metformin/empagliflozin sulfonylureas

DPP-4 inhibitors

SGLT2 inhibitors

thiazolidinediones -used to control blood sugar level

Injectable medication- GLP-1 receptor agonists and insulin

Lifestyle changes

Healthy diet

Regular exercise

Weight management

Healthy eating like fruits, vegetables, protein, wholegrain and healthy fat

Regular blood sugar monitoring - explain how to use a glucometer to monitor their blood sugar level

Medication management

Physical activity – encourage regular exercise like meditation, breathing exercises

Foot care - wearing comfortable shoes

Regular checkups to monitor progress

Asymptomatic in early stages

Nonspecific symptoms (may have classic symptoms of diabetes mellitus type 1)

Fatigue

Recurrent infections

Prolonged wound healing

Visual changes (blurred vision)

Greater in high-risk populations: Indigenous, Latin American, South Asian, Asian, or African descent

Older adults: reduction of beta-cell function, decreased sensitivity, altered carbohydrate metabolism, and a progressive increase in A1c

Home care: enable the patient or caregiver to reach an optimal level of independence

Patient and caregiver teaching: disease process, physical activity, medications, monitoring blood glucose, diet, and resources

Enable the patient to become the most active participant in their care

Fasting Plasma Glucose (FPG) test: > 126 mg/dL (7.0 mmol/L) post-overnight fast

Two-Hour Oral Glucose Tolerance Test (OGTT): > 200 mg/dL (11.1 mmol/L) post-sugary solution.

Glycated Hemoglobin (Hb) A1C test: > 6.5% (48 mmol/mol) signals possible type 2 diabetes
Repeat Testing: Confirmatory for elevated blood sugar without symptoms.

Symptomatic Diagnosis: Random plasma glucose > 200 mg/dL signifies type 2 diabetes with symptoms.

Metabolic abnormalities:

1.    Insulin resistance

2.    Pancreas decreased ability to produce insulin

3.    Inappropriate glucose production from liver

4.    Alteration in production of hormones and adipokines

Gradual Onset, and person may go many years without hyperglycemia being detected

Osmotic fluid/ electrolyte loss from hyperglycemia may become severe (Hyperosmolar coma)

Family History

Age

Certain ethnic group (Native American, African American, Hispanic, Asian American, Pacific Islander)

Being overweight or obese

Physical Inactivity

Gestational Diabetes

Hypertension (High Blood Pressure)

Sleep Apnea

Smoking

Fasting Plasma Glucose (FPG) for GDM (One-Step Approach): ≥92 mg/dL (5.1 mmol/L).

Oral Glucose Tolerance Test (OGTT) for GDM (One-Step Approach): ≥180 mg/dL (10.0 mmol/L) after one hour.

Two-Step Approach for Gestational Diabetes Mellitus (GDM) (Fasting): 95 or 105 mg/dL (5.5/5.8 mmol/L).

Patient assessment & History collection

Health education & Teach self-monitoring of blood glucose.

Medication administration & risk prevention

Collaborate with a dietitian to create a diet plan & encourage regular physical activity.

regularly monitor blood glucose level, Blood Pressure, liquid profiles & collaborate with other healthcare professions.

Schedule regular follow up appointments

Cardiovascular: heart disease, stroke

Neuropathy: nerve damage (peripheral neuropathy)

Nephropathy: kidney damage (chronic kidney disease)

Retinopathy: eye damage (vision problems, blindness)

Foot problems: ulcers, infections, amputations

Skin conditions: bacterial and fungal infections

Slow wound healing

Increased risk of infections

Astle, Duggleby, Potter, Perry, Stockert & Hall. (2024). Potter and Perry's Canadian Fundamentals of Nursing (7th edition). Elsevier, Canada.

Belleza, M. (2020, June 4). Diabetes Mellitus. Nurseslabs. https://nurseslabs.com/diabetes-mellitus/

Fletcher, B., Gulanick, M., & Lamendola, C. (2002, January). Risk Factors for Type 2 Diabetes Mellitus. The Journal of Cardiovascular Nursing, 16(2), 17–23. https://doi.org/10.1097/00005082-200201000-00003

Goyal, R., Singhal, M., & Jialal, I. (2023). Type 2 Diabetes. In StatPearls [National Library Of Medicine]. https://www.ncbi.nlm.nih.gov/books/NBK513253/

Msn, T. C. (2023, October 13). Diabetes Mellitus: Nursing Diagnoses, Care Plans, Assessment & Interventions | NurseTogether. NurseTogether. https://www.nursetogether.com/diabetes-nursing-diagnosis-care-plan/

Risk Factors for Type 2 Diabetes. (2023, October 10). National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/diabetes/overview/risk-factors-type-2-diabetes

Type 2 diabetes - self-care: MedlinePlus Medical Encyclopedia

U.S. National Library of Medicine. (n.d.). Type 2 diabetes - self-care: Medlineplus medical encyclopedia. MedlinePlus