Diabetes Mellitus Nursing Diagnosis

Topic: Endocrinology
Words: 1443 Pages: 5

Diabetes mellitus (DM) is a metabolic disease caused by an imbalance in insulin regulation. Insulin is a hormone produced by the pancreas whose function is to signal glucose absorption by the body cells. Diabetes occurs when the body produces less insulin or cannot effectively use the insulin produced, leading to high blood glucose levels that precipitate the development of serious complications. It is prudent to study the disease because of the adverse effects on people’s health. Diabetes mellitus triggers various health problems and places a large financial strain on individuals, families, and the healthcare system. In addition, the high prevalence of the disease does not match the diagnosis rate, as many people are unaware that they have the disease (Silva et al., 2018). The lack of adequate advocacy regarding the diagnosis and health effects of the disease necessitates the need to study the disease among affected individuals and their families. In addition, there is a risk that the rising number of people with diabetes and the complexity of their care may put existing healthcare systems under strain.


Diabetes Mellitus is one of the leading causes of death in the US. In 2019, diabetes was the direct cause of 1.5 million deaths, and people aged 65 years and older account for 40% of diabetes cases (Centers for Disease Control and Prevention, 2020). There are three main types of diabetes mellitus; type-1 diabetes occurs when the body does not produce insulin, while type-2 diabetes results from the body’s ineffective use of insulin. Gestational diabetes occurs when blood sugar levels are high but below those of diagnostic diabetes due to pregnancy. Comorbidities from diabetes include increased risk of heart attacks and strokes, kidney failure, and cardiovascular disease. Diabetes mellitus is a major risk factor for cardiovascular disease (CVD), the most common cause of death among adults with the disease. Most diabetes patients have type-2 diabetes, whose risk factors include obesity and physical inactivity. Minority populations, including African Americans, Hispanics, American Indians, and Native Hawaiians, are more likely to be affected by type-2 diabetes than whites. The prevalence rate of diabetes among American Indians is the highest in the country as they are two to five times more than whites. Diabetes is a complex public health challenge due to increased complications and an increased number of undiagnosed individuals.

Deficient Knowledge

Knowledge of diabetes mellitus has been highlighted in numerous studies as a key resource for guiding and educating diabetic patients about their behaviors. Based on general knowledge and views of chronic diseases like diabetes, health promotion has long been acknowledged as an important component of any disease control and prevention approach. Ineffective health maintenance, as evidenced by high blood sugar and a lack of information about controlled diabetes, hinders a holistic healthcare approach that can effectively improve patient outcomes. Diabetes patients lack adequate knowledge regarding risk factors, target blood glucose levels, dietary options, and self-care practices. The most successful diabetic control recommendations include consistent support of health education and strong motivation, which are required to bring about positive improvements in diabetes self-care habits.

How Deficient Knowledge Apply to Diabetes Mellitus

The outcome of diabetes is largely determined by the patient’s ability to self-manage the disease. The lack of understanding and awareness of diabetes symptoms can make it difficult to recognize the condition early on. Diabetes-related chronic problems can be effectively controlled with adequate knowledge regarding the disease progression. Deficient knowledge regarding diabetes mellitus entails information about the condition’s prognosis, therapy, and specific care needs, which results in uncontrolled diabetes (Chawla et al., 2019). Diabetic patients and their families are unaware of suitable meal regimens, insulin dosages, and symptoms of elevated blood sugar. In addition, patients lack adequate education regarding interpreting diagnostic results leading to a skewed prognosis entailing uncontrollable diabetes that results in comorbidities such as cardiac difficulties.

The unfamiliarity with insulin injection dosages exercise for normoglycemia, and interpretation of diagnostic information is a major concern in healthcare as the patient cannot control the chronic disease. Patients lack information on how to mix Neutral Protamine Hagedorn (NPH) insulin and regular insulin when sick, develop a daily menu that meets one’s diabetic needs, properly dispose of insulin syringes, and lancets how to use a glucometer. The deficiency in knowledge is evidenced by verbal statements of misconceptions regarding disease progression and expressions of requests for information by the patients. In addition, the deficient knowledge is evidenced by inadequate follow-through of instructions and the development of preventable comorbidities. Diabetes management starts with patients as individuals with knowledge and support to manage the disease are healthier than those who lack information about controlling the disease.


The most significant challenge regarding deficient knowledge that affects successful outcomes of individuals with diabetes is the support system. A support system is a group of individuals who congregate to assist diabetic patients with their daily life skills. The patients’ type of support system has a considerable influence on their adherence to the diabetic regimen and self-care options. Individuals are more likely to adhere to instructions regarding dosages and diet if they have an efficient support system and have a quality relationship with their health providers. Patients with supportive families are more likely to take their medication correctly, participate in exercises and follow a diet rich in carbohydrates and low in fat. Family support helps patients adjust to the condition; thus, negative interactions between patients and family members can lead to a lack of control and increased complications (Kumar & Mohammadnezhad, 2022). Non-compliance rates are higher among patients who require long-term medication therapy; this interaction between health providers and family affects the effectiveness of self-care programs. The support system can hinder the adherence to a medication when they lack sufficient knowledge on how to control the condition.

Programs and Interventions

Various programs and interventions are provided to diabetic individuals to learn self-management skills. One such program is the diabetes self-management education and support program (DSMES) developed by Stanford University, which provides education and support to control diabetes mellitus. The DSMES program helps patients lower blood sugar and prevent complications by enhancing patient knowledge on ways to manage the condition. The program provides written information about diabetes management for patients to manage diabetes mellitus. Rural diabetes self-management program such as Chronic Disease Self-Management Program (CDSMP) delivers a six-week workshop to patients addressing diet and medication use.

Interventions to control diabetes entail nutritional management, glucose monitoring, and other lifestyle concerns. Nutritional management relates to meal planning and weight control as the foundation of diabetes management (Carpenter, DiChiacchio, & Barker, 2018). It is vital to consult a registered dietitian to design a therapeutic plan in terms of diet. Weight loss is key for managing type-2 diabetes; thus, increased exercise is needed to lose weight, which can significantly improve blood glucose levels. Meal planning entails considering the patient’s food preferences and ensuring consistent time intervals between meals to prevent hypoglycemic reactions. Continuous glucose monitoring systems entail technology-based interventions such as telehealth and mobile applications that enable remote monitoring of patients to ensure rural patients do not have increased complications. The patients enter data into the mobile applications, which provide feedback regarding blood sugar levels in an automated system. This system improves communication between healthcare providers and patients, thus improving diabetic care.

Program and Intervention in Deficient Knowledge

The diabetes self-management education and support program (DSMES) can help alleviate the issues in managing diabetes due to a lack of adequate knowledge regarding control measures. The program can help patients learn how to control diabetes by impacting relevant information on management measures that reduce the number of emergency visits. The patient information may include the number of insulin injections needed per day and how to adjust the dosages, particularly when fasting, illnesses, or hyperglycemia. The program can teach patients the systematic rotation of injection sites to prevent lipodystrophy and how to treat hypoglycemia with glucagon injection. In addition, the program can inform patients and family members about recognizable signs of hypoglycemia such as shaking, sweating, hunger and weakness. Managing diabetes through education and support is key to a healthy life as it helps prevent serious health complications.


Patient empowerment should be central to diabetes education to address health behavior and self-care changes. Deficient knowledge of nursing diagnosis is a key factor that inhibits diabetes control measures leading to increased complications among the affected. The lack of adequate knowledge about diabetes risk factors, target blood glucose levels, dietary options, and self-care practices is detrimental to management practices pertaining to the chronic condition. Programs and interventions such as diabetes self-management education and support programs (DSMES), continuous glucose monitoring, and nutritional management are key in aiding diabetic patients in managing the condition.


Carpenter, R., DiChiacchio, T., & Barker, K. (2018). Interventions for self-management of type 2 diabetes: An integrative review. International journal of nursing sciences, 6(1), 70–91. Web.

Centers for Disease Control and Prevention. (2020). Prevalence of Diagnosed Diabetes. CDC. Web.

Chawla, S., Kaur, S., Bharti, A., Garg, R., Kaur, M., Soin, D., Ghosh, A., & Pal, R. (2019). Impact of health education on knowledge, attitude, practices, and glycemic control in type 2 diabetes mellitus. Journal of family medicine and primary care, 8(1), 261–268. Web.

Kumar, L., & Mohammadnezhad, M. (2022). Health Care Workers’ Perceptions on Factors Affecting Diabetes Self-Management Among Type 2 Diabetes Mellitus Patients in Fiji: A Qualitative Study. Frontiers in Public Health, 10. Web.

Silva, J. A. da, Souza, E. C. F. de, Echazú Böschemeier, A. G., Costa, C. C. M. da, Bezerra, H. S., & Feitosa, E. E. L. C. (2018). Diagnosis of diabetes mellitus and living with a chronic condition: participatory study. BMC Public Health, 18(1). Web.

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