Decoding Diabetes Complications: Risks, DKA, and Treatment Strategies

by | Friday, June 30, 2023

Introduction:

Hey Friends 👋🏼

As a Nurse, it’s crucial to understand the potential complications that can arise from diabetes and how to manage them effectively. This knowledge is vital for nurses, as we play a vital role in patient education and managing these complications (Diabetes Australia, 2020).

While diabetes can be managed with proper care, uncontrolled blood sugar levels can lead to various complications, including the life-threatening condition called diabetic ketoacidosis (DKA) (Mayo Clinic, 2021).

In this blog post, we will delve into the risks associated with diabetes, explore DKA as a serious complication, and discuss the available treatment options.

This blog post is a continuation of our series on diabetes. You can read the previous post, “Understanding Diabetes: A Quick Nurses Guide to Diabetes in Australia,” HERE.

Understanding The Risks: Why People With Diabetes Are Vulnerable

Diabetes can increase the risk of various health complications due to the impact of consistently high blood sugar levels on the body (Diabetes Australia, 2020).

These complications can affect multiple organ systems, including the eyes, kidneys, nerves, heart, and blood vessels (Australian Institute of Health and Welfare, 2020).

Some of the major risk factors include:

  1. Poorly controlled blood sugar levels: Consistently high blood sugar can damage blood vessels and nerves, leading to various complications (Diabetes Australia, 2020).
  2. High blood pressure: This can further exacerbate the damage caused by diabetes on blood vessels and organs (Australian Institute of Health and Welfare, 2020).
  3. High cholesterol: Elevated cholesterol levels can contribute to the development of atherosclerosis, which increases the risk of heart disease and stroke (Australian Institute of Health and Welfare, 2020).
  4. Smoking: Smoking can worsen the effects of diabetes on the blood vessels, increasing the risk of complications (Australian Institute of Health and Welfare, 2020).

A Closer Look At Diabetic Ketoacidosis (DKA)

Diabetic ketoacidosis (DKA) is a severe complication of diabetes that occurs when blood sugar levels are consistently high (Mayo Clinic, 2021).

While it is more common in people with type 1 diabetes, it can also occur in those with type 2 diabetes.

DKA is a medical emergency that can lead to coma or even death if left untreated (Mayo Clinic, 2021).

When the body cannot use glucose for energy due to a lack of insulin, it starts to break down fat for fuel.

This process produces ketones, acidic byproducts that can build up in the blood, leading to ketoacidosis (Mayo Clinic, 2021).

Symptoms of DKA include excessive thirst, frequent urination, nausea, vomiting, abdominal pain, rapid breathing, and confusion (Mayo Clinic, 2021).

Treatment Strategies For DKA:

  1. Hospitalisation: DKA is a medical emergency that typically requires hospitalisation for close monitoring and treatment (Mayo Clinic, 2021).
  2. Insulin administration: Insulin is administered to lower blood sugar levels and suppress the production of ketones (American Diabetes Association, 2021).
  3. Fluid replacement: Intravenous fluids are given to replenish fluids lost through frequent urination and to help dilute the excess sugar in the blood (American Diabetes Association, 2021).
  4. Electrolyte replacement: Electrolytes, such as potassium, sodium, and chloride, are essential for proper nerve and muscle function. They may be administered intravenously to correct imbalances caused by DKA (American Diabetes Association, 2021).
  5. Monitoring: Continuous monitoring of blood sugar and ketone levels is crucial for adjusting treatment as needed (American Diabetes Association, 2021).

Conclusion:

As a nurse, understanding the risks and complications associated with diabetes, such as DKA, is essential for providing comprehensive patient care (Royal Australian College of General Practitioners, 2020). By being aware of the warning signs and the necessary treatment strategies, you can help patients manage their diabetes effectively and prevent the onset of life-threatening complications (Diabetes Australia, 2020).

Ongoing education on diabetes and its complications is vital for staying informed and providing optimal care to your patients (Royal Australian College of General Practitioners, 2020).

I encourage you to continue learning about diabetes and its complications and to apply this knowledge in your practice.

Stay tuned for our upcoming blog posts in this series, where we will delve deeper into managing diabetes and its complications.

References:

American Diabetes Association. (2021). Standards of Medical Care in Diabetes—2021. Diabetes Care, 44(Supplement 1), S1-S232. https://doi.org/10.2337/dc21-Sint

Australian Institute of Health and Welfare. (2020). Diabetes. Retrieved from https://www.aihw.gov.au/reports/diabetes/diabetes

Diabetes Australia. (2020). Diabetes complications. Retrieved from https://www.diabetesaustralia.com.au/about-diabetes/diabetes-complications/

Mayo Clinic. (2021). Diabetic ketoacidosis. Retrieved from https://www.mayoclinic.org/diseases-conditions/diabetic-ketoacidosis/symptoms-causes/syc-20371551

Royal Australian College of General Practitioners. (2020). General practice management of type 2 diabetes. Retrieved from https://www.racgp.org.au/clinical-resources/clinical-guidelines/key-racgp-guidelines/view-all-racgp-guidelines/management-of-type-2-diabetes

Understanding Diabetes: A Quick Nurses Guide to Diabetes in Australia, Type 1 and Type 2 Differences and Management Strategies

by | Saturday, April 8, 2023

Nurses encounter diabetes frequently in their clinical and non-clinical nursing. Still, patients don’t always fully understand the condition, and nurses need different levels of diabetes knowledge depending on whether they work in a clinical or non-clinical area. As a nurse, you are crucial to managing and educating patients about their health conditions. In this blog, we will explore the basics of diabetes, including the differences between type 1 and type 2, and highlight how important our role is as a nurse caring for patients with diabetes here in Australia.

Diabetes in Australia – The Statistics

  • Men are more likely to have diabetes than women.
  • 1 in 5 or 20% of Australians over age 80 have diabetes.
  • Type 2 diabetes accounts for 85-90% of all diabetes cases, with type one accounting for up to 10%.
  • In more than 60% of cases, type 2 diabetes can be prevented with education and lifestyle modifications such as diet improvement, regular exercise, and sleep hygiene.

(Australian Institute of Health and Welfare., 2023)

Understanding Diabetes: The Basics

Diabetes is a long-term metabolic disorder that makes it hard for the body to control the amount of glucose (sugar) in the blood. Glucose gives our cells and organs the energy they need to work, and it is controlled mainly by the hormone insulin, made by the pancreas. In people with diabetes, there is either a lack of insulin production or the body becomes resistant to insulin, leading to elevated blood sugar levels.

Types of Diabetes: Type 1 and Type 2

Type 1 Diabetes: An Autoimmune Battle

Type 1 diabetes, also called “juvenile” diabetes or insulin-dependent diabetes, happens when the body’s immune system attacks and kills the beta cells in the pancreas that make insulin by accident. This autoimmune response results in little or no insulin production, causing glucose to build up in the bloodstream. Type 1 diabetes is typically diagnosed in children and young adults but can occur at any age. The exact cause of type 1 diabetes is unknown, but genetics and environmental factors may play a role (Ohiagu, Franklyn O et al., 2021).

Management of Type 1 Diabetes:

Since individuals with type 1 diabetes cannot produce their insulin, they require daily insulin injections or an insulin pump to regulate their blood sugar levels. A healthy diet and regular exercise are essential to managing type 1 diabetes. Today, sensor monitors with Bluetooth can connect to phones and wristwatches to make daily monitoring easy and continuous (Partridge et al., 2016).

The most common type of diabetes is type 2 when the body stops responding to insulin or doesn’t make enough of it. It is often linked to a bad diet, insufficient exercise, and being overweight. Even though it’s more often diagnosed in adults, type 2 diabetes is becoming more common in children and teens as obesity rates rise (Pandey et al., 2015).

Management of Type 2 Diabetes:

Type 2 diabetes is often treatable by changing your lifestyle, such as eating healthier, being more active, and losing weight if needed. Oral medications may also be prescribed to help regulate blood sugar levels. Insulin injections may be needed if oral medications and lifestyle changes are insufficient to keep blood sugar levels in check. With either approach, many medications are available today for patients to manage their diabetes. Nurses must be familiar with these and contextualise them for their clinical area (Pandey et al., 2015).

Conclusion:

As a nurse, your role in diabetes care and education is invaluable. By understanding the differences between type 1 and type 2 diabetes and their management strategies, you can provide better support and guidance to your patients, helping them lead healthier, more fulfilling lives. Remember that continuing to learn is vital to stay informed and giving the best care to people with diabetes.

Instagram Post

I created and shared a post on Instagram about diabetes almost two years ago.

CLICK HERE.

Next Up

Over the next couple of weeks, there will be additional blogs on diabetes. These will continue to explore diabetes management, including the different medications and the possible complications and implications of fasting for surgery.

Join along and Subscribe to the Monthly Dose Newsletter.

References

Australian Institute of Health and Welfare. (2023). Diabetes: Australian facts, Summary – Australian Institute of Health and Welfare. https://www.aihw.gov.au/reports/diabetes/diabetes/contents/summary

Ohiagu, Franklyn O, Chikezie, Paul C, & Chikezie, C. M. (2021). Pathophysiology of diabetes mellitus complications: Metabolic events and control. Biomedical Research and Therapy, 8(3), 4243-4257. https://doi.org/10.15419/bmrat.v8i3.663

Pandey, A., Chawla, S., & Guchhait, P. (2015). Type-2 diabetes: Current understanding and future perspectives. IUBMB Life, 67(7), 506-513. https://doi.org/10.1002/iub.1396

Partridge, H., Perkins, B., Mathieu, S., Nicholls, A., & Adeniji, K. (2016). Clinical recommendations in the management of the patient with type 1 diabetes on insulin pump therapy in the perioperative period: a primer for the anaesthetist. BJA: British Journal of Anaesthesia, 116(1), 18-26. https://doi.org/10.1093/bja/aev347