A disease is classified as ‘chronic’ when it cannot be cured and will last throughout the duration of the patient’s life. Type II diabetes is an example of a chronic disease which is on the rise and which can be managed but cannot be entirely ‘cured.’ Unlike type I diabetes, which typically manifests itself in early childhood as an autoimmune disorder, type II diabetes is caused by a combination of environmental and genetic factors. “The majority of people (80%) who develop type 2 diabetes are overweight” (Burden 2003).
What two nursing preventions can nurses do for this chronic illness?
Because type II diabetes is classified as a lifestyle-related disorder, treating it requires a change of diet and altering other habitual factors. “The basis of initial treatment is to pay attention to dietary intake and to encourage exercise so as to induce weight loss, the rationale being to improve nutrition, maintain normoglycaemia, be aware of cardiovascular risk factors and prevent the complications of diabetes” (Burden 2003). One of the reasons that nursing can be so effective in treating diabetes is that its perspective addresses the needs of the ‘whole person’ in his or her entirety. It is not enough to merely tell someone to eat less and to move more to lose weight. The nurse must take into consideration the culture of the patient; the patient’s personal stressors; economic and social considerations and other priorities in designing a treatment plan which can be followed. The ideal is to forestall the need for the use of insulin or other medications. However, “it should be made clear to the patient that he or she is not failing if insulin is eventually required but that it is an inevitable consequence of type 2 diabetes” (Burden 2003). Even prediabetic patients who are able to control their glucose through dietary and exercise modifications will still need to manage the condition for a relatively long-term duration.
If more intensive treatment is needed in the form of medication and administration of insulin, the nurse can also be very effective in helping the patient learn how to engage in self-care, including monitoring his or her glucose. Learning to inject one’s self with insulin can seem like a daunting task for many patients and nurses can provide assistance and support in this area. Appropriate administration of insulin is vital. For example, “it is important to vary the injection site so as to prevent the development of lipo-hypertrophy (usually the case when using human insulin) or atrophy (more often seen in those using animal insulin)” (Burden 2003). Given the severe consequences of long-term untreated or poorly-treated diabetes, nurses have a vital role to play in the treatment of this chronic illness.
“The nurse’s role in diabetes care may be as a specialist or as part of general care – primary or secondary. Wherever care is given, the emphasis is always on patient self-management” (Burden 2003). With all chronic illnesses, maximizing patient autonomy is required given that it is the patient who will be primarily responsible for his or her own care. (Although in some instances, such as a child or adolescent with type II diabetes, involving the parents or caregivers may be necessary as part of the treatment plan). The nurse may have a specific, specialist’s role as a diabetes educator or may be involved in a more general plan of care for the patient.
Burden, M. (2003). Diabetes: treatment and complications – the nurse’s role. Nursing Times,
99 (2): 30. Retrieved from http://www.nursingtimes.net/nursing-practice/clinical-zones/diabetes/diabetes-treatment-and-complications-the-nurses-role/205780.article
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