Diabetes: The Difference Nursing Care Makes

We are undoubtedly living in an era of double pandemic as the prevalence of diabetes is increasing due to a lot of triggering factors such as sedentary lifestyle, stress, unhealthy food habits, and also due to the steroid therapy currently used for SARS COVID-19 treatment.

World Diabetes Day 2020 was observed with the theme being The Nurse and Diabetes. This is of course to recognize the important role that nurses play in caring for diabetics.

The WHO released some interesting statistics on nurses according to which nurses make up 59% of the medical staff and the number of professional nurses all over the world comes up to around 19.3 million. With the increase in the number of diabetics across the world, the part that nurses and support staff play gains more importance. A nurse is usually a patient’s first point of contact in a hospital and hence it is important that the nurse be able to handle the patient well with the right care.

Nurses Play a Key Role in:

• Diagnosing diabetes early to ensure prompt treatment.
• Providing self-management training and psychological support for people with diabetes to help prevent complications.
• Tackling the risk factors for type-2 diabetes to help prevent the condition.

With the right expertise, nurses can make all the difference to people affected by diabetes.

Care That Needs to Be Taken by Diabetic Patients

• The Need for and the Importance of Regular Sugar and Blood Pressure Check-ups at Home

  The monitoring of blood sugar and blood pressure during this period is very important. The need for good control of sugar is to prevent acute complications as there is a chance that the sugar levels can fluctuate between low (‹ 70 mg/dL – hypoglycemia) and high (› 250 mg/dL – hyperglycemia) due to many reasons, even without any symptoms for some of them. Maintaining optimal sugar control during this period not alone prevents patients from getting infections but also helps in preventing the risk of microvascular (damage to the eyes, kidneys and nerves) and macrovascular (heart attack, stroke) complications in the future.

  Maintaining optimal BP of around 130/80 mm of Hg and checking BP at regular intervals will help adjust the dosage, as some symptoms are not specific to low or high BP.

  Continuing regular medications and connecting with the health care team for assistance in case of emergencies is advised.

• The Precautions That Diabetic Patients Must Bear in Mind

  Personal hygiene and social distancing are a top priority during this period; apart from this all diabetic people should follow some precautions to take care of themselves which includes the following:

  • Taking Care of the Feet: For people with diabetes, foot care is equal to face care. They should watch out for any corns, fissures, ulcers, etc. and apply moisturising lotion every day for hydration.
  • Taking Care of the Gums: Brushing teeth twice daily to prevent dental caries is essential.
  • Avoid Skipping Medications: There is a possibility that skipping medications for even a day could result in opportunistic infections due to fluctuating blood sugars.
  • Eating a Balanced Diet: Overeating and consuming simple sugars are to be avoided.
  • Physical Activity: This is a must. Walking 30 minutes daily for 5 days in a week is essential. If possible, more physical activity can also be incorporated to maintain the blood sugar level. Also, basic stretches & aerobic exercises can be performed.
  • Breathing Exercises: This improves oxygen saturation & practicing yoga helps in developing mental strength and improves well-being.
• The Red Flags That Must Not Be Overlooked in Case of an Emergency
  • If there are any kind of skin changes in the toes or legs such as ulceration, redness or skin infection, immediate consultation with the health care team to prevent further damage is of paramount importance.
  • A very common condition that can manifest in diabetic people with high blood sugar is diabetic ketoacidosis. If patients experience giddiness, feel thirsty, feel exhausted or pass urine frequently, they should check their sugar levels and report immediately to their physician and get treated. It can lead to emergencies if left untreated.
  • Symptoms for low sugar and high sugar can seem similar, so it is a must to check the blood sugar level and keep track. Low sugar can happen due to various reasons – a higher dosage of medications, sudden improved physical activity without a change in the dosage, delay in consuming food or reducing the quantity of food without adjusting the medication dosage, etc. It’s very important to identify low sugar and treat it effectively at home. If untreated, it can lead to a hypoglycemic coma. There are some medications available to treat hypoglycemia at home so a consultation with a physician is recommended to prevent complications.
• Diet for Diabetic Patients During This COVID Time

  A healthy, balanced and nutritious diet is recommended for all diabetic people.

  • Consuming small quantities of food at regular intervals prevents sudden spike in sugar as well as low sugar levels.
  • Reducing portion size and using small plates to consume food helps in avoiding over-eating.
  • Increasing intake of green leafy vegetables and fruits with a low glycaemic index is recommended; 3 to 4 servings of this can be consumed every day.
  • Avoiding junk food, including flaxseeds in the diet (to maintain the glucose level & reduce bad cholesterol), and consuming a fist full of nuts every day is recommended.
• Unusual Symptoms Diabetic Patients Should Be Aware of
  • Abnormal behaviour by people with diabetes (talking incoherently, seeming confused, etc.) is indicative of low sugar and immediate treatment is necessary. If left untreated, it may lead to a hypoglycemic coma.
  • Unusual sweating or pain in the back or neck with breathlessness should not be ignored as people with longstanding diabetes can get heart attack without chest pain. Hence, emergency help from the health care team is recommended.
  • Passing urine more frequently than usual with a burning sensation in the private parts indicates that the sugar levels are high. This could result in a urinary tract infection and hence medical attention should be sought.
  • Colour changes in the legs with mild temperature indicate cellulitis. If people with poorly controlled diabetes scratch their leg unknowingly, there is a chance of getting a skin infection called cellulitis.
  • Unusual weakness in the upper and lower limbs on one side of the body followed by recovery within a short time indicates a mild stroke and what has occurred is called a transient ischemic attack (TIA). In such cases, there is a chance of a future stroke risk, which can be prevented if immediate medical attention is given.

A study has revealed that in India, people with comorbid conditions like diabetes, hypertension, heart problems, etc. are at an increased risk of succumbing to coronavirus. Deaths are maximum in people above 60 years of age, but irrespective of age, people who have other health conditions, need to be on guard against coronavirus.