Diabetes Mellitus

Chapter IX Coping With Diabetes

NURSING IMPLICATIONS

Dealing with diabetes

The newly diagnosed diabetic patient is probably left feeling confused and overwhelmed. They may have difficulty concentrating on learning all the things they have to follow in order to develop a healthy diabetic care plan.

Good diabetes care requires a daily effort to follow a diet, stay active, and take medicine as indicated. By taking one day at a time and learning all they can about their disease, the patient may begin to feel less frightened and more in control of their lives.

Some people have difficulty believing that they have diabetes despite all the evidence that is presented Other people understand that they have diabetes, but still do not follow their care plan. The goal at this point is to accept the diagnosis so that learning may begin and eventually achieve independence and good health by following a care plan designed specifically for the patient.

The newly diagnosed diabetic may feel angry. Angry feelings are normal and a healthy part of adjusting to their disease, as long as the patient does not allow it to interfere with achieving the goals necessary to developing a good health plan.

Depression can be very debilitating for people with diabetes. Symptoms of depression include feelings of helplessness, loneliness, lack of self-esteem, fatigue, irritability, and changes in sleep patterns or eating habits. If any of these symptoms are identified, refer the patient to counselors with experience in helping people with diabetes.

It is normal to grieve over the loss of the healthy self when first diagnosed with diabetes or when complications occur, Time and support from family, health-care providers and friends can help the patient resolve grief.

One of the most difficult things for the patient to come to terms with is the fact that even if the patient follows his/her care plan to the letter, it still might not be possible to achieve perfect control.

Treatment Plan and Regular Assessments

With the help of the health-care team, people with diabetes can live long, healthy lives. It is very important for people with diabetes to understand how to stay healthy following a proper diet, exercise, and be aware of changes in their bodies.

Points to Remember

Good diabetes care is a daily responsibility.
Local diabetes organizations offer programs so people with diabetes can share experiences and support.
Good health care prescribed for people with diabetes, can also benefit anyone who wishes to stay healthy.
Medical guidance is available from a variety of sources such as diabetes groups, local medical societies and hospitals, diabetes clinics, and the diabetic health care team.

Treatment Plan

It is essential that the health care team include the following in the patient’s treatment plan:

Each patient needs personalized advice on proper eating, which includes types of food, amounts, and timing of meals and snacks.
Exercise is critical in achieving and maintaining diabetic control. Helping the patient understand the appropriate exercise level and how to incorporate exercise in their daily lives can help them control diabetes.
Each patient needs to know the dose and timing of oral medication or insulin and how to take the medication.
The patient needs to know the appropriate values for blood glucose, blood pressure, and weight.
The patient needs to have a working understanding of the complications associated with diabetes.

Regular Treatment Assessments

At each regular visit, the patient should be assessed for the following:

Encourage the patient to talk about any problems and questions they might have.
Changes in diet, medication, monitoring, and exercise should be evaluated at each visit.
All self-monitoring results and treatments should be reviewed and re-evaluated.
A physical exam should be performed and include an evaluation of weight, blood pressure, eyes and vision, kidney function, feet and skin care.
Diabetes education should be a continuous process.

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