Diabetic patients on discharge with an insulin pump benefit from its small size, carrying convenience, effectiveness, and simple operation. Insulin must be injected 5 to 30 minutes before eating to avoid hypoglycemic reactions such as hunger, cold sweats, fatigue, headache, palpitations, or other low blood sugar symptoms. In the event of these symptoms, carbohydrate foods should be consumed immediately. Carry a clear identification card in case coma occurs.
2.5 Psychological Guidance: Targeted psychological counseling and encouragement can help patients analyze their current state of tension and the adverse effects of not accepting reasonable treatment. This can lead to the unfavorable progression of the disease. There are many factors that cause mental stress, generally divided into internal and external causes. Internal factors are mostly caused by the patients themselves, such as some patients viewing diabetes as incurable or overly serious, leading to anxiety if the condition cannot be controlled timely or repeats itself. Seeing other diabetic patients with complications like retinopathy, blindness, lower extremity vascular disease, or amputation may lead to worry and melancholy. External factors include work pressure, complex interpersonal relationships, and others' lack of understanding, which are not conducive to disease control. It is necessary to adjust the mental state according to specific circumstances and causes, treat the disease appropriately, and actively receive treatment to prevent exacerbations and complications.
For severe complications in some diabetic patients, poor disease control is often the primary cause. If regular treatment corrects the body's glucose, protein, and fat metabolism disorders, it can prevent or delay the incidence of complications, as shown in study results. Additionally, elderly patients with stable disease control contribute not only to personal physical and mental health but also alleviate the ideological burden on families and children, significantly impacting family life.
2.6 Guidance for Family Members: Conduct ideological work within the family and surroundings, enabling patients to frequently experience happy life moments and feel the joy of living; correctly handle the patient’s abnormal psychology. Do not abandon, ignore, or exert pressure on them. Be more concerned about the patient’s condition and psychological state, effectively communicate to show attention and care, provide enthusiastic support, encourage and assist them in controlling diabetes through healthy means. Monitor their conditions closely, assist patients in completing self-care projects, and give them an atmosphere of family life filled with warmth.
2.7 Inspection and Guidance: Guide patients to conduct self-tests on urine at home and regularly review blood glucose, renal function, and electrocardiogram at the hospital. Delaying the emergence of complications improves patient knowledge on diabetes.
2.8 Diabetic Foot Prevention Guide: The occurrence of diabetic foot relates to peripheral nerve lesions, vascular lesions, and infections. If left untreated, it can develop into amputations. Therefore, early detection and timely prevention of diabetic foot are very important for disease control. Warn patients not to sit cross-legged for long periods, walk long distances, or sit for extended periods. Concurrent peripheral neuritis, limb dysesthesia, or abnormalities should avoid using hot water bottles to keep warm to prevent burns. Cotton socks can be used to keep extremities warm and prevent frostbite. If a hot water bottle is needed, ensure the water temperature does not exceed 50°C and does not directly contact the skin. Choose appropriately sized shoes with soft textures, good ventilation, cotton, or wool socks. Patients should wash their feet with warm water every night, ensuring the water temperature does not exceed 37°C, avoiding hard rubbing to prevent skin abrasions. Dry the feet thoroughly with a soft, absorbent cloth. Pay special attention to the toes and skin sutures, avoiding sprinkling talcum powder on the feet. Apply vegetable oil to dry feet to prevent cracking. Trim nails not too short, and do not scratch pruritus. Quit bad habits like walking barefoot, even indoors, and wear cloth slippers. Avoid wearing new shoes for more than two hours and alternate with old shoes to protect the feet. Trim toenails horizontally, not into a half-moon shape, to prevent wounds and inflammation. If nail corners are too sharp, use a sharp nail file to smooth them but avoid filing too deeply. For poor vision, family members can assist. If accidental skin injury occurs, do not self-treat; seek medical attention for proper wound care. Guide patients to check their feet daily instead of soaking them in hot water. Diabetes complicated by neuropathy can cause loss of foot sensation, unknowingly harming themselves, such as wearing unsuitable shoes. Proper foot care can avoid nearly 50% of lower limb amputations in patients.
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