Understanding and Managing Type 2 Diabetes

Transcription

1 VEA Bringing Learning to Life Program Support Notes Understanding and Managing Type 2 Diabetes Professional Development 32mins Teacher Notes by Anne Hill, Nurse Educator Produced by VEA Pty Ltd Commissioning Editor Simon Garner B.Ed. Executive Producer Mark McAuliffe Dip.Art (Film & TV) Dip.Ed. B.Ed. Ph.D. Suitable for: Aged Care Training To order or inquire please contact VEA: Address 10 Mitchell Place, Suite 103 White Plains, NY PH: Fax: vea@veavideo.com Website

2 For Teachers: Introduction Diabetes is Australia s fastest growing chronic disease. At present, there are over 3 million people in Australia with diabetes. Up to 90% of these have Type 2 Diabetes, a predominantly lifestyle and agingrelated disease. While there is great concern about increasing numbers of young people acquiring Type 2 Diabetes, its prevalence remains high among older people. Workers in aged care are highly likely to encounter residents and other people in their care who have Diabetes. Understanding the condition and how it must be dealt with is critical for workers in residential aged care. Program Timeline 00:00:00 Introduction 00:01:01 Chapter 1 Diabetes Definitions, types, characteristics and symptoms 00:04:46 Summary Diabetes Definitions, types, characteristics and symptoms 00:05:40 Chapter 2 Monitoring blood glucose levels 00:09:50 Summary Monitoring blood glucose levels 00:10:39 Chapter 3 Obtaining a blood glucose level reading 00:13:04 Summary Obtaining a blood glucose level reading 00:13:40 Chapter 4 Managing blood glucose levels with diet 00:17:26 Summary Managing blood glucose levels with diet 00:18:08 Chapter 5 Managing blood glucose levels with medications 00:26:06 Summary Managing blood glucose levels with medications 00:26:51 Chapter 6 Recognition and management of adverse effects 00:29:50 Summary Recognition and management of adverse effects 00:30:43 Conclusion 00:31:08 Credits Other Relevant Programs available from VEA Communicating with Aged Care Residents Effective Wound Management Communicating with Colleagues Eliminating Bullying and Harassement from the Aged Care Workplace Protecting the Vulnerable - Identifying and Reporting Elder Abuse Please visit our website for more relevant programs VEA Bringing learning to life - 2 -

3 Student Worksheet: While Viewing the Program 1. There are two types of Diabetes. Type 1 & Type 2. Describe the difference between these types. 2. Which type is more prevalent in the aged community? 3. List six common signs and symptoms of Diabetes. 4. What are the common triggers for type 2 Diabetes? 5. What is meant by the term DKA? 6. List the signs and symptoms of DKA - 3 -

4 7. What is the suggested treatment for extreme hypoglycaemia? 8. In the case where a patient s meal is more than 20 minutes away what is suggested that they be given? 9. What triggers the release of insulin into the bloodstream? 10. Describe the action of insulin in the bloodstream. 11. Complete the sentences: a) In type 1 Diabetes the body s cells are of insulin. b) In type 2 Diabetes the body s cells are to insulin. 12. Describe the action of the pancreas in response to elevated blood glucose levels 13. What steps are required to obtain an accurate BGL? List all 13 steps - 4 -

5 14. Complete these sentences a) The symptoms of diabetes 1 are controlled by b) The symptoms of diabetes 2 are controlled by and 15. Why can t insulin be ingested orally? 16. Why does the body need glucose? 17. Fill in the gaps. In Diabetes type 1, the cells of the pancreas are exhausted of 18. What is a glucometer used for? 19. List the normal ranges of BGL in the healthy non diabetic person 20. How often should BGL be obtained in the healthy pre diagnosed type 2 diabetic patient? 21. When would elevated blood glucose levels prompt you to notify the medical officer? 22. When obtaining a sample of blood from the finger for monitoring, what area of the finger should be lanced? 23. What is the most common administration device used for delivery of insulin in the aged care setting? - 5 -

6 24. What are the preferred administration sites for delivery of insulin? 25. What does the term GI refer to in relation to food? 26. List a low GI food type 27. Explain the actions of Low GI foods 28. What are the different types of insulin available for injection? 29. When delivering Insulin via injectable pen or with syringe and needle (needle length 1.5cm), what angle should the needle be inserted into the tissue? 30. When delivering Insulin via syringe and needle (needle length 2.5cm) what angle should the need be inserted into the tissue? 31. Should the insulin pen be shaken or inverted x 10 prior to administering the insulin? 32. Draw and label the food triangle from foods to be most consumed to foods to be most limited by the resident with Diabetes

7 Suggested Student Responses 1. There are two types of Diabetes. Type 1 & Type 2. Describe the difference between these types. Type 1 Diabetes is insulin dependent, and Type 2 is non insulin dependent. 2. Which type is more prevalent in the aged community? Type 2 is more prevalent. 3. List six common signs and symptoms of Diabetes. They include frequent urination, increased thirst, blurred vision, poor wound healing, weariness, unexplained weight gain or loss, loss of sensation to feet, increased BGL. 4. What are the common triggers for type 2 diabetes? Age, poor diet, sedentary life style, obesity 5. What is meant by the term DKA? Diabetic Ketoacidosis 6. List the signs and symptoms of DKA Acetone smelling breath, sweating, confusion, blurred vision, tremors, agitation, confusion, coma. 7. What is the suggested treatment for extreme hypoglycaemia? Administer orange juice, jelly beans 8. In the case where a patient s meal is more than 20 minutes away what is suggested that they be given? A sandwich 9. What triggers the release of insulin into the bloodstream? Raised blood glucose levels trigger the release of insulin into the bloodstream. 10. Describe the action of insulin in the bloodstream. Insulin causes glucose to enter body s cells in order to be used as energy. 11. Complete the sentences: a. In type 1 Diabetes the body s cells are depleted of insulin. b. In type 2 Diabetes the body s cells are resistant to insulin. 12. Describe the action of the pancreas in response to elevated blood glucose levels The pancreas produces increasing amounts of insulin until its capacity is exhausted 13. What steps are required to obtain an accurate BGL. List all 13 steps 1. Explain procedure to patient 2. Gather equipment needed 3. Select one of the patient s fingers for the blood sample 4. Put on disposable gloves 5. Ask resident to wash and dry their hands 6. Insert strip into glucometer 7. Pierce the finger with the lancet 8. Discard the used lancet 9. Squeeze the finger 10. Hold test strip over the drop of blood 11. Note blood glucose level on the screen 12. Wipe excess blood from the finger 13. Document the reading - 7 -

8 14. Complete these sentences a. The symptoms of diabetes 1 are controlled by insulin injections. b. The symptoms of diabetes 2 are controlled by diet and oral medications. 15. Why can t insulin be ingested orally? Insulin is a protein and therefore would be digested in the gut. 16. Why does the body need glucose? The body needs glucose for energy. 17. Fill in the gaps. In Diabetes type 1, the beta cells of the pancreas are exhausted of insulin 18. What is a glucometer used for? A glucometer is used to measure the level of glucose in the blood. 19. List the normal ranges of BGL in the healthy non diabetic person The non-diabetic range of blood glucose levels is ideally between 3 and 6 mmol/l before meals, and up to 8 mmol/l after meals. 20. How often should BGL be obtained in the healthy pre diagnosed type 2 diabetic patient? Twice daily 21. When would elevated blood glucose levels prompt you to notify the medical officer? When they are 17mmol/l or greater for more than 12 hours. 22. When obtaining a sample of blood from the finger for monitoring, what area of the finger should be lanced? The side of the pad is the area that should be lanced when obtaining a blood sample. 23. What is the most common administration device used for delivery of insulin in the aged care setting? A cartridge filled insulin pen is the most common device used. 24. What are the preferred administration sites for delivery of insulin? The abdomen and the thigh. 25. What does the term GI refer to in relation to food? Glycaemic Index 26. List a low GI food type Whole grain bread is a type of low GI food. 27. Explain the actions of Low GI foods Low GI foods are digested and absorbed slowly, causing slow sustained release at lower levels. 28. What are the different types of insulin available for injection? The types of insulin injections available are long acting, intermediate acting and rapid acting. 29. When delivering Insulin via injectable Pen or with syringe and needle (needle length 1.5cm), what angle should the needle be inserted into the tissue? The needle should be vertical, or perpendicular to the finger. 30. When delivering Insulin via syringe and needle (needle length 2.5cm) what angle should the need be inserted into the tissue? The needle should be at a 45 degree angle

9 31. Should the insulin pen be shaken or inverted x 10 prior to administering the insulin? The insulin pen should be inverted x