Diabetes Management - Assignment Example

Diabetes management xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx Name xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx Course xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx Lecturer xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx Date Diabetes Management Introduction Diabetes is a chronic medical disease which is common in the current world. This condition results to an increase in blood sugar, glucose, levels. There are severe complications associated with diabetes; poor circulation, vascular disease, kidney failure, heart disease, stroke and neurological diseases. It is important to note that diabetes cannot be cured. However, it can be treated successfully. The complications that rise with diabetes can be prevented by carefully monitoring sugar level, cholesterol levels and high blood pressure. There are three types of diabetes, gestational, type 1 and type 2 (Inge & Krebs 2004). Gestational diabetes is a form of diabetes that is commonly found only on pregnant women. Type 1 is also referred to as insulin-independent diabetes or juvenile, occurs when the human body is not able to secrete enough insulin. It is usually diagnose in adolescence or childhood and it requires treatment with insulin in the lifelong. Type 2 diabetes, also referred to as adult onset, is more common than type 1 diabetes. In recent times, type 2 is becoming more common in children as a result of increase in obesity among the young people. The main issue facing this condition is resistant to insulin. The body is able to secrete insulin but it is unable to process glucose in the body. In some cases, however, some patients suffer from insulin deficiency. It is not to the same degree as seen in type 1. Management of a diabetes patient calls for a skills of active participation of the patient and several professionals such as diabetes educator, dietitian, specialist physician and general practitioner (Nathan & Davidson 2007). Aim The aim of this paper is to evaluate diabetes management from the Diabetes Australia. This will assist in developing a health education website on the management of diabetes. The website will be a useful tool in gaining important information on how to manage diabetes. Literature review Diagnosis According to Knowler & Fowler (2002) blood tests are done to diagnosis diabetes. All the tests involve drawing of blood and sending the sample to the lab for analysis. Various test used for diagnosis include; an oral glucose tolerance (OGTT), fasting plasma glucose (FPG), Hemoglobin A1c, glycohemoglobin, HbA1c or A1C test (Fisher & Brownson 2007). Random Plasma Glucose (RPG) is another test that is used to diagnose diabetes in regular check up. The A1C is mainly used to detect prediabetes and diabetes type 2. It is not recommended for gestational or type 1 diabetes. The test shows the average of an individual’s blood glucose level for the last 3 months and does not indicate daily fluctuations. This test has an advantage over the traditional glucose test as it does not require fasting and the test can be done at any time. The normal level of A1C test is below 5.7 %. People with A1C below this are at a risk for diabetes while those above 5.7% are at a high risk of suffering from diabetes (Patel & MacMahons 2008). Duckworth & Abraira (2009) assert that FPG is also used to detect prediabetes and diabetes. it is a common test compared to OGTT as it is less expensive and convenient. The test measures blood glucose after the individual has fasted for about 8 hours. It is mostly done in the morning. Individual with fasting glucose level between 100 -125 mg/dL are said to have Impaired fasting glucose while those above 126 mg/dL and has been confirmed by three repeated test within a test, confirm presence of diabetes (Bolen & Feldman 2007). The OGTT is used in diagnosis of gestational, prediabetes and diabetes. The test is more sensitive than FPG test. However, it is less convenient when it comes to administering. The blood glucose is measured after an individual fast for more than 8 hours and 2 hours after drinking a liquid that contains glucose dissolved in water (Gaede & Pederson 2008). An individual is said to have prediabetes if the two-hour glucose level falls between 140 – 199 mg/dL. This type od prediabetes ix known as impaired glucose tolerance. A blood glucose test above 200 mg/dL indicates presence of diabetes (Gaede & Perderson 2008). Assessment Metzger & Lowe (2008) assets that assessing diabetes involves assessing patient’s overall emotional, mental, physical health status, confirming the glycemic control status and complications that may be as a result of diabetes and star treatment. Assessing a diabetic individual does involve determining the purpose for their visit and permits the practitioner an opportunity to inform the patient about the process of the disease and various ways to prevent any assumed complications (Inzucchi 2012). Health care and medication for diabetes patients One way of caring for a diabetic patient is through the management of blood glucose management. This management reduces macrovascular and micovascular diabetes complications. Weinger & Carver (2008) maintain that there is a need, therefore, to control hypertension in order to reduce eye, kidney and cardiovascular risks. In order to management blood pressure, some strategies may be applied which include; strategies to reduce excess body weight and sodium intake. These calls for an increase intake of vegetables, fruits, avoid high consumption of alcohol, low intake of fat dairy products and increase in physical activity. The patients may also use medication in treatment of hypertension. Such medications include; ACE inhibitors, thiazide diuretics, angiotensin receptor blockers, calcium channel blockers, beta blockers and ACE inhibitor-diuretic combinations. It is important to understand that multidrug therapy is vital in order to achieve and sustain blood pressure that is recommended for patients with diabetes. Regular check-ups are necessary and treatment ought to be adjusted when need be (McDowell & Brown 2007). For patients with history of cardiovascular diseases, an aspirin therapy is recommended daily. This will reduce any cardiovascular events. Dental care is a significant care that should be extended to the patient. Poor control of glycemic may worsen tooth decay and periodontal disease. Conversely, these diseases may lead to worsening of glycemic control. A diabetic patient is ought to be encouraged to floss and brush teeth after each meal and visit a dentist yearly (Sinclair 2009). Depression management is essential in taking care of a diabetic patient. It is obvious presence od diabetes may increase the risk of depression. Indeed, diabetic patients when depressed are not in a good position to do self-management tasks. Therefore, screening and treating for depression may effectively improve diabetes management. In addition, treatment of depression with medication, psychotherapy or even a combination of both may assist in improving an individual’s well-being. According to Funnell & Brown (2007) Medical nutrition therapy is part of diabetes management. It is usually provided by a dietitian who evaluates the nutrition status of the patient and collaborates with the individual in order to create an individual meal plan. A MNT is important in order to achieve weight and other types of treatment goals (Dunning 2009). Physical activities is vital element in the in improving glycemic control, CVR risk, help in weight maintenance. Aerobics activities are recommended for the patients. In absence of contraindications, adult with diabetes are basically advised to do resistance exercise thrice a week (Inge & Krebs 2004). Medication therapy for management of weight may be administered for patients with diabetes and are obese or overweight. In some cases bariatric surgery may be necessary in patients who are obese and are not responding to medical management. The risks and bariatric surgery largely depend on skills of the surgeon, individual circumstance and type of surgical procedure (Diabetes Care 2007). Self care behavior is recommended for the patient. The individuals should work together with the health care group in order to develop a personal physical activity and food plan. Long term complications may be prevented if the patient practice the following safe care behaviors; eat variety of food low in sodium, sugar and saturated fats and high in fiber; reduce the size of food portion in order to avoid increase in weight; intense physical activities; dentist care; stop smoking; seek assist for depression, stressed related stress and distress; regularly check up for blood glucose and take the prescribed medication (Nathan & Kuenen 2008). Factors complicating management Several factors do complicate the management of diabetes. However, it is important to note that these factors are independent from the disease itself. Risk factors It is obvious that diabetes is an independent risk factor for micro and macrovascular disease. Glycemic control has evidently led to the control of long term macrovascular complications. In addition, the control of hypertension has reduced the complications that lead to microvascular. Reduction in micro and microvascular does not only depend on glycemic control but aslo on modification of various factors such as hypertension, dyslipidaemia and smoking. It is evident that diabetes increases the development of atherosclerosis of aorto-ilio-femoral and coronary systems. These are the main cause of premature death of patient suffering from diabetes type 2. Cardiovascular diseases are common in women who are suffering from diabetes. Essentially, management of these factors, that is, smoking, dyslipidaemia and hypertension will lead to the reduction of developing macrovascular diseases (Funnell & Brown 2007). Smoking, if a lifestyle of a diabetic patient may results in management complication. It has been confirmed that smoking is a major contributor to the development of macrovascular complications for diabetic patients. Evidently, minimal interventions may reduce cessation rates. In most patients, diagnosis of diabetes brings in an opportunity to bring in cessation of smoking. Presence of hypertension in individuals with diabetes is a significant contributor risk factor for retinopathy, nephropathy and macrovascular disease such as peripheral, cerebral and coronary. In order to reduce morbidity, early detection, regular review and active treatment are essential. A physician should aim at reducing blood pressure to normal levels as such people are susceptible to hypertension damage. Dyslipidaemia is frequent in patients suffering from diabetes and is a risk factor for the macrovascular complication s in diabetes. It is important to identify and treat the condition (Diabetes Australia 2008). Poor control of dyslipidaemia with persistent of hyperglycemia leads hypertriglyceridaemia. Essentially, diabetes is a common condition in the current world. The disease is as a result of increased glucose level in the blood. This may be attributed to insufficient insulin or failure of insulin in processing glucose in the blood. Three types of diabetes have been identified; gestational, type 1 and type 2. They affect different ages; however, they may be universal. The most important is managing the condition as it is not possible to cure the disease. References Bolen, S & Feldman, L 2007, Systematic review: comparative effectiveness and safety of oral medications for type 2 diabetes mellitus. Ann International Medicine, 386-399 Diabetes Australia, 2008, Diabetes management in general practice. The National Diabetes Services Scheme, Sydney Diabetes Care, 2007, America Diabetes Association: Clinical practice recommendations- Standard of Medical Care in Diabetes. Washington Duckworth, W & Abraira, C 2009, Glucose control and vascular complications in veterans with type 2 diabetes. New English Journal Medicine , 129-139 Dunning, T 2009, Care of People with Diabetes: Amanual of nursing practice. New York: Wiley Fisher, E & Brownson, C 2007, The Robert Wood Johnson Foundation Diabetes Initiative: demonstration projects emphasizing self-management. Diabetes Education, 86-88 Funnell, M & Brown, T 2007, National standards fro diabetes self-management education. Diabetes Care, 1630-7 Gaede, P & Pederson, O 2008, Effect of a multifactorial intervention on mortality in type 2 diabetes. New English Journal Medicine, 580-591 Gaede, P & Perderson, O 2008, Multifactorial intervention and cardiovascular disease in patients with type 2 diabetes. New English Journal Medicine, 383-393 Inge, T & Krebs, N 2004, Bariatric surgery for severely overweight adolescents: concerns and recommendations. Pediatrics, 114 (1): 217-223 Inzucchi, S 2012, Diagnosis of diabetes. The New England Journal of Medicine, 1-12 Knowler, W & Fowler, S 2002, Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. New English Journal Medicine, 393-403 McDowell, J & Brown, F 2007, Diabetes: a handbook for the primary healthcare team. New York: Wiley Metzger, B & Lowe, L 2008, Hyperglycemia and adverse pregnancy outcomes. New English Journal Medicine, 1991-2002 Nathan, D & Davidson, M 2007, Impaired fasting glucose and impaired glucose tolerance: implications for care. Diabetes Care, 30(3): 753-359 Nathan, D & Kuenen, J 2008, Translating the AIC assay into estimated average glucose values. Diabetes Care, 31 (8): 1473-1478 Patel, A & MacMahons, S 2008, Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes. New English Journal Medicine, 2560-2572 Sinclair, A 2009, Diabetes in old age. London: Wiley Weinger, K & Carver, C 2008, Educating your patient with diabetes. New York: Routledge Read More