The term ‘diabetes’ means excessive urination and the word ‘mellitus’ means honey. Diabetes mellitus is a lifelong condition caused by a lack, or insufficiency of insulin. Insulin is a hormone – a substance of vital importance that is made by your pancreas. Insulin acts like a key to open the doors into your cells, letting sugar (glucose) in. In diabetes, the pancreas makes too little insulin to enable all the sugar in your blood to get into your muscle and other cells to produce energy. If sugar can’t get into the cells to be used, it builds up in the bloodstream. Therefore, diabetes is characterized by high blood sugar (glucose) levels.

1. Monnuzan Ahmed
B.Sc. in Nursing(DU)
Masters in Public Health at American International University-Bangladesh
monnuzanahmed@gmail.com

2.  What is Diabetes?
 Types of Diabetes.
 Symptoms of Diabetes.
 Causes and Risk Factors.
 Diagnosis of Diabetes.
 Prevention of Diabetes.
 Complication.
 Treatment.
 Nursing care plan.
 Health education.

3.  The term ‘diabetes’ means excessive urination and the word
‘mellitus’ means honey.
 Diabetes mellitus is a lifelong condition caused by a lack, or
insufficiency of insulin. Insulin is a hormone – a substance of vital
importance that is made by your pancreas. Insulin acts like a key to
open the doors into your cells, letting sugar (glucose) in. In diabetes,
the pancreas makes too little insulin to enable all the sugar in your
blood to get into your muscle and other cells to produce energy. If
sugar can’t get into the cells to be used, it builds up in the
bloodstream. Therefore, diabetes is characterized by high blood
sugar (glucose) levels.
 So Diabetes mellitus can be defined as it is a group of metabolic
diseases characterized by high blood sugar (glucose) levels that
result from defects in insulin.

4. There are three main types of diabetes mellitus:
 Type 1 DM results from the pancreas's failure to produce enough
insulin. This form was previously referred to as "insulin-dependent
diabetes mellitus" (IDDM) or "juvenile diabetes". The cause is
unknown.
 Type 2 DM begins with insulin resistance, a condition in which cells
fail to respond to insulin properly. As the disease progresses a lack
of insulin may also develop. This form was previously referred to as
"non insulin-dependent diabetes mellitus" (NIDDM) or "adult-onset
diabetes". The primary cause is excessive body weight and not
enough exercise.
 Gestational diabetes is the third main form and occurs when
pregnant women without a previous history of diabetes develop high
blood-sugar levels.

5. The classic symptoms of untreated diabetes are:
 weight loss
 polyuria (increased urination)
 polydipsia (increased thirst)
 and polyphagia (increased hunger)
 nausea
 Vomiting
 blurred vision
 fatigue
 slow-healing wounds
 itching skin
 increased susceptibility to infections

6. Health care providers do not yet know what causes
diabetes. The following factors may increase your
chance of getting diabetes:
 Family history of diabetes
 Overweight
 Unhealthy diet
 Physical inactivity
 Increasing age
 High blood pressure
 Ethnicity
 Impaired glucose tolerance (IGT)
 History of gestational diabetes
 Poor nutrition during pregnancy

7.  Random blood sugar test. A blood sample will be taken at a
random time. Regardless of when you last ate, a random blood
sugar level 11.1mmol/L — or higher suggests diabetes.
 Fasting blood sugar test. A blood sample will be taken after an
overnight fast( 8 hours). A fasting blood sugar level less than
5.6 mmol/L is normal. A fasting blood sugar level from 5.6 to
6.9 mmol/L is considered prediabetes. If it's 7 mmol/L or higher
on two separate tests, you have diabetes.
 Oral glucose tolerance test. For this test, you fast overnight, and
the fasting blood sugar level is measured. Then you drink a
sugary liquid, and blood sugar levels are tested periodically for
the next two hours. A blood sugar level less than 7.8 mmol/L is
normal. A reading between 7.8 mmol/L and 11.0 mmol/L
indicates prediabetes. A reading of more than 11.1 mmol/L
after two hours indicates diabetes.

8.  There is no known preventive measure for
type 1 diabetes. Type 2 diabetes — which
accounts for 85-90% of all cases — can often
be prevented or delayed by maintaining a
normal body weight, engaging in physical
exercise, and consuming a healthful diet.

9. Possible complications include:
 Cardiovascular disease
 Nerve damage (neuropathy)
 Kidney damage (nephropathy)
 Eye damage (retinopathy)
 Foot damage
 Hearing impairment

10. The goal of diabetes management is to keep blood glucose levels
as close to normal as safely possible. These includes:
 Dietary Management and Physical Activity:
Modifying eating habits and increasing physical activity are typically
the first steps toward reducing blood sugar levels.
 Insulin Therapy:
People with type 1 diabetes require multiple insulin injections each
day to maintain safe insulin levels. Insulin is often required to treat
type 2 diabetes too.
Doctor will determine your dose and how often you need to take
insulin.
 Oral Medications:
Sometimes blood sugar levels remain high in people with type 2
diabetes even though they eat in a healthy manner and exercise.
When this happens, medications taken in pill form may be
prescribed.

11.  Assessment: Symptoms.
 Diagnosis: Fluid volume deficit, pain, altered
nutrition, anxiety & fear.
 Planning: Address the nursing diagnosis.
 Intervention: Prevent complication.
 Evaluation: Goals.

12. Assessment: Dry Mucus, excessive thirst, confused.
Nursing Diagnosis :
Fluid Volume Deficit related to polyuria.
Planning:
Demonstrate adequate hydration evidenced by stable vital signs,
palpable peripheral pulse, skin turgor and capillary refill well,
individually appropriate urinary output, and electrolyte levels
within normal limits.
Intervention:
 Monitor vital signs.
 Assess peripheral pulses, capillary refill, skin turgor, and mucous
membranes.
 Monitor input and output, record the specific gravity of urine.
 Measure weight every day.
 Provide fluid therapy as indicated.
Evaluation: Fluid volume deficiency is corrected.

13.  Keep tight control of your blood sugar. This reduces the
risk of most complications.
 Lower your risk of heart-related complications by:
◦ Taking a daily medications—particularly if you already
have some signs of heart disease.
◦ Aggressively managing other risk factors such as:
 High blood pressure
 High cholesterol
 Cigarette smoking
 Obesity
 Visit an eye doctor and a foot specialist every year to
reduce eye and foot complications.