🩸 Nursing Care Plan on Diabetes Mellitus

Medical-Surgical Nursing | NANDA Nursing Care Plan Format

Endocrine Nursing | Practical File Ready

⚠️ Educational Purpose Only: This nursing care plan is prepared for academic practical file work. Not for actual patient care or clinical decision-making.

📋 Student Information

Student Name	[Your Name]
Course	BSc Nursing / GNM / ANM
Subject	Medical-Surgical Nursing / Endocrine Nursing
Topic	Nursing Care Plan on Diabetes Mellitus
Format	NANDA-I Nursing Care Plan Format
Date of Submission	[Enter Date]
Clinical Instructor	[Instructor Name]

📄 Page 1 — Patient Identification Data

Name	Mr. Ramesh Kumar Sharma
Age	55 Years
Sex	Male
Address	Mansarovar, Jaipur, Rajasthan
Occupation	Shopkeeper
Marital Status	Married
Religion/Category	Hindu / General
Annual Income	₹4,80,000/- approximately
Diagnosis	Type 2 Diabetes Mellitus with Hyperglycemia
Type of Family	Nuclear Family
Family Size	5 Members
Ward Name	Medical Ward
Bed Number	12
Doctor Incharge	Dr. A. K. Meena, MD Medicine
Date of Admission	12/03/2026
Hospital Name	Sawai Man Singh Hospital, Jaipur

📄 Page 2 — Chief Complaints & Clinical History

CHIEF COMPLAINTS

The patient was admitted to the medical ward with the following complaints:

Excessive thirst since 2 weeks
Frequent urination, especially during night, since 2 weeks
Generalized weakness and fatigue since 10 days
Increased hunger since 1 month
Occasional blurred vision since 1 week
Delayed healing of small wound over right foot since 8 days
Dryness of mouth and skin
Unintentional weight loss of approximately 3 kg in last 2 months

HISTORY OF PRESENT ILLNESS

Mr. Ramesh Kumar Sharma, a 55-year-old male shopkeeper, was apparently well until about 2 weeks before admission when he started experiencing excessive thirst and frequent urination. He reported passing urine 10–12 times per day and 3–4 times at night, which disturbed his sleep. He also complained of dryness of mouth, increased hunger, generalized weakness, and easy fatigability while doing routine work at his shop.

The patient noticed that a small wound over the right foot, caused by minor trauma while walking, was healing slowly. He also experienced occasional blurred vision and mild headache. He ignored the symptoms initially and increased his water intake. As weakness and frequency of urination increased, he visited the outpatient department where random blood sugar was found to be 320 mg/dL. He was advised admission for blood glucose monitoring, diabetic evaluation, wound care, medication adjustment, and patient education.

On admission, the patient was conscious and oriented but appeared weak and anxious about his condition. His vital signs were stable except mildly elevated blood pressure. Blood investigations revealed fasting blood sugar 180 mg/dL, post-prandial blood sugar 286 mg/dL, HbA1c 8.5%, and urine sugar positive. The patient was diagnosed as Type 2 Diabetes Mellitus with Hyperglycemia and was started on diabetic diet, oral antidiabetic medication, blood glucose monitoring, wound care, and health education.

PAST MEDICAL HISTORY

Known case of Type 2 Diabetes Mellitus for 5 years.
Patient was taking oral antidiabetic medication irregularly.
History of hypertension for 3 years; on antihypertensive medication.
No history of tuberculosis, asthma, epilepsy, thyroid disorder, or chronic kidney disease.
No history of previous diabetic ketoacidosis or hypoglycemic coma.
No known drug allergy or food allergy.

PAST SURGICAL HISTORY

No history of major surgery.
No history of amputation or diabetic foot surgery.
No history of blood transfusion.
No history of previous hospitalization for any major illness.

📄 Page 3 — Family History & Composition

FAMILY HISTORY

The patient belongs to a nuclear family.
There are 5 members in the family — patient, wife, one son, one daughter-in-law, and one grandson.
Father had history of Type 2 Diabetes Mellitus and hypertension.
Mother had history of hypertension.
Younger brother is also diagnosed with Type 2 Diabetes Mellitus.
No family history of tuberculosis, bronchial asthma, epilepsy, or psychiatric illness.
There is a positive family history of diabetes mellitus.

FAMILY COMPOSITION

Name	Age/Sex	Education	Occupation	Marital Status	Relationship	Health Status
Mr. Ramesh Kumar Sharma	55/M	B.A.	Shopkeeper	Married	Self / Patient	Type 2 Diabetes Mellitus with Hyperglycemia
Mrs. Sunita Sharma	50/F	Secondary	Housewife	Married	Wife	Healthy
Mr. Amit Sharma	28/M	B.Com	Private Job	Married	Son	Healthy
Mrs. Pooja Sharma	25/F	B.A.	Housewife	Married	Daughter-in-law	Healthy
Master Aarav Sharma	3/M	-	-	Unmarried	Grandson	Healthy

FAMILY TREE

👨

Mr. Ramesh Kumar Sharma

Self / Patient

Type 2 Diabetes Mellitus

♡

👩

Mrs. Sunita Sharma

Wife

Healthy

👨

Mr. Amit Sharma

Son

Healthy

👩

Mrs. Pooja Sharma

Daughter-in-law

Healthy

👦

Master Aarav Sharma

Grandson

Healthy

📄 Page 4 — Dietary, Personal, Socio-Economic & Environmental History

DIETARY HISTORY

The patient takes a mixed diet but mostly vegetarian food at home.
He consumes 4–5 cups of tea daily with sugar.
He has a habit of eating sweets, biscuits, namkeen, and fried snacks frequently.
He usually takes heavy dinner late at night due to shop timing.
Intake of green leafy vegetables, salads, fruits, and high-fiber food is inadequate.
He does not follow a regular diabetic diet plan.
He often skips breakfast and takes irregular meals.
Fluid intake is adequate, but thirst has increased due to hyperglycemia.
No known food allergy reported.

PERSONAL HISTORY

Sleep: Disturbed due to frequent urination at night.
Appetite: Increased appetite for last 1 month.
Bowel: Regular, once daily.
Bladder: Increased frequency of urination, especially at night.
Habits: Occasional tobacco chewing for 10 years; no alcohol intake reported.
Activity level: Sedentary lifestyle; spends most of the day sitting at shop.
Exercise: No regular walking or exercise routine.
Hygiene: Maintains average personal hygiene but has inadequate foot care practices.
Allergy: No known drug or food allergy.
BMI: 28.4 kg/m² — Overweight.

SOCIO-ECONOMIC HISTORY

The patient belongs to a middle-class family.
Main source of income is his grocery shop and son's private job.
Family income is sufficient for basic needs and treatment expenses.
Patient has access to nearby hospital and medical facilities.
Family members are supportive and willing to help in diet control and medication adherence.

ENVIRONMENTAL HISTORY

The patient lives in a pucca house with adequate ventilation and lighting.
Safe drinking water supply is available.
Sanitation facilities are adequate.
House surroundings are clean.
No exposure to industrial pollution or harmful chemicals.
Cooking is done using LPG gas.

📄 Page 5 & 6 — Physical Examination

GENERAL CONDITION

Patient is conscious, oriented to time, place, and person. He appears weak and mildly anxious. Patient is cooperative during examination. No acute respiratory distress is present. Mild dehydration signs are observed due to hyperglycemia and polyuria.

VITAL SIGNS

Temperature: 98.4°F
Pulse: 88 beats/min, regular
Respiration: 20 breaths/min
Blood Pressure: 146/90 mmHg
SpO₂: 98% on room air
Random Blood Sugar: 320 mg/dL on admission
Pain Score: 2/10 due to mild right foot wound discomfort

GENERAL APPEARANCE

Built: Moderately built and overweight.
Posture: Normal sitting and standing posture.
Gait: Slightly cautious due to right foot wound.
Speech: Clear and coherent.
Skin: Dry skin with mild dehydration signs.
Facial expression: Mildly anxious regarding blood sugar control.

SYSTEMIC EXAMINATION

Cardiovascular	S1 and S2 heard clearly. No murmur. Pulse 88/min regular. Peripheral pulses palpable. Blood pressure mildly elevated. No pedal edema.
Respiratory	Chest symmetrical. Respiratory rate 20/min. Vesicular breath sounds heard bilaterally. No wheeze, crackles, or respiratory distress.
Neurological	Patient conscious and oriented. GCS 15/15. Pupils equal and reacting to light. No focal neurological deficit. Mild tingling sensation occasionally present in both feet.
Skin	Skin dry and warm. Mild dehydration present. Small superficial wound over right foot with delayed healing. No cyanosis, clubbing, or icterus.
Head & Face	Head normal in shape. Face symmetrical. No facial puffiness. Mild tired look present.
Eyes	Conjunctiva pink. Sclera white. Pupils equal and reactive. Patient complains of occasional blurred vision. No redness or discharge.
Ear	External ear normal. No discharge. Hearing response normal.
Nose	Nose normal. No nasal discharge. Nostrils patent.
Mouth & Pharynx	Oral mucosa slightly dry. Tongue moist but coated. No throat congestion. Dental hygiene average.
Neck	Neck movement normal. No lymph node enlargement. Thyroid not enlarged. No JVD.
Abdomen	Abdomen soft and non-tender. No distension. Bowel sounds present. No organomegaly detected.
Extremities	No pedal edema. Peripheral pulses palpable. Small superficial wound present on right foot. Mild numbness and tingling sensation in feet. Capillary refill less than 3 seconds.

📄 Page 7 — Vital Signs Monitoring Record

DATE/TIME	TEMP	PULSE	RESP	BP	SpO₂	RBS/FBS
Day 1 — Admission	98.4°F	88/min	20/min	146/90	98%	RBS 320 mg/dL
Day 2 — Morning	98.2°F	84/min	19/min	140/86	98%	FBS 210 mg/dL
Day 3 — Morning	98.6°F	82/min	18/min	136/84	99%	FBS 168 mg/dL
Day 4 — Discharge	98.4°F	78/min	18/min	130/80	99%	FBS 132 mg/dL

📈 Nursing Trend: Blood sugar gradually reduced from 320 mg/dL to 132 mg/dL with insulin therapy, diabetic diet, medication adherence, hydration, and monitoring.

📄 Page 8 — Diagnostic Investigations

SR. NO.	INVESTIGATION	NORMAL VALUE	PATIENT VALUE	INTERPRETATION
1	Hemoglobin	13–17 g/dL	12.8 g/dL	Slightly low
2	Total WBC Count	4,000–11,000/mm³	9,800/mm³	Normal
3	Platelet Count	1.5–4 lakh/mm³	2.6 lakh/mm³	Normal
4	Fasting Blood Sugar	70–110 mg/dL	210 mg/dL	Elevated
5	Post-Prandial Blood Sugar	<140 mg/dL	286 mg/dL	Elevated
6	Random Blood Sugar	<200 mg/dL	320 mg/dL	Marked hyperglycemia
7	HbA1c	<6.5%	9.1%	Poor long-term glycemic control
8	Urine Sugar	Absent	+++	Glycosuria present
9	Urine Ketone	Absent	Negative	No ketoacidosis
10	Serum Creatinine	0.7–1.3 mg/dL	1.0 mg/dL	Normal renal function
11	Blood Urea	15–40 mg/dL	34 mg/dL	Normal
12	Serum Sodium	135–145 mEq/L	138 mEq/L	Normal
13	Serum Potassium	3.5–5.0 mEq/L	4.2 mEq/L	Normal
14	Total Cholesterol	<200 mg/dL	232 mg/dL	Elevated
15	LDL Cholesterol	<100 mg/dL	148 mg/dL	Elevated
16	HDL Cholesterol	>40 mg/dL	36 mg/dL	Low
17	Triglycerides	<150 mg/dL	210 mg/dL	Elevated
18	Foot Wound Swab	No pathogenic growth	Mild bacterial growth	Local wound infection risk

📄 Page 9 — Medical Management (Drug Chart)

SR. NO.	MEDICATION	DOSE	FREQUENCY	ROUTE	ACTION / PURPOSE
1	Inj. Regular Insulin	As per sliding scale	Before meals and bedtime	Subcutaneous	Rapid control of high blood glucose level.
2	Tab. Metformin	500 mg	BD after meals	Oral	Biguanide; decreases hepatic glucose production and improves insulin sensitivity.
3	Tab. Glimepiride	2 mg	OD before breakfast	Oral	Sulfonylurea; stimulates pancreatic insulin secretion.
4	Tab. Telmisartan	40 mg	OD	Oral	Antihypertensive; controls blood pressure and protects kidney function in diabetes.
5	Tab. Atorvastatin	20 mg	HS	Oral	Statin; lowers LDL cholesterol and reduces cardiovascular risk.
6	Tab. Pantoprazole	40 mg	OD before breakfast	Oral	Proton pump inhibitor; prevents gastric irritation due to medicines.
7	Tab. Multivitamin	1 tablet	OD	Oral	Supports general health and nutritional status.
8	Tab. Vitamin B Complex	1 tablet	OD	Oral	Helps nerve health and reduces neuropathy-related symptoms.
9	Normal Saline	500 mL	As prescribed	IV infusion	Maintains hydration and corrects fluid deficit due to polyuria.
10	Povidone Iodine Dressing	Local application	Once daily	Topical	Antiseptic dressing for right foot wound to prevent infection.
11	Tab. Amoxicillin + Clavulanic Acid	625 mg	BD	Oral	Antibiotic; prevents/treats local wound infection as prescribed.
12	Tab. Paracetamol	500 mg	SOS	Oral	Analgesic and antipyretic; relieves pain or fever if present.

Nursing Note: Monitor blood glucose before insulin administration. Observe for signs of hypoglycemia such as sweating, tremors, dizziness, hunger, confusion, and weakness. Maintain diabetic diet and regular medication schedule.

📄 Page 10 — NANDA Nursing Diagnoses

Risk for unstable blood glucose level related to inadequate diabetes management, irregular diet pattern, sedentary lifestyle, and insufficient knowledge regarding diabetic care as evidenced by RBS 320 mg/dL, FBS 210 mg/dL, PPBS 286 mg/dL, HbA1c 9.1%, polyuria, polydipsia, and fatigue.
Deficient knowledge regarding diabetes mellitus, medication adherence, diabetic diet, blood glucose monitoring, foot care, and prevention of complications as evidenced by irregular medication intake, lack of regular blood sugar monitoring, and poor understanding of diabetic diet.
Risk for infection related to hyperglycemia, delayed wound healing, and impaired immune response as evidenced by superficial right foot wound and mild bacterial growth in wound swab.
Impaired skin integrity related to delayed wound healing secondary to diabetes mellitus as evidenced by superficial wound over right foot, dry skin, and delayed tissue repair.
Imbalanced nutrition: more than body requirements related to excessive intake of sweets, fried foods, irregular meals, and sedentary lifestyle as evidenced by BMI 28.4 kg/m², dyslipidemia, and uncontrolled blood sugar level.
Risk for peripheral neurovascular dysfunction related to long-term uncontrolled diabetes mellitus as evidenced by occasional tingling and numbness in both feet.
Fatigue related to altered glucose metabolism and hyperglycemia as evidenced by patient complaint of weakness, tiredness, and reduced activity tolerance.
Ineffective health maintenance related to inadequate lifestyle modification, tobacco chewing habit, irregular follow-up, poor dietary control, and lack of regular exercise as evidenced by uncontrolled diabetes, elevated HbA1c, dyslipidemia, and overweight status.

📄 Page 11-13 — Nursing Care Plans (NANDA Format)

Nursing Care Plan — 1: Risk for Unstable Blood Glucose Level

ASSESSMENT	NURSING DIAGNOSIS	GOAL / EXPECTED OUTCOME	PLANNING	IMPLEMENTATION	EVALUATION
Subjective: Patient complains of increased thirst, frequent urination, weakness, and tiredness. Patient says, “Mera sugar control nahi ho raha hai.” Objective: RBS 320 mg/dL, FBS 210 mg/dL, PPBS 286 mg/dL, HbA1c 9.1%, dry mouth, polyuria, irregular medication history, irregular diet pattern.	Risk for unstable blood glucose level related to inadequate diabetes management, irregular diet pattern, sedentary lifestyle, and insufficient knowledge regarding diabetic care as evidenced by RBS 320 mg/dL, FBS 210 mg/dL, PPBS 286 mg/dL, HbA1c 9.1%, polyuria, polydipsia, and fatigue.	Short-term goal: Patient’s blood glucose level will gradually reduce toward acceptable range within 3–4 days. Long-term goal: Patient will maintain blood glucose level through medication adherence, diabetic diet, exercise, and regular monitoring.	Monitor blood glucose regularly. Assess signs and symptoms of hyperglycemia and hypoglycemia. Administer insulin and oral antidiabetic drugs as prescribed. Maintain diabetic diet plan. Encourage adequate hydration. Educate patient regarding self-monitoring and medication adherence.	Checked blood glucose before meals and at bedtime. Administered regular insulin according to sliding scale as prescribed. Administered Metformin and Glimepiride as ordered. Observed patient for hypoglycemia signs such as sweating, tremors, dizziness, hunger, confusion, and weakness. Provided diabetic diet with controlled carbohydrate intake. Encouraged patient to drink adequate water unless contraindicated. Explained importance of taking medicines regularly and not skipping meals after insulin or antidiabetic tablets. Instructed patient to maintain a blood sugar record diary.	Patient’s blood glucose level improved gradually. RBS reduced from 320 mg/dL on admission to FBS 132 mg/dL by discharge. Patient verbalized understanding of medication schedule, diet control, and regular blood glucose monitoring.

Nursing Care Plan — 2: Deficient Knowledge

ASSESSMENT	NURSING DIAGNOSIS	GOAL / EXPECTED OUTCOME	PLANNING	IMPLEMENTATION	EVALUATION
Subjective: Patient says, “Mujhe diabetic diet aur foot care ke baare mein poori jankari nahi hai.” Patient reports irregular medicine intake and no regular blood sugar monitoring. Objective: Poor knowledge about diabetes complications, irregular follow-up, unhealthy diet habits, no regular exercise, right foot wound present.	Deficient knowledge regarding diabetes mellitus, medication adherence, diabetic diet, blood glucose monitoring, foot care, and prevention of complications as evidenced by irregular medication intake, lack of regular blood sugar monitoring, and poor understanding of diabetic diet.	Short-term goal: Patient will verbalize basic understanding of diabetes, medication, diet, and foot care within 48 hours. Long-term goal: Patient will demonstrate correct self-care practices and follow regular treatment plan after discharge.	Assess patient’s existing knowledge about diabetes. Teach disease process in simple language. Explain medication schedule and importance of compliance. Teach diabetic diet and exercise plan. Educate regarding foot care and warning signs. Involve family members in teaching.	Explained diabetes as a condition in which blood sugar remains high due to insufficient insulin action. Explained importance of taking antidiabetic medicines regularly at the same time daily. Taught patient not to skip meals after insulin or tablets. Explained diabetic diet: avoid sweets, sugary drinks, fried foods, refined flour, and excess rice/potato. Advised intake of whole grains, pulses, green vegetables, salads, and controlled portions. Taught daily foot inspection, washing feet with lukewarm water, drying between toes, applying moisturizer except between toes, and wearing comfortable footwear. Instructed not to walk barefoot. Educated family to support diet control and follow-up visits.	Patient and family verbalized understanding of diabetes care. Patient correctly repeated medication timing, diabetic diet restrictions, foot care steps, and warning signs requiring medical attention.

Nursing Care Plan — 3: Risk for Infection

ASSESSMENT	NURSING DIAGNOSIS	GOAL / EXPECTED OUTCOME	PLANNING	IMPLEMENTATION	EVALUATION
Subjective: Patient complains of mild discomfort at right foot wound site. Objective: Superficial right foot wound present, delayed healing, dry skin, hyperglycemia, wound swab showing mild bacterial growth, no fever.	Risk for infection related to hyperglycemia, delayed wound healing, and impaired immune response as evidenced by superficial right foot wound and mild bacterial growth in wound swab.	Short-term goal: Patient will remain free from signs of systemic infection during hospitalization. Long-term goal: Wound will heal without complications, and patient will follow proper wound and foot care at home.	Assess wound condition daily. Monitor temperature and signs of infection. Maintain aseptic technique during dressing. Administer antibiotics as prescribed. Maintain blood glucose control. Teach foot hygiene and wound care.	Inspected wound for redness, swelling, discharge, warmth, pain, and foul smell. Monitored temperature and WBC count. Performed daily dressing using aseptic technique with povidone iodine as prescribed. Administered Amoxicillin + Clavulanic Acid 625 mg BD as ordered. Maintained blood glucose monitoring and insulin therapy to promote wound healing. Encouraged protein-rich diabetic diet for tissue repair. Educated patient to keep feet clean and dry and avoid barefoot walking.	Patient remained afebrile. No pus discharge or spreading redness observed. Wound condition improved, and patient verbalized correct wound care and foot care measures before discharge.

📄 Page 14 — Discharge Summary

Mr. Rajesh Kumar Sharma, 54-year-old male, was admitted to the medical ward with complaints of increased thirst, frequent urination, weakness, fatigue, occasional blurred vision, and delayed healing of a small right foot wound. On admission, his random blood sugar was 320 mg/dL, fasting blood sugar was 210 mg/dL, post-prandial blood sugar was 286 mg/dL, and HbA1c was 9.1%, indicating uncontrolled Type 2 Diabetes Mellitus.

During hospitalization, the patient was managed with regular blood glucose monitoring, insulin therapy according to sliding scale, oral antidiabetic medications, diabetic diet, hydration, wound dressing, and health education. His blood glucose level gradually improved. By discharge, fasting blood sugar reduced to 132 mg/dL, vital signs were stable, and the right foot wound showed improvement without signs of systemic infection.

The patient and family were educated regarding diabetes mellitus, medication adherence, diabetic diet, regular exercise, blood glucose monitoring, foot care, wound care, prevention of complications, and follow-up visits. Patient is being discharged in stable condition with advice to continue medicines regularly and follow diabetic lifestyle modification.

At discharge, the patient is advised to:

Take all antidiabetic medicines exactly as prescribed by the physician.
Do not skip meals after taking insulin or oral antidiabetic tablets.
Monitor blood sugar regularly and maintain a blood glucose record diary.
Follow a diabetic diet: avoid sweets, sugary drinks, fried foods, refined flour, and excess rice or potato.
Include whole grains, pulses, green leafy vegetables, salads, fruits in controlled quantity, and protein-rich food as advised.
Drink adequate water unless restricted by the physician.
Walk for at least 30 minutes daily as tolerated.
Maintain ideal body weight and avoid sedentary lifestyle.
Stop tobacco chewing completely.
Inspect feet daily for cuts, cracks, redness, swelling, blisters, or wounds.
Wash feet daily with lukewarm water and dry properly, especially between toes.
Do not walk barefoot, even inside the house.
Wear comfortable, well-fitting footwear.
Keep right foot wound clean and dry; continue dressing as advised.
Report immediately if wound shows redness, swelling, pus discharge, foul smell, fever, or increasing pain.
Recognize symptoms of hypoglycemia such as sweating, tremors, hunger, dizziness, confusion, and weakness.
Carry sugar candy/glucose tablets for emergency hypoglycemia management.
Attend follow-up visit after 1 week or as advised by the physician.
Repeat HbA1c every 3 months and lipid profile as advised.
Consult doctor immediately if blood sugar remains very high, patient develops vomiting, excessive weakness, drowsiness, chest pain, breathlessness, or altered sensorium.

📄 Page 15 — Health Education

Medication Compliance —
Patient was educated to take antidiabetic medicines regularly at the prescribed time. He was advised not to stop medicines when symptoms improve because diabetes is a chronic condition requiring long-term control. Patient was instructed not to skip meals after taking insulin or oral antidiabetic tablets, as this may cause hypoglycemia. He was taught to keep medicines safely, follow correct dose, and consult the doctor before changing any medicine. Family members were advised to support the patient in maintaining a regular medication schedule.

Blood Glucose Monitoring —
Patient was advised to monitor fasting and post-prandial blood sugar regularly as prescribed. He was instructed to maintain a blood glucose diary with date, time, reading, medicine taken, diet changes, and symptoms if any. HbA1c testing every 3 months was advised to assess long-term glucose control. Patient was educated that good sugar control helps prevent complications such as diabetic foot, kidney disease, eye disease, nerve damage, heart disease, and stroke.

Diabetic Diet —
Patient was advised to follow a balanced diabetic diet with controlled carbohydrate intake. He was instructed to avoid sweets, sugar, jaggery, honey, sugary tea, cold drinks, packaged juices, bakery items, fried snacks, refined flour products, and excessive rice or potato. He was advised to include whole wheat roti, oats, dal, pulses, sprouts, green leafy vegetables, salad, curd, and protein-rich foods in controlled portions. Meals should be taken at regular intervals and skipping meals should be avoided. Portion control was emphasized. Patient was advised to consult a dietician for an individualized diabetic diet chart.

Exercise and Weight Control —
Patient was advised to perform regular physical activity such as brisk walking for 30 minutes daily, at least 5 days per week, as tolerated. He was instructed to avoid prolonged sitting and include light household activity. Exercise helps improve insulin sensitivity, reduces blood glucose level, controls weight, improves lipid profile, and reduces cardiovascular risk. Patient was advised to start slowly and increase activity gradually. He should avoid exercise during severe hypoglycemia, very high blood sugar with illness, or if feeling dizzy or weak.

Foot Care —
Patient was educated that diabetic patients are at high risk of foot ulcers due to reduced sensation, poor circulation, and delayed wound healing. He was advised to inspect both feet daily for cuts, cracks, redness, swelling, blisters, wounds, or color changes. Feet should be washed daily with lukewarm water and dried properly, especially between toes. Moisturizer may be applied to dry skin but not between toes. Nails should be cut straight across. Patient should not walk barefoot and should always wear soft, comfortable footwear. Any foot injury should be reported early.

Hypoglycemia Management —
Patient was taught symptoms of low blood sugar such as sweating, tremors, hunger, dizziness, headache, palpitations, confusion, irritability, weakness, and fainting. If symptoms occur and patient is conscious, he should immediately take 15 grams of fast-acting carbohydrate such as glucose powder/tablet, sugar candy, or sweet drink, then recheck blood sugar after 15 minutes if possible. After recovery, he should take a small snack or meal. Family members were educated to seek emergency help if patient becomes unconscious or unable to swallow.

Prevention of Complications —
Patient was educated that uncontrolled diabetes can affect eyes, kidneys, nerves, heart, blood vessels, and feet. Regular eye check-up, kidney function test, urine microalbumin, lipid profile, blood pressure monitoring, and foot examination were advised. Patient was instructed to stop tobacco chewing completely because tobacco increases risk of vascular disease, delayed wound healing, heart disease, and stroke. He was advised to attend regular follow-up and never ignore wounds, infection, chest pain, breathlessness, severe weakness, vomiting, or altered sensorium.

Follow-up Care —
Patient was advised to visit the physician after 1 week or as instructed. He should bring blood sugar records, medicine list, and wound dressing details during follow-up. HbA1c should be repeated every 3 months. Lipid profile, renal function test, urine test, eye examination, and foot examination should be done as advised. Patient and family were encouraged to maintain long-term lifestyle modification for better diabetes control and prevention of complications.

📄 Page 16 — Bibliography

Brunner, L.S. & Suddarth, D.S. (2022). Textbook of Medical-Surgical Nursing (15th ed.). Wolters Kluwer. Chapter: Management of Patients with Diabetes Mellitus and Metabolic Disorders.
NANDA International. (2024). Nursing Diagnoses: Definitions and Classification 2024–2026 (13th ed.). Thieme Medical Publishers.
Lewis, S.L., Bucher, L., Heitkemper, M.M., Harding, M.M., Kwong, J., & Roberts, D. (2023). Medical-Surgical Nursing: Assessment and Management of Clinical Problems (12th ed.). Elsevier.
Ignatavicius, D.D., Workman, M.L., Rebar, C.R., & Heimgartner, N.M. (2024). Medical-Surgical Nursing: Concepts for Interprofessional Collaborative Care (11th ed.). Elsevier.
Doenges, M.E., Moorhouse, M.F., & Murr, A.C. (2024). Nursing Care Plans: Guidelines for Individualizing Client Care Across the Life Span (11th ed.). F.A. Davis Company.
American Diabetes Association. (2025). Standards of Care in Diabetes—2025. Diabetes Care, 48(Supplement 1).
World Health Organization. (2025). Diabetes — Fact Sheet. WHO, Geneva.
Indian Council of Medical Research. (2024). ICMR Guidelines for Management of Type 2 Diabetes Mellitus. ICMR, New Delhi.

⚕️ Medical Disclaimer: This nursing care plan is prepared for educational and academic purposes only as part of nursing practical file work (ANM, GNM, BSc Nursing). It is not intended for actual patient care, clinical decision-making, or medical diagnosis. Always refer to your institution's guidelines and standard nursing textbooks.