DIABETIC FOOT EXERCISE FOR BLOOD GLUCOSE INSTABILITY INTWO OLDER ADULTS WITH TYPE 2 DIABETES MELLITUS: ACLINICAL CASE REPORT

Abstract

Background: Older adults with type 2 diabetes mellitus are vulnerable to blood glucose instability and lower-extremity complaints, including stiffness, numbness, and tingling. Diabetic foot exercise is a simple non-pharmacological nursing intervention that may support peripheral circulation, muscle activity, and glucose utilization. Case Summary: This report describes two anonymized male residents of a nursing home in Cirebon, Indonesia, who had type 2 diabetes mellitus and the nursing diagnosis of unstable blood glucose level related to insulin resistance. Case 1 was a 69-year-old man with recurrent nocturia, fatigue, difficulty walking with a walker, foot stiffness and numbness, and random blood glucose of 421 mg/dL. Case 2 was a 73-year-old man with foot stiffness and tingling, nocturia, fatigue, hunger, anxiety regarding blood glucose elevation, hypertension history, and random blood glucose of 205 mg/dL. Investigation and Diagnosis: Both cases were assessed through nursing interview, physical examination, vital signs, medication review, and serial random blood glucose monitoring. Management: Diabetic foot exercise was implemented once daily for three consecutive days, 10-15 minutes per session, after routine pharmacological therapy. The intervention was combined with monitoring, education regarding diet and exercise adherence, and collaboration for antidiabetic medication. Outcome: In Case 1, random blood glucose decreased from 421 to 206 mg/dL; symptoms of stiffness and numbness persisted and the nursing problem was not fully resolved. In Case 2, random blood glucose decreased from 205 to 105 mg/dL and foot stiffness/tingling improved; the nursing problem was considered resolved. Conclusion: Diabetic foot exercise may be a feasible adjunctive nursing intervention for older adults with diabetes, but outcomes can vary according to baseline glucose level, mobility limitation, symptom severity, and adherence to diet and exercise.