Nursing management of the patient with diabetes can involve treatment of a wide variety of physiologic disorders, depending on the patient’s health status and whether the patient is newly di-agnosed or seeks care for an unrelated health problem. Nursing management of the newly diagnosed patient and the patient with diabetes as a secondary diagnosis is presented in subsequent sec-tions. Because all diabetic patients must master the concepts and skills necessary for long-term management of dia-betes and its potential complications, a solid educational foun-dation is necessary for competent self-care and is an ongoing focus of nursing care.
Diabetes mellitus is a chronic illness requiring a lifetime of spe-cial self-management behaviors. Because diet, physical activity, and physical and emotional stress affect diabetic control, patients must learn to balance a multitude of factors. They must learn daily self-care skills to prevent acute fluctuations in blood glucose, and they must also incorporate into their lifestyle many preven-tive behaviors for avoidance of long-term diabetic complications. Diabetic patients must become knowledgeable about nutrition, medication effects and side effects, exercise, disease progression, prevention strategies, blood glucose monitoring techniques, and medication adjustment.
In addition, they must learn the skills associated with monitoring and managing diabetes and must incorporate many new activities into their daily routines. An appreciation for the knowledge and skills that diabetic patients must acquire can help the nurse in providing effective patient education and counseling (Beebe & O’Donnell, 2001).
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