DIABETES

Diabetic Complications

Diabetic Complications

Introduction

Diabetes mellitus is a chronic illness that requires constant medical care and educational activities of the patient. The latter, serves for self-management of the disease so that it can prevent acute complications and at the same time can reduce the risk of long-term complications. At the base of diabetes is the alteration of the control of blood glucose , one of many homeostatic control mechanisms in our bodies and that make possible life. Proper control of blood glucose by the body allows for regular supply of primary fuel, glucose, to the central nervous system (Banks, 2006 ).

The diabetes , its complications, is currently one of the major health problems of the economically developed countries and at the same time, one of the first items of health care spending. Among the main reasons for the growth of the spread of this disease are the ' improper diet and lack of exercise. It is good to specify that there are different types of diabetes, which differ on the cause (Banks, 2006 ).

Patient's Details and Medical History

For this prior case study, Mr. A has been taken as a sample case who has been diagnosed with diabetes mellitus. He is 65 years old and lives in a county of United Kingdom. In order to carry out this study, proper consent has been obtained from Mr. A and he has been assured for keeping all his details confidential. Currently, he is facing some complications because of his disease. Having assessed the case of Mr. A, some nursing diagnosis has been derived relating his condition. Now, there is a need to prioritise those nursing diagnoses and provide rationale for that with supportive evidence. According to Column, prioritising care is an essential nursing skill and it is differentiating between problems needing immediate attention and those requiring subsequent action requires great skill and judgment. Mr. A has been diagnosed with diabetes mellitus. He never had any surgery. He is a Black American. He has an increased production of hepatic glucose, particularly at improper time periods.

Aetiology and Pathogenesis

As Mr. A belongs to Black Americans' group, he has insufficient initiatives for healthcare. Being diagnosed having diabetes, his frequency of retinopathy has been increased from 50% and could be 75% or more after 20 years. A key factor in the development of diabetic retinopathy is an insulin deficiency, which causes the accumulation of sorbitol and fructose, thereby increasing the osmotic pressure, intracellular oedema, thickening of the capillary endothelium and narrowing of their lumen. Increased protein in the plasma increases the aggregation of blood and inhibits fibrinolysis, causing microthrombogenesis, loss of pericytes and endothelial cells in the retinal capillaries, which violates the vascular permeability and lead to oedema of the intercellular tissue of the retina. Violation of perfusion in parafoveal vessels provides for the development of exudative maculopathy. Progressive obliteration of retinal capillaries causes retinal ischemia, accompanied by the elaboration of a development of neo-vascularisation as early proliferative changes in the ...