According to the Center for Disease Control and Prevention, aka the CDC, greater than 11% of people in the United States have been diagnosed with diabetes. Which is why understanding Type 1 Diabetes and its treatment plan is so important for nurses to be able to communicate with their patients.
What is Diabetes?
Diabetes is when the body doesn’t produce 1) any insulin, 2) not enough insulin, or 3) not properly functioning insulin to carry glucose into the cells. Therefore, the glucose is left floating around in the blood which can lead to a number of problems.
For more information about Diabetes Type 1 and Type 2, be sure to visit Nursing Fundamentals: A Guide to Diabetes.
What is Type 1 Diabetes?
In Type 1 Diabetes, the patient will produce little to no insulin naturally in their body. Because of this, Type 1 Diabetes is usually diagnosed early on in childhood.
Patient Education for Type 1 Diabetes
For patients with Type 1 Diabetes Mellitus, since their body is unable to produce enough insulin, the only real treatment is insulin. So education around injecting insulin and blood sugar is very important.
Monitoring Blood Sugar
Teaching your patient with Type 1 Diabetes how to monitor their blood sugar, aka blood glucose level, is necessary to their success. Doing so will help the patient determine how much insulin they’re going to need around meals and at bedtime. It’s also important to educate your patient on foods that will raise their blood sugar so that they are able to inject the right amount of insulin before meals.
Hypoglycemia
Teach the patient the average range their blood sugar should be within. If they are below 70, they are hypoglycemic and need sugar right away. Teach the patient and their family members what to do when they experience these cool and clammy symptoms, indicating hypoglycemia.
Hyperglycemia
Be sure to also educate the patient on what the opposite of hypoglycemia is, hyperglycemia. A blood sugar of over 250, meaning the patient needs insulin right away. Teach the patient and their family members what to do when they experience these hot and dry symptoms, indicating hyperglycemia.
Glucose Meter
While in the hospital, patients are going to become familiar with the blood glucose meter and you pricking their fingers for them. But after discharge, they’re going to be doing this at home all on their own. So performing a demonstration, having the patient talk it over with you, and eventually having them do a return demonstration is going to be super important prior to discharge.
Do this by pricking the patients’ finger and collecting the blood sample yourself. Explain to the patient and their family members exactly what you’re doing and why, as far as collecting the blood and having the meter read the results. Then once you feel the patient has a decent understanding of the process, have them explain it to you while you preform the collection. Lastly, after the patient is able to explain the process independently, have them prick their own finger and work the glucose meter. Remain with your patient during this process and guide them as necessary.
If the patient is too young or unable to collect the sample on their own for whatever reason, then educate whoever is going to be monitoring their blood sugar at home. Whether that be the patients’ family, friend, or caregiver, they all need to know how to work the glucose meter and get an accurate read.
Insulin Injections
Now that the patient is able to obtain their blood sugar level, start educating them on how to give an insulin injection as well as the type of insulin you’re giving. Is it long acting or short acting? Does it work right away, or does it take time? How much insulin are you giving them and why? Is there a sliding scale? These are all important topics to cover when setting up your diabetic patient for success.
The patient will receive adequate supplies before they go home, but make sure they know what those supplies will look like and what they do. Make sure the patient knows how to draw up their insulin and what the injection needle should look like. Teach them the injection sites appropriate for insulin and how rotating injection sites is important.
Just like with using the glucose meter, explain exactly what you are doing when drawing up and injecting the insulin. Then have the patient explain it to you and ask any questions they might have. Lastly have the patient draw it up and inject themselves before being discharged.
Diabetic Nurse Educator
Being diagnosed with Type 1 Diabetes for the first time means that there’s a lot of new information. Putting in an order for a Diabetes Nurse Educator to come talk with your patient is a great idea! The educator will be able to spend more time with the patient and answer any questions in great detail. The nurse educator will have access to the chart and can see all diagnosis as well as any doctors’ orders. This way the nurse educator will be able to teach your patient what returning home with this new diagnosis will look like. They can also provide resources and tools outside of the hospital, like diabetic support groups for patients and families.
Be sure to visit Nursing Fundamentals: A Guide to the Complete Healthcare Team for more.
Diabetic Complications
Lastly, the patient should be made aware of diabetic complications so they can be on top of their care.
Diabetic Neuropathy and Foot Ulcers
Teach the patient about diabetic neuropathy and how it can lead to diabetic foot ulcers. Educate your patient on inspecting their feet daily and always wearing shoes that cover their toes to protect their feet. Make sure they are able to see a podiatrist to keep up with their care. Teach the patient to seek medical treatment if they notice any type of sore or wound on their foot, especially one that is not healing.
Visit Nursing Fundamentals: A Guide to Wounds for more information.
Diabetic Retinopathy
Educate the patient that with diabetes comes increased sugar in the blood vessels which can lead to vision complications. The patient should have yearly eye exams to make sure their vision is stable. Let the patient know that if they are experiencing any issues with their vision to seek medical help.
Other Complications
Continue to educate your newly diagnosed diabetic patient on diabetic complications and stress the importance of proper blood glucose control. Provide them with any pamphlets or handouts your facility may have on diabetes control and possible complications for them to read on their own time. Including but not limited to cardiovascular disease, cerebrovascular disease, diabetic ketoacidosis (aka DKA), diabetic coma, and even death if not treated appropriately.
Be sure to visit Patient Education: A Guide to Treating and Managing Type 2 Diabetes for more!
Do you work with Type 1 Diabetic patients? Comment below!
Plus be sure to visit the following for more nursing info:
- How to Get the Most Out of Your Preceptorship
- How to Pass the NCLEX in 75 Questions
- Important Lab Values to Know for NCLEX
And be sure to follow along with the Patient Education Series:
- How to Spot a Stroke and Save a Life
- Identifying Sepsis and Understanding its Care and Treatment
- What is Hypertension? Causes, Symptoms, and Treatments
- What is Heart Failure? Risk Factors, Symptoms, and Treatments
- What are Urinary Tract Infections? UTI Prevention and Treatments
- What is Asthma? Risk Factors, Symptoms, and Treatments
- What is COPD? Risk Factors, Symptoms, and Treatments
- What is Pneumonia? Symptoms, Labs, and Treatments
Referenced CDC diabetes statistics can be found here.