Management of the patient with diabetes mellitus during surgery or illness.

In conclusion, the stress of surgery, illness, and everyday life can be managed if both the diabetic and the nurse are aware of the effects of stress upon diabetic control and are prepared to deal with those effects. Stressors need to be identified. The patient needs to know how to respond to illness before it occurs. With proper interventions, a positive outcome with minimal risk can result.

Vascular complications associated with diabetes mellitus.

Angiopathy is a significant complication of diabetes that often results in tremendous losses for the client: vision, mobility, a sense of well-being, occupational choice, independence, and financial security. Diabetic angiopathy is not a single complication, and the two types of angiopathy can overlap in pathophysiology, persons affected, and alterations experienced. The variety of pathophysiologic factors implicated at this time and the range of alterations experienced by the client illustrate the complexity of diabetes. The uncertainty concerning the etiology of diabetic angiopathy is related to the current incomplete understanding of diabetes itself. Because the client can experience so many alterations, not all of which are understood, the nurse has the opportunity and responsibility to perform thorough assessments and to implement creative approaches when caring for these patients (Table 6). And as more is learned about diabetes and diabetic angiopathy, the losses experienced by the diabetic may be lessened as nurses apply this knowledge clinically.