Case Analysis of Diabetes Mellitus

Castro, Jeanne Joelle S.
BSN 4Y1-2 (Group 2B)
Case Analysis of Diabetes Mellitus
Background:
Diabetes is a disease that occurs when the blood glucose, also called blood sugar, is too
high. Blood glucose is the main source of energy and comes from the food the person eats.
Insulin, a hormone made by the pancreas, helps glucose from food get into the cells to be used
for energy. Sometimes the body doesn’t make enough insulin or doesn’t use insulin well.
Glucose then stays in the blood and doesn’t reach the cells.
Over time, having too much glucose in the blood can cause health problems. Although
diabetes has no cure, a person having this can take steps to manage the disease and stay
healthy.
Types of Diabetes
1. Type 1 Diabetes (Insulin Dependent)
- If a client has type 1 diabetes, the body does not make insulin. The immune system
attacks and destroys the cells in the pancreas that make insulin. Type 1 diabetes is
usually diagnosed in children and young adults, although it can appear at any age.
People with type 1 diabetes need to take insulin every day to stay alive.
2. Type 2 Diabetes
- If a client has type 2 diabetes, the body does not make or use insulin well. It can develop
type 2 diabetes at any age, even during childhood. However, this type of diabetes occurs
most often in middle-aged and older people. Type 2 is the most common type of
diabetes.
3. Gestational Diabetes
- Gestational diabetes develops in some women when they are pregnant. Most of the
time, this type of diabetes goes away after the baby is born. However, if a woman had
gestational diabetes, she can have a greater chance of developing type 2 diabetes later
in life. Sometimes diabetes diagnosed during pregnancy is actually type 2 diabetes.
Other types of Diabetes Mellitus:
- Less common types include Monogenic Diabetes, which is an inherited form of Diabetes,
and Cystic Fibrosis-related Diabetes.
Epidemiology:
As of 2015, 30.3 million people in the United States, or 9.4 percent of the population, had
diabetes. More than 1 in 4 of them didn’t know they had the disease. Diabetes affects 1 in 4
people over the age of 65. About 90-95 percent of cases in adults are type 2 diabetes.
Risk Factors:
● Age: mostly 45 and above (but it can also occur in children)

● Family history of Diabetes
● Overweight/ Obesity
● Physical inactivity
● Hypertension
Complications:
● Heart disease
● Stroke
● Kidney disease
● Eye problems (ex. Diabetic Retinopathy)
● Dental disease
● Nerve damage
● Diabetic Foot problems (Delayed wound healing)
Signs and Symptoms:
● Frequent urination
● Excessive thirst
● Unexplained weight loss
● Extreme hunger
● Sudden vision changes
● Tingling or numbness in the hands or feet
● Feeling very tired much of the time
● Very dry skin
● Sores that are slow to heal
● More infections than usual
Diagnostics:
● Fasting Blood Sugar Test

● Random Glucose Test
● A1c Test (Glycated Hemoglobin Test)
● Oral Glucose Tolerance Test
● Fingerstick Glucose Test
● Urine Dipstick Test
● Lipid Profile
Medical Management:
● Insulin Therapy- Insulin therapy is an essential part of the treatment of diabetes in

children; the dosage of insulin is adjusted according to blood glucose levels so that the
levels are maintained near normal; many children are prescribed with an insulin regimen
given at two times during the day: one before breakfast and the second before the
evening meal.
● Diet- Current dietary management of diabetes emphasizes a healthy, balanced diet that
is high in carbohydrates and fiber and low in fat.
● Activity- Type 1 diabetes mellitus requires no restrictions on activity; exercise has real
benefits for a child with diabetes; current guidelines are increasingly sophisticated and
allow children to compete at the highest levels in sports.
● Continuous Glucose Monitoring- The American Diabetes Association’s Standards of

Medical Care in Diabetes recommend consideration of continuous glucose monitoring for
children and adolescents with type 1 diabetes, whether they are using injections or
continuous subcutaneous insulin infusion, to aid in glycemic control.
Nursing Interventions:
● Ensure adequate and appropriate nutrition. The child with diabetes needs a sound
nutritional program that provides adequate nutrition for normal growth while it maintains
the blood glucose at near normal levels; the food plan should be well balanced with
foods that take into consideration the child’s food preferences, cultural customs, and
lifestyle; if a particular meal is going to be late, the child should have a complex
carbohydrate and protein snack.
● Prevent skin breakdown. Teach the caregiver and child to inspect the skin daily and
promptly treat even small breaks in the skin; encourage daily bathing; teach the child
and caregiver to dry the skin well after bathing, and give careful attention to any area
where skin touches skin, such as the groin, axilla, or other skin folds; emphasize good
foot care.
● Prevent skin infection. Diabetic children may be more susceptible to urinary tract and
upper respiratory infections; teach the child and caregiver to be alert for signs of urinary
tract infection; instruct them to report signs of urinary tract or upper respiratory tract
infections to the care provider; insulin should never be skipped during illness; fluids need
to be increased.
● Regulate glucose levels. The child’s blood glucose levels must be monitored to
maintain it within normal limits; determine the blood glucose level at least twice a day,
before breakfast and before the evening meal; offer encouragement and support, helping
the child to express fears and acknowledging that the fingerstick does hurt and it is
acceptable to dislike it.
● Provide child and family teaching in the management of hypoglycemia and

hyperglycemia. If the blood glucose is higher than 240mg/dl, the urine may be tested
for ketones; be aware of the most likely times for an increase or decrease in the blood
glucose level in relation to the insulin the child is receiving; and teach the child and
family to recognize the signs of both hypoglycemia and hyperglycemia.

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Castro, Jeanne Joelle S.

BSN 4Y1-2 (Group 2B)

Case Analysis of Diabetes Mellitus

1. Type 1 Diabetes (Insulin Dependent)

● Age: mostly 45 and above (but it can also occur in children)

Signs and Symptoms:

● Fasting Blood Sugar Test

● Insulin Therapy- Insulin therapy is an essential part of the treatment of diabetes in

● Continuous Glucose Monitoring- The American Diabetes Association’s Standards of

● Provide child and family teaching in the management of hypoglycemia and

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