How to Care for the Diabetic Client

By

Manuel A. Gallegos RN, BSN

Personal Care Assistant Class

Spring 2014

The Digestive System

Objectives1. Understand the role of insulin and how healthy people convert glucose

into energy in the cells

2. Define Diabetes

3. Understand the difference between Type I and Type II Diabetes

4. Know signs, symptoms, and treatment of hyperglycemia versus hypoglycemic patients

5. Know 3 areas Caregivers can significantly help protect Diabetic clients

How Our Bodies Turn Food Into Energy

All parts of the body (muscles, brain, heart, and liver) need energy to work: This energy comes from the food we eat

Our bodies digest the food we eat by mixing it with fluids (acids and enzymes) in the stomach. When the stomach digests food, the carbohydrate (sugars and starches) in the food breaks down into another type of sugar, called glucose

The stomach and small intestines absorb the glucose and then release it into the bloodstream

Once in the bloodstream, glucose can be used immediately for energy or stored in our bodies, to be used later

However, our bodies need insulin in order to use or store glucose for energy. Without insulin, glucose stays in the bloodstream, keeping blood sugar levels high

Play videohttp://www.youtube.com/watch?v=jHRfDTqPzj4&feature

=related

How does insulin work?Insulin helps your body turn blood sugar (glucose) into

energy

It also helps your body store it in your muscles, fat cells, and liver to use later, when your body needs it

After you eat, your blood sugar (glucose) rises

This rise in glucose triggers your pancreas to release insulin into the bloodstream

Insulin travels through the blood to your body's cells

How does insulin work cont..?Insulin tells the cells to open up and let the glucose inOnce inside, the cells convert glucose into energy or store

it to use laterWithout insulin, your body can't use or store glucose for

energyInstead, the glucose stays in your blood

How the Body Makes Insulin?

Insulin is a hormone made by beta cells in the pancreasBeta cells are very sensitive to the amount of glucose in

the bloodstreamNormally beta cells check the blood's glucose level every

few seconds and sense when they need to speed up or slow down the amount of insulin they're making and releasing

When someone eats something high in carbohydrates, like a piece of bread, the glucose level in the blood rises and the beta cells trigger the pancreas to release more insulin into the bloodstream

The pancreas produces insulin

Definition of DiabetesDiabetes mellitus (sometimes called "sugar diabetes") is a

condition that occurs when the body can't use glucose (a type of sugar) normally

Glucose is the main source of energy for the body's cellsThe levels of glucose in the blood are controlled by a

hormone called insulin, which is made by the pancreasInsulin helps glucose enter the cells

What is the difference between Type I and Type II Diabetes?

Type 1 diabetes, once known as juvenile diabetes or insulin-dependent diabetes, is a chronic condition in which the pancreas produces little or no insulin, a hormone needed to allow sugar (glucose) to enter cells to produce energy

Type 2 diabetes, which is far more common, occurs when the body becomes resistant to the effects of insulin or doesn't make enough insulin

Insulin Resistance

Definition continued….In diabetes, the pancreas does not make enough insulin (

type 1 diabetes)

Or the body can't respond normally to the insulin that is made (type 2 diabetes)

This causes glucose levels in the blood to rise, leading to symptoms such as increased urination, extreme thirst, and unexplained weight loss

Difference Between Type I and Type II Diabetes

Hyperglycemia Symptoms

Causes and Treatment of Hyperglycemic Clients

CAUSES: Too much food, too little insulin, illness or stress ONSET: Gradual, may progress to diabetic coma. BLOOD SUGAR: Above 200 mg/dL.

Normal range: 70-115 mg/dL WHAT CAN YOU DO? Test blood sugar

If over 250mg/dL for several tests, CALL YOUR DOCTOR OR 911 ASAP

Cycle of Diabetic Patient

Symptoms of Hypoglycemia

Causes and Treatment of Hypoglycemia

Hypoglycemia (Low Blood Sugar) CAUSES: Too little food, too much insulin or diabetes

medicine, or extra exercise

ONSET: Sudden, may progress to insulin shock. BLOOD SUGAR: Below 70 mg/dL. Normal range: 70-115 mg/dl

WHAT CAN YOU DO? Drink a cup of orange juice or milk or eat several hard candiesTest Blood sugar

#1 area Caregivers can help Diabetic clientsPERSONAL HYGIENE :Bathe client regularly and thoroughly, at least once a dayApply talcum powder frequently to areas of the skin

prone to excessive sweatingBathe feet daily, dry them thoroughly and dust them with

talcum powder, or swab with alcoholAny infection of the skin must be treated immediatelyMake sure client sees his or her doctor regularlyDental hygiene must be thorough, visit your dentist

regularly, and follow the advice

2nd Area Caregivers can assist diabetic clients

AVOID INJURY :Small cuts, even abrasions should be dressed immediately Shave with utmost careIn dressing wounds, avoid antiseptics which may burn or

irritate the skin, such as iodine, carbolic acid, phenol or salicylic acid

Be very careful when cutting your finger and toe nails Cut them after a bath when soft, using a nail cutter

Do not try to cut them very shortThe nails should be cut in line with the toes

3rd area Caregivers can help protect diabetic clients

FOOT CARE :Never allow client to walk barefoot and avoid tight shoes which may cause cornsShoes should be broad at the tip so as not to jam the toes and new shoes should

be worn only for about half an hour at a time, preferably with cotton socksDo not cut corns or apply corn removers If the circulation of blood in your legs and feet is disturbed or impeded, the

results can be very serious, and you may even lose your feet

Things to do: Inspect and massage clients feet regularly and encourage regular walks to

improve circulationSpend a few minutes a day lying down with feet raised above the level of your

bodyWear warm stockings in cold weatherDo not wear socks with tight elastic bands

Diabetic Foot Care Tips

Examples of Diabetic Ulcers

Important thoughts for DiabeticsControl diet and regular exercise are critical for diabeticsDaily self monitoring in the home and at work, routine

check-ups by your doctor, will help verify your conditionSelf monitoring includes blood glucose testing and should

be performed on a regular basisGood diabetic control is requires accurate records of all

tests performedResults should be discussed with your doctor at each visitA well controlled diabetic feels better and lives a long,

healthy, and productive life

Summary1. Insulin responds to increases in glucose in the blood stream

and helps the body’s cells use glucose for energy

2. Diabetes is defined as a condition that occurs when the body can't use glucose (a type of sugar) normally

3. Type I Diabetes is a condition where the body does not produce any insulin and in Type II Diabetes the cells become resistant to insulin or the pancreas does not produce insulin

4. Hyperglycemia may cause extreme thirst, frequent urination, blurred vision, and nausea

5. Hypoglycemia may cause shaking, sweating, anxiousness, and weakness

6. Diabetic foot ulcers are very dangerous

7. Caregivers should help clients with personal hygiene, avoiding injuries, and thorough foot care

References http://kulsummehmood.hubpages.com/hub/controldiabetes

http://www.mayoclinic.com/health/type-1-diabetes/DS00329

http://care.diabetesjournals.org/content/27/suppl_1/s5.full

http://kidshealth.org/parent/diabetes_center/words_know/diabetes_mellitus.html

http://www.ghc.org/healthAndWellness/index.jhtml?item=/common/healthAndWellness/conditions/diabetes/foodProcess.html

http://www.ghc.org/popup.jhtml?item=/common/healthAndWellness/conditions/diabetes/insulinProcess.html