Diabetes insipidus is a condition where the kidneys do not function properly. This condition occurs when there is not enough blood glucose in the body to support the function of the pancreas to produce insulin.
As a result, people with diabetes who are not using insulin for their treatment have difficulty in regulating their blood glucose levels. This can be problematic, as people with diabetes can’t tell if and how much of a medication they’re taking.
Since medication affects many things in the body, including the brain, making sure that an individual with diabetes is taking their medication as prescribed is an important part of care.
Fluid intake recommendations
Diabetes insipidus is a rare condition in where the outside world does not receive enough blood sugar to maintain healthy function. This is called diabetes without treatment or non-treated diabetes.
In order for a person with diabetes to retain insulin and glucose levels, adequate fluid intake is critical. According to the National Diabetes Association, women with diabetes are recommended to drink at least 2 glasses of water per hour of drinking sessions.
Unfortunately, people with diabetes can have trouble measuring their thirst so an accurate water intake is not always the best idea. Fortunately, people with diabetics often hold excess water inside their cells in the form of sweat which is full of water. This makes for an even more necessary habit of keeping track of!
So how much should a person with non-treated diabetes drink? According to the National Diabetes Education Program (NDEP) Clinical Practice Guideline 310K (modified), about half a glass per hour while taking care of yourself and your family.
When a patient has diabetes insipidus, or DIF, which is a type of diabetes in which the inability to process blood due to lack of an active insulin regimen reduces or eliminates the production of the hormone A1C, glucose monitoring is not necessary.
This medication may be helpful in maintaining a reasonable blood sugar level. As such, it is important for patients to regularly update their meds and to keep track of any test results.
Typically, patients must be measured at least once per day to ensure adequate med compliance, and frequent monitoring is needed to prevent low blood levels or insufficient production of the medication.
Another important part of care that requires attention is adherence. Because DIF medications can sometimes have side effects such as appetite change or sleep change, it is important for patients to keep track of how often they are taking their medications.
Education on symptoms
When caring for a client with diabetes insipidus, you must be aware of signs and symptoms. These include:
Worsening or stopping the intake of sweets, especially high sugar sweets
Keeping track of blood glucose levels to prevent hypoglycemia (low sugar blood)
Keeping tabs on how much insulin is needed to manage the diabetes and monitoring its effectiveness when administered. (Typically, it must be injected only by a trained person.)
Being prepared for possible withdrawals or drop in glucose levels which can be dangerous for the individual with diabetes. Keeping tabs on how much insulin is needed can help save some of it.
Frequent urine checks
As a registered nurse, you may be familiar with the term frequent urination. This refers to checking the patient’s urine output and/or frequency during care.
It is important for a patient with diabetes who is not taking insulin to frequently urinate to help keep blood sugar levels up. Additionally, checks in the early stages of diabetes where glucose is not necessary are helpful.
In the early stages of diabetes, frequent checking may also help remind patients of their condition. When a patient does not feel comfortable having a nurse check their urine often, there are two tools one can use to do so: a urinary guide wire and an insulin glider! Both of these allow the nurse to easily check the urine output and frequency without too much exertion on the part of the nurse.
Client compliance with medication dosage
When caring for a client with diabetes insipidus, the nurse expects to administer the drug or drug dosage each time the client takes a dose. This can be difficult when the client does not take their insulin as prescribed or does not follow the schedule of medication administration.
Insulin is a drug and has a specific way to enter your body during medication administration. Regularly taking your insulin on time can prevent several cases of hypoglycemia (low blood sugar), such as when eating a mealtime snack or coffee breakfast.
When taking an insulin shot, the nurse should be prepared to immediately draw some blood and give an insulin test if there is too little or none in the system. Once this is done, the first shot can be given within minutes of second shot taken to ensure proper blood and insulin levels.
Medical referral if symptoms are not improving
When the client’s diabetes insipidus (DIC) is not improving on its own, a nurse can contact a medical ethics committee to determine if a referral is needed.
Some patients with DIC do not improve with standard therapies such as low-dose insulin, oral glucose, and fluid intake. A referral from a medical ethics committee can be used if the patient does not have an adequate response to the other therapies available.
When seeking a referral for this patient, the nurse must first determine if the patient has any comorbidities that would affect the response to therapy. If so, then the nurse can politely but firmly remind them of this before offering any therapy.