Diabetes as a Health Condition - Term Paper Example

Diabetes Name Course Tutor Date Introduction The body cells assimilate glucose for metabolism and the glucose productions controlled by insulin, an enzyme produced by the pancreas. However, in diabetes, the body is unable to either produce insulin or regulate its production. With less energy for metabolism, people with diabetes face severe symptoms that lead to disability and premature death. However, through medicine, research and social programs, ways of managing diabetes and enable the patients live quality worthwhile lives are endorsed. Diabetic educators take up roles to assist these patients and their families in self care tips but as the disease prevalence increases, the educators also face challenges in carrying out their roles. This paper focuses on an overview of diabetes as a health condition and the challenges faced by diabetes educators in assisting diabetic individuals and their families cope with diabetes. Types of Diabetes Diabetes conditions occur in varied forms although Diabetes mellitus is the commonest kind of diabetes characterized by glycosuria (O’Brien, Thow and Ofei, 2006). A rare form known as Diabetes insipidus is characterized by excessive tasteless urine production, a condition referred to as polyuria. In discussing diabetes, Diabetes mellitus is usually referred and there are three common types. First, there is type I diabetes, previously referred to as insulin dependent diabetes or childhood onset diabetes because it occurs mostly at young ages and results from insulin deficiency in the body. In most cases, the body’s inability to produce insulin is caused by congenital factors. This kind of diabetes accounts for about 10 percent of diabetic cases and it is managed through insulin injection. Second, type II diabetes that was previously referred to as non-insulin dependent diabetes or adult onset diabetes is the most prevalent type of Diabetes mellitus and accounts for about 85 to 90 percent of all diabetes cases. With this type of diabetes, the pancreas is unable to regulate insulin production and sometimes insulin deficiency occurs. Third, gestational diabetes occurs in pregnant women where they experience hyperglycaemia despite lacking prior symptoms of diabetes. The prevalence rate is about 6 percent of all diabetes cases. Sometimes, gestational diabetes predisposes these women to type II diabetes. Diabetes prevalence in Australia and the world The World Health Organization (WHO), (2000) reports that approximately over 170 million people suffer from diabetes worldwide and the trend is rising so fast that the number is expected to double by 2030. Type II diabetes is especially common in the developed countries and with the increasing global industrialization, developing countries are steadily following suit and soon the condition will be pandemic. Diabetes affects people of all demographics world-wide and is a burden to the health care system in Australia (National Public Health Partnership, 2003, 2). The Australian Bureau of Statistics’ (2006, 6) national health survey estimates that 3.5 percent of the population was diagnosed with Diabetes mellitus in the year 2005 excluding the percentage of gestational diabetes. 83 percent were diagnosed with type II diabetes while 13 percent with type I diabetes. The study further shows that 56,300 people showed high levels of sugar in the blood and urine although not yet diagnosed with diabetes. However, this already shows that these people are at risk of getting diabetes and the steady rising trend of the disease since 1999 confirms the situation (O’Brien, Thow and Ofei, 2006). In terms of gender, there was no significant difference; with men at 4 percent while women at 3 percent. However, there was remarkable difference as far as age was concerned. Over 50 percent of patients with Type II diabetes were over 50 years of age while over 35 percent of young persons of 24 years and below had type I diabetes. To further confirm the worrying trends of diabetes rise in Australia is the ABC News (2008, July 2) report, where Australia is position only second to the Scandinavian countries as far as escalating figures of diabetes is concerned. Risks factors in Diabetes Together with cardiovascular and chronic kidney diseases, diabetes account for almost two thirds of deaths caused by illnesses in Australia and impose about a third of the overall Australian burden (O’Brien, Thow and Ofei, 2006; NPHP, 2003). The burdens are imposed on the health care scheme and families in terms of both emotions and finances because managing diabetes is very expensive. Other than congenital factors or some pharmacotherapy inducing factors, the rising trend of diabetes is associated with the certain risk factors prevalent in modern lifestyles such as obesity and overweight, unhealthy diet, physical inactivity and high blood pressure due to stress. Industrialization has also introduced toxins in the environment that can predispose individuals to type II diabetes; for instance many plastics contain Biphesnol A which is known to cause this type of diabetes. Diabetes complications predispose the individual to macrovascular, microvascular and peripheral vascular diseases. Macrovascular diseases affect important body organs like the heart and brain and can lead to coronary failure and stroke while microvascular diseases bring complications to the smaller blood vessels therefore causing retinopathy, neuropathy and kidney failure diseases. Since there is limited metabolism in diabetes patients acute ketoacidosis can occur thereby toxifying the blood and in some instances, patients go into a diabetic coma. The general signs and symptoms in diabetic patients include frequent thirst and hunger feelings as well as frequent urination. In type I diabetes the child weighs less despite eating and both mental and physical fatigues are experienced. Other common symptoms with these patients include poor vision resulting from prolonged absorption of glucose. Diabetic dermadromes and feet lesions are other painful conditions present in diabetic patients due to peripheral ischemia. If feet lesions exacerbate, they lead to gangrene and amputation of the lower extremity is done to prevent further infection. Diagnosis of diabetes is usually confirmed with blood tests that check the amount of glucose in the blood. Diabetes management The chronic nature of diabetes makes its cure difficult to achieve and the disease management is demanding but euglycemic conditions should be met by the patient as often as manageable. Diabetic educators advise the patients on disease management and care tips that can improve life’s quality. First, that patient needs to focus on a good, healthy diet. Second, exercise and fitness programs can be advised to retain the blood glucose levels within the acceptable range and reduce risks of other predisposing conditions like cardiovascular disease and hypertension. Third, appropriate diabetic medication is available; the most important one being insulin therapy, especially in type I diabetes that uses Humulin N (NPH) insulin or the available synthetic analogs. Depending on the type, insulin can have a quick onset of action and is the major regulator of blood sugar. Drugs are administered in type II diabetes and this can also be accompanied by insulin administration. Most diabetic drugs require oral administration and the main purpose is to lower the blood’s glucose levels. Diabetic patients especially those with type II diabetes are likely to experience hypertension and dyslipidmia and therefore lifestyle modifications are necessary to avoid further complications. Habits like smoking, drinking alcohol or abusing substances should be reduced or stopped all together. There are socks and shoes tailor-made to suit the needs of diabetic patients with foot ulcers. Educating the patients and encouraging them to participate in peer social circles allows them to understand the nature of the disease and hopefully lead a better life if the principles taught are applied. Physicians are involved in treatment and management of diabetes for both in patients and out patients although some circumstances require team work between podiatrists, dieticians, optometrists and nurse practitioners specialized in diabetes care. The backbone of the task is upon the Certified Diabetes Educators who strive to show the importance of self care in diabetes management. Diabetes Educators and challenges they face Diabetes educators provide professional healthcare in diabetes management and their dynamic roles entail education, counselling, clinical care and also research and management for reduction or prevention of diabetes complication and promoting health (Dunning, 2007). With understanding, it is established that the level of self care practices and emotional support from family and other close persons differentiates the perception of life’s quality among the diabetic patients. The Diabetes Educators have the responsibility to impart these necessary self-care knowledge and skills to the patients but their role is met with challenges that prevent goal achievement. One of the challenges faced by diabetes educators is the increase in the role demands and diversity in the scope of practice. In the 1970s when type I diabetes was more prevalent, the educator’s role was concentrated mainly on paediatric diabetes care and didactic and theoretical methods were used in most patients to teach on insulin medication and ways to reduce and manage blood sugar levels and other complications. However, with the rise of the disease and affect across all demographics and the changes in economic structure, the diabetes educator is required to advance further in education and role training so as to provide adequate control to the increasing complications. The role now focuses on research, diet management, insulin dose control and other specializations. Additionally, with the varying self care skills among the patients, the diabetes educators have to use interventions that are almost tailor-made to every patient. Not all patients require the same amount of insulin administration at the same time even if the disease onset was the same. Currently, role specialization takes the form of elderly care, gestational diabetes educator and insulin pump therapist among others. Moreover, other professionals are also training on the diabetes educator roles. Clinicians, general practitioners and some pharmacists apply these roles to their clients therefore reducing the need to visit the diabetic educator. This creates a lot of competition within the healthcare field and the once united associations of diabetes educators are now faced with disintegrations as individuals compete for clients. This is especially true where many private diabetic clinics are set by certified health care providers. The drawback is that diabetes educators with limited education, speciality and experience face reduction in services and this can negatively affect their careers or level of income. Furthermore, information sharing concerning latest interventions across the diabetes educators’ teams can be confined to specific united teams or individuals therefore reducing the overall goal of providing a nationwide health care to diabetes patients. Still, several studies that have been done now shift health care from hospitals to homes. Family interventions have been rated top in providing the best care or patients yet the current busy nature of diabetes educators may not allow enough time to teach the different families on the care. Many hospitals and health care facilities provide scheduled times when a diabetes educator is available so that families and patients can attend to learn about diabetes. However, with the busy modern life, not everyone may be able to attend and this reduces the chances for standard self-care. An option is to visit the private clinics or hire a family diabetes educator but again this may not work for low income earners. Another challenge is the cost of managing and treating diabetes complications especially for the patient. Insulin and oral diabetic drugs are very expensive because of the many resources directed towards their manufacturing. Many health insurance schemes are available but they rarely cover chronic conditions like diabetes. As much as diabetes educators would wish the best for the patients and advice on the care that the patient needs, the truth remains that in most cases, diabetes is expensive to manage even to some middle class persons. The efforts of the diabetes educator go to waste when the patient faces amputations, leads a poor quality life or dies prematurely because of insufficient money to cover medical costs. Facing emotional pain from the patients and family is another challenge in itself. Diabetes educators are also human beings with emotional cognition abilities and are able to empathise with the patients and it doesn’t help that the number of diabetes patients is increasing. Reassuring a patient or family of the sufferer that things will be alright despite the knowledge of a shortened life is difficult and requires a lot of understanding from the diabetes educator. This prompts the educator to train in counselling skills. Other than financial burdens some people perceive diabetes with less seriousness and continue with drinking and smoking kind of lifestyles therefore undermining the role of the educator. Such kind of patients can later be rushed to hospitals in emergency or critical conditions and may not recover or will require amputations because of lateness in beginning disease management programs. Conclusion The practice scope and role of diabetes educator continues to widen and consequently the challenges increase too. Research and innovations as well as growing demands of the society as diabetes prevails, impact the shift of the educators’ roles making them adapt to the changes (Dunning, 2007). Adapting to changes means facing new challenges and acquiring newer roles to enable them curb the diabetes condition. Patients, families, governments and sponsors need to unanimously support the efforts of diabetes educators because undeniably there efforts in controlling and managing diabetes are noticeable especially in countries like Australia, UK and Canada. On their part, the diabetes educators need positively adjust to the increasing demands in diabetes care. Bibliography Australian Bureau of Statistics (2006, February 27). “National health survey summary of results, Australia; 2004-05.” (6). Available online http://www.ausstats.abs.gov.au/Ausstats/subscriber.nsf/0/3B1917236618A042CA257 11F00185526/$File/43640_2004-05.pdf ABC News. (2008 July, 2). “Escalating diabetes figures present worrying trends.” Retrieved April 17, 2010, from http://www.abc.net.au/news/stories/2008/07/02/2292706.htm Dunning, T. (2007,November). ‘The complex and constantly evolving role of diabetes educators.” Diabetes voice. Vol 52. Retrieved April 17, 2010 from http://www.diabetesvoice.org/files/attachments/article_550_en.pdf National Public Health Partnership. (2003, May). “Diabetes in Australia.” (2). Available online http://www.dhs.vic.gov.au/nphp/catitrg/diabetesbgpaper.pdf O’Brien, K., Thow, A. & Ofei, S. (2006).”Diabetes hospitalization in Australia 2003- 2004.”Australian Institute of Health and Welfare. Canberra: AIHW. Bul. 47(84):1-3. Available online http://www.aihw.gov.au/publications/aus/bulletin47/bulletin47.pdf WHO (2000). “Global prevalence of diabetes: Estimates for the year 2000 and projections for 2030.” Retrieved April 17, 2010 from http://www.who.int/diabetes/facts/en/diabcare0504.pdf Read More