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 Insulin resistance and reduced insulin secretion are two symptoms of type 2 diabetes. It causes
the bloodstream to circulate with an excessive amount of sugar. Insufficient insulin production by the
pancreas causes cells to react poorly to insulin and consume less sugar.

It is a long-term chronic condition that most frequently affects obese or overweight adults who
are physically inactive. Blood sugar levels are increased due to insufficient sugar absorption by the liver,
adipose, and muscle cells. Over time, this may cause serious health issues such as renal disease, vision
loss, and heart problems.

The Philippine Practice Guidelines on the Diagnosis and Management of Diabetes Mellitus
recommend that Filipinos over the age of 40 and those who are at risk of developing diabetes be tested
every year due to the high prevalence and adverse effects of diabetes.

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The Three Methods used to diagnose Diabetes Mellitus Type 2.
● Fasting Plasma Glucose Test
These test your blood sugar levels after an overnight fast (not eating).
● Oral Glucose Tolerance Test
This device checks your blood sugar levels before and after you consume a glucose-containing beverage.
● Hemoglobin A1C
The A1C test determines your average blood sugar level over the previous two or three months.

Diabetes Mellitus laboratory results are the only way to identify whether the patient has Type 1 or Type 2
Diabetes Mellitus.

The elevated fasting glucose level and HbA1c level confirm the presence of Diabetes Mellitus. Glucose
should not be present in the urine; it also suggests Diabetes Mellitus. The absence of ketones is consistent
with type 2 Diabetes Mellitus. In type 1 Diabetes Mellitus, the presence of ketones indicates that the body
uses fat stores for energy, a rare process in type 2 Diabetes Mellitus. YL’s elevated total and LDL
cholesterol levels, high triglycerides, and low HDL cholesterol are consistent with values often seen in
those with type 2 Diabetes Mellitus because of insulin resistance.

There are so many risks that come with Type 2 diabetes mellitus.

Factors that may increase your risk of type 2 diabetes include the following:

● Weight. Type 2 diabetes is one of the risks associated with obesity.

● Age. Because the risk of type 2 diabetes increases with age, people aged 35 and up are more
likely to have it. But now even children as young as teens are developing it too.
● Genes. It might have if there is a family history of diabetes.

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 ● Races. African Americans, American Indians, Asian Americans, Hispanics or Latinos, or Pacific
Islanders are at higher risk of Type 2 Diabetes Mellitus.
● Inactivity. not physically active, having bad habits, a sedentary lifestyle, or a job that requires
sitting for long periods of time.
● have prediabetes or a history of gestational diabetes; there are types of diabetes that develop
during pregnancy or giving birth to a baby weighing 9 pounds or more.

You can develop type 2 diabetes at any age, even during childhood. You are more likely to develop type 2
diabetes. If you have these risk factors, consult the doctor while they're not getting worse.

• Frequent urination
• Excessive thirst
• Unexplained weight loss
• Extreme hunger
• Sudden vision changes
• Tingling or numbness in the hands or feet
• Feeling very tired much of the time
• Dehydrated skin
• Sores that are slow to heal

-Medical MANAgEMENt
● Perform a health history assessment for the patient and the patient's family to help address the
disease and symptoms associated with a diabetes diagnosis.

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 ● Evaluation of the patient's physical condition, such as getting the patient's blood pressure while
sitting and standing to detect orthostatic changes, body mass index (BMI), and visual acuity (VA).
● Examine the patient's skin, foot, mouth, nervous system, and other areas to identify and prevent
complications such as foot damage, skin infections, gum disease, and retinopathy, which can
result in blindness.
● Perform laboratory examinations. A1C test, fasting blood sugar test, glucose tolerance test, lipid
panel, microalbuminuria test, urinalysis, serum creatinine level, and Electrocardiography (ECG).

-Nursing Intervention
● Educate the patient on taking their blood sugar using the blood sugar meter device and
interpret the results.
● Talk about the type of insulin used, the dosage, and the time of injection with the patient to
avoid delays in effect duration and glucose instability.
● Explain thoroughly to patients how their medication works, how it functions, and what side
effects to expect. Patients must consider each drug’s risks and significance.
● Recommend the patient practice reading labels, estimating the amount of food in their meal,
and choosing foods with a low glycemic index, more fiber, and less fat.
● Demonstrate to patients the importance of a healthy meal plan and assist them with weight
loss goals.

Remission
- has been shown to be due to the normalization of the high-fat levels inside the liver and pancreas, and
the only way to achieve this is by major weight loss. There are three main ways that people have put their
diabetes into remission: a low-carbohydrate diet, a low-calorie diet, and bariatric surgery.
Maintaining a balanced diet:
If you live with type 2 diabetes, eating a balanced diet can help you manage your blood sugar levels and
weight.

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- protein-rich food
- nutrient-dense foods
- monounsaturated and polyunsaturated fatty acids
- heart-healthy fats
- foods high in fiber
( fruits, vegetables, whole grains, legumes, nuts, seeds, and beverages )

Foods you should limit or avoid with type 2 diabetes:

- high-fat meat
- full-fat dairy
- sweets
- sugar-sweetened beverages
- sweeteners
- processed foods
- trans-fat

Exercising regularly
The benefits of exercising are independent of weight loss. and at least 150 minutes of moderate-intensity
aerobic activity per week.

Here are 10 exercises that can help you reach your fitness goals:
- walking - calisthenics
- cycling - yoga
- swimming - pilates
- team sports - resistance band exercise
- aerobic dance - weightlifting

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Preventing or delaying Diabetes may reduce significant health complications, including heart disease,
stroke, and eye and foot difficulties. The likelihood of developing health issues decreases with the duration
of Diabetes. You may help prevent or delay the development of type 2 diabetes by following a low-calorie
diet and participating in regular physical exercise.

● Lose weight and keep it off. By losing 5 to 7 percent of your starting weight, you may be able
to stop or postpone the onset of Diabetes. If you weigh 200 pounds (90 kg.), your objective would
be to shed between 10 and 14 pounds (4 kg. And 6 kg.).
● Monitoring Blood Sugar levels. Regular monitoring of your blood sugar using the kit at home
will keep you on track to stabilize and balance your sugar level.
● Move more. Five days a week, engage in at least 30 minutes of physical exercise. Discuss the
ideal activities with a healthcare provider if you have yet to be active. Develop gradually toward
your goal.
● Eat healthy foods. Eat fewer calories daily to help you lose weight by consuming smaller
servings. Another strategy for cutting calories is to choose meals with less fat. Replace sugary
drinks with water.
● Track your progress. You can succeed by taking a few easy steps. The best way to maintain and
progress toward your goals is to monitor them.

Inquire with your doctor about additional adjustments you might make to avoid or postpone type 2
diabetes.

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Promotion:
Sr. Callista Roy in her Metaparadigm in Nursing is by promotes adaptation or coping for
individuals or groups thus contributing to health, quality of life, and dying with dignity by enhancing
environmental interactions. The goal of her theory is to help the patient to adapt or cope and maintain the
balance of the various stimuli in the situation.

As Nursing students, we can promote by giving Awareness of TYPE 2 DIABETES MELLITUS

To the barangays, Health Centers, and Schools, We’re in technologies we can post on social media or to a
friend if ever they have encountered or some friend that suffers from this illness.

Four reactions in adaptive modes:

1. Physiologic mode - Maintaining physiological homeostasis using the (senses, fluid and
electrolytes, neuro, and endocrine function)

People with type 2 diabetes frequently experience impairments in their sense of smell, taste,
hearing, vision, and physical sensation, which exacerbates the consequences of aging. There is convincing
evidence that diabetes complications including retinopathy and neuropathy may be prevented. Perhaps
the most dreaded sense of loss is blindness.

People with type 2 diabetes mellitus frequently have fluid and electrolyte imbalances. Although
the reason is frequently multifaceted, diabetic ketoacidosis and hyperglycemia are the usual problems
with focal stimuli.

Your nerves are damaged by high blood sugar, and as a result, they may stop communicating with
various body organs. Nerve injury can result in health issues ranging from little numbness to discomfort

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that makes it difficult to carry out daily tasks. Diabetics who have nerve damage make up about half the
population.

Blood sugar levels are maintained by endocrine glands. The pancreas' primary job is to keep
blood sugar levels balanced. A sizable gland is situated behind the stomach. Along with other hormones, it
creates glucagon and insulin. Diabetes results from inadequate insulin production by the pancreas or
improper insulin utilization by the organism (called insulin resistance).

2. Self-concept mode - concerned with the patient's bodily impressions, ideals, objectives, and
moral and ethical beliefs.
- the capacity to share feelings and sensations about their illnesses without being afraid in
order to quickly treat them.
- reassuring them that their type 2 diabetes and its effects on their looks won't prevent
them from feeling confident
- Patients with diabetes are encouraged to keep their blood sugar levels stable
In their daily life, normal.
- Due to their spiritual convictions, many religions impose dietary restrictions.

3. Role function mode - is referred to as the position one holds in society

- Genes, family history Races, and ethnicity may have a part in the development of type 2 diabetes
mellitus.

4. Interdependence mode - are all part of the Relationships, interactions, and the giving and
receiving of love, respect, and worth.
- intimate connections with parents, people who believe in god, or special loved ones.
- Support systems can include friends who can relate to your circumstances while you
adjust to your ailments.
- Love, nurturing, and affectionate acts are both given and received.