DIABETIC PATIENT STRATEGIC PROJECT PLAN

Diabetic Patient Strategic Project Plan



Diabetic Patient Strategic Project Plan

Introduction

In this essay we will be discussing a patient with type 2 Diabetes Mellitus and will also be discussing the nursing care that will be received by the patient following a hypoglycemic attack. The patient being described is a fictitious 45 year old lady called Mrs.Tia Gordon; she lives in a flat in a city centre with her husband Bert. Mrs.Tia has had type 2 diabetes for years which has been poorly controlled by medication and diet. Mrs.Tia's diabetes has now progressively worsened; she has been commenced on a self-managed insulin therapy plan. She is cared for by the community nursing team and her GP; she attends the regular diabetic clinic. Mrs.Tia has no other medical conditions but is currently suffering a cold. On a trip to the chemists Mrs.Tia feels unwell, clammy, trembling and confused; the chemist calls Bert and the district nurse. On her arrival the district nurse treats Mrs.Tia for a hypoglycaemic attack, to which Mrs.Tia responds, but is concerned about Mrs.Tia's high temperature, she arranges for Mrs.Tia to be admitted to hospital.

Discussion

Little of human food choice and intake on a daily basis is directly determined by the chemical composition of foods and the physiological characteristics of the individual; it is very much influenced by events occurring around and between these factors, perceptions, beliefs and responses to cues. There are global rules that operate on human eating behavior; food choice and intake reflect food availability, existing eating habits but also learning mechanisms, and individual beliefs and expectations, i.e. cognitive influences and meanings. Context largely influences food intake and diet content; it would, thus, be interesting to identify eating behaviors related to food choice in diabetic patients or to glycemic control and explore their importance and contribution. Still, data in this area are very scarce.

The adoption of new food habits is not an easily achieved goal. Diabetic patients encounter several educational, environmental, psychological and lifestyle difficulties in modifying their lives to accommodate disease management. Barriers to dietary adherence include complications with daily life (eating out, social events) and temptations, need for food planning, need for constant self-care, denial of the severity of the disease, poor understanding of diet-disease associations, misinformation, lack of appropriate social support and time constraints. Patients also encounter troubles following food exchange systems and express their need for revised dietary strategies that would incorporate appropriate education on how to make healthy food choices.

Aetiology and Pathophysiology

Diabetes Mellitus has two principle classes, type 1 and type 2; approximately 90% of people with diabetes suffer from type 2, (Burden, 2003a). Type 1 diabetes is characterised by the destruction of the Beta cells. The Islets of Langerhans within the pancreas contain two types of cells, Alpha cells and Beta cells. Alpha cells secrete glucagons and Beta cells secrete insulin hormone. Patients with type 1 diabetes do not have this insulin production often due to the destruction of the Beta ...