Application of Dorothea Orem's Self-Care Deficit Theory in the comprehensive management of type 2 diabetes mellitus

Abstract

The study examined type 2 diabetes mellitus from the perspective of Dorothea Orem's Self-Care Deficit Theory and described how this approach guided nursing practice and research. It explained that self-care was a learned process that sustained life and well-being; when the subject did not meet their self-care demands, a deficit developed that required total or partial compensatory nursing systems and educational support. She reviewed the pathophysiology, noting that hyperglycaemia resulted from peripheral insulin resistance and progressive beta cell dysfunction, which predisposed individuals to chronic complications. He identified common signs and symptoms, classified the disease (type 1, type 2, and gestational), and specified modifiable and non-modifiable risk factors, highlighting the role of overweight, poor diet, and sedentary lifestyle. He described how diagnosis was based on tests such as HbA1c and FPG, and how treatment combined lifestyle modifications with stepwise pharmacological therapies, usually starting with metformin and, depending on the response, insulin analogues or incretin drugs and SGLT-2 inhibitors. He noted that prevention was based on health education, a low glycaemic index diet and regular physical activity. Finally, he developed nursing care focused on education, continuous monitoring, early detection of complications and addressing social determinants, concluding that the Orem model strengthened patient autonomy and optimised clinical and community outcomes.