NANDA-I 2024-2026 edition · Reviewed November 2, 2026 by the editorial team
What happens in diabetes and where nursing comes in
Diabetes depends largely on what the person does every day: taking medications, checking blood glucose, eating and staying active. That is why many nursing diagnoses focus on self-management and teaching. Over time, poor circulation and neuropathy put the skin of the feet at risk.
What to assess
- Fingerstick blood glucose and HbA1c if available.
- How they take their medications and inject insulin.
- Diet, physical activity and daily schedule.
- Feet: skin, nails, sensation, pulses and footwear.
- Which signs of hypo- and hyperglycemia they recognize.
- Family support and financial or access barriers.
NANDA-I 2024-2026 nursing diagnoses for diabetes
| Code | Diagnosis | When it applies |
|---|---|---|
| 00489 | Risk for ineffective blood glucose pattern self-managementRisk · former code 00179 | Blood glucose out of target range due to errors in diet, medication or monitoring. |
| 00276 | Ineffective health self-managementProblem-focused | Unable to fit the treatment plan into daily life. |
| 00435 | Inadequate health knowledgeProblem-focused · former code 00126 | Does not know how to adjust the diet, recognize hypoglycemia or care for their feet. |
| 00047 | Risk for impaired skin integrityRisk | Neuropathy and dry skin increase the risk of foot wounds. |
| 00228 | Risk for ineffective peripheral tissue perfusionRisk | Vascular disease reduces blood flow to the legs and feet. |
| 00004 | Risk for infectionRisk | Hyperglycemia promotes infections, especially wound infections. |
How to prioritize them
In the hospital, blood glucose control and skin come first; for discharge, self-management and teaching. Your assessment makes the final call: anything that threatens life (airway, breathing, circulation) comes first.
Sample nursing diagnosis statements
Risk for Ineffective Blood Glucose Pattern Self-Management related to inadequate knowledge of matching food intake to insulin, irregular meal times, and irregular self-monitoring, in a patient with type 2 diabetes starting basal insulin (associated condition).
Ineffective health self-management related to complex treatment regimen and insufficient knowledge of sodium restriction and weight monitoring as evidenced by skipping the diuretic on workdays, not weighing self at home, 3 kg weight gain in 5 days, and second admission for decompensated heart failure in 6 months.
Inadequate Health Knowledge regarding insulin management related to information given in technical terms without supervised practice as evidenced by incorrect injection technique on return demonstration, inability to identify symptoms of hypoglycemia, and stating that they skip the dose when they do not eat.
Risk for impaired skin integrity related to inadequate foot care, inappropriate footwear and dry skin from insufficient moisturizing, in a patient with type 2 diabetes and peripheral neuropathy (associated condition).
Risk for ineffective peripheral tissue perfusion related to smoking, sedentary lifestyle and insufficient knowledge of factors that worsen circulation, in a patient with type 2 diabetes and hypertension (associated conditions).
Risk for infection related to malnutrition, inadequate care of the insertion site and insufficient knowledge of catheter care, in a patient with a central venous catheter (associated condition).
Fictional cases written by our team. Adapt them to your patient with the PES statement generator.
Nursing care plan summary
Main goals and interventions for the priority diagnoses. Each diagnosis page has the full plan, with rationales and a case study.
Risk for ineffective blood glucose pattern self-management (00489)
Goals
- Patient checks and records fasting blood glucose every day during the first 2 weeks on insulin.
- Before discharge, patient names at least three symptoms of hypoglycemia and explains how to treat it with 15 g of fast-acting carbohydrate and a recheck after 15 minutes.
Interventions
- Teach in short sessions and ask the patient to explain what they learned in their own words (teach-back method).
- Have the patient demonstrate insulin technique and site rotation, and correct errors on the spot.
- Teach how to use the glucometer, log readings with date and time, and bring the log to every appointment.
- Provide a written hypoglycemia plan: symptoms, the 15-15 rule, and when to call for help.
Ineffective health self-management (00276)
Goals
- Before discharge, the patient explains what each medication is for and when to take it.
- Weighs self every morning before breakfast and records it for the 4 weeks after discharge.
Interventions
- Check with the provider or pharmacist whether the regimen can be simplified (fewer doses per day).
- Set up a weekly pill organizer with the patient and a large-print medication schedule.
- Teach in short sessions and use teach-back: ask the patient to explain in their own words.
- Provide a written action plan with green (stable), yellow (call) and red (go to the ED) zones.
Inadequate health knowledge (00435)
Goals
- Patient explains in their own words what diabetes is and what insulin does within 48 hours.
- Patient demonstrates insulin administration without errors on two occasions before discharge.
Interventions
- Ask what the patient knows and believes about their illness before explaining.
- Use plain words, short sentences and only a few topics per session.
- Spread teaching over several short sessions during the stay, not just on the day of discharge.
- Demonstrate the technique and have the patient repeat it until they can do it without errors.
Build the full care plan as a table with the generator.
Frequently asked questions
What is the nursing diagnosis for diabetes?
The most common is Risk for ineffective blood glucose pattern self-management (00489). It was previously called Risk for unstable blood glucose level (00179).
Is "Unstable blood glucose level" still in NANDA-I 2024-2026?
That label belongs to the previous edition. In 2024-2026 the focus shifts to blood glucose pattern self-management (00489).
Which nursing diagnosis do I use for hyperglycemia in the hospital?
Risk for ineffective blood glucose pattern self-management (00489) if there are factors that could throw it off, plus the problem-focused diagnoses it causes, such as Inadequate fluid volume (00421).
Other conditions
Study material: the diagnosis selection, sample statements and care plans were written by our editorial team using the NANDA-I 2024-2026 classification. They do not replace clinical judgment or your facility's protocols.
Classification sources: NANDA-I 2024-2026, Thieme supplement · Elsevier summary of changes. Reviewed November 2, 2026.