Nursing Care for Type I Diabetes: Diagnostic Procedures, Pathophysiology, and Management

NURSING CARE CASE STUDY
UNIVERSITY:
NAME :
ASSIGNMENT

Nursing care for Type I diabetes
2
Introduction
Type I diabetes is a chronic diseases which is characterised by increased high blood
pressure referred to as hyperglycaemia. It is autoimmune disease which often results on the
attack of pancreatic better cells produced by insulin. Lack of adequate insulin, leads to rise in
blood glucose, many children are affected by type 1 diabetes, due to the body inactivity to
produce insulin. This leads to breaking down of fats to be used as an alternate source of
energy, these results into release of ketones, (Atkinson, 2014 pp. 70). The child in the case
study has depicted this characteristics couple with increased thirst and urination. Thus this
review assesses the diagnostic procedures suitable for the patient and nursing approach in
managing type 1 diabetes.
Diagnostic procedures of Type 1 Diabetes
Type I diabetes is often diagnosed suddenly or unexpectedly. The disease often presents
with symptoms that appear as cold or flu. Its initial presentation is characterised by flu or
malaise but medical practitioners often spot the signs quickly and request for additional tests.
i) Glycated haemoglobin tests, (A1C)
The blood tests in this diagnostic indicate the average blood sugar level for the last 2-3
months. It is useful in measuring the percentage of blood sugar which is present in the
oxygen carrying capacity in haemoglobin. The higher blood sugar often has more
haemoglobin with sugar attachment. A1C of 6.5% or more in two independent tests is an
indicative of diabetes, (Chiang et al, 2014 pp. 2040).
ii) Random blood sugar tests
The blood sample can be taken at random times which may be confined with repeated
tests. Values are expressed in milligrams per decilirter- mg/Dl or millimolesper litter-
mmol/L .random blood sugar tests of 200mg/Dl or 11.1 mmol/L or higher are often an
indicative of diabetes. When it is compounded with symptoms such as urination and extreme
thirst as for the child in the case study confirms the prognosis.
iii) Fasting blood sugar tests
This involves taking blood samples which are taken over night. A fasting blood sugar
which is less than 100mg/Dl or 5.6 mmol/L shows normal levels. Fasting blood sugar level
from 100-125mg/Dl or 5.6-6.9mmol/L shows a pre diabetes stage, while readings of 126
mg/dL or 7 mmol/L shows diabetes stage, (Orchard et al, 2015, pp 50).
Ongoing monitoring of blood sugar levels is key in diagnosing type 1diabetes. Fasting
blood glucose is key in assessing how the body tolerates blood glucose levels fasting night. It

Nursing care for Type I diabetes
3
gives an overview of how the body works without food impact. Oral glucose tolerant further
is essential, in that people take blood tests, by drinking sugar and then measuring their blood
sugar over period of two hours. This is an indicative measure of benchmarking the tolerance
of sugar in the body, and how carbohydrates re are treated in the body. Random blood sugar
testing is essential in assessing the current status of blood sugar levels of the patient. It is the
first tests taken by doctors to assess elevation.
After diabetes diagnosis, assessment of A1C levels are assessed, as they vary
depending on the age, making comparisons with various tests provides effective management
plan. Further to complement the diagnostic tests, blood and urine samples will be regularly
assessed to check the cholesterol levels, functionality of thyroid, kidney and liver functions,
(Santin et al, 2015, pp. 35).
Path physiology of type 1 diabetes
Type 1 diabetes is chronic diseases affecting the autoimmune system which occurs as
susceptible individual which may be further compounded by environmental factors. The
immune system is triggered by the development of auto immune response which is against
beta cell antigens or molecules which develop the autoimmune response against the beta cell
antigens of pancreas. Is approximated that 85% of type 1 diabetes have circulating islet,
which majority of the patients have detectable anti insulin antibodies, which are against the
glutamic acid decarboxylase in the pancreatic cells, (Dabelea et al, 2017 pp. 828-830).
Various scenarios have been put forward on the development of type 1 diabetes.
Environmental triggers have been shown to trigger and induce islet autoimmunity and beta
cell death, which leads to sequence of pre diabetic stage and eventual onset of type 1
diabetes. In wide variations of time between the autoimmunity and clinical onset of type 1
diabetes, have been shown to be present in the interactions of genetic factors and
environmental factors which contribute to the diseases.
In clinical cases type 1 diabetes occurs due to the circulating insulin which is low or not
available in plasma glucagon or elevated in , there is failure of pancreatic cells in responding
to insulin secretory stimuli. The pancreas exhibit lymphocytic infiltration and destruction
which leads to failure of the cells which secrete the insulin in the langerhands islets, which
causes insulin deficiency. The observed deficiency of insulin causes many physiological
processes which is characterised by the destruction and disruption of glucose uptake. In
extremes cases insulin deficiency leads to osmosis diuresis and dehydration effects, which
lead to elevated diabetic keto acidosis which is life threatening, (Russell et al, 2014 pp. 315-