1、 Daily nursing precautions
1. Develop good living habits: have a regular lifestyle, moderate diet, and moderate work and rest. 2. Quitting smoking: Compared with non-smoking diabetes patients, smoking diabetes patients have a significantly increased risk of major vascular diseases such as atherosclerosis, stroke, myocardial infarction, lower limb vasculitis and foot necrosis. 3. Abstinence: Alcohol will aggravate diabetes or cause hypoglycemia and cover up hypoglycemia symptoms, which will increase blood triglyceride and lactic acid levels. 4. Control fat intake: diabetes patients often have hyperlipidemia, which promotes the occurrence and development of macrovascular complications. 5. Moderate exercise: Take a walk for at least 30 minutes each morning, afternoon, and evening. Other fitness activities can also be carried out depending on the conditions. 6. Emotional stability: Don't rush or get angry when faced with things, maintain emotional stability. Great joy and anger can raise blood sugar. 7. Regular follow-up: At least once a month. Regularly measure urine sugar, and it is better to self test blood sugar if possible. In special circumstances such as fever, diarrhea, or general discomfort, seek medical attention promptly. Regularly measure blood pressure and maintain it at a normal level. Hypertension can accelerate the occurrence and development of complications of diabetes. 8. At least one comprehensive examination should be conducted annually, including visual acuity testing, fundus examination, 24-hour urine protein testing, and neurological examination.
2、 Nursing of exercise therapy
1. Require patients to adhere to long-term and regular physical exercise. 2. The form of exercise adopted should be aerobic activities such as walking, cycling, aerobics, and household chores. 3. Effects and prevention: 1) Common side effects include hypoglycemia, hyperglycemia, ketosis, cardiovascular accidents, and sports system injuries. The occurrence of side effects is mainly related to activity intensity, time, pre activity meal time, food types, pre activity blood glucose levels, and medication use. 2) Prevention of side effects: Type 1 diabetes patients should supplement with small amounts of extra food or reduce insulin intake before activities. The activity level should not be too high, and the duration should not be too long, preferably 15-30 minutes. In addition, to avoid injury during activities, attention should be paid to the environment during the activity. It is better to carry sweet Dim sum and illness cards with you during the activity in case of urgent need.
3、 Medication care
1. Oral hypoglycemic medication care: 1) Educate patients to take medication on time and according to the dosage, and not to increase or decrease it arbitrarily.
2) Observe the efficacy and adverse reactions of the medication. Evaluate drug efficacy by observing blood glucose, glycated hemoglobin, and other parameters. Oral sulfonylurea drugs should be observed for hypoglycemic reactions. 2. Nursing of insulin therapy: Adverse reactions of insulin therapy include hypoglycemia, insulin allergy, and subcutaneous fat atrophy or hyperplasia at the injection site. Hypoglycemia is more common in type 1 diabetes patients. When hypoglycemia occurs, patients may experience dizziness, palpitations, excessive sweating, hunger, and even coma. Once it occurs, blood sugar should be tested in a timely manner, and sugar rich foods should be consumed or 50% glucose should be intravenously administered according to the condition. The main manifestations of insulin allergy are local itching and urticaria at the injection site. To avoid insulin malabsorption caused by changes in subcutaneous fat at the injection site, it is necessary to change the injection site in a planned manner.
4、 Local care
1. Skin care: Encourage patients to take frequent showers, change clothes frequently, and keep their skin clean to prevent skin suppuration and infection; Guide patients to choose soft and loose clothing, avoiding the use of elastic bands and various straps. 2. Respiratory, oral and nasal care: Guide patients to maintain oral hygiene, brush their teeth before bedtime and early in the morning, and rinse their mouth after meals; Keep the respiratory tract unobstructed and avoid contact with respiratory infections such as pneumonia, colds, tuberculosis, etc. 3. Foot care. 4. Promote blood circulation in limbs: Pay attention to keeping your feet warm in winter and avoid long-term exposure to cold or humid environments; Engage in moderate exercise every day to promote blood circulation; Regularly massage the feet, starting from the toe end upwards; Actively quit smoking. 5. Keep your feet clean and avoid infection: Clean your feet with neutral soap and warm water every day. The water temperature should be close to your body temperature. Wash the gaps between your toes thoroughly, and then gently dry them with a clean, soft towel; Do not cut your nails too short, they should be level with your toes. 6. Preventing trauma: Educate patients not to walk barefoot to prevent stabbing injuries. Be cautious of burns when using electric blankets or baking lamps in winter.
5、 Complications care
1. Hypoglycemic reactions and management: Elderly people are prone to hypoglycemia, and when their blood sugar is below 2.8 mmol/L, they may experience symptoms such as hunger, palpitations, excessive sweating, and dizziness. If hypoglycemia persists for a long time or continues to decrease, there may be changes in consciousness or even coma. Once hypoglycemia occurs, it is necessary to promptly consume sugary foods or intravenously administer 20-30ml of 50% glucose. 2. Pay attention to personal hygiene and maintain overall and local cleanliness, especially in the oral cavity, skin, and perineum. 3. Diabetes foot and nursing: the key is to prevent skin damage and infection. Daily foot examination, cleaning, massage, frequent nail trimming, smooth and loose shoes and socks. If there is any damage or infection to the foot, it should be treated promptly.