Educating Newly Diagnosed Type II Diabetic Patients

= Objectives = At the end of this unit the student will be able to:


 * 1) Define the concept of diabetes
 * 2) Identify the type of diabetes
 * 3) Describe the signs and symptoms of hyper and hypoglycemia.
 * 4) Describe the benefits of regular exercise and how regular exercise can improve blood glucose control.
 * 5) Perform self-monitoring of blood glucose using a blood glucose meter as evidenced by demonstration of the technique to the nurse.
 * 6) Demonstrate proper skin and foot care.

= Diabetes Overview =

What is Diabetes?
The term “Diabetes” comes from the Latin language and it refers to the act of excretion. The term “Mellitus”, Mel in Greek language, means honey. The combination of the two terms describes the act of the excretion of glucose in large amounts of urine. This symptom, along with excessive thirst, hunger and weight loss, describes the typical clinical picture of this disease (Diabetes Mellitus, 2009).

Diabetes is a disease in which the body does not produce or properly use the insulin hormone (Diabetes Mellitus, 2009), which is synthesized in the pancreas by the β cells in the islets of Langerhan. Insulin is used by our body as the vehicle to transport glucose as a form of energy through the cell receptors.

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How is Diabetes Diagnosed?
The Diabetes Mellitus (DM) diagnoses, is defined as a fasting blood glucose level of 126 milligrams per deciliter (mg/dL) or more. People with pre-diabetes condition usually have blood glucose levels higher than normal but not higher than 126 mg/dL. These individuals with pre-diabetes are at increased risk for developing Type II Diabetes, heart disease and stroke, and have one of the following conditions listed below (Diabetes Mellitus, 2009).

1. Impaired fasting glucose (100 to 125 mg/dL). 2. Impaired glucose tolerance (fasting glucose less than 126 mg/dL and a glucose level between 140 and 199 mg/dL two hours after taking an oral glucose tolerance test)

Classification

 * Type I: Approximately 5% to 10% of diagnosed cases of diabetes are Type 1. Type 1 diabetes develops when the body’s immune system destroys pancreatic beta cells, the only cells in the body that make insulin.

Insulin is a hormone that regulates blood sugar levels. Type 1 diabetes is associated with autoimmune, genetic, and environmental risk factors (Center for Disease Control and

Prevention, 2005).


 * Type II: Approximately 90% to 95% of diagnosed cases are Type 2 diabetes. Type 2 diabetes begins as insulin resistance followed by the gradual inability of pancreatic beta cells to produce insulin. Type 2 diabetes is associated with old age, obesity, physical inactivity, race/ethnicity, and a family history of diabetes (National Diabetes Information Clearing House)
 * Gestational: Approximately 4% of women are diagnosed with gestational diabetes during pregnancy. It is a form of sugar intolerance that is usually resolved after pregnancy. During pregnancy, gestational diabetes requires treatment to normalize maternal blood sugar levels in order to avoid complications for the fetus. Risk factors for gestational diabetes are obesity and a family history of diabetes (National Diabetes Information Clearing House).

Signs and symptoms Of hypo and hyperglycemia
Hypoglycemia


 * Shaking
 * Sweating
 * Anxious
 * Dizziness
 * Hunger
 * fast Heart Beat
 * Impaired vision
 * weakness, fatigue
 * Headache
 * Irritable

Hyperglicemia


 * Frequent Urination
 * Dry Skin
 * Hunger
 * Blurred Vision
 * Drowsiness
 * Nausea

Diabetes Type II and Exercise:

Exercise is very important in managing type 2 diabetes. Combining diet, exercise, and medicine (when prescribed) will help control your weight and blood sugar level. Exercise helps control type 2 diabetes by:


 * Improving your body's use of insulin.
 * Burning excess body fat, helping to decrease and control weight (decreased body fat results in improved insulin sensitivity).
 * Improving muscle strength.
 * Increasing bone density and strength.
 * Lowering blood pressure.
 * Helping to protect against heart and blood vessel disease by lowering 'bad' LDL cholesterol and increasing 'good' HDL cholesterol.
 * Improving blood circulation and reducing your risk of heart disease.
 * Increasing energy level and enhancing work capacity.
 * Reducing stress, promoting relaxation, and releasing tension and anxiety.

Self Monitoring Blood Glucose

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Caring for Your Feet
There are many things you can do to keep your feet healthy.


 * Check your feet every day. Look at your bare feet for red spots, cuts, swelling, and blisters. If you cannot see the bottoms of your feet, use a mirror or ask someone for help.
 * Be more active. Plan your physical activity program with your health team.
 * Ask your doctor about Medicare coverage for special shoes.
 * Wash your feet every day. Dry them carefully, especially between the toes.


 * Keep your skin soft and smooth. Rub a thin coat of skin lotion over the tops and bottoms of your feet, but not between your toes. Read more about skin care. If you can see and reach your toenails, trim them when needed. Trim your toenails straight across and file the edges with an emery board or nail file.
 * Wear shoes and socks at all times. Never walk barefoot. Wear comfortable shoes that fit well and protect your feet. Check inside your shoes before wearing them. Make sure the lining is smooth and there are no objects inside.
 * Protect your feet from hot and cold. Wear shoes at the beach or on hot pavement. Don't put your feet into hot water. test water before putting your feet in it just as you would before bathing a baby. Never use hot water bottles, heating pads, or electric blankets. You can burn your feet without realizing it.
 * Keep the blood flowing to your feet. Put your feet up when sitting. Wiggle your toes and move your ankles up and down for 5 minutes, two (2) or three (3) times a day. Don't cross your legs for long periods of time. Don't smoke.