OSSSC Nursing Disease Guide

Non-communicable · Very high priority

Diabetes mellitus

Core disease facts with the linked government programme, prevention and treatment or cure reality.

TypeNon-infectious metabolic disorder involving insulin deficiency, insulin resistance or both.

Government programmes, schemes and services

  • Programme: National Programme for Prevention and Control of Non-Communicable Diseases (NP-NCD): Promotes healthy living and screens adults aged 30 years and above for diabetes and other common NCDs, then links confirmed cases to treatment and follow-up.
  • Service: Ayushman Arogya Mandir and National NCD Portal: Arogya Mandirs provide nearby screening and continuing primary care, while the portal records risk assessment, diagnosis, treatment and follow-up.
  • Odisha initiative: NIRAMAYA and Nidaan: Support access to listed medicines and specified diagnostic tests in Odisha government health facilities; they are broad health schemes, not diabetes-control programmes.

Prevention

  • Prevent: Screen adults ≥30 years; healthy weight, diet, activity, tobacco avoidance, foot/eye/kidney checks

Treatment and cure reality

  • Treat: Usually controlled, not cured. Lifestyle measures, oral/injectable medicines and insulin; selected type 2 patients may achieve remission but still need follow-up.

Must remember

  • Core problem: Chronic hyperglycaemia caused by impaired insulin secretion, insulin action, or both.
  • Type 1: Autoimmune beta-cell destruction; usually requires insulin from diagnosis.
  • Type 2: Insulin resistance with progressive beta-cell dysfunction; most common type.
  • Classic symptoms: Polyuria, polydipsia, polyphagia, unexplained weight loss, fatigue, recurrent infections, and slow wound healing.
  • Diagnostic values: Fasting plasma glucose ≥126 mg/dL; 2-hour Oral Glucose Tolerance Test ≥200 mg/dL; glycated haemoglobin ≥6.5%; or random plasma glucose ≥200 mg/dL with classic symptoms.
  • Prediabetes values: Fasting 100–125 mg/dL, 2-hour value 140–199 mg/dL, or glycated haemoglobin 5.7–6.4%.
  • Hypoglycaemia clues: Sweating, tremor, hunger, palpitations, confusion, seizure, or coma; give fast-acting carbohydrate if conscious.
  • Diabetic ketoacidosis: Hyperglycaemia, ketosis, metabolic acidosis, dehydration, abdominal pain, and Kussmaul breathing; more typical of type 1.
  • Hyperosmolar hyperglycaemic state: Extreme hyperglycaemia and dehydration with little ketosis; more typical of type 2.
  • Microvascular complications: Retinopathy, nephropathy, neuropathy.
  • Macrovascular complications: Coronary disease, stroke, and peripheral arterial disease.
  • Foot care: Daily inspection, washing/drying, proper footwear, no barefoot walking, and early referral for ulcers.
  • Programme screening: Adults 30 years and above are screened, commonly with a glucometer, with confirmatory testing according to protocol.
  • Urine Benedict’s test trap: Detects reducing sugar; it is not the preferred diagnostic test for diabetes and can react with substances other than glucose.