Diabetes Nursing Management | Chapter 53 – Lewis’s Medical-Surgical Nursing (12th)

Описание: Chapter 53 of Lewis’s Medical-Surgical Nursing explores diabetes mellitus (DM), a chronic multisystem disease characterized by hyperglycemia resulting from abnormal insulin production, impaired insulin utilization, or both. The chapter distinguishes between type 1 diabetes, an autoimmune β-cell destruction leading to absolute insulin deficiency, and type 2 diabetes, a progressive disorder linked to insulin resistance and inadequate secretion. Additional forms such as MODY, gestational diabetes, and prediabetes are also discussed. Pathophysiology covers normal insulin metabolism, counterregulatory hormones, and genetic and environmental risk factors. Clinical manifestations include the classic triad of polyuria, polydipsia, and polyphagia, as well as fatigue, weight changes, infections, and vision disturbances. The text reviews diagnostic criteria including A1C, fasting glucose, OGTT, and random glucose levels. Interprofessional care emphasizes patient education, self-management, and the ABCs of diabetes: controlling A1C, blood pressure, and cholesterol. Treatment includes insulin therapy (basal-bolus plans, insulin pumps, inhaled insulin), oral agents such as metformin, sulfonylureas, meglitinides, thiazolidinediones, DPP-4 inhibitors, SGLT2 inhibitors, and non-insulin injectables like GLP-1 receptor agonists and amylin analogs. Nutrition therapy, carbohydrate counting, exercise, and blood glucose monitoring are key strategies. Complications such as DKA, HHS, neuropathy, nephropathy, and retinopathy are explained alongside nursing priorities for prevention and patient teaching.



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