What Nurses Need to Know About Treating Patients With Diabetes

Lifestyle adjustment to diabetes can be difficult and the complexity of the disease can be confusing. For example, some patients may not understand why they need to limit their fruit intake — after all, fruit is healthy! Through education, nurses can equip patients to help them prevent and manage diabetes.

According to the Centers for Disease Control, more than 30 million Americans have diabetes, and another 84 million have prediabetes. The World Health Organization lists diabetes as the 7th leading cause of death worldwide. Nurses have a key role in helping change these numbers to impact overall global health.

Nurses can assess each individual patient and adjust their educational approach to best meet the patient’s needs and health literacy level. Patient education often includes key laboratory values, signs of diabetes or complications, healthy lifestyle choices, and self-care practices. Strategies to manage stress and psychosocial issues are also important.

What Are the Differences Between Type 1 and Type 2 Diabetes?

While they share a similar name, Type 1 and Type 2 diabetes are two different chronic diseases. People with Type 1 do not produce insulin, while people with Type 2 make insulin but the cells cannot respond adequately to take up the glucose and eventually their pancreas cannot make enough insulin.

Below is a table describing the major differences between these two types of diabetes.

  Type 1 Diabetes Type 2 Diabetes
Previous Name Juvenile Diabetes Adult Onset Diabetes
Frequency About 5% About 90%
Diagnosis Most often appears in children Usually in adults over 30
cause Autoimmune condition Unknown
Genetics Can be genetic; increased risk for families More likely due to obesity and sedentary lifestyles
Prevention No prevention May be prevented with healthy lifestyle choices
Management Cannot be controlled without insulin Initial control often possible with oral medications and lifestyle changes
Hypoglycemia Common Uncommon

Type 1 diabetes is an autoimmune condition. The immune system attacks the pancreas with antibodies, damaging the organ’s ability to make insulin.

Although the exact cause of Type 2 diabetes is unknown, it is often related to lifestyle factors. Obesity can cause insulin resistance resulting in the inability of the pancreas to keep up with blood sugar levels. Type 2 diabetes is becoming more and more common in children and teens due to the increase in childhood obesity and sedentary lifestyles.

Some women develop gestational diabetes (diabetes for the first time during pregnancy). While it normally goes away after childbirth, about 50% of these women develop Type 2 diabetes later in life. As a result, nurses need to emphasize strategies to lower risk.

Forms of diabetes other than Type 1 and Type 2 can manifest due to diseases of the pancreas, surgeries, medications and infections. In such cases, which make up 1% to 5% of people with diabetes, a close watch of blood sugar levels is advised.

What Are the 4 Key Topics in Diabetes Education?

Nurses should focus on four key education topics: weight management, exercise, A1C, and smoking. If a patient with prediabetes makes lifestyle changes, they can reduce their risk of Type 2 diabetes.

  1. Weight management. Teach patients how to calculate ideal body weight and encourage them to try to lose weight. Educate patients about healthy food choices, foods to avoid or limit, portion sizes, and the plate method for meal planning.

Fact: Even a weight loss of 5% to 10% can reduce A1C levels, improve fitness and heart health, and decrease use of diabetes, high blood pressure and lipid medications.

  1. Exercise. Explore ways patients can increase activity. Help them aim for 150 minutes per week of moderate activity and at least two days of strength training. Even canned goods or stretch bands will work in the absence of gym equipment.

Fact: The American Diabetes Association suggests that even brief bursts of exercise (“3 in 30” or three minutes of exercise every thirty minutes) helps improve glucose levels.

  1. Important lab values for diabetes include the hemoglobin A1C, fasting plasma glucose and the oral glucose tolerance test. A1C is the most critical lab value for risk assessment, diagnosis, treatment planning and monitoring.

Fact: A1C target levels vary by individual, but 5.7 to 6.4 is prediabetes and a level greater than or equal to 6.5 is diabetes.

  1. Stop smoking. Ask about tobacco use and provide smoking cessation resources like Smokefree or 1-800-QUIT-NOW. Smoking can not only cause diabetes, it can also make insulin dosing and disease management more difficult.

Fact: Smokers are up to 40% more likely to develop Type 2 diabetes than nonsmokers. The more a person smokes, the higher the risk so even decreasing the amount of smoking helps.

Diabetes research continues to advance our understanding of the disease, so nurses need to be aware of ongoing changes. A Bachelor of Science in Nursing (BSN) program can help you learn more about effective communication, teaching strategies and evidence-based practice while also providing you with the knowledge and skills necessary to care for patients with diabetes.

Learn more about the UL Lafayette online RN to BSN program.


Sources:

CDC: Division of Diabetes Translation at a Glance

World Health Organization: Top 10 Causes of Death

NCBI: The Case for Diabetes Population Health Improvement – Evidence-Based Programming for Population Outcomes in Diabetes

Nursing 2020: Keeping Up to Date With Diabetes Care and Education

HealthLine: Type 1 and Type 2 Diabetes: What’s the Difference?

Everyday Health: All About Diabetes: Types, Symptoms, Causes, and Treatment for Type 1, Prediabetes, Type 2, and Gestational Diabetes Mellitus

WebMD: Type 1 Diabetes

WebMD: Types of Diabetes Mellitus

CDC: Gestational Diabetes

Healthline: 11 Foods to Avoid With Diabetes

Diabetes Forecast: What Is the Plate Method?

American Diabetes Association (ADA): Weight Management in Type 2 Diabetes

ADA: Physical Activity/Exercise and Diabetes

ADA: A1C Does it All

Centers for Disease Control (CDC): Working Together to Manage Diabetes: A Guide for Pharmacy, Podiatry, Optometry, and Dentistry (PPOD) Providers – Messages to Reinforce with Your Patients

CDC: Smoking and Diabetes

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