Diabetes prevalence is reaching epidemic proportions, with more than 422 million people affected worldwide. Diabetes can cause blindness, kidney failure, heart attacks, strokes, nerve damage and even necessitate amputation. It can also lead to a mental health condition known as "diabetes distress." Therefore, it is vital for nurses to understand how to help patients through education, management and support.
An article in Current Diabetes Reports says, "An estimated 9.1% of the overall U.S. population has diagnosed diabetes, 5.2% has undiagnosed diabetes, and an additional 38.0% has prediabetes." The World Health Organization estimates diabetes as the seventh leading cause of death worldwide. These numbers are expected to continue to rise with increases in elderly population, sedentary lifestyle and widespread obesity.
The best way to stop the diabetes epidemic is prevention. The Centers for Disease Control and Prevention report that one in four people who have diabetes don't know it. This is why it is important for nurses to provide patient education, not only to those diagnosed with diabetes, but those who are at high risk for developing diabetes.
Nurses can help by:
- Educating patients about risk factors, like family history, advancing age, excess weight and a sedentary lifestyle.
- Partnering with patients to develop personal prevention strategies like limiting sugar and carbohydrates, increasing activity, aiming toward their ideal body weight, and setting small weight loss goals.
- Teaching patients about critical lab values and how to recognize and report signs and symptoms of hypoglycemia or hyperglycemia.
- Providing education and counseling for patients who are borderline diabetic or have metabolic syndrome as well as patients diagnosed with diabetes.
The Front Lines
Nurses are at the forefront of diabetes care. They are often present at diagnosis and may care for patients throughout the life of the disease. Watch patients' lab values closely, particularly the A1C, C-reactive protein and fasting blood glucose values. Provide information on topics related to diabetes to both patients and caregivers.
Diabetes Education Topics
Disease and Management
Healthy food choices
· Foods to eat (nuts, oatmeal)
· Foods to avoid (sugar, white flour)
· How much, how often, what type
· Ways to increase activity throughout the day
Types of diabetes
· Type I
· Type II
· Metabolic syndrome
· Impact of smoking on diabetes
· Smoking cessation strategies
· Blood glucose monitoring
· Hypoglycemia signs and management
· Insulin administration
Diabetes and Mood
Diabetes does not just affect blood sugar — it can lead to mental health changes, causing emotional strain and therefore impacting relationships. It can cause mood swings, confusion, anxiety, depression and stress. With end-stage disease, diabetes contributes to caregiver burden or distress. Nurses can listen to concerns and connect them with resources. Check out the Defeat Diabetes Foundation to find local diabetes support groups.
Diabetes Nurse Educator
Nurses who want to specialize in diabetes education can become a Certified Diabetes Care and Education Specialist through the National Certification Board for Diabetes Educators, or become a diabetes nurse (although that requires an MSN). These roles are vital to help patients:
- Identify their risk factors
- Identify if they have diabetes or prediabetes
- Work through the emotional and physical response to a diagnosis
- Identify resources in their community
- Manage their disease throughout all stages of life to minimize nerve damage and other symptoms
Patients with diabetes must follow a lifelong care plan that includes a modified diet, weight management, medications and lifestyle changes. It's a complex disease, and it often falls to the nurse to educate patients about how to manage diabetes and recognize signs that their plan is not working for them.
Finally, diabetes research continually advances our understanding of the disease and provides new treatment approaches. It is the responsibility of the nurse to stay abreast of these new developments and incorporate them into practice. RN to BSN programs provide the latest information on diabetes, training in evidence-based nursing care, and skills necessary to educate patients with all levels of health literacy.
Learn more about the University of Rhode Island online RN to BS in Nursing program.
Sources:HealthyPeople.gov: Health Literacy
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