Professional Documents
Culture Documents
Submitted by:
Arciaga, Mary Grace J.
Macavinta, Joseph Celrin III V.
Mongaya, Meryll L.
Nico, Nelson E.
Submitted to:
Mr. Andr N. Canaria, MSN, RN
Serious Complications of
Diabetes Mellitus
PRESENTED BY:
JOSEPH CELRIN V. MACAVINTA III, RN
Complications of Diabetes Mellitus
A . MACROVASCULAR COMPLICATIONS
complications result from changes in the medium to large blood vessels
2. Cerebrovascular disease
Twice the risk for people with diabetes
Transient ischemic attacks
Stroke
B. MICROVASCULAR COMPLICATIONS
Diabetic Microvascular disease (Microangiopathy) is the thickening of capillary
basement membrane
1. Diabetic Retinopathy
leading cause of blindness
deterioration of the small blood vessels that nourish the retina
Complications of Diabetes Mellitus
3 main stages
a. Nonproliferative (Background)
Early stage, asymptomatic
Blood vessels develop microaneuryms that causes swelling and forming of
exudates
Macular edema causes distorted vision
b. Preproliferative
Increased destruction of retinal blood vessels
c. Proliferative
Abnormal growth of new blood vessels in retina
New vessels rupture causing bleeding into the vitreous and blocking light and
will form scar tissue, which can pull on and detach the retina
Complications of Diabetes Mellitus
2. Diabetic Nephropathy
Account for almost 50% of new cases of end-stage renal disease (ESRD)
About 25% of those requiring dialysis or transplantation
Consistently elevated blood glucose level may cause stress in the kidneys
filtration mechanism allowing blood proteins to leak into the urine that
results to increase pressure in the blood vessels in the kidney.
3. Diabetic Neurophathy
May affect peripheral (sensorimotor), autonomic, and spinal nerves.
Complications of Diabetes Mellitus
b. Autonomic Neuropathy
Broad range of dysfunction affecting almost every organ system of the body
3 manifestations are related to cardiac, gastrointestinal and renal systems.
Cardiovascular fixed, slightly tachycardic, orthostatic hypotension
Gastrointestinal - delayed gastric emptying, bloating, nausea, vomiting, and
diabetic constipation or diarrhea
Renal urinary retention, erectile dysfunction
Sudomotor Neuropathy decrease or absence of sweating (anhidrosis) of the
extremities, with a compensatory increase in upper body sweating. Dryness
of the feet increases the risk for development of foot ulcers
Complications of Diabetes Mellitus
Contents:
Based on the patients food preferences, lifestyle, activity, usual eating habits
and ethnic and cultural background
Diabetes diet must be balanced, nutritious and low in fat, cholesterol and
simple sugars.
The total daily calories are evenly divided into three meals (with snacks for
youth with type 1 diabetes).
Combining starchy foods with protein and fat containing foods tends to slow
their absorption and lower the glycemic response.
Raw and whole foods result in lower glycemic response than eating chopped,
pureed or cooked foods.
Eating whole fruits instead of drinking juices glycemic response since fiber in
the fruits slows absorption.
Small amounts of simple sugars are now allowed when consumed with a
complex meal.
Lowers BGL by glucose uptake by body muscles and improving insulin utilization
HDL and total cholesterol and triglyceride levels (DM pt have risk of CVD)
If with insulin pre-meals, take BGL before meals to determine each dose
Rare
Systemic Allergic Immediate local skin reaction that gradually Desensitization (small
Reaction spreads into generalized urticaria (hives) amounts of insulin)
Generalized edema or anaphylaxis
Complications of Insulin Therapy
Weight loss
Use of more
Daily insulin requirement of 200 units or more
Resistance to concentrated insulin
Most common cause OBESITY
injected insulin (U500)
Prednisone (to block
antibodies)
Complications of Insulin Therapy
The nurses role in diabetes care may be as a specialist or as part of general care -
primary or secondary. Wherever care is given, the emphasis is always on patient self-
management.
Rights of patient to choose among treatment modalities should be addressed and it
requires nurses to change and modify roles as health-educator, care provider and as
an advocate for diabetic patient.
Nurses caring for patients with diabetes need to be working towards the same
objectives, therefore target-setting and determining priorities for managing their
condition are important aspects of care. But to no avail, nurses and patients may still
encounter issue with chosen plan of care, despite of effective communication
among health professional and significant others.
Issues in Diabetes Care Management
Cultural and religious origins will inform the decisions that most patients make about
managing their condition
Lack of knowledge about diabetes and available services for treatment and support.
Poverty
Fatalism
Religious Convictions
Diet restrictions and Exercise interventions
Values and health behaviors
Language
Depression and Diabetes
Identity Issues Research on diabetes indicates that identity issues have a significant
effect on treatment adherence. The need for identity coherence - the maintenance
of personas exemplifying enduring conceptions of oneself (Swann & Bosson, 2008)
and the wish to attain ones desired identity affect diabetes self-management.
Diabetes treatment plays an ambivalent role in identity issues, sometimes preventing
individuals from achieving their identity goals - achieving their desired self and
participating in activities integral to ones self-concept (Swann & Bosson, 2008) - and
sometimes allowing individuals to attain their goals.
Depression and Diabetes
High blood glucose levels can contribute to the formation of fatty deposits in blood
vessel walls. Over time, that can restrict blood flow and increase the risk of
hardening of the blood vessels (atherosclerosis).
Lack of blood flow can affect your hands and feet. Poor circulation can cause pain
in the calves while youre walking (intermittent claudication). People with diabetes
are particularly prone to foot problems due to narrowed blood vessels in the leg and
foot. Your feet may feel cold, and you may be unable to feel heat due to lack of
sensation.
Diabetes and Effect on Cardiovascular System
Cardiovascular system is one of the most important systems in the human body. It
is comprised of the heart, blood and blood vessels. Blood is being pumped out
from the heart and is the one responsible in delivering oxygen and other nutrients
to all the parts of the body. It also cleans up our body by picking up the waste
products on its way back to the heart so our body can get rid of them.
Diabetes and Effect on Cardiovascular System
Cardiovascular diseases are the major cause now of deaths related to diabetes. In a
study published few years back in the Journal of the American Medical Association,
deaths due to some heart conditions went up by 23% in diabetic women despite the
27% drop of the same in non-diabetic women. As for diabetic men, there is only
about 13% decrease in heart disease related deaths as compared to the 36% drop
in non-diabetics. Thus, the two indeed go together.
Diabetes and Effect on Cardiovascular System
Risk Factors
Diabetes is now considered by the American Heart Association a major risk factor in
cardiovascular diseases. Other factors that contribute to the possibility of acquiring
cardiovascular diseases in diabetic patients include hypertension, smoking,
and dyslipidemia.
As the old saying goes, prevention is better than cure. There are many ways on
how to prevent the increased possibility of cardiovascular events in diabetic
patients. Several alterations or modifications to the risk factors can be done to
maintain your health despite diabetes.
The simplest step one can start with is to stop smoking. Diabetic or not, cessation
of smoking will really prove beneficial to ones overall health condition.
Maintaining blood pressure to less than 130/85 or 130/80 mm Hg helps control the
occurrence of hypertension. Having a body mass index (BMI) of less than 27 is also
a must for diabetic patients to control their overall condition.
Diabetes is indeed a life-long condition that demands a lot of attention. There
may be no hard and real cure for this disease, but it can be maintained and
controlled by proper care and having thorough knowledge and understanding
about the condition.
DIABETES SELF CARE
MANAGEMENT AND
TRAINING
PRESENTED BY:
MERYLL L. MONGAYA, R.N.
Role of self-care in management of
diabetes mellitus
The needs of diabetic patients are not only limited to adequate glycemic control but also
correspond with preventing complications; disability limitation and rehabilitation.
7 essential self-care behaviors in people with diabetes
1. healthy eating
2. being physically active
3. monitoring of blood sugar
4. compliant with medications
5. good problem-solving skills
6. healthy coping skills
7. risk-reduction behaviors.
Diabetes self management education
WHO has also recognized the importance of patients learning to manage their
diabetes.
Mission:
Establish the diabetes nurse educator as an integral part of the diabetes team.
Ensure the promotion of comprehensive diabetes education and care to people with
diabetes and the population at risk through the provision of standardized training and
certification of diabetes nurse educators.
Effect positive changes in diabetes education and care through research.
Promote health and prevent diabetes mellitus through consciousness raising.
Establish linkages with government and non-government agencies locally and
internationally.
PHILIPPINE ASSOCIATION OF DIABETES EDUCATORS
Vision:
is to be a respected group of globally competent diabetes nurse
educators with the mission of moving people to action through
continuous training, research, linkages, and collaboration. We aim to
establish the diabetes nurse educator as an integral part of the diabetes
team.
Course description
Philippines
foremost endocrinologist, and
a group of dedicated doctors
banded together in October
1990, and along with other
diabetes lay crusaders.
Vision:
We see a citizenry that is
knowledgeable about diabetes
mellitus and skillful in the prevention
and management of the disease.
Mission:
We aim to improve the quality of
life of Filipinos by developing and
providing a comprehensive and
effective diabetes education
program for the country.
DIABETES NURSING EDUCATION IN UK
first meet the eligibility requirements set forth by the National Certification
Board for Diabetes Educators (NCBDE).
http://www.idf.org/philippine-association-diabetes-educators-pade-association-diabetes-nurse-educators-philippines
https://www.capella.edu/lp/diabetesnursing/?revkey=199494&WT.srch=1&dfaid=1&cid=8cb11a49-5faa-455f-a02e-
5715b0ae2f05&keninvocaid=p.160.8cb11a49-5faa-455f-a02e-
5715b0ae2f05.93859&gclid=CN2YofagwNICFQsQvQodINcHZg