Diabetes mellitus (DM) 

is a chronic disease characterized by insufficient insulin production in the

pancreas or when the body cannot efficiently use the insulin it produces. This leads to an increased
concentration of glucose in the bloodstream (hyperglycemia). It is characterized by disturbances in
carbohydrate, protein, and fat metabolism. Sustained hyperglycemia has been shown to affect almost all
tissues in the body. It is associated with significant complications of multiple organ systems, including
the eyes, nerves, kidneys, and blood vessels.

Classifications of diabetes mellitus include:

 Type 1 diabetes is characterized by destruction of the pancreatic beta cells.

 Types 2 diabetes involves insulin resistance and impaired insulin secretion.

 Gestational diabetes mellitus is when a pregnant woman experiences any degree of glucose
intolerance with the onset of pregnancy.

 Diabetes mellitus associated with other conditions is when specific types of diabetes develop
due to other causes (e.g., pancreatic diseases, hormonal abnormalities, medications).

 Prediabetes (impaired glucose tolerance or impaired fasting glucose) is a new classification of

diabetes indicating a metabolic stage between normal glucose homeostasis and diabetes.

Nursing Care Plans for Diabetes Mellitus

Nursing care planning goals for patients with diabetes include effective treatment to normalize blood
glucose levels and decrease complications using insulin replacement, a balanced diet, and exercise.
The nurse should stress the importance of complying with the prescribed treatment program through
effective patient education. Tailor your teaching to the patient’s needs, abilities, and developmental
stage. Stress the effect of blood glucose control on long-term health.

TAHAP ORIENTASI

Nurse : excuse me, is this true with mrs ica ?

P : yes I,am

N : introduce me nurse sari on duty today.

N : After checking the blood sugar of mrs ica earlier, it turns out that mrs ica's blood sugar is 230 mg/dL

Setelah tadi pengecekan gula darah ibu, ternyata gula darah ibu 230 mg/dL

P : what is the normal blood sugar?

memangnya berapa gula darah normalnya sus?

N : normally 140-200 mg/dL miss. So, before mrs ica eats, I will give insulin injections which are intended
to be used to control blood sugar in diabetics.

normalnya 140-200 mg/dL miss. Jadi, sebelum ibu makan saya akan memberikan suntikan insulin yang
bertujuan digunakan untuk mengontrol gula darah pada penderita diabetes.
P : oh so after the insulin injection can i eat right away?

oh jadi setelah suntik insulin apa saya bias langsung makan?

N : You can only eat after waiting 30 minutes for the medicine to work on your body. This procedure will
take about 5-10 minutes. are you ready?

ibu baru bisa makan setelah menunggu 30 meniit obatnya bekerja pada tubuh . Prosedur ini akan
memakan waktu sekitar 5-10 menit. apakah ibu bersedia?

P : oke sure.

Tahap Kerja

1. Menjaga privacy klien

2. Mengatur posisi klien

NURSE : mrs ica please pay attention. I will explain while doing this action of giving insulin so that you
can inject insulin by yourself at home

Ibu tolong perhatikan. Saya akan menjelaskan selagi melakukan tindakan pemberian insulin ini agar ibu
bisa melakukan penyuntikan insulin secara mandiri dirumah

PASIEN : all right

3. Lepaskan penutup pena Jika menggunakan intermediate-acting insulin dengan lembut putar pena
diantara telapak tangan 15 detik untuk campuran

N : Firstly, prepare your kit.

You will need:

 An insulin pen

 Enough insulin inside to give the required dose

 A new pen needle

 A sharps disposal box for used pen needles to go into

Make sure you have your kit available at all times and if possible, inform your family as to its location.

Wherever possible, wash your hands with soap and water before injecting.

P : ok, I will remember it

N : Put a new needle onto your pen.

Remove the caps of the pen needle

Hold the pen upright and perform an ‘air shot’. This requires dialling up at least 2 units and pressing the
plunger to expel a test shot of insulin. This helps to clear any bubbles out of the needle. If you do not get
a steady stream, repeat the air shot until you do get a steady stream of insulin coming out.

P : I get what you mean

N : And then dial up your dose.

Pick a soft fatty area to inject. Tops of thighs, belly, bum and triceps

 Put the needle in and keep the pen steady.

 Push the plunger relatively slowly to inject the dose.

P : ouch ! I'm in a little bit of pain.

N : yeah, it's beacuse your skin was injected by a needle.

After the dose has been injected, hold the needle in for a good 10 seconds to help insulin get delivered
and prevent any of the dose escaping out.

After removing the needle, Sometimes there will be a little blood or bruising, which is normal. Wipe with
a tissue or cotton ball, but do not press it.

P : I have some question. can I inject insulin only in one place?

N : you must Avoid injecting insulin in bruised or injured parts of body, and inject it in a different part of
the body than the current injection location.

P : Can I eat whatever I want and as much as I want after injecting insulin?

N : Diabetic patients need to limit their consumption of foods that are high in calories and
carbohydrates. For ex White bread, white rice, and refined flour foods such as pasta are high in
carbohydrates, but not high in fiber.

P : sounds really important, so what else can I consume besides that?

N : You can swap out white rice for diabetes-friendly carbohydrates like brown rice, corn, or sweet
potatoes.

P : I get what you're saying. Thank you for taking the time to explain everything to me. When I get home,
I'll take care of it.

N : ur welcome^^