Diabetes occurs when the body can no longer process glucose (blood sugar) normally. In a healthy body, the hormone insulin regulates glucose levels.
With Type 1 diabetes, there is little to no insulin production in the body. In Type 2 diabetes, the body still makes insulin, but insulin resistance keeps it from processing glucose properly. A diabetes diagnosis of either type requires careful management of glucose levels.
Diabetes is of particular concern for Mississippi residents. According to the Mississippi State Department of Health, an estimated 308,295 adult residents (13.6% of the population) were living with diabetes in 2016. Mississippi has the highest incidence of diabetes in the United States. Additionally, comorbidities and complications from diabetes impact the quality of life for Mississippians with diabetes. Given the high incidence of diabetes in the state, it's crucial that nurses know how to help these patients.
Type 1 Diabetes: Irreversible Yet Treatable
Type 1 diabetes occurs when the body makes very little or no insulin. Formerly called juvenile diabetes, this condition is managed with glucose monitoring, diet, exercise and insulin injections. It isn't preventable or reversible, but it's possible for Type 1s to live a full life with proper management.
People with Type 1 diabetes face a lifetime of monitoring and controlling their blood sugar. They may benefit from stress management resources, including counseling and support groups. Because managing nutrition is crucial for Type 1 diabetes, the services of a dietitian can also be helpful.
Blood glucose monitors, a low-carb/high fiber diet, and medication or insulin injections are vital to self-care for those with Type 1 diabetes.
Type 2 Diabetes: Manageable Through Nutrition and Lifestyle Changes
Type 2 diabetes, formerly known as adult-onset diabetes, results when the body doesn't manage the insulin it produces as well as it should. Insulin is supposed to move glucose from the bloodstream into the cells where it can be used as fuel. With too much sugar left in the blood, plenty of unpleasant symptoms can compromise one's quality of life. This is also true for Type 1 diabetes.
While some cells are starved of energy from poor-performing insulin, other cells are damaged by excessive blood sugar. Type 2 diabetes affects the entire body. Vision, circulation, dental health and the nervous system can all suffer from high blood sugar.
For Type 2 diabetes, blood sugar levels can often be lowered through diet and lifestyle changes.
Caring for Type 2: Educating the Patient
Type 2 diabetes is linked with obesity. According to the Obesity Action Coalition (OAC), prevalence of diabetes is three to seven times higher in adults affected by obesity and 20 times more likely in those with a body mass index (BMI) greater than 35. Overweight and obese patients are encouraged to lose weight to reverse insulin resistance.
A Type 2 diagnosis calls for dietary changes. While there is no perfect diet that works for everyone, some basic guidelines from the American Diabetes Association will start most patients on the path to more balanced glucose through nutrition.
- Eat whole, unprocessed foods whenever possible.
- Avoid starchy vegetables like potatoes.
- Skip foods with added sugars and refined grains like those found in bakery items.
- Enjoy water instead of sugary drinks and diet beverages.
- Stick to low-carb, vegetarian or Mediterranean diets as a basis for meal planning.
Exercise is a key component to improving blood sugar levels and insulin resistance. People with diabetes may have comorbidities that make it challenging to stay fit, so it's important to establish an appropriate plan of action for each individual. Low-impact activities like walking, stationary cycling and yoga are great ways to start. A realistic and consistent plan that provides small wins initially can encourage people to push for greater improvement.
Lifestyle is another factor. Reducing or eliminating tobacco and alcohol use decreases the strain on organs and body systems affected by diabetes, as both substances can elevate blood sugar levels and lead to insulin resistance.
NPR reported anecdotal evidence from Tennessee residents and nurses Steve and Karen Wickham who are helping people with Type 2 diabetes bring blood sugar under control with less dependence on drugs. The story noted, "Type 2 diabetes can be reversed with weight loss and exercise; but research shows that people need lots of help to achieve control of blood sugar with just a change in diet and lifestyle, and they rarely get enough support. It's easier for doctors and patients to rely primarily on medication."
As a nurse, you are well-positioned to support your patients by helping them discover the best ways to manage diabetes (Type 1 and Type 2) and possibly reverse it (Type 2).
Guidance for Helping Patients
Coursework in an RN to BSN program can prepare nurses to provide appropriate care for a variety of health conditions, including diabetes. Some courses at Mississippi College are especially beneficial.
Health Assessment is a necessary skill for nurses, allowing for a more precise diagnosis and improved patient outcomes.
Community Health Nursing teaches concepts and skills that enable nurses to better help the populations in their area. Understanding the particular health challenges in Mississippi can aid in preventing diabetes and promoting improved health in the state.
Transcultural Patterns of Health Care is a class that cultivates a nurse's understanding of the impact of culture and religion on health.
As a trusted member of your patients' healthcare team, you can help them find ways to lead rich, fulfilling lives while managing diabetes.
Learn more about the Mississippi College RN to BSN online program.
Sources:Mayo Clinic: Diabetes: Does Alcohol and Tobacco Use Increase My Risk?
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