Patients newly diagnosed with type 2 diabetes mellitus have a lot to learn, and you and your colleagues need to ensure that patient teaching is based on current research. Above all, patients must learn that controlling their condition requires a day-by-day commitment.
Because obesity is the most significant risk factor related to type 2 diabetes, teach patients and their families how to manage their diet control and obtain regular exercise. Also teach them how to administer prescribed medications, regularly monitor blood glucose levels, and recognize signs and symptoms of complications. To help you help your patient, follow these evidence-based guidelines:
- Obtain a complete health history, including current medications, vaccination status, and substance use.
- Evaluate the patient’s nutritional status and eating patterns.
- Assess for early signs and symptoms of complications: changes in vision, mental status, urinary habits, and sexual activity; decreased peripheral sensation and perfusion; and dysrhythmias.
- Obtain vital signs, height, weight, and waist circumference.
- Check for infections, especially skin, dental, genitourinary, and foot infections.
- Monitor the results of laboratory tests, especially for plasma glucose, serum electrolytes, and urine chemistry.
- Determine the patient’s knowledge of diabetes and readiness to learn.
Planning and Implementation
- Consult a diabetes educator on admission.
- Develop a plan of care—including medications, meal plan, exercise regimen, and blood glucose testing—with the multidisciplinary team.
- Review the treatment plan with the patient.
- Teach the patient how to self-monitor blood glucose levels, recognize the signs and symptoms of hypoglycemia, and treat it.
- Advise the patient to monitor fat and carbohydrate intake and participate in physical activity.
- Teach the patient about prescribed medications, including antidiabetic and anti-obesity medications.
- Monitor intake and output. Weigh the patient daily.
- Monitor the patient for signs and symptoms of hypoglycemia.
- Treat hypoglycemia and recheck the blood glucose level in 15 minutes.
- Demonstrate an understanding of all self-care practices and ability to correctly perform blood glucose monitoring.
- Be able to state the signs and symptoms of complications.
- Have contact information for available support resources.
- Verbalize post-discharge follow-up instructions.
For more information, see Evidence-Based Nursing Monographs: Type 2 Diabetes Mellitus from Mosby’s Nursing Consult.