Clinical Specialization on Diabetes Mellitus: Teaching Session

This presentation focuses on diabetes mellitus, encompassing type I, type II, and gestational diabetes. It delves into the disease's etiology, symptoms (such as acanthosis nigricans, fatigue, and blurred vision), and long-term health issues like hypertension and kidney failure. The diagnostic process, including fasting plasma glucose and A1C tests, is outlined. The presentation emphasizes management strategies, including nutritional uptake, physical activity, and medication. Nursing interventions, such as blood sugar monitoring and insulin administration, are highlighted. The roles and responsibilities of nurses in screening, self-care promotion, and medication management are discussed, along with relevant nursing standards from organizations like the NMBA and ADEA. The presentation also includes a detailed reference list of supporting literature.

Clinical Specialization
on Diabetes

Diabetes mellitus:
•Two types of diabetes: type I and type II
•Type I diabetes occurs when autoimmune
process destroyed the beta cells.
•Type II diabetes occurs due to decreased
production and sensitivity of insulin in the
body (Dabelea et al., 2017).

Gestational Diabetes:
•Occurs during pregnancy, witnessing glucose
intolerance
•Insulin resistance induced by the placental
hormones
•Later development of type II diabetes mellitus.
•Risk of Glycosuria condition occurrence
(Koivusalo et al., 2016)

Symptoms:
• Acanthosis nigricans
• Fatigue
• Numbness or tingling in hands and feet
• Skin infection
• Blurred vision
• Irritation
• Polyuria
• Polyphagia
• Polydipsia (Varni et al., 2018).

Long-term health issues:
•Hypertension
•Cardiac disorder
•Neuropathy
•Retinopathy
•Kidney failure
•Stroke
•Peripheral vascular disease (Deng et al., 2018).

Diagnostic process:
For type I and type II
•Fasting plasma glucose (FPG) test
•A1C test
•Random plasma glucose (RPG) test
For gestational diabetes
•Glucose challenge test
•Oral glucose tolerance test (OGTT) (American Diabetes
Association, 2017)

Management process:
•Managing nutritional uptake
•Physical activity
•Monitoring
•Medication
•Knowledge and education (Reusch &
Manson, 2017) .

Nursing Interventions
•Monitoring blood sugar level
•Administrating insulin
•Monitoring blood pressure
•Monitoring feet
•Educating the patient regarding the nutrition
and monitoring process and physical activities
(Butcher et al., 2018).

Nurses role and responsibilities:
• Screening, detection and prevention
• Self-care promotion
• Mental health
• Monitoring urine
• Nutrition management
• Monitoring blood glucose level
• Oral medication therapies
• Vaccination and injection
• Hypoglycaemia and hyperglycaemia management (Whitehead et al.,
2017).

Nursing standards for diabetes:
•Nursing and Midwifery Board of Australia
(NMBA)
• Australian and New Zealand Council of Chief
Nurses and Midwives Officers
(ANZCCNMO) (Beadnell, 2018).
•Australian Diabetes Educators
Association(ADEA) (King et al., 2019).

Reference:
American Diabetes Association. (2017). 2. Classification and diagnosis of diabetes. Diabetes care, 40(Supplement 1), S11-S24.
Beadnell, C. (2018). The way forward: Expanded prescribing roles for nurses and midwives. Australian Nursing and Midwifery Journal, 25(8),
16.
Butcher, H. K., Bulechek, G. M., Dochterman, J. M. M., & Wagner, C. (2018). Nursing Interventions classification (NIC)-E-Book. Elsevier
Health Sciences.
Dabelea, D., Stafford, J. M., Mayer-Davis, E. J., D’agostino, R., Dolan, L., Imperatore, G., ... & Black, M. H. (2017). Association of type 1
diabetes vs type 2 diabetes diagnosed during childhood and adolescence with complications during teenage years and young
adulthood. Jama, 317(8), 825-835.
Deng, E., Nham, S., Wong, V., Leung, D., & Leung, M. (2018). Impact of Changes in Glycaemic Control on Long-Term Cardiovascular
Outcomes in Patients with Type 2 Diabetes Mellitus. Heart, Lung and Circulation, 27, S60.
King, O., Nancarrow, S., Grace, S., & Borthwick, A. (2019). Interprofessional role boundaries in diabetes education in Australia. Health
Sociology Review, 1-15.
Koivusalo, S. B., Rönö, K., Klemetti, M. M., Roine, R. P., Lindström, J., Erkkola, M., ... & Andersson, S. (2016). Gestational diabetes mellitus
can be prevented by lifestyle intervention: the Finnish Gestational Diabetes Prevention Study (RADIEL): a randomized controlled
trial. Diabetes care, 39(1), 24-30.
Reusch, J. E., & Manson, J. E. (2017). Management of type 2 diabetes in 2017: getting to goal. Jama, 317(10), 1015-1016.
Varni, J. W., Delamater, A. M., Hood, K. K., Raymond, J. K., Driscoll, K. A., Wong, J. C., ... & Corathers, S. D. (2018). Diabetes symptoms
predictors of health-related quality of life in adolescents and young adults with type 1 or type 2 diabetes. Quality of Life Research,
27(9), 2295-2303.
Whitehead, L. C., Crowe, M. T., Carter, J. D., Maskill, V. R., Carlyle, D., Bugge, C., & Frampton, C. M. (2017). A nurse‐led I nterdisciplinary
approach to promote self‐management of type 2 diabetes: a process evaluation of post‐intervention experiences. Journal of
evaluation in clinical practice, 23(2), 264-271.

Thank You