Diabetes Association. (2018). Standards of medical care in diabetes—2018 abridged for primary care providers. Clinical diabetes: a publication of the American Diabetes Association, 36(1), 14.
Duarte, J. M., Bertotti, A. C., &Puchulu, F. (2019). Early neuropathy. Importance of neurophysiological assessment in cases of metabolic syndrome with or without hyperglycemia. Medicina, 79(3), 212-216.
Kapoor, N., Jagan, J., & Thomas, N. (2017). Management of hypoglycemia. Current Medical Issues, 15(3), 211.
Qaseem, A., Wilt, T. J., Kansagara, D., Horwitch, C., Barry, M. J., &Forciea, M. A. (2018). Hemoglobin A1c targets for glycemic control with pharmacologic therapy for nonpregnant adults with type 2 diabetes mellitus: a guidance statement update from the American College of Physicians. Annals of internal medicine, 168(8), 569-576.
Starr, J. M. (2019). Older adults with intellectual disability: the National Institute for Health and Care Excellence (NICE) guidelines.
Tamarai, K., Bhatti, J. S., & Reddy, P. H. (2019). Molecular and cellular bases of diabetes: Focus on type 2 diabetes mouse model-TallyHo. Biochimica et BiophysicaActa (BBA)-Molecular Basis of Disease.
Whitehead, L. C., Crowe, M. T., Carter, J. D., Maskill, V. R., Carlyle, D., Bugge, C., & Frampton, C. M. (2017). A nurse‐led interdisciplinary approach to promote self‐management of type 2 diabetes: a process evaluation of post‐intervention experiences. Journal of evaluation in clinical practice, 23(2), 264-271.
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