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Chapter: 11th 12th std standard Class Nursing Health Care Hospital Hygiene Higher secondary school College Notes

Complications of Diabetes Mellitus

A diabetic is likely to develop acute complications as a result of sudden decrease or increase in blood sugar levels.

COMPLICATIONS OF DIABETES MELLITUS

 

A. Acute complications

 

A diabetic is likely to develop acute complications as a result of sudden decrease or increase in blood sugar levels.

 

1. Hypoglycaemia

 

The rapid lowering of blood sugar (below 40 - 50 mg/dl) is known as hypoglycaemia. The person may experience increased appetite, weakness, sweating, restlessness, palpitation and giddiness. The diabetic who develops hypoglycaemia should immediately be given sugar or glucose.

 

2. Ketoacidosis

 

When the body cannot utilize carbohydrates to provide energy, it burns fats and certain amino acids. This results in increased formation of ketones, which accumulate in the blood resulting in ketoacidosis. This is a serious condition and the patient can go into a coma.

 

3. Infections

 

In diabetics, cuts and wounds heal slowly. They are prone to infections of the skin, urinary tract and foot.

 

B. Long term complications

 

Diabetics are predisposed to two types of complications of long duration.

 

Increased predisposition of the diabetic for atherosclerosis (hardening of blood vessels due to deposition of fatty substances) because they generally have high levels of blood lipids as cholesterol and triglycerides, which make them susceptible to heart disease and stroke.

Lesions that affect the small blood vessels (microangiopathy) of the eyes and kidneys. Lesions of the eye (retinopathy) results in rapid deterioration of eye sight. Lesions of the kidney (nephropathy) result in the excretion of protein in the urine. Neglect may lead to kidney failure. Diabetics can develop lesions of the peripheral nervous system (neuropathy).

 

Patients with neuropathy experience tingling, numbness and it is a degenerative condition of sensory nerves resulting in pain and absence of reflexes.

 


Extra Notes : PATIENT EDUCATION

 

Environmental factors play a major role in the incidence of NIDDM in those with a family history. Since we have no control on the selection of our ancestors, care should be taken to delay the onset of diabetes mellitus by increasing physical activity and reduction in the intake of fatty foods which result in obesity which in turn can cause diabetes.

 

Diabetics should be educated on the nature of the disease and the possibility of acute and long term complications of the disease, if blood sugar is not kept under control. Adequate information enables the diabetic to improve the psychological acceptance of the disease. The importance of following the instructions of the doctor and the dietitian regarding diet, drugs and exercise should be explained.

 

A diabetic should monitor urine, blood sugar and serum lipids at regular intervals to ensure overall well-being. They should learn self monitoring of urinary sugar using commercially available strips. Patients who require insulin injections should know how to measure the insulin dose and give their own injections. Diabetics should be informed about the symptoms of hypoglycaemia and the immediate need for sugar. They should be aware of complications such as ketoacidosis and danger of infections which require immediate medical attention. Diabetic patients should maintain a diary to keep a record of their urinary and blood sugar results, body weight and alterations in their diet and drugs.

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11th 12th std standard Class Nursing Health Care Hospital Hygiene Higher secondary school College Notes : Complications of Diabetes Mellitus |


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