PDF Diploma in Kenya Registered Community Health Nursing (KRCHN)

Assessment and Management of Patients with Diabetes Mellitus: Type 1 and Type 2 Therapy, Education and Diet

A US nursing textbook chapter on diabetes assessment and management, externally authored by Linda Self and not a KMTC lecture. It opens with the scale of the problem - about 7% of the US population diabetic, twice as many again prediabetic, 21% of over-60s and 45% of new diagnoses in children and adolescents - then the autoimmune beta-cell destruction of type 1 and the reduced production with lowered sensitivity of type 2, and the five limbs of management: nutrition, exercise, monitoring, pharmacologic therapy with insulin and the sulfonylurea and other oral antidiabetic agents, and education. The diet is given at 45 to 65% of daily calories as carbohydrate, 25 to 50 g of fibre a day, fat under 30% of energy with saturated fat under 10% and cholesterol under 300 mg a day, with teaching on foot care, eye care, general hygiene and when to call the doctor. It closes on the review points: evaluating type 2 treatment within three months and starting insulin when glycated haemoglobin stays above 8% in an educated patient.

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