hronic complications may beset the diabetic patient (Robertson, 1995, p. 34). Of the acute complications, the most prevalent in insulin-treated patients is hypoglycemia. More than 90 percent of Type I diabetics experience episodes of symptomatic hypoglycemia, and some Type II diabetics also experience symptomatic hypoglycemia. Unrecognized and untreated, hypoglycemic can result in seizures, unconsciousness, brain damage, and death.
In assessing diabetic patients, the nurse practitioner must proceed on an assumption that the diabetic patient of interest is characterized by hypoglycemia unawareness, a condition wherein the first manifestation of hypoglycemia may be the neuroglycopenic symptoms (Wierenga & Hewitt, 1994, p. 139). The indicators considered in this paper for the maintenance of health for assessment of the diabetic patient within the context of hypoglycemia unawareness are as follows:
1. Blood-glucose levels must be within the 4.4 to 8.3 mmol/L range.
2. When fasting blood-glucose levels are persistently 10 mmol/L or higher, the blood-glucose level should be measured between 2 and 4 AM the following day to assure that blood-glucose levels are within the 4.4 to 8.3 mmol/L range.
3. Scheduled meals and snacks must not be skipped, and should not be delayed for more than 30 minutes from the scheduled time.
4. Alcohol consumption should not exceed two ounces of liquor, eight ounces of wine, or 24 ounces of beer per week.
5. Body weight should be maintained within 10 percent of prescribed weight.
Foot condition evaluation is of special significance in the assessment of Type II diabetic patients (Plummer & Albert, 1995, p. 47). Feet should be examined by the nurse practitioner for peripheral neuropathy, peripheral vascular disease, foot ulcers, and deformities. Potentially unsafe nail and foot care practices should be identified by the nurse practitioner during the assessment process. Foot care assess...