Diabetic Nursing Practice

According to the United States Library of Medicine, diabetes is a disease that occurs when the body does not make or use insulin correctly, therefore causing fluctuating amounts of glucose in the blood. Diabetes is a disease that affects millions of adults and children from various cultures. According to the American Diabetes Association (2014), someone is diagnosed with diabetes every 19 seconds. The Center of Disease Control and Prevention most recent statistical report indicated there were 29.1 million adults and children affected by diabetes. Those numbers are astounding. Unfortunately, the American Diabetes Association (2014) estimates by year of 2050, one out of three adults will have diabetes. Therefore, it is imperative that adults take aggressive measures to prevent this disease. By the same token, diabetes diagnosed in children and adolescent is becoming more prevalent every day. The American Diabetes Association (2014) reported there were about 216, 00 children in the United States with diabetes. It is predicted that one out three children will be diagnosed with diabetes in their life. The statistics for both adults and children with diabetes are frightening; however, early detection can help lower the risk of developing the debilitating effects of diabetes.

It is estimated that 387 million people, globally live with diabetes (Phillips & Mehl, 2015). According to Medical News Today [MNT], diabetes is a metabolic disorder; which causes patients to be extremely thirsty and produce a lot of urine. Diabetes arises due to high blood pressure, due to the body not being able to produce enough insulin or because the body does not respond well to high insulin levels (MNT, 2016). There are four types of diabetes; there is the pre-diabetic stage, type 1 diabetes, type 2 diabetes and gestational diabetes. In 2014, 29 million people died due to diabetes. This equates to 1 diabetic patient dying every seven seconds due to preventable complications (including complications affecting lower limbs) caused by diabetes. It is said that 20-40% of health care costs are spent on the treatment of lower limb complications due to diabetes. The risk of a diabetic patient developing a foot ulcer is 25% and foot ulcers account approximately 85% of lower limb amputations. Diabetic complications that affect lower limbs are caused by both type 1 and type 2 diabetes (Phillips & Mehl, 2015). It is said that the World Health Organization described diabetic foot syndrome as including all possible complications in relation to the feet of a diabetic patient. Diabetic foot syndrome is defined as the ulceration of the foot, from the ankle downwards. Causes of foot ulceration include peripheral sensory neuropathy, vascular disease (ischaemia) and infection

Diabetes is a disease that causes the human body to not create or not use insulin effectively. The body needs insulin to take the energy or sugars and turn it into energy. The human body needs energy to survive. Diabetes can be broken into three main categories. Type 1 diabetes is where the body makes no insulin at all. Type 2 diabetes is where the body does not produce enough insulin or it does not use it correctly. Gestational diabetes is more of a type 2 diabetes for pregnant women, which usually returns to normal after birth (Ruder 7-8).

venous leg ulcers and diabetic foot ulcers. Canadian Association of Wound Care (CAWC) has published

Before realizing what was happening, a nurse was trying to put an IV in my arm. The needle compared to my little arm looked huge and too long to go in my arm. I refused to let them touch me and tried to run to my mom. When they had a hard time succeeding at putting my IV in, they decided to get help from my mom. She calmly told me to lay down and to watch her, while they put the needle in. It was hard to ignore the pain pulsing through my arm and all the commotion happening all around me. I looked at my mom and saw the tears that were falling down her face as they held me down. When they were done, there was an IV and a cast on my arm, so that I would not be able to pull the IV out. Then they wheeled me into another room where my mom held and comforted me, while we waited to hear the results.

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

Diabetic Peripheral Neuropathy (DPN) is one of the most common microvascular complications in diabetes and can result in foot ulceration, ampuation and an impaired quality of life(Carrington AL, et al 2002,Boulton AJ,et al 2004). The reported prevalence of diabetic peripheral neuropathy ranges from 16% to as high as 66%2 and its prevelance is believed to increase with the duration of diabetes and poor glucose control.(Boulton AJ.et al 2000) It’s accounts for 50–75% of non-traumatic amputations in diabetic patients.(Holzer SE, et al 1998, Boulton AJM, 1998,Malay DS, et al 2006)

Often in New Zealand’s health system, health professionals interact together to improve the health outcomes for Type 2 Diabetics. This essay will examine the roles of both general practitioners and primary care nurses. This includes the services provided for Type 2 Diabetes and the organisations in the NZ health system that these professionals work for. The last part will examine how the differing perspectives of these health professionals, creates challenges for the way Type 2 Diabetes service is addressed in NZ’s health system.

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.

C.S. is a morbidly obese 32-year-old female admitted to the hospital on 8/26/05 with an admitting diagnosis of poly-drug overdose. According to the patient, the last thing she remembers is going to bed and then waking up in the hospital 2 days later without any recollection of what had happened. She has a history of suicide twice in the past, but denies suicidal ideations this time. C.S. also has a history of Diabetes type II that is normally controlled with oral medications. She states that she checks her blood glucose at home and it has been in the 200mg/dl range for the past month. Current blood glucose is 256mg/dl. C.S. is to be discharged tomorrow with a new prescription for insulin.

According to Healthy People 2012 there are more then 800,000 new cases of diabetes each year, with the numbers on the rise. With this in mind, Healthy People 2012 has identified diabetes as their number five focus area. In order to reach their goal of improving the quality of life for people with diabetes they have identified diabetes teaching as their number one objective. Furthermore, in order to reduce the number of complications of diabetes, Healthy People 2012 has identified foot ulcers as their ninth objective. Through patient education Healthy People 2012 hopes to reduce the number of foot ulcers in people with diabetes, as diabetes is the number one cause of nontraumatic amputations in the United States. In order to

The Diabetic care profil (DCP) is an instrument to assess social and psychological factors related to diabetes and its treatment. The questionnaire consists of 234 items including demographic information, self-care practices, and 116 questions divided into 16 profile scales with 4 to 19 questions per scale.

After diagnosing a disorder a GP will refer to the specialist services, diabetes specialist nurses also knows a community diabetes specialist nurse gives a service to adults who are 18 and over. They give an education program, support the individual of self-care skills effectively. It is their responsibilities to stop problems and work together with a primary care group to take care of critical and complex needs of a diabetic individual. Specialist dietitian’s aims to help the individual quality of life and understand educate to the food they can eat. A food meal is planned with an amount of nutritional needs including carbohydrate, vegetables and fruits. (Diabetes.co.uk, 2017a)

Type 2 Diabetes Mellitus (T2DM) is one of the fastest growing chronic diseases affecting children ages 6 to 11 worldwide (Montgomery, Johnson & Ewell, 2015). This recent development is occurring at an alarming rate, with numbers expected to quadruple by the year 2050 (Montgomery, et al., 2015). Without timely intervention from the healthcare system, this condition could have a devastating effect on the health outcomes of children across North America. Many studies have identified some common factors that put youth at major risk for developing T2DM, with childhood obesity, physical inactivity, low socioeconomic status, and lack of knowledge and access to healthy food choices among the leading causes (Dean & Sellers, 2015; Montgomery et al., 2015). There are many opportunities for Community Health Nurses (CHNs) to play a role in health promotion within this population. This paper will address the social factors contributing to adolescent T2DM, the current role of CHNs in addressing this condition, and ways to ensure these children have adequate access to health care.

Research question: What are the contributing factors in developing a diabetic foot ulcer in Type 2 diabetics in the community?