Help! Overwhelmed by diabetes

classicdame, MSN, EdD · Feb 5, 2008

Diabetes is a chronic disease. Concentrate on the mental status of someone who has just learned they have a life-threatening chronic disease. Stages of grief, for instance. I have new patients who are so in denial they refuse to check blood sugars because, if it is high, they have to "do something". To them, ignorance is bliss. I have also noticed that some people have to have a big event occur before they take it seriously. This could be a retinal hemorrhage, MI, CVA - whatever. But the bottom line is not the disease but how we PERCEIVE the impact of the disease on our life.

Roseyposey · Feb 5, 2008

Hi everyone: I've been searching on my college website, but can't wrap my brain around this one. Working on case study presentation for mental status and diabetes (person is hyperglycemic). Can anyone direct me to any websites (CEU, etc....) or give me some direction on search for info. so I can look at nursing interventions, diagnostic tests, etc...I have a feeling I'm making this harder than it actually is. I know there's tons of info out there, I must just need a good swift kick in the a a$$ to get this presentation going. Thanks, in advance and all ideas are greatly appreciated!!

Need a little more information - by mental status, do you mean like an acute change in mental status related to an episode of hyperglycemia, how high is the BS? Is the person Type I or Type II?

dansingrn · Feb 5, 2008

You might want to look specifically at DKA info. When a child with type 1 DM goes into DKA, there are often mental status changes. These are related to the dehydration, electrolyte imbalances and the cerebral edema that can accompany DKA. Look closely at the case study. They probably aren't looking for the subtleties, but the bigger issues. Cerebral edema is the most dangerous sequelae of DKA in type 1.

If this is an older adult with type 2, search for mental status changes associated with hyperglycemic, hyperosmolar, nonketotic coma (HHNC). (Of course coma is a "mental status change", but look at the picture leading up to coma.)

Hope this helps.