What are the nursing measures for diabetes?

Diabetes is a disease that threatens people's life and health, so the daily care of diabetic patients needs to be extra cautious, because a little carelessness may lead to the aggravation of patients' illness and affect their life safety. So what are the nursing measures for diabetes? What is the nursing routine of diabetes? How to care for diabetes?

1, diet health care

Diet therapy is the most basic treatment for any form of abnormal glucose metabolism disease, which can reduce the burden of islet, obviously improve the sensitivity of islet, reduce blood lipid and blood sugar, reduce insulin resistance and control the disease.

1, advocate low sugar, low fat, moderate protein and high fiber diet; Eat less and eat more meals to reduce the burden of pancreatic islets after meals. The content of each meal should be balanced and quantified regularly. Ideal weight (kg)= height (cm)- 105.

2. The staple food is coarse rice, flour and moderate miscellaneous grains, and glucose, sucrose, honey and its products are not allowed. Try to use vegetable oil containing unsaturated fatty acids, such as olive oil and peanut oil, and avoid using animal oil. Stay away from high-fat and high-cholesterol foods, such as fat, animal offal and egg yolk, and eat less fried foods. Do not drink or drink less. Eating more foods rich in cellulose, such as coarse grains, vegetables, beans, etc., has the functions of relaxing bowels, regulating fat and lowering blood sugar.

3. The total diet and contents of most diabetic patients are as follows:

(1) Carbohydrate accounts for 50%~65% of the total calories, 250~300g/ day (mainly rice or flour), which can be appropriately increased for those who are thin and have more physical activities.

② protein accounts for 10%~20% of total calories, and the ratio of plant protein to animal protein is 2: 1. You can eat 30~50g of beans every day, and the animal protein is mainly lean meat, beef, chicken, fish, shrimp and eggs. The total amount is 150~250g/ day.

③ Fat accounts for 15%~25% of the total, and 50~80g of fat is provided every day, with vegetable fat as the best.

Dietary fiber: eat more high-fiber beans and vegetables, or eat a small amount of fruit. If your blood sugar is too high, you shouldn't eat fruit.

2. Exercise health care

Exercise can promote glucose utilization, increase insulin sensitivity, improve glucose metabolism, lower blood sugar and increase body resistance. The intensity varies from person to person, step by step, fixed time and quantitative, and enough is enough. Exercise for 20~30 minutes after meals 1 hour can achieve better hypoglycemic effect, and it is best not to exercise on an empty stomach to avoid hypoglycemia. You can choose brisk walking, jogging, cycling, playing Tai Ji Chuan, ballroom dancing, aerobics and table tennis.

3. Nursing care of oral hypoglycemic agents

Oral hypoglycemic agents are one of the methods to treat diabetes. Doctors are mainly selected according to the patient's disease type, blood sugar level, obesity, age, liver and kidney function, etc. Pay attention to observe whether there are any side effects when taking the medicine, and give feedback to the doctor in time if there is any discomfort. Usually take it 30 minutes before meals, take it on time and in quantity according to the doctor's advice, and check it regularly. The doctor will adjust the dosage or change the drug type according to the change of blood sugar level and condition.

4. Nursing care of insulin therapy

Insulin is suitable for patients with 1 type diabetes and type 2 diabetes who are ineffective in oral hypoglycemic agents, or patients with acute complications and various serious chronic complications of diabetes.

1, according to the doctor's advice on time, according to the dose of injection. Quick-acting insulin is injected before meals 15~20 minutes, medium-acting or long-acting insulin is generally injected before meals 1 hour, and mixed insulin is injected 30 minutes before meals; Too early or too late injection may lead to low or high blood sugar, interfere with curative effect or cause hypoglycemia risk; The inhaled dose should be accurate. When using mixed insulin, it should be quick-acting first and then long-acting.

2. The injection site should be selected and rotated in a planned way: subcutaneous injection is usually performed on the anterolateral upper arm, the inner thigh, the buttocks and the abdomen; In order to avoid atrophy or thickening of subcutaneous tissue, injections should be made alternately, and the position of each injection should be changed. Do not inject the same part twice a week.

3, the side effect is hypoglycemia, which is the most common and dangerous, mainly related to too much dose, too little eating and too much exercise; And allergic reactions. People with diabetes can carry candy, biscuits and other foods with them. Once hypoglycemia occurs, it can be supplemented immediately.

5. Nursing care of complications

1, Infection: Diabetic patients have poor immunity, decreased resistance and are prone to various infections. Therefore, they should pay attention to personal hygiene, take a bath frequently, change clothes frequently, brush their teeth frequently and gargle frequently to prevent infection, and immediately notify the doctor to deal with it in time.

2, diabetic foot: keep the foot clean, often clean, massage, trim toenails, wear loose, soft and comfortable shoes and socks, pay attention to observe the color of the foot, and whether it is broken. And handle it in time.

3, ketoacidosis, hyperosmotic non-ketotic diabetic coma: according to the doctor's advice, establish venous access to ensure the input of liquid and insulin.

6, psychological care

Diabetes is a lifelong disease, which cannot be cured at present, but can be controlled. Through comprehensive treatment, nursing and health care, you can live as long as ordinary people. We must maintain a positive attitude, and we must not neglect the illness and not accept formal treatment, which will lead to serious chronic complications and disability and death.

7. Skills

Diabetic patients should learn to use the rapid blood glucose meter correctly, go to the outpatient clinic for monitoring and reexamination regularly, pay attention to increasing or decreasing clothes when the climate changes, pay attention to the cleanliness of skin and feet, and live a regular life, avoid overwork, ensure adequate sleep, and quit smoking and drinking.

8, the principle of diabetes diet

(1) Control calorie intake. People with normal weight can generally be given a weight of 105 ~ 126 kilojoules (25 ~ 30 kilocalories) per kilogram, which can be appropriately adjusted according to different labor intensity. Obese patients should gradually control calories to reduce their weight to normal weight.

(2) Under the premise of controlling the total thermal energy, the thermal energy ratio of carbohydrates can be kept at about 65%, that is, the thermal energy ratio cannot be too limited. It is important to strictly limit the intake of monosaccharides, such as sucrose, maltose, glucose and fructose, and foods containing more of these sugars, without excessively restricting staple foods such as rice, flour and foods containing more starch polysaccharides. This can improve glucose tolerance, reduce blood cholesterol and triglycerides, improve the sensitivity of peripheral tissues to insulin, and prevent excessive mobilization of body fat, leading to ketoacidosis.

(3) Sufficient protein supply can increase the heat energy ratio of protein to 15% ~ 20%, but those with hepatic coma and renal insufficiency should be another matter.

(4) Fat intake can account for 20% ~ 25% of thermal energy. To limit the intake of animal fat and high saturated fatty acid fat, cholesterol should be limited to below 300 mg per day.

(5) Ensure to provide abundant vitamin B and B vitamins from the diet. Nicotinic acid and other B vitamins promote carbohydrate metabolism. Pay attention to providing foods rich in calcium, phosphorus, zinc, chromium, copper and iodine.

(6) Ensuring adequate dietary fiber can reduce blood sugar and improve glucose tolerance. Diabetics eat bean gum and pectin.

(4) Ensure the supply of fresh fruits and vegetables, but limit the fruits and vegetables with high sugar content, such as sugarcane, fresh dates, hawthorn, dried persimmons, cabbage heads and fresh day lilies.

(5) People with diabetes should strictly limit their food intake. When they are still hungry after eating the prescribed food, they can take the following measures.

(1) Cook for three times. Use vegetables with sugar content below 3%, such as celery, zucchini, wax gourd, leek and rape. After stewing, discard the soup and add water to cook again. Repeat for three times, you will feel full after eating, but the calories are very low.

② Defatted broth. After the broth or chicken soup is cooled, remove the condensed oil skin from the soup, then dry it and cool it to remove the oil skin, so that patients can satisfy their hunger.

The foreign powder is frozen. Cabbage, that is, cabbage powder, can be boiled with L grams of cabbage powder and 400 ml of water until the cabbage powder is completely dissolved, then a little low-calorie sweetener is added, cooled and frozen to satisfy hunger.