Introduction Diabetes is a chronic illness that effects a large number of the population, 243,125 New Zealanders were diagnosed according to the 2013 census (Diabetes New Zealand, 2014a). Diabetes mellitus is a metabolic disease that causes unstable hyperglycaemia resulting from a defect in insulin secretion or action within the body (Belonwu, Obimba, Ozougwu & Unakalamba, 2013). Diabetes is a condition that can have detrimental effects on the lives of people suffering from diabetes, diabetes is a condition that has long term side effects that can be life-threatening. The purpose of this literature review is to explore what is best evidence based nursing practice to improve wound healing of diabetic foot ulcers. Foot ulcers account for 60% of lower limb amputations, causes of lower limb amputations include peripheral vascular disease (any disorder that involves the circulatory system outside the brain or heart). (Emedical Health, 2014), and the presence of ischemia due to neuropathy (reduced circulation to the tissue causing the skin cells to die (Chadwick & Haycocks, 2012). For this reason, the literature review will examine the question ‘what is the best evidence-based nursing practice to improve the outcome of diabetic foot ulcers’ this literature review will critically analyse three themes within the current international literature. Best evidence based practice will be identified, to improve diabetic foot ulcer outcomes. Research method To improve the literature
Diabetes is a disease where the body is unable to produce or use insulin effectively. Insulin is needed for proper storage and use of carbohydrates. Without it, blood sugar levels can become too high or too low, resulting in a diabetic emergency. It affects about 7.8% of the population. The incidence of diabetes is known to increase with age. It’s the leading cause of end-stage renal disease in the US, and is the primary cause of blindness and foot and leg amputation. It is known to cause neuropathy in up to 70% of diabetic patients. Individuals with diabetes are twice as likely to develop cardiovascular disease. There are two types of diabetes: Type 1 and Type 2.
Don’t ask me how I feel, I’m not going to tell you. Talking about it makes it worse. When I explain my pain, I have to think about it. Ignore it; maybe it will go away. I dwell on my fears of what may happen. I don’t want to pass that fear on to you. You don’t see it as I do. It’s not your body; it’s not your life. I don’t tell you because I don’t want you to be afraid for me. I can deal with it. I’ll be OK. I don’t tell you because I know that my words are inadequate. I can’t express what it is, yet I do want you to know (even if you can’t exactly feel it). I want to let you in to my world. I want you to know how different my life is from yours, even though it looks much the same. I’m not scarred or crippled.
Public health emphasizes the importance of prevention and proactively taking care of one’s body. As people grow older, they must follow certain guidelines to ensure that they age healthily and successfully. One of the biggest concerns facing the aging population is chronic diseases. Chronic diseases are long term diseases that have a slow progression. Once chronic diseases pass “certain symptomatic or diagnostic thresholds,” they become a permanent aspect of an individual’s life because “medical and personal regimens can sometimes control but can rarely cure them” (Albert and Freeman 105). One chronic condition that is a cause of concern is diabetes. Diabetes is not only one of the leading causes of death in the over 65 population but
The most significant difference between the regular insulin and the rapid acting insulin is the onset. The onset for rapid-acting or lispro is 10-15 minutes, and for the regular it is ½-1 hour.
Type 2 diabetes is a polygenic, complex disease that has become a worldwide health crisis. According to the World Health Organization over 422 million people in the world had this disease in 2014 (1), the Center for Disease Control and Prevention stated that in the United States alone 29 million people had diabetes in 2014 (2). While the genetic predisposition contributing to the diabetes phenotype is not fully understood to date it still remains an area of active research. There are also various environmental factors that contribute stress to the glucose homeostasis system that provide a different approach in understanding this disease. Comprehending the pathogenesis of the disease has been an area of constant research for decades. There is hope that pharmaceutical developments can follow along and find medical treatments that can target the key pathogenic elements of this disease.
need for increased understanding of the economic, and societal seriousness of diabetes and its complications, and of the escalating costs to individuals, families, workplaces, society and governments.
After the initial investigation, the BSN nurse would then research current treatments for pressure ulcers as they relate to diabetic patients. To properly care for a diabetic foot ulcer, the BSN nurse would suggest debridement and a dressing to prevent tissue dehydration, absorb excess fluid, and to prevent wound contamination (American Diabetes Association 2006). Patient education would also be necessary to ensure she does not bear weight on the affected limb to promote healing. According to the American Diabetes Association, the biggest challenge for healing a diabetic wound is keeping the patient from bearing weight on the affected limb. The BSN nurse may be equipped to handle the patient education better than the ADN nurse due to the amount of research done on the subject.
The goal to treat an ulcer in a diabetic patient is to heal the wound faster to prevent infection, pressure has to be take off the area by “offloading” the foot, remove dead tissue by the process of debridement, apply to dress per doctors order, and focus on managing the patient’s blood sugar effectively to promote healing. In addition, to prevent infection, the patient must keep the dressing clean, cleanse the wound daily and change the bandage and dressing, the patient must also avoid walking on barefoot.
The recommendations for change to practice at the level of the provider would include first treating the underlying problem that Mrs. Smith was admitted for. According to the literature, a progressively worsening diabetic foot ulcer involves implementing a multitude of strategies to prevent amputation of the limb. This allow for decreased rates in mortality and can increase quality of life. Adequate wound management such as debridement, and offloading techniques should be instilled. Furthermore, education by the provider would be of critical importance for Mrs. Smith in terms of consistent foot care and management of her disease process (Yazdanpanah, Nasiri, & Adarvishi, 2015). Due
The recommendations for change to practice at the level of the provider would include first treating the underlying problem that Mrs. Smith was admitted for. According to the literature, a progressively worsening diabetic foot ulcer requires implementing a multitude of strategies to prevent amputation of the limb. Adequate wound management, including debridement if required, and offloading techniques should be instilled for Mrs. Smith. Furthermore, education by the provider would be of critical importance for Mrs.
Nearly 16 million people in the United States have diabetes, the disease classified as a problem with insulin. The problem could be that your body does not make insulin, does not make enough, or it simply does not know how to use it properly. Diabetes is also known as "diabetes mellitus".
This is a diabetes case study of Mr. Charles D., a 45-year old male who is experiencing classic symptoms of hyperglycaemia. Recently divorced and living alone in a new home, Charles has complained of recent weight loss, excessive thirst, and frequent urination. He is a busy CEO for a major technological company. This case study for Charles will educate him as to what are the causes of diabetes: explain the presenting signs and symptoms emphasize the psycho-social impact to his amended life, and instruct him in the economic impact that he and millions share.
Diabetes, often referred to by doctors as diabetes mellitus, describes a group of metabolic diseases in which the person has high blood glucose (blood sugar)1 . In 2011 The American Diabetes Association repoted a 25.8 million people in America living with diabetes 2. Diabetes is a illness that can be caused by the body not being able to produce enough insulin and or cells in the body not responding adequately to the insulin provided. Insulin which is produced by the pancrease, regulates the amount of glucose (which provieds energy to all cells) in the blood.
Diabetes is a chronic metabolic disorder that "occurs when the body is unable to produce or respond to insulin, a hormone that allows blood glucose to enter the cells of the body and generate the body's energy" (Ebony, 115). Diabetes is a disease that affects approximately 3% of the world' population. In American alone, 10.3 million people report having diabetes, while an estimated 10 million more individuals may have undiagnosed diabetes (Morwessel, 540). The gene for diabetes is located in the HLA region on chromosome 6, and the most probable organization of the responsible gene is on a 19-kb region of INS-IGF2, which affects HLA-DR4 IDDM susceptibility. Diabetes Mellitus, was first diagnosed in the year 1000 BC, by the
Diabetes is a chronic condition in which the body produces too little insulin (Type One Diabetes) or can’t use available insulin efficiently ( Type Two Diabetes). Insulin is a hormone vital to helping the body use digested food for growth and energy.