How to Care for the Diabetic Client

1. By
Manuel A. Gallegos RN, BSN
Personal Care Assistant Class
Spring 2014

2. The Digestive System

3. Objectives
1. Understand the role of insulin and how healthy people convert
glucose into energy in the cells
2. Define Diabetes
3. Understand the difference between Type I and Type II Diabetes
4. Know signs, symptoms, and treatment of hyperglycemia versus
hypoglycemic patients
5. Know 3 areas Caregivers can significantly help protect Diabetic
clients

4. How Our Bodies Turn Food Into Energy
 All parts of the body (muscles, brain, heart, and liver) need energy
to work: This energy comes from the food we eat
 Our bodies digest the food we eat by mixing it with fluids (acids and
enzymes) in the stomach. When the stomach digests food, the
carbohydrate (sugars and starches) in the food breaks down into
another type of sugar, called glucose
 The stomach and small intestines absorb the glucose and then release
it into the bloodstream
 Once in the bloodstream, glucose can be used immediately for
energy or stored in our bodies, to be used later
 However, our bodies need insulin in order to use or store glucose for
energy. Without insulin, glucose stays in the bloodstream, keeping
blood sugar levels high

6. Play video
 http://www.youtube.com/watch?v=jHRfDTqPzj4&feature
=related

7. How does insulin work?
 Insulin helps your body turn blood sugar (glucose) into
energy
 It also helps your body store it in your muscles, fat cells,
and liver to use later, when your body needs it
 After you eat, your blood sugar (glucose) rises
 This rise in glucose triggers your pancreas to release
insulin into the bloodstream
 Insulin travels through the blood to your body's cells

9. How does insulin work cont..?
 Insulin tells the cells to open up and let the glucose in
 Once inside, the cells convert glucose into energy or store
it to use later
 Without insulin, your body can't use or store glucose for
energy
 Instead, the glucose stays in your blood

10. How the Body Makes Insulin?
 Insulin is a hormone made by beta cells in the pancreas
 Beta cells are very sensitive to the amount of glucose in
the bloodstream
 Normally beta cells check the blood's glucose level every
few seconds and sense when they need to speed up or
slow down the amount of insulin they're making and
releasing
 When someone eats something high in carbohydrates, like
a piece of bread, the glucose level in the blood rises and
the beta cells trigger the pancreas to release more insulin
into the bloodstream

11. The pancreas produces insulin

12. Definition of Diabetes
 Diabetes mellitus (sometimes called "sugar diabetes") is a
condition that occurs when the body can't use glucose (a
type of sugar) normally
 Glucose is the main source of energy for the body's cells
 The levels of glucose in the blood are controlled by a
hormone called insulin, which is made by the pancreas
 Insulin helps glucose enter the cells

14. What is the difference between Type I and
Type II Diabetes?
 Type 1 diabetes, once known as juvenile diabetes or
insulin-dependent diabetes, is a chronic condition in
which the pancreas produces little or no insulin, a
hormone needed to allow sugar (glucose) to enter cells to
produce energy
 Type 2 diabetes, which is far more common, occurs when
the body becomes resistant to the effects of insulin or
doesn't make enough insulin

15. Insulin Resistance

16. Definition continued…. In diabetes, the pancreas does not make enough insulin
(type 1 diabetes)
 Or the body can't respond normally to the insulin that is
made (type 2 diabetes)
 This causes glucose levels in the blood to rise, leading to
symptoms such as increased urination, extreme thirst, and
unexplained weight loss

17. Difference Between Type I and Type II
Diabetes

18. Hyperglycemia Symptoms

19. Causes and Treatment of Hyperglycemic
Clients
 CAUSES: Too much food, too little insulin, illness or stress
 ONSET: Gradual, may progress to diabetic coma.
 BLOOD SUGAR: Above 200 mg/dL.
Normal range: 70-115 mg/dL
 WHAT CAN YOU DO? Test blood sugar
If over 250mg/dL for several tests, CALL YOUR DOCTOR
OR 911 ASAP

20. Cycle of Diabetic Patient

21. Symptoms of Hypoglycemia

22. Causes and Treatment of Hypoglycemia
Hypoglycemia (Low Blood Sugar)
CAUSES: Too little food, too much insulin or diabetes
medicine, or extra exercise
 ONSET: Sudden, may progress to insulin shock. BLOOD
SUGAR: Below 70 mg/dL. Normal range: 70-115 mg/dl
 WHAT CAN YOU DO? Drink a cup of orange juice or
milk or eat several hard candies
Test Blood sugar

23. #1 area Caregivers can help Diabetic clients
 PERSONAL HYGIENE :
 Bathe client regularly and thoroughly, at least once a day
 Apply talcum powder frequently to areas of the skin prone
to excessive sweating
 Bathe feet daily, dry them thoroughly and dust them with
talcum powder, or swab with alcohol
 Any infection of the skin must be treated immediately
 Make sure client sees his or her doctor regularly
 Dental hygiene must be thorough, visit your dentist
regularly, and follow the advice

24. 2nd Area Caregivers can assist diabetic
clients
AVOID INJURY :
 Small cuts, even abrasions should be dressed immediately
 Shave with utmost care
 In dressing wounds, avoid antiseptics which may burn or
irritate the skin, such as iodine, carbolic acid, phenol or
salicylic acid
 Be very careful when cutting your finger and toe nails Cut
them after a bath when soft, using a nail cutter
 Do not try to cut them very short
 The nails should be cut in line with the toes

25. 3rd area Caregivers can help protect diabetic
clients
 FOOT CARE :
 Never allow client to walk barefoot and avoid tight shoes which may cause corns
 Shoes should be broad at the tip so as not to jam the toes and new shoes should
be worn only for about half an hour at a time, preferably with cotton socks
 Do not cut corns or apply corn removers
 If the circulation of blood in your legs and feet is disturbed or impeded, the
results can be very serious, and you may even lose your feet
Things to do:
 Inspect and massage clients feet regularly and encourage regular walks to
improve circulation
 Spend a few minutes a day lying down with feet raised above the level of your
body
 Wear warm stockings in cold weather
 Do not wear socks with tight elastic bands

26. Diabetic Foot Care Tips

27. Examples of Diabetic Ulcers

28. Important thoughts for Diabetics
 Control diet and regular exercise are critical for diabetics
 Daily self monitoring in the home and at work, routine
check-ups by your doctor, will help verify your condition
 Self monitoring includes blood glucose testing and should
be performed on a regular basis
 Good diabetic control is requires accurate records of all
tests performed
 Results should be discussed with your doctor at each visit
 A well controlled diabetic feels better and lives a long,
healthy, and productive life

29. Summary
1. Insulin responds to increases in glucose in the blood stream
and helps the body’s cells use glucose for energy
2. Diabetes is defined as a condition that occurs when the body
can't use glucose (a type of sugar) normally
3. Type I Diabetes is a condition where the body does not
produce any insulin and in Type II Diabetes the cells become
resistant to insulin or the pancreas does not produce insulin
4. Hyperglycemia may cause extreme thirst, frequent urination,
blurred vision, and nausea
5. Hypoglycemia may cause shaking, sweating, anxiousness,
and weakness
6. Diabetic foot ulcers are very dangerous
7. Caregivers should help clients with personal hygiene,
avoiding injuries, and thorough foot care

30. References
 http://kulsummehmood.hubpages.com/hub/controldiabetes
 http://www.mayoclinic.com/health/type-1-diabetes/DS00329
 http://care.diabetesjournals.org/content/27/suppl_1/s5.full
 http://kidshealth.org/parent/diabetes_center/words_know/diabetes_mellitus.html
 http://www.ghc.org/healthAndWellness/index.jhtml?item=/common/healthAndWellness/condit
ions/diabetes/foodProcess.html
 http://www.ghc.org/popup.jhtml?item=/common/healthAndWellness/conditions/diabetes/insuli
nProcess.html