Diabetes mellitus (DM) is a long-term, debilitating condition characterized by hyperglycemia throughout the body. Globally, the prevalence of this serious health issue is on the rise. Diabetes affects an estimated 463 million people worldwide, or one in every eleven persons aged 20 to 79. A total of 4.2 million people died from diabetes-related illnesses in 2019. Nearly every organ in the body is affected by long-term problems of Diabetes, but none more so than the heart, brain, and kidney. Abnormalities primarily cause multiorgan dysfunction and higher mortality from Diabetes complications in the structure and function of micro-and macro vessels.
Chronic kidney disease (CKD) is another significant consequence associated with Diabetes. It is the primary cause of renal failure and death in diabetics in both industrialized and developing countries. Coronary artery disease and stroke are the two most common macrovascular consequences. Patients with Diabetes are at increased risk of cardiovascular and cerebrovascular disease, which account for more than half of all deaths related to the disease. Type 1 and type 2 diabetes are the most common forms of the disease. Heterogeneity refers to the fact that the pathophysiology of two diseases is not the same.
Nutritional Diet for Diabetes
In terms of managing Diabetes, lifestyle management remains critical, but developing diabetes self-management skills, promoting medical nutrition therapy and regular physical activity, and being mindful of the disease’s potential psychosocial consequences must all be addressed individually to achieve long-lasting and tangible results effects. Perhaps the most prominent area where therapeutic individualization has become increasingly significant is diabetic medication. With the proliferation of treatment options for diabetes control, the complexity of diabetes care has expanded, allowing us to give our patients more deliberate, tailored, and successful care.
The most preferred diet for a diabetic patient is the Mediterranean diet. The diet is abundant in vegetables, fruits, legumes, nuts, beans, cereals, grains, fish, and unsaturated fats like olive oil. It is typically associated with a limited diet of meat and dairy products. The diets support healthy blood sugar levels. Foods rich in nutrients such as fruits, vegetables, nuts, and seeds are encouraged in the Mediterranean diet. Whole grains and heart-healthy fats are also included in the diet. Type 2 diabetes can be prevented by following this diet’s blood sugar-stabilizing principles (Martín-Peláez et al., 2020). There. Multiple studies have demonstrated that the Mediterranean diet reduces fasting blood sugar levels and improves hemoglobin A1C, a test used to determine long-term blood sugar control (Martín-Peláez et al., 2020). In addition, there is evidence that the Mediterranean diet can help lower insulin resistance, a disease that makes it difficult to regulate blood sugar levels.
For Diabetes, there is a need to make various adjustments to management, especially on children and adults. First, dietary advice should begin gradually. Second, there is a need to initialize efforts to build a positive relationship with children and their families by providing clear instructions. Third, the entire team should be given more specific guidelines to avoid hypoglycemia, focusing on consistency in the messaging and dietary guidelines. Finally, every individual should be given nutritional information focused on reducing comorbidities of Diabetes.
Clinical Manifestations, Findings, Labs, and Other Expected Diagnostic Tests for Diabetes
The clinical manifestations of diabetes vary depending on the type of diabetes. Diabetic symptoms like polyuria, polydipsia, and polyphagia are more common in type 1 diabetes than type 2. Type 1 diabetes, which rapidly develops severe hyperglycemia, and type 2 diabetes, which has exceptionally high levels of hyperglycemia. Extreme weight loss occurs only in type 1 diabetes or when type 2 diabetes goes undiagnosed for a lengthy period. Unexpected weight loss, exhaustion and restlessness, and discomfort in the body are symptoms of Diabetes that are often overlooked. Likewise, mild or gradual signs of illness may go overlooked.
Other warning signs of diabetes include delayed wound healing, repeated infections, especially in the genital areas, urinary tract, skin, and oral cavity, dry mouth, burning, pain and numbness on feet, Acanthoses nigricans(the presence of velvety dark patches of the neck, armpit, groin which is an indicator of insulin resistance), decreased vision and impotence (Granado-Casas et al., 2019). The standard diagnostic for conditions includes fasting blood sugars, random blood sugars, HBIAC, and glucose tolerance tests.
Over the past two or three months, average blood sugar levels have been measured using the A1C test. It is normal to have an A1C of less than 5.7 percent, but having an A1C of more than 6.5 percent indicates Diabetes. Blood sugar levels less than or equal to 140 mg/dL (7.8 mmol/L) are expected. Blood sugar levels between 140 and 199 mg/dL (7.8 mmol/l) are termed pre-diabetic. Impairment of glucose tolerance is a term used to describe this condition. Type 2 diabetes is diagnosed with a blood sugar level of 200 mg/dL (11.1 mmol/L) or above. A physician should be informed in cases where blood sugars are consistently elevated and A1C tests are above 6.5% since these results are indicative of Diabetes.
Nursing Care for Diabetes
Diabetes nursing care planning goals include successful treatment to regulate blood glucose levels and prevent complications through insulin replacement therapy, a balanced diet, and exercise. The nurse should emphasize the need to follow the prescribed treatment plan through appropriate patient education. Instruction should target the patient’s specific needs, talents, and developmental stage. Make a point of emphasizing the significance of blood glucose control in terms of long-term health. A nurse should construct a diagnostic relating to nutrition and diet, which can be impaired nutrition less than the body requirement as indicated by insulin shortage as evidenced by any presenting of diabetes such as increased urine output and reported inadequate food consumption. The nurse can intervene by advising the patient to follow a diabetic diet that includes complex carbohydrates (apples, broccoli, peas, dried beans, carrots, peas, and oats) (Lennerz et al., 2018). They aid in reducing blood glucose and insulin needs, the reduction of serum cholesterol, and the enhancement of satiation. I should plan my food intake based on the specific features of insulin and the distinct responses of each patient.
There is widespread agreement on the need to limit or eliminate processed red meats, refined carbohydrates, and sugars (particularly sugar-sweetened beverages) to prevent and control type 2 diabetes (Lennerz et al., 2018). There is a small glycemic benefit to substituting low-glycemic-load diets for foods with a more significant glycemic load. Additional study is needed to determine the specific benefits or risks associated with exercise in individuals with type 2 diabetes.
Complications and Monitoring of Diabetes
Diabetes has significant consequences, including cardiovascular disease, peripheral neuropathy, kidney damage, retinopathy, foot damage, Alzheimer’s disease, and depression. To avoid these essential effects, diabetes screening programs must be implemented and strict follow-up for diabetic patients. The importance of routine follow-up cannot be emphasized. During follow-up visits, education should be reinforced, growth should be monitored, blood glucose monitoring findings should be examined, and HbAIC, urine glucose, and ketones should be tested. Annual retinal and microalbuminuria eye exams are recommended for anyone over puberty more than five years after diagnosis.
Evaluation of Client Understanding
I will ask numerous questions regarding the degree of knowledge to assess understanding of the instruction. In addition, I will closely monitor the client’s adherence to the nutritional therapy prescribed. Sugar levels within the typical range for one month will reveal the client’s level of comprehension. Finally, nutritional therapy is an effective way to manage Diabetes. The Mediterranean diet is the most preferred diet for diabetic patients. The diet includes vegetables, fruits, legumes, nuts, beans, cereals, grains, fish, and unsaturated fats like olive oil. There is evidence that the Mediterranean diet can aid in the reduction of insulin resistance.
Granado-Casas, M., Alcubierre, N., Martín, M., Real, J., Ramírez-Morros, A. M., Cuadrado, M., Alonso, N., Falguera, M., Hernández, M., Aguilera, E., Lecube, A., Castelblanco, E., Puig-Domingo, M. & Mauricio, D. (2018). Improved adherence to Mediterranean diet in adults with type 1 diabetes mellitus. European journal of nutrition, 58(6), 2271-2279.
Lennerz, B. S., Barton, A., Bernstein, R. K., Dikeman, R. D., Diulus, C., Hallberg, S., Rhodes, E. T., Ebbeling, C. B., Westman, E. C., Yancy, W. S. & Ludwig, D. S. (2018). Management of type 1 diabetes with a very low–carbohydrate diet. Pediatrics, 141(6).
Martín-Peláez, S., Fito, M., & Castaner, O. (2020). Mediterranean Diet effects on type 2 diabetes prevention, disease progression, and related mechanisms. A review. Nutrients, 12(8), 2236.