Review of The Consequences of Diabetes Mellitus

Abstract

This research paper will explain five consequences of diabetes as it relates to the health, safety, and well-being of older adults. Moreover, the following will describe how healthcare professionals can educate older adults how to manage their care and ultimately prevent such consequences. Lastly, I will briefly discuss the significance of diabetes in my life and why I chose this topic.

Consequences of Diabetes Mellitus

Diabetes is a major health problem which has reached epidemic proportions globally. According to the American Diabetes Association, one in four people age 65 or greater has diabetes. The largest occurrences have taken place in populations where there has been swift and vast changes in lifestyle. As the population ages, and becomes increasingly sedentary and overweight these numbers will only grow. It is the seventh leading cause of death among older adults in the U.S.. Poorly controlled diabetes leads to severe consequences among the older adult population. The consequences include hypo/hyperglycemia, malnutrition, falls, depression, and visual impairment. In order to prevent such undesirable consequences, it is the responsibility of healthcare workers to assess, educate in an easily understandable way, and treat each client on an individual basis.

Hypoglycemia and hyperglycemia can have potentially devastating consequences among the elderly population. Thus, education on the prevention of hypoglycemia should be a top priority for health care professionals. Client’s should be taught to recognize classic symptoms of hypoglycemia such as sweating, shaking, irritability, dizziness, delirium, and in extreme cases seizures or loss of consciousness. Alternatively, hyperglycemia is indicated by blurred vision, fatigue, headache, nausea, vomiting, and if left untreated fruity breath odor caused by a life-threatening condition called diabetic ketoacidosis. Assessing one’s cognitive and functional abilities is critical to determine his or her capability to manage their diabetes. Essential education should include operation of a glucometer, awareness of normal blood glucose ranges, understanding the purpose of each prescribed medication, calculating insulin dosing, and proficient technique of medication administration.

Many individuals burdened by diabetes constantly struggle to adhere to a well-balanced diabetic diet. This is especially true among the older adult population due to circumstances including diet misconceptions, appetite loss, impaired sense of taste or smell, dentition concerns, dysphagia, and functional loss affecting the client’s ability to shop for and prepare suitable diabetic adherent meals. Consequently resulting in malnutrition and potential weight loss. Assessing a client’s oral intake ability, their nutritional understanding specific to diabetes, presence of family support along with their living situation, and functional abilities in reference to their means to transportation as well as culinary skills will ensure the best possible outcome. Encourage resources such as meals on wheels to alleviate the stress of cooking, dining at senior centers in an effort to promote social interaction with meals, and schedule an appointment to consult with a registered dietitian. (Hill, J. 2019)

Whether the cause be hypoglycemia, malnutrition, dehydration, clients suffering from diabetes are at an increased risk for falls. Both diabetes and it's treatment can interfere with good balance and a steady gait. The elevated blood glucose often causes nerve damage or neuropathy in approximately half of the people that develop diabetes. Clients should be encouraged to exercise and stay active to maintain strengthening and improve balance and gait. For those suffering from impaired functional ability, adapted exercises focusing on balance and gait can still be completed. Therapy may be indicated if appropriate for clients who suffered recent fall or are at high fall risk for fall. Teach ways to avoid falls such as safe uncluttered environment, appropriate footwear, adequate lighting, etc. Falls can result in severe lasting consequences and further exacerbate complications of diabetes so prevention is vital. (Haltbakk et al., 2019)

In 2017, adults in the U.S. age 85 or older accounted for the second highest suicide rate at 20.1%. Although the connection between diabetes and depression is not entirely understood, chances are if you have diabetes diabetes you have an increased risk of developing depression. Often times the stress of managing the disease triggers depression. And if you're depressed, you may have a greater chance of developing diabetes. Clients suffering from depression often have decreased quality of life by social isolation, poor self-management by diet and medication noncompliance, and a higher risk for developing complications associated with negligent diabetes control. Interventions include screening clients for depression, medication changes, psychotherapy, and collaborative care. Encourage the spouse or family to be more active in supporting the client in the management of disease. Referring the client to mental health therapy and/or support groups can help with the isolation felt and emotional distress of diabetes. (Jones et al., 2015)

Uncontrolled diabetes can result in serious health consequences. Diabetics are at higher risk for developing visual impairments such as glaucoma, cataracts, and diabetic retinopathy. Diabetic retinopathy is the leading cause of vision loss among American adults age 20-74. The retina is a thin layer of tissue located in the back of the eye. It makes vision possible by converting light into signals that can be interpreted by the brain. Poorly managed glucose levels causes permanent damage to the blood vessels of the retina resulting in symptoms such as blurred vision, vision loss, blind spots, and seeing dark spots or floaters (small specs in your vision field). Currently, treatment is intended to prevent, delay, or reduce vision loss. Educating clients on the importance of eating a healthy diet, being compliant with pharmacological management, monitoring blood pressure and glucose levels (normal range), exercising, as well as scheduling routine health and eye exams. (Boyer, D & Tabandeh, H, 2014)

Diabetes is a chronic disease capable of causing dire consequences if improperly managed. I elected to complete my project on this topic because of my experience working in an endocrinology clinic. As a nurse, I spent much of my time teaching patients imperative skills such as operating a glucometer and administering insulin. In my involvement, I find that patients with diabetes are motivated to live a healthy lifestyle, but many are either misinformed or lack the knowledge If healthcare professionals devoted more time stressing the importance of managing blood glucose levels through an individualized plan of care, patients would experience exceptional outcomes.

References

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