Discuss about the Diabetes Mellitus for Exercise Psychologist and Nutritionist.
Diabetes is a disorder that occurs when the body does not produce enough insulin leading to high blood sugar levels. There are two types of diabetes, type 1 and type 2. Type 1 occurs when the body does not produce enough insulin, while type 2 occurs when the body does not make or use insulin. Once a person suffers from this condition, it is incurable and chronic. This condition can only be monitored since it has no specific cure. (Wadwa, et al., 2010)
In order to manage the condition of diabetes, Diabetes Education is of great importance. Diabetic education is done by a team which involves specialist in different fields such as, certified diabetic advisor, exercise psychologist, nutritionist, and psychologist. Diabetes self-management training requires daily knowledge on medication, exercise, and psychological status, spiritual and cultural need of the client. It is important to understand the patients’ lifestyle before undertaking the Diabetes Education so as to help design the best plan for the client. This knowledge is also important for the educator to predict the questions that can arise from the client and how to deal with them in a diabetes expertise manner. For example one has to know the clients’ hobbies and lifestyle such as running, walking, visiting the gym and swimming so as to advice appropriately in managing the daily programs e.g. time for gym and time for other activities (American Diabetes Association, 2014)
A newly diagnosed diabetic client experiences negative emotions such as shame, hopelessness, frustration, fear, anger, and guilt. These conditions if not controlled in the appropriate timeline can greatly affect the health condition of the client. These emotions can lead to client’s depression.
Why is this important for the EN to understand?
Understanding the emotions of a client as EN is important in establishing what the client is going through. This is helps in identifying the areas that one has to emphasize in order to manage the client’s condition fully.
Persons with diabetes have increased risk of experiencing foot problems. Diabetes causes damage to peripheral nerves and blood vessels hence leading to problems in the feet. Once the problem develops, there is low blood flow to the feet and decreased sensation. In this condition, tissue gangrene may occur due to insufficient oxygen flow to the feet tissues. Other problems like Cellulittoes and Osteomyelitis may develop. These problems have great impact on the health condition of the diabetic client. Development of foot problem by a diabetic client can be identified by observing the following signs and symptoms;
- Hammertoes, this is a condition where the toes bend due to muscle weakness.
- Bunions, this is when the big toe bends in the direction of other toes.
- Ingrown toenails, this occurs when side of the toenail grows into nail field.
- Cracking of the heel skin due to dry skin.
- Tinea pedis, this is a fungal infection of skin of the feet.
- Brittle nail, this occurs as a fungal infection of the nail
These problems can be treated differently depending on the nature of the problem. Some can be treated with antifungal and antibiotics while others can be treated by wearing correct shoes. It is important for an enrolled nurse to understand these signs and symptoms so as to predict the infections on the client and advice the client appropriately on the best way to deal with the situation. (Tan et al., 2011)
Factors that can affect blood glucose levels and cause hyperglycemia.
- Having illness, hormones produced by the body to fight illness can raise the level of blood sugar. Patients suffering from diabetes need special treatment to contain this raise in glucose level.
- Having emotional stress. During stress the adrenal gland activates the production of glucose stored in various organs.
- Having surgery or being injured. When someone who is under this condition, the body conditions itself to cope with the blood loss and pain hence leading to production of large amount of blood glucose.
- Taking medications such as phenothiazine, estrogen glucagon and others can raise the blood sugar.
Factors that can affect blood glucose levels and cause hypoglycemia.
- patients with cancer tend to skip meals because they don’t feel hungry or because of the chemotherapy treatment that makes the food taste differently
- Kidney failure. Kidney is responsible for the generation of glucose from amino acid. When kidney fails, there is no generation of glucose from amino acid leading to low levels of glucose in the blood.
- Diabetic clients taking drugs such as quinine may experience low blood glucose. This is because Quinin has side effects on the kidney.
- A diabetic client may experience low blood glucose when he/she takes too much insulin. Excess insulin makes the body cells to absorb too much sugar from the blood.
American Diabetes Association. (2014). Diagnosis and classification of diabetes mellitus. Diabetes care, 37(Supplement 1), S81-S90.
Geraldes, P., Hiraoka-Yamamoto, J., Matsumoto, M., Clermont, A., Leitges, M., Marette, A., ...& King, G. L. (2009). Activation of PKC-δ and SHP-1 by hyperglycemia causes vascular cell apoptosis and diabetic retinopathy. Nature medicine, 15(11), 1298-1306.
Tan, T., Shaw, E. J., Siddiqui, F., Kandaswamy, P., Barry, P. W., & Baker, M. (2011). Inpatient management of diabetic foot problems: summary of NICE guidance. BMJ: British Medical Journal (Online), 342.
Wadwa, R. P., Urbina, E. M., Anderson, A. M., Hamman, R. F., Dolan, L. M., Rodriguez, B. L., ...& SEARCH Study Group. (2010). Measures of Arterial Stiffness in Youth With Type 1 and Type 2 Diabetes. Diabetes care, 33(4), 881-886.