In addition to the textbook, utilize at least one peer-reviewed, evidence based resource to develop your post.
You did a great job explaining the etiology and pathophysiology of Diabetic Ketoacidosis. I would like to touch upon the patient teaching component of this week’s topic discussion. You make a good point about teaching diabetes patients to test their glucose levels more often. Glucose monitoring is a big topic among diabetes researchers and clinicians, even more so is the topic of self-monitoring blood glucose (SMBG) levels. Schnell, Hanefeld, & Monnier (2014) state SMBG is a critical for the optimization of diabetes treatment in insulin-treated diabetes patients. SMBG is beneficial because it helps diabetes patients hit their hemoglobin A1c (HbA1c) targets, minimizes glucose variability, and helps to predict and prevent hypoglycemia (Schnell, Hanefeld, & Monnier, 2014). SMBG also positively influences lower morbidity and all-cause mortality rates among Type I and II diabetes patients (Schnell, Hanefeld, & Monnier, 2014). Those who check their blood glucose levels often are proactively changing their lifestyles for the better. SMBG prompts patients to eat healthier meals, exercise lightly more often, minimize stress, stay hydrated, and follow their medication regimen. Checking glucose levels at least 4 to 5 times a day will heighten patients’ awareness to avoid the type of lifestyle that advance DK symptoms.
Effectively managing blood glucose levels and maintaining glycemic control includes monitoring ketones levels. FNPs can encourage their diabetes patients to add this action after checking their blood glucose levels. FNPs can help educate diabetes patients on ketones, proper ketone levels, how ketones level get too high (above 3.0 mmol/L) or too low (below 1.5 mmol/L), and what actions to take to avoid hypoglycemia if ketone levels get too low. Patients at risk for DK may be interested in adopting a ketogenic diet, a low-carbohydrate, high-fat, adequate-protein diet that reduces one’s chances of inducing DK (Urbain & Bertz, 2016).
References
Schnell, O., Hanefeld, M., & Monnier, L. (2014). Self-Monitoring of Blood Glucose: A Prerequisite for Diabetes Management in Outcome Trials. Journal of Diabetes Science and Technology, 8(3), 609–614. http://doi.org/10.1177/1932296814528134
Urbain, P., & Bertz, H. (2016). Monitoring for compliance with a ketogenic diet: what is the best time of day to test for urinary ketosis? Nutrition & Metabolism, 13, 77. http://doi.org/10.1186/s12986-016-0136-4
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