Diabetes; a Contemporary Approach. Managing Diabetes in a Patient with Enduring Mental Health Problems.

DIABETES; A CONTEMPORARY APPROACH

2486 WORDS
CONTENTS
CONTENTS PAGE 1
INTRODUCTION PAGE 2
DISCUSSION PAGE 2
CONCLUSION PAGE 8
REFERENCES PAGE 9
ARTICLES ACCESSED ONLINE PAGE 12
APPENDIX 1 SCENARIO PAGE 13
APPENDIX 2 ‘EATWELL PLATE’ PAGE 14

Introduction
Lavinia had suffered a relapse in her mental health and had been using illicit drugs and alcohol to combat the disturbing positive symptoms of her illness and had stopped taking any of her prescribed medications. The nursing assessment indicated that the first issue to deal with was her chaotic behaviour and once that was under control a series of therapeutic interventions could be put in place to aid her recovery. Initially her chaotic presentation and challenging behaviours (Beer et al, 2005; Xeniditis et al, 2001) made it difficult to engage with her with in a therapeutic way and she resisted staff’s attempts to help her. The decision was made to manage her using intramuscular injections (IM) of an anxiolytic that necessitated using physical restraint in order to administer the IM. The first few days were not pleasant for Lavinia due to staff needing to restrain and inject her in order to manage her challenging behaviours but her chaotic behaviour did resolve over time and she became more accepting of staff interventions. Lavinia’s named nurse engaged with her and spent time ‘counselling’ her and a series of therapeutic interventions were agreed. Mental health nurses are specialists in caring for people with mental health problems and it has been identified that they have deficits in their knowledge of diabetes (Nash, 2009). This was the case in caring for Lavinia at the time. Little emphasis was placed on the importance of managing her diabetes because staff were not aware of the implications of poor diabetes management.

Discussion
In the United Kingdom mental illness is by far the largest single

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