Diabetes mellitus (DM) is regarded as one of the most potentially disabling illnesses accompanied by multiple complications. One of the primary complications associated with diabetes is known as retinal vascular disorder, also referred to as retinopathy. The disease is a leading cause of blindness among members of the working population and overall disability. In discussing the prevalence and severity of the illness, Ahmed et al., (2016) say, "It is documented that more than 77% of patients who survive for over 20 years with DM are affected by retinopathy." Untreated retinopathy due to diabetes not only leads to blindness but also heightens the economic burden experienced by the health care industry in a given community. Some of the common characteristics that accompany the disease include retinal ischemia and an increased level of retinal vascular permeability. Vision loss is a major possibility secondary to neovascularization and vitreous hemorrhage.
Treatment of diabetic retinopathy remains a major possibility. It is in this regard that Stewart, (2016) asserts, "Remarkable advances in the diagnosis and treatment of DR have been made during the past 30 years, but several important management questions and treatment deficiencies remain unanswered." Management of the illness depends on early diagnosis and timely treatment. All the patients with both types of diabetes mellitus must undergo diagnosis in the form of fundus examination and the screening eye examination. Some of the drugs used for treatment include corticosteroids and anti-VEGF drugs. A study completed by Duh et al.,(2017) based on clinical trials concludes that “In the modern era, multiple phase 3 clinical trials have demonstrated the superiority of intravitreous anti-VEGF injections to laser monotherapy in reducing vision loss and improving rates of vision gain in eyes with DME.”
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Impaired Physical Mobility
Mobility is associated with an individual's ability to move and encompasses both the gross and motor motions. Crawford & Harris, (2016) in their discussions, believe that "Physical mobility requires sufficient muscle strength and energy, along with adequate skeletal stability, joint function, and neuromuscular synchronization." Some of the risks associated with gross physical mobility include chronic illnesses, chronic pain, and traumatic injury. The authors go on to assert that impaired mobility comes with a host of negative consequences on virtually all the available body systems. On a long term basis, the immobility can give rise to loss of function and deconditioning. The impaired physical immobility also comes with psychosocial effects characterized by mood and affect changes. Impaired mobility might give rise to anxiety, boredom, anger, grieving, and altered nonverbal patterns. The patient might also develop an altered body image, which might significantly lower their body image. Most fundamentally, it might give rise to a sense of powerlessness in an individual.
The treatment of impaired physical mobility will begin with the prompt treatment of the wound. Depending on its nature, the wound can be treated using various strategies that will include using antibiotics and cleaning the affected area with aseptic means. For older adults, exercise will also be recommended, especially in cases where the wound affected the muscles of the individual (Ross et al., 2013). The nurse will also guide the patient on certain nutritional needs that could restore their mobility. This could include foods that strengthen the muscles and improve bone strength in the affected areas. Vitamin D supplement drugs will play a significant role in the strengthening of bones, which will ultimately enhance their physical movement. The physician can also prescribe assistive devices such as the crutches and wheelchairs for a particular period before the full healing process occurs.
References
Ahmed, R. A., Khalil, S. N., & Al-Qahtani, M. A. (2016). Diabetic retinopathy and the associated risk factors in diabetes type 2 patients in Abha, Saudi Arabia. Journal of family & community medicine, 23(1), 18.
Crawford, A., & Harris, H., (2016). Caring for adults with impaired physical mobility. Nursing2018, 46(12), 36-41.
Duh, E. J., Sun, J. K., & Stitt, A. W. (2017). Diabetic retinopathy: current understanding, mechanisms, and treatment strategies. JCI insight, 2(14).
Ross, L. A., Schmidt, E. L., & Ball, K. (2013). Interventions to maintain mobility: What works?. Accident Analysis & Prevention, 61, 167-196.
Stewart, M. W., (2016). Treatment of diabetic retinopathy: recent advances and unresolved challenges. World journal of diabetes, 7(16), 333.
