Types of Diabetes Mellitus Disease with Nursing Intervention

Definition of Diabetes Mellitus Disease:

Diabetes mellitus disease is commonly referred to as a group of metabolic diseases characterized by hyperglycemia resulting from insufficiency secretion of insulin, less insulin action, or both.

Types of Diabetes Mellitus Disease or Classification of  Diabetes Mellitus:

There are three major types of diabetes which are discussed below:

1. Type-1 Diabetes Mellitus Disease or Diabetes Mellitus Type 1:

Type- 1 Diabetes Mellitus is known as Insulin Dependent Diabetes Mellitus (IDDM) or Juvenile diabetes. Pancreases fail to produce enough beta cells or insulin.

2. Type-2 Diabetes Mellitus Disease or Diabetes Mellitus Type 2:

Type-2 Diabetes Mellitus is known as Non-Insulin Dependent Diabetes (NIDDM), beta cells produce insufficient Insulin.

3. Gestational Diabetes Disease:

Insufficient production of insulin during pregnancy by the mother. This diabetes recovers following pregnancy, but they are at risk for developing type -2 diabetes mellitus later in life.

Sign and Symptoms of Diabetes Mellitus Disease or Diabetes Mellitus Symptoms:

Sign and symptoms of diabetes mellitus are the following:

For Type-1 Diabetes Mellitus Disease:

• Fast onset because of no insulin-producing,
• Polyphagia ( increased appetite),
• Polydipsia ( increased thirst),
• Polyurea ( increased urination ),
• Unexplained Weight loss,
• Frequent genital infections ( Balanitis/ vaginitis),
• Delay healing process,
• Dry mouth.

For Type-2 Diabetes Mellitus Disease:

• Slow onset because of some insulin-producing,
• Polyurea,
• Polydipsia,
• Candidal infection,
• Delay healing process,
• Blurred vision,
• Lower extremities parenthesis,
• Headache,
• Extremely fatigue,
• Dehydration.

Causes of Diabetes Mellitus Disease:

There are different causes for diabetes mellitus which are in the below:

For Type-1 Diabetes Mellitus Disease:

• Type-1 diabetes mellitus is caused by the destruction of the beta cells of the pancreas and when the beta cells are destroyed, the pancreas unable to produce insulin at all.
• Viral infection of the pancreas.
• Autoimmune disease.

For Type-2 Diabetes Mellitus Disease:

• Type-2 diabetes mellitus is caused by insufficient production of insulin by the pancreas, sometimes the amount of insulin is normal but the tissue is resistant to glucose,
• Heredity,
• Obesity,
• Long time use of steroid, phenytoin, thiazide diuretics,
• Thyroid hormone dysfunction,
• Severe or recurrent pancreatitis,
• Acromegaly,
• Lack of physical activity,
• Cancer of the pancreas.

Diagnosis for Diabetes Mellitus Disease:

Various diagnosis ways for diabetes mellitus are mentioned below:

For Type-1 Diabetes Mellitus Disease:

1. Fasting blood/ plasma glucose level (FBS) more than 126mg/dl ( 7.0mmol/L)
2. 2 hours of breakfast plasma glucose level of more than 200mg/dl ( 11.1mmol/L)
3. OGTT( Oral glucose tolerance test)
4. Random plasma/ blood glucose ( RBS)

For Type-2 Diabetes Mellitus Disease:

1. Fasting blood/ plasma glucose level (FBS) more than 126mg/dl ( 7.0mmol/L),
2. 2 hours of breakfast plasma glucose level more than 200mg/dl ( 11.1mmol/L),
3. Random plasma/ blood glucose ( RBS),
4. Hba1c,
5. TSH ( thyroid-stimulating hormone test),
6. FT3 and FT4.

Treatment for Diabetes Mellitus:

There are different treatment processes for diabetes mellitus. Those are in the following:

For Type-1 Diabetes Mellitus Disease:

Treatment of type-1 involves diet and exercise.

• Dietary Management and Physical Exercise:

Dietary management and exercise are typically the first steps toward reducing blood sugar levels. Dietary carbohydrate and activity must be co-ordinated with insulin action so that-

1. Insulin is available for optimal metabolism when the food that was eaten is absorbed.
2. Food is available while insulin is acting to prevent hypoglycaemic reactions.

• Insulin therapy:

1. Rapid-acting (Aspart, Lispro, Glucolize),
2. Short-acting (Regular).

• Intsermediate acting (Neutral protamine hegadorn)

1. Long acting (Luntus, Levemir).
2. Continuous subcutaneous insulin ( CSII) –Rapid-acting insulin infused continuously 24 hours through an insulin pump, at 1 or more basal rates.

For Type-2 Diabetes Mellitus Disease:

Type-2 DM is treated first with weight reduction, a diabetic diet, and exercise. When these first measures fail to control hyperglycemia, oral medications are to be used.

The oral medications are-

1. Sulfonylureas:

which stimulates the release of insulin from pancreatic islets, reduces blood glucose. Those are chlorpropamide, glyburide, glipizide.

1. Meglitinides:

Stimulate a rapid or short-lived release of insulin from the pancreas such as repaglinide, metformin.

• Alpha-glucosidase

1. Glinides.
2. Insulin secretagogues.
3. Incretines.

• Thiazolidione
• Boguanide

Prevention for Diabetes Mellitus Disease:

There are different ways of preventing diabetes mellitus which are mentioned below:

• Maintain a better healthy lifestyle.
• Eat a healthy diet.
• Control of body weight.
• Turn off the television and computer and get more physical activity.
• Take whole grains and whole grains products over highly processed carbohydrates.
• Avoid sugary drinks and choose water, coffee, or tea instead.
• Eat good fats instead of bad fats.
• Limit red meat and choose nuts, whole grains, poultry, or fish.
• No smoking.
• Regular monitor of blood glucose.
• Taking care of body especially eye and food.
• Check feet to make sure there is no nerve damage or interruption of blood flow.
• Consult with a physician at least once a month when the age for more than 45 years.
• Monitor and control blood pressure.

Complications of Diabetes Mellitus Disease:

Various complications of diabetes mellitus are in the below:

• Hyperglycaemia,
• Hypoglycemia,
• Diabetic ketoacidosis,
• Hyper-osmolar hyperglycaemic non-kenotic syndrome (HONK syndrome),
• Cardiovascular disease,
• Cerebro-vascular disease,
• Diabetic neuropathy,
• Diabetic nephropathy male erectile dysfunction.

Nursing Intervention for Diabetes Mellitus Disease:

There are different types of nursing intervention for diabetes mellitus which are mentioned in the following:

• Monitor and control blood sugar.
• Monitor body weight daily.
• Provide a diabetic diet and determine the diet and eating patterns and compare with blood glucose.
• Collaboration with dieticians about patient diet.
• Administer medications and insulin properly.
• Collaboration examination of blood sugar with insulin therapy.
• Observe the signs of hypoglycemia such as changes in the level of consciousness; skin moist/cold, rapid pulse, hunger, sensitivity to stimuli, anxiety, and headache.
• Teach patient and family about hypoglycemia and hypoglycaemic sign symptoms.
• Observe for the signs of infection and inflammation: fever, flushed appearance, wound drainage, purulent sputum, and cloudy urine.
• Promote and teach good hand hygiene.
• Provide feet care (observe and investigate reports of hyperesthesia, pain, or sensory loss in the feet or legs) and teach how to care for feet.
• Recommended regular ophthalmologic examination.
• Investigate and check for ulcers, reddened areas, pressure points, loss of pedal pulses.
• Provide skincare: keep skin dry, gently massage bony areas.
• Keep bed sheets dry, tidy, and wrinkle-free.
• Careful wound care.
• Maintain asepsis technique during IV insertion, administering of medications, check any swelling and redness, and change IV sites as indicated.
• Provide cognitive and emotional support to the patient.
• Teach about home care and control of blood sugar.
• Monitor laboratory values: blood glucose, serum osmolality, Hb/Hct, BUN/Cr.
• Carry out the prescribed regimen for correcting DKA as indicated.
• Assist the patient to develop coping strategies and discuss with the patient the need for activity and help inactivity in daily living.
• Encourage the patient to do some exercises to control blood sugar.
• Treat hypoglycaemic reactions promptly by giving sugar, juice, hard candy, honey, or IV dextrose.
• Keep accurate records of vital signs, fluid intake, urine output, and caloric intake.
• Check sign symptoms of complication diabetic effects.
• Observe for signs of the urinary tract and vaginal infections, and monitor urinary protein and early signs of nephropathy.

More questions related to this topic:

1. Diabetes Mellitus: Types, Symptoms, Causes, Treatments.
2. Diabetes Mellitus: An Overview.
3. Diabetes Mellitus Definition.
4. What Type of Disease is Diabetes?
5. What are the Two Major Types of Diabetes Mellitus?
6. What are the Symptoms of a Diabetic Person?
7. Why Do People Get Diabetes?
8. What is Type 1 Diabetes Mellitus?
9. What is Type 2 Diabetes Mellitus?

Maria Mona

Maria Khatun Mona is a Founder and Editor of Nursing Exercise Blog. She is a Nursing and Midwifery Expert. Currently she is working as a Registered Nurse at Evercare Hospital, Dhaka, Bangladesh. She has great passion in writing different articles on Nursing and Midwifery. Mail her at “maria.mona023@gmail.com”