Opinions please on diabetes project presentation

Esme12, ASN, BSN, RN · Jul 17, 2012

I would switch 9 and 2. 8 and 3. Go over diabeties and how it affects the family/patient and how proper teaching/education will improve the prognosis and compliance. Then get into the how to's....:)

Kaysmom8 · Jul 17, 2012

Do you think that the types of insulin should be taught along with the units to be administered for #2? I think that #6 should only be the administration sites and complications of not rotating injections? and would you cut out the importance of exercising for #8?

Thank you for your advice, because I'm almost in tears because I have #6 and I don't understand how to teach the units because I can't find the standard method on how to figure out units to administer, I was told the doctor determines the daily units and there are a few ways that diabetics can use to figure out what method works best for them. Do you know what method a type 1 most commonly uses to figure out their units to give and I would really appreciate it if someone could break this down for me.

JustBeachyNurse, LPN · Jul 17, 2012

Just like a carbohydrate to insulin ration, dosing of insulin is individualized as per patient needs, with the exception of DKA treatment (which would be done in an inpatient hospital setting not home/community environment)

i'd keep 2, 3, & 6 together, perhaps include about insulin pumps.

You can also check out the American Diabetes Association website they have some awesome patient education materials Here's their page for type 1: Type 1 - American Diabetes Association

Since most of the time a type one is diagnosed in childhood/teens this would be a patient and family education session. Perhaps also include information about the American Diabetes Association, the local hospital Certified Diabetes Educator, Registered Dieticians, etc. and also family support. Most pediatric hospitals have support groups for kids & families affected by type 1 diabetes.

Good luck!

VickyRN, MSN, DNP, RN · Jul 18, 2012

The attached Basic Carbohydrate Counting Document may be of help to you with your project :)

Basic Carbohydrate Counting.pdf

Double-Helix, BSN, RN · Jul 18, 2012

1. what diabetes is

2. types of insulin

3. tools for insulin administration

I'm not sure you need this as a separate topic. The tools for insulin administration, I'm assuming, are the vial of insulin, a syringe and a needle. This can easily be covered under the insulin administration section. What else were you thinking would be included here?

4. glucometer and hyper/hypoglycemia

I think it might make more sense to change the title of #3 to "diabetic testing equipment." Include how to use the glucometer, lancets, and test strips. You can also include syringes and needles and how to draw up insulin in this section. Include hyper/hypo glycemia with section 1.

5. insulin administration steps/how to administer

6. location and units to administer

In Type 1 diabetes, most insulin doses are calculated based on a target blood sugar, correction factor, and carbohydrate count. The doctor's order will read something like this:

"Give one unit of Novalog for every 25 (correction factor) points above 120 (target blood sugar)." "Give one unit of Novalog for every 15 grams of carbohydrates eaten."

Immediately before a meal, the blood sugar is checked. Let's say that it's 220. Using the order from above: "Give one unit of Novalog for every 25 points above 120." The blood sugar is 220. 220-120 = 100. 100 / 25 = 4. The patient gets 4 units of Novalog to correct the current blood glucose. Then factor in the carbohydrates. "Give one unit of Novalog for every 15 grams of carbohydrates eaten." The patient plans on eating a meal that contains 60 grams of carbohydrates. 60 / 15 = 4. The patient gets 4 more units of Novalog for the carbohydrate coverage, for a total of 8 units.

7. time of day

I also don't think this needs to be separate. It can be included with # 6. Since you will be administering insulin (except lantus) with meals, it's not really important to have specific times, although meals should preferably be eaten within the same 1-2 hour window each day. If you decide to leave this separate, I think it makes more sense to put it before step 5. Teach when they will be testing blood glucose and when they will be giving insulin. Then teach how to give it.

8. importance of when to exercise

Exercise is important because it helps bring glucose into the cells. But the specific timing of the exercise is much less important. I would get rid of this section or make "exercise" it's own topic. Include how exercise affects blood sugar, what to eat before exercise, when to check blood sugar, etc.

9. psychological/psychosocial aspects

This is a huge education/awareness piece. Type 1 diabetes is a life long struggle and a huge lifestyle adjustment. It is very, very difficult for both children and their caregivers. Non-compliance, especially among the teenage population, can lead to very dangerous onset of diabetic ketoacidosis. It's super important that children and families get the support that they need to better manage this diagnosis.

A huge portion of teaching that I think you're missing is diet modification. Specifically- what are carbohydrates? How do you know how many grams of carbs are in a food? Go over how to read a nutrition label- serving sizes, carbohydrates and sugars. Talk about the importance of whole grain, high fiber carbs vs refined carbs (how are they broken down differently? Which will raise the blood sugar more? How often should you have snacks? What happens if you go too long without eating carbohydrates? Provide sample meal plans. Diet is vital in managing diabetes correctly. Teaching this is of much more value than teaching about exercise.

Esme12, ASN, BSN, RN · Jul 18, 2012

1.) 1. what diabetes is

2.) 9. psychological/psychosocial aspects 8. importance of when to exercise

3.) DIET!!

4.) 4. glucometer hyper/hypoglycemia what to look for and treatment.

5.) 2. types of insulin 7. time of day3. tools for insulin administration

6.) 5. insulin administration steps/how to administer and 6. location and units to administer

Maybe more like this. You have gotten excellent advice.