HOME CARE OF DIABETIC PATIENTS WITH CHRONIC KIDNEY DISEASE STAGE 3 COMPLICATIONS IN THE COMMUNITY: CASE STUDY

Abstract

Diabetes mellitus is a chronic disease with a steadily increasing prevalence, especially among patients who are unable to achieve effective glycemic control. Poor blood glucose management significantly increases the risk of various complications, with chronic kidney disease being among the most common and severe, adversely affecting patients' quality of life and potentially leading to disability and the need for dialysis if not properly managed. The objective of this study was to analyze and compare the causes, disease mechanisms, pathophysiology, physiology, signs and symptoms, disease progression, and health data of the case studies, and to propose guidelines for nursing care planning for diabetic patients with stage 3 chronic renal disease in a home-care context. The study involved two patients: the first was a 76-year-old Thai woman with a 19-year history of diabetes, who successfully maintained adequate blood glucose control. She also had comorbidities including hypertension, hyperlipidemia, and stage 3 chronic kidney disease, and was diagnosed with type 2 diabetes mellitus with hypertension and chronic kidney disease stage 3. The second patient was an 87-year-old Thai woman with a 24-year history of diabetes who struggled to regulate her blood glucose levels, and had similar comorbid conditions. The findings of this study highlight the differences in health outcomes between patients with well-controlled versus poorly controlled diabetes. This study underscores the importance of care for diabetic patients in the community, particularly those with stage 3 chronic kidney disease. Community support and appropriate health education provided by healthcare professionals can significantly improve disease management, reduce the risk of severe complications, and enhance overall quality of life.