Diabetes care

Diabetes Mellitus (DM) is simply known as diabetes. It is a very common metabolic disorder. It is a disorder characterized by impaired insulin secretion and/or variable degrees of peripheral insulin resistance leading to hyperglycemia.

Complications of DM

It can be classified as Acute and Chronic complications.

Acute Complications of DM include:

  1. Hypoglycaemia
  2. Hyperosmolar Hyperglycaemic
  3. Diabetic Ketoacidosis

Chronic Complications- tend to occur after years of poor glycaemic control

  1. Microvascular Complications
  2. Retinopathy
  3. Nephropathy
  4. Neuropathy
  5. Macrovascular Complications
  6. Angina Pectoris
  7. Myocardial Infarction
  8. Transient Ischaemic attack
  9. Strokes
  10. Peripheral artery disease
  11. Immune Dysfunction

Care and Prevention of Complications

  • Hypoglycaemia
  • This is simply a state of low blood sugar.
  • It can happen at any time of the day depending on several factors. It is a common complication of management of Diabetes
  • Each person has a different reaction to blood sugar. These are some symptoms that may be observed; Feeling shaky, Being nervous or anxious, Sweating, chills and clamminess, Irritability or impatience, Confusion, Fast heartbeat, Feeling lightheaded or dizzy, Hunger, Nausea, Color draining from the skin (pallor), Feeling Sleepy, Feeling weak or having no energy, Blurred/impaired vision, Tingling or numbness in the lips, tongue, or cheeks, Headaches, Coordination problems, clumsiness, Nightmares or crying out during sleep, Seizures.
  • Despite all of these, the only way to be sure you are experiencing hypoglycaemia is to check your blood sugar level using a glucometer.
  • If you cant get to a glucometer and you are experiencing these symptoms, treat like you have hypoglycaemia.
  • WHAT TO DO:  Take a serving of something with a high glycaemic control and check your blood sugar again after 15 minutes. If it hasn’t risen to 3.8 mmol/l, take another serving.
  • These are some examples of things to take: 1 Tablespoon of sugar, honey or corn syrup; ½ cup of juice or regular Soda (Fanta, Cola etc), Glucose tablets, Hard candies.
  • In some case hypoglycaemia may progress to a Coma and will require medical assistance
    1. It is important to record all episodes of hypoglycaemia you experience and discuss them with your health care provider.
Fig 1. Signs of Hypoglycemia
  • Eye Care
  • Diabetic retinopathy is the most common cause of blindness in the US. Other than good glycaemic control, it is important to undergo screening by retinal examination annually.
  • Early detection and treatment are key in prevention of blindness
  • Renal Care
  • Diabetic nephropathy is a leading cause of CKD. It may cause glomerular hypertension and decreased glomerular filtration rate.
  • It is usually asymptomatic until renal failure or nephrotic syndrome develop
  • Urinary albumin levels should be monitored annually for early detection of nephropathy
  • Foot Care
    • this is an essential part of diabetes care; because of the effect diabetes mellitus has on the nervous system, it can cause great damage to the feet.
    • Even a small cut can result in serious consequences
    • These are some key things to practice
      • Avoid tight shoes
      •   Do not walk barefoot
      • Do not move around in the dark
      • Do not do your own pedicure
      • Present to a health care professional when any injury is noticed no matter how small
      • Inspect your foot daily
Fig 2. Foot examination/foot care(Columbus Regional Health, 2020)
  • Glycaemic control
    • Ensure you take you medications as prescribed by your Doctor
    • Make sure to practice daily blood sugar monitoring multiple times a day
    • Keep a record of blood sugar monitoring
    • Go for your follow-up appointments
    • Diet is also important. In summary, eat a balanced and moderated diet. Each meal should be rich in vegetables. Reduce carbohydrates but don’t avoid them.
    • Avoid things that are processed, made of white flour, high in sugar
    • Eat little portions at a time
    • A dietician can give a more detailed meal plan
    • Physical exercise is of utmost important(moderate aerobic exercise 150min/week)
    • Eg. Brisk walking for 15-20 mins 5 days a week, dancing, running, jumping rope etc.

Published by Gray Healthcare Foundation

A Non Governmental organisation with Headquarters in Africa ,dedicated to uplifting the health of the elderly population .Passionate about the elderly , we drive increased inclusivity ,availability of essential health care services, advocacy and research for those aged 60 years and above.

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