Diabetes and Diabetes and Psychiatric NursingPsychiatric Nursing

ByByHatim Abdulaziz BanjarHatim Abdulaziz Banjar

BSN,RNBSN,RNNursing Quality Manager, Hospital Risk and Patient Safety Nursing Quality Manager, Hospital Risk and Patient Safety

Officer of Alamal Hospital in JeddahOfficer of Alamal Hospital in Jeddah24/9/201024/9/2010

Contact : 00966540572716Contact : 00966540572716Hab.1978@hotmail.comHab.1978@hotmail.com

IntroductionIntroduction

A ‘diabetes epidemic’ is underway with a world A ‘diabetes epidemic’ is underway with a world wide predicted figure of 370 million by the year wide predicted figure of 370 million by the year 2030. 2030. Much of this increase will occur in developing Much of this increase will occur in developing countries and in people in their most productive countries and in people in their most productive years.years. Deaths attributed to diabetes (4 million per Deaths attributed to diabetes (4 million per year).year). DM is the sixth leading cause of death above 60 DM is the sixth leading cause of death above 60 years, and seventh across all age groups in years, and seventh across all age groups in developed countries developed countries

Diabetes and psychiatryDiabetes and psychiatry Sir Henry Maudsley commented “Diabetes is a Sir Henry Maudsley commented “Diabetes is a disease which often shows itself in families in which disease which often shows itself in families in which insanity prevails” (The Pathology of the Mind, 1899).insanity prevails” (The Pathology of the Mind, 1899).There are numerous reports of type 2 diabetes There are numerous reports of type 2 diabetes mellitus, in psychiatric patients and numerous reports mellitus, in psychiatric patients and numerous reports of patients with diabetes developing psychiatric of patients with diabetes developing psychiatric disorders.disorders.It remains unclear, however, whether there is an It remains unclear, however, whether there is an intrinsic relationship between abnormal glucose intrinsic relationship between abnormal glucose metabolism and particular psychiatric disorders or is it metabolism and particular psychiatric disorders or is it the other way around.the other way around.

Mortality Among diabetic Persons Mortality Among diabetic Persons With Psychotic DisordersWith Psychotic Disorders

Individuals suffering with diabetes and Individuals suffering with diabetes and individuals with serious mental are more likely individuals with serious mental are more likely than the general population to die prematurelythan the general population to die prematurely The combination of more than one of those high The combination of more than one of those high risk disorders (diabetes and mental illness or risk disorders (diabetes and mental illness or drug abuse) increases the mortality rate for the drug abuse) increases the mortality rate for the individual and take it to a total different level that individual and take it to a total different level that the individual suffering with such a combination the individual suffering with such a combination is living in a real danger zoon and the slightest is living in a real danger zoon and the slightest mistake is fatal.mistake is fatal.

The new directionThe new direction

Up to recent times diabetes and psychiatric Up to recent times diabetes and psychiatric disorders have been treated in deferent and disorders have been treated in deferent and separate centers separate centers

that there is a strange disregard to the fact of the that there is a strange disregard to the fact of the existence of a great relation between both sides existence of a great relation between both sides and that sometimes lead to late diagnoses of the and that sometimes lead to late diagnoses of the occurrence of the secondary disorder. occurrence of the secondary disorder.

the new direction is to have Joint liaison the new direction is to have Joint liaison psychiatry-diabetes clinic that can deal with both psychiatry-diabetes clinic that can deal with both sides of the equation. sides of the equation.

Diabetes and psychiatric nursingDiabetes and psychiatric nursing

psychiatric nurses must have a full psychiatric nurses must have a full understanding of the coexistence and the understanding of the coexistence and the relation between diabetes and psychiatric relation between diabetes and psychiatric disorders disorders they must combine between the knowledge of they must combine between the knowledge of psychiatric nursing and a diabetes educator.psychiatric nursing and a diabetes educator.Psychiatric nurses should introduce Testing of Psychiatric nurses should introduce Testing of blood glucose levels regularly to their nursing blood glucose levels regularly to their nursing care plans for patients with relevant psychotic care plans for patients with relevant psychotic disorders and relevant antipsychotic medications disorders and relevant antipsychotic medications

EducationEducation

Psychiatric nurses must target the patient and Psychiatric nurses must target the patient and family and care for the following points in family and care for the following points in education :education :

*What is diabetes *What is diabetes

*Types of diabetes*Types of diabetes

*Symptoms of Diabetes*Symptoms of Diabetes

*Diabetes Complications*Diabetes Complications

*Hypoglycemia *Hypoglycemia

*Hypoglycemia symptoms*Hypoglycemia symptoms

Drug abuse Reduce ability manage diabetes and Drug abuse Reduce ability manage diabetes and blood glucose levels due to altered perception.blood glucose levels due to altered perception.

stay hydrated at all times.stay hydrated at all times.

Always carry fast acting (quickly absorbed) Always carry fast acting (quickly absorbed) glucose.glucose.

Test your blood glucose levels regularly.Test your blood glucose levels regularly.

Stick to your normal diabetes routine as much Stick to your normal diabetes routine as much as possible.as possible.

The correct way of use and disposal of sharps The correct way of use and disposal of sharps related to diabetesrelated to diabetes

Wound and skin integrity and care Wound and skin integrity and care

*Choose as safe an environment as *Choose as safe an environment as possible possible

*Carry something with you explaining *Carry something with you explaining that you have diabetes that you have diabetes

*Make sure some of the people with *Make sure some of the people with you are aware you have diabetes and you are aware you have diabetes and know what to do in an emergency.know what to do in an emergency.

ConclusionConclusion

Diabetes and psychiatric disorders go hand in Diabetes and psychiatric disorders go hand in hand and have a complete circular relation that hand and have a complete circular relation that makes it real hard to define that relation and put makes it real hard to define that relation and put it in a clear perspective that break things down in it in a clear perspective that break things down in to clear roles for nursing and nurses working to clear roles for nursing and nurses working with patients having both sides of that equation with patients having both sides of that equation needs to upgrade the level of performance and needs to upgrade the level of performance and be able to defuse both sides in to one care plan be able to defuse both sides in to one care plan and that needs a full understanding of both and that needs a full understanding of both sides.sides.The new direction may be the Joint liaison The new direction may be the Joint liaison psychiatry-diabetes clinics and nurses need to psychiatry-diabetes clinics and nurses need to be fully aware of that direction for them to prevail be fully aware of that direction for them to prevail in the coming world of fine nursing. in the coming world of fine nursing.

ReferencesReferences

(1) DIABETES AND PSYCHIATRY: THE (1) DIABETES AND PSYCHIATRY: THE INTERFACEINTERFACE

DAYAL NARAYAN, MBBS, Junior Resident; &  SHAHUL AMEEN, M.D., Senior DAYAL NARAYAN, MBBS, Junior Resident; &  SHAHUL AMEEN, M.D., Senior Resident; Central Institute of Psychiatry, Ranchi, India.Resident; Central Institute of Psychiatry, Ranchi, India.

(2) Drugs To Help You Can Actually Be (2) Drugs To Help You Can Actually Be HarmfulHarmful

By Carol Simontacchi, CCN, MS According to a recent release of the Alliance for By Carol Simontacchi, CCN, MS According to a recent release of the Alliance for Human Research Protection 2005 Human Research Protection 2005

(3)Psychiatric aspects of diabetes mellitus(3)Psychiatric aspects of diabetes mellitusPeter Trigwell &Robert PevelerPeter Trigwell &Robert PevelerAdvances in Psychiatric Treatment (2998), vol. 4, pp. 159-166Advances in Psychiatric Treatment (2998), vol. 4, pp. 159-166

Thank youThank you