Diabetes

Diabetes

1. Peripheral neuropathy

   • Damage in the nerves that lead from the brain and spinal cord towards the peripheries
   • Tingling, numbness, pain, burning sensation, balance impairment, slow wound healing
   • Falls risk Ax, daily inspections of the feet and skin, wound care, pressure injury care, non-slip socks, non-tight clothing/socks/shoes, DVT prophylaxis, passive and active exercises, patient education, refer to podiatrist

2. Nephropathy

   • Damage to the nephrons; Affects the kidneys ability to remove / filter waste products and excess fluid.
   • FBC, regular toileting, U/A, encourage oral fluids (appropriate to patient's condition), monitor oral food intake, monitor BP, daily weight
   • Swollen ankles, risk of fall, confusion, proteinuria, altered UO, less need for hypoglycaemic medications, haematuria

3. Retinopathy

   • Damage to the blood vessels inside the retina (back of the eye)
   • Blurred vision, vision loss, spots in field of vision, eye strain, headaches, loss of balance due to poor vision
   • Falls Ax, refer to the patient to ophthalmologist, communication strategies - verbal discussions - clear and simple, use of visual aids, keep the environment well lit and clutter free

4. Why do people get these conditions? Damage to nerves and nerve signalling, weakens the walls of small blood vessels that supply the nerves with oxygen and nutrients. Nerve damage due to toxins released in metabolism of glucose and lipids in the blood.