By: Dana Weaver, RN, First Texas Home Health, for SENIOR Magazine (Northshore edition)
Diabetes is a disease in which the body does not produce or properly use insulin. Insulin is a hormone that is needed to convert sugar, starches and other food into energy needed for daily life. The cause of diabetes continues to be a mystery, although both genetics and environmental factors such as obesity and lack of exercise appear to play roles. Diabetes, particularly type 2 diabetes, is reaching epidemic proportions in the United States.
TYPES OF DIABETES
Type 1 diabetes is the body’s failure to produce insulin. It is estimated that 5-10% of Americans who are diagnosed with diabetes have type 1 diabetes.
Type 2 diabetes is from insulin resistance (a condition in which the body fails to properly use insulin), combined with relative insulin deficiency. Most Americans who are diagnosed with diabetes have type 2.
Pre-diabetes is a condition that occurs when a person’s blood glucose is higher than normal but not high enough for a diagnosis of type 2 diabetes. There are 54 million Americans who have pre-diabetes, in addition to the 20.8 million with diabetes.
There are three different ways to diagnose diabetes. One is a fasting plasma glucose over 126mg/dl. Another is a two-hour plasma glucose of over 200mg/dl during an oral glucose tolerance test. Last are symptoms of hyperglycemia and a casual plasma glucose over 200mg/dl. Each must be confirmed on a subsequent day unless indisputable symptoms of hyperglycemia are present.
Pre-diabetes is classified as an impaired fasting glucose of 100mg/dl-125mg/dl or two-hour plasma glucose of 140mg/dl to 199mg/dl.
With so many advances in treatments and technologies for patients with diabetes, managing the condition has become increasingly complex for both patient and provider. For the nearly 21 million Americans who have diabetes, and the estimated 39 million who will have it by the year 2050, the challenge is to juggle many aspects of their lives with the many demands of therapy.
In addition, because of the serious complications that may ensue when blood sugar targets aren’t achieved, nurses often have the challenging task of translating a treatment regime into a plan of care that a patient can follow. Nurses must teach and motivate patients to adhere to plans for meals and physical activity, take medications, monitor blood glucose levels, and make frequent adjustments in their self-care. In addition, the psychosocial aspects of managing a chronic condition, which often are placed on the back burner, should be addressed. Nurses possess the necessary skills in patient teaching and coaching, but they need specific strategies for helping patients manage their diabetes more effectively.
If you or someone you love has been diagnosed with diabetes, chances are you have a million questions running through your head. You can get help from health care professionals trained to focus on different areas. First Texas Home Health (refer to ad on facing page) has diabetic education programs for patients with nurses to guide you through this disease process
Dana Weaver, RN is the Administrator for First Texas Home Health and has been a diabetic education instructor for 15 years, with certification (cpt) as an insulin pump trainer.