Clinical Assessment, Diagnosis and Treatment of Diabetes - Essay Example

? Diabetes Table of Contents 1 Introduction 3 2 Case Study 3 3 Path Physiology of Diabetes 3 4 Clinical manifestations and features of diabetes 4 1.5 Clinical Assessment, Diagnosis and Treatment of Diabetes 5 1.6 Management of Type 2 Diabetes 5 1.7 Complications of diabetes 6 1.8 Multi-Professional Diabetes Services 7 1.9 Evaluation of education strategies towards effective self management of diabetes 8 1.10 Evidence based knowledge related to the assessment, treatment and management based on the best practice 8 1.11 Conclusion 8 Bibliography; 10 1.1 Introduction The Case Study revolves around middle –aged patient who has been diagnosed with symptoms of Type 2 Diabetes. The paper begins with an explanation of the path physiology that is related to type 2 Diabetes. This is followed by explaining the clinical manifestation and features that are related to the condition. Clinical assessment, diagnosis, and treatment of the condition are extensively discussed with the inclusion of the most preferred kind of tests. Additionally, the paper gives a clear outline of the management, complication, and multi professional diabetes services that are relevant to type 2 diabetes. 1.2 Case Study Sarah is 39 years old lady admitted to the ward due to abdominal pain, loss of weight, dehydration, and generally feeling unwell. On admission, Sarah does not have past medical history but genetically has diabetes and heart disease. Through examinations such as chest x-rays, ECHO, blood and urine test, it is clear that there is glucose in the urine, with further investigations showing that she has type 2 diabetes. Finally, the study gives evidence on the evaluation of education strategies in relation to the effective self management on Sarah, and evidence based knowledge with regard to assessment, treatment and management based on the best treatment. 1.3 Path Physiology of Diabetes Diabetes is a combination of disorders in the metabolic systems that are characterised by a chronic hyperglycaemic condition resulting from inadequate action of insulin (Clark, 2004). In essence, type 2 comprises of an impaired secretion of insulin, as well as, increased resistance of insulin. Moreover, the impairment of cell functions and pancreatic deteriorates over time (Anderson and Braun, 2007). Apparently, type 2 diabetes is caused by a combination of genetic factors that are related to the secretion of insulin, resistance of insulin and environmental factors such as lack of exercise, over eating and aging. Besides, type 2 is a disease that is caused by multi factors that entail multiple genes and environmental factors, which vary depending with the situation (Barnett, A., 2011). None the less, the advancement of type 2 diabetes is purely associated with a family history of diabetes like in the case of Sarah. The considerable higher concordance rate between monozygotic twins as compared to that between dizygotic twins indicates the involvement of genetic factors. Hence, it is assumed that pathogenesis is involved in the genetic abnormality, in the molecules related to the regulatory system of glucose metabolism. The role of environmental factors such as aging, obesity, insufficient energy consumption among others are independent risk factors that are associated with type 2 diabetes. Impaired secretion of insulin and its actual resistance contribute to the advancement of path physiological conditions. Essentially, impaired insulin secretion is a reduction of the response of glucose, which is present at the onset of diabetes. The tolerance of glucose is induced by reduction of glucose response in the early phase of insulin secretion, over and above, the reduction of insulin secretion after any meals (Winter et al., 2002). This reduction is crucial as it plays a basis path physiological change especially when the disease is at the early stage. If not treated it results to a decrease in pancreatic and cell mass in a human being a situation that affects the long term of blood glucose, (Williams et al., 2007). On the other hand, resistance of insulin is a condition where by insulin in the body does not give out required action that is equal to concentration of blood. The impairment of insulin in organs such as liver and muscles is a common characteristic of path physiology as the resistance of insulin develops and expands before the disease is realised (Elliott et al., 2006). 1.4 Clinical manifestations and features of diabetes Type 2 is a form of Diabetes that mostly occurs after the age of 40 years and hence referred to maturity onset diabetes. Basically, this type of diabetes is stronger than the type 1 diabetes although the magnitude of genetic composition is not known but is thought to involve numerous genes. Type 2 diabetes accounts for more than 85per cent of the total population suffering from the disease all over the world (Ford, 2004). The frequency of the condition and most common age of onset of is not the same depending on different populations, with the highest prevalence being found in specific ethic groups around the world. Of importance to note is that, since it is a family disease proper diet and exercise may postpone the onset of the condition or better still the disease may not occur at all (Fox and Hanas, 2007). In light with this, type 2 diabetes is characterized by increased thirst, which could be caused by dehydration, increased hunger especially after eating, dry mouth, frequent urination and headaches, poor vision especially at night, unexplained weight loss even when there is increased hunger, over and above, the general feeling of being weak, unwell or fatigue. Some of these symptoms have been demonstrated by tests that have been done on Sarah. 1.5 Clinical Assessment, Diagnosis and Treatment of Diabetes It is crucial that anytime a person suspects to have diabetes she, or he should see the doctor promptly so that an accurate diagnosis is done. In fact, early diagnosis and treatment helps to prevent diabetes –related complication (Day, 2002). Simply, blood tests are used to determine the blood glucose levels. Three most common tests that assist in the diagnosis include: Fasting blood glucose test: this is the most common test that entails taking a blood sample to measure the level of glucose in the blood after some hours of intentional starving. Random Blood test; this test entails taking a sample of blood regardless of when a person ate to determine the blood glucose level. HbA1c test; this blood test is used to indicate the average glucose level over a specific period of time. It further assists in monitoring progress of the condition and effectiveness of treatment (Henry and Edelman, 2011). Of importance to note is that, the accepted range of glucose in the blood is 40-80 mmol/L before any meal. In this regard, if classical symptoms done in the blood glucose level is higher than 11mmol/L for a random blood glucose test or higher than 7mmol/L for a fasting blood glucose test. Urine test; this test can also be used to measure the glucose level in the blood as they demonstrate high levels of glucose although they are not used in seclusion. In case, diabetic symptoms are suspected the doctor may also examine the eyes, kidneys and heart to ensure that there no damages caused by diabetes. In Treatment, it is evident that Diabetes cannot be cured but can be controlled. Treatment ensures that the level of blood glucose is maintained, over and above, preventing complications that are associated to it. This involves balancing lifestyle factors such as diet and exercise and prescribed medications. To effectively control diabetes, it is advisable that the patient receives treatment and is monitored by a doctor. Promotion of health, early diagnosis of the disease, been aware of the condition with the inclusion of effective monitoring of the glucose level in the blood is very important toward treatment (Calpis and Frangopoulos, 2012). 1.6 Management of Type 2 Diabetes Lifestyle factors particularly exercise and diet are crucial roles towards the treatment of type 2 diabetes (Mehra and Wilson, 1997). In the diet, it is recommended that food containing refined sugars should not be used such as chocolate, soft drinks, and jam among others. Instead natural carbohydrates such as, whole meal bread and cereals which are easily convertible to energy are highly recommended (Gorshow et al., 2008). Diets for such patients should be less fatty with high dietary fibre. Besides, regular and moderate exercise is important in ensuring that the level of glucose in the blood is balanced. It further maintains a healthy body weight, controls blood pressure and cholesterol levels (Burant, 2004). Never the less, medication is ultimate in controlling type 2 diabetes and any other type of diabetes. However, it varies according to the stage in which the disease was diagnosed. In light of this, type 2 diabetes in Sarah was diagnosed at the early stages of the disease meaning that the disease can easily be controlled (Davidson, 2000). 1.7 Complications of diabetes Diabetes is known to have a sudden onset and chronic complications especially if it is not well managed. Acute complications includes hypoglycaemia, a condition that is caused by the abnormal low levels of blood glucose brought about by the excessive medication, taking less food than required or even too much exercise has been taken (Zierath and Hawley, 2008). Thus, hypoglycaemia affects the proper functioning of cells in the nervous system, leading to nervousness, dizziness, weakness among other complications. In case the condition is treated early, it prevents symptoms from becoming severe. However, if diabetes is not treated it may lead to a coma or seizure (Niewoehner, 2004). On the other hand, chronic complications occur when the blood vessels are damaged. In essence, diabetes cause small blood vessels to weaken and break while the large vessels coagulate, contracted and become clogged-up with fatty deposits, a process known as atherosclerosis. As a result, there is poor circulation, which paves the way for easy infections (O?zcan, S., 2003). Of importance to note is that, complications in diabetes occur only when the disease is not controlled for a long period of time. Moreover, complications in diabetes may include; damage of nerves, clouded vision, kidney failure, teeth and gum problems and impotence in men. In nerves, diabetes is capable of damaging nerves especially those of the lower legs, and hands (Poretsky, 2002). This further causes numbness, and pain in the affected areas. In eyes, diabetes weakens the tiny vessels in the retina, a condition that is known as diabetic nephropathy. Besides, when kidney blood vessels are injured, they are unable to function efficiently culminating to kidney failure. Diabetic patients are more susceptible to developing teeth and gums infections, which require them to regularly visit dentist (Thomas, 2013). 1.8 Multi-Professional Diabetes Services Diabetes mellitus is rated among the common chronic disorders in United Kingdom and is alleged to affect all groups of people. In light of this, several multi professional diabetes services have come up in a bid to provide patients like Sarah with different professional services that will assist them in managing type 2 diabetes (McCray, 2009). Although the onset of type 2 diabetes is less dramatic as compared to other types of diabetes, the long term consequences are similarly devastating (Higham, 2006). None the less, the provision of diabetes services and care is handled by a huge range of professionals such as the general practitioners, specialist diabetes teams, patients and their caretakers. Achieving good outcomes for patients like Sarah can only be dependent by the provision of well organised and coordinated professional services. For instance, in the United Kingdom diabetes began with producing leaflet giving an explanation on what treatment and advice to expect from the healthcare team. The aim of Diabetes care is to empower individuals be have the courage to manage their own diabetes and help them adopt and maintain a healthy life style. Moreover, patients like Sarah are given an opening to involve herself in every step of the health care (Hughes et al., 2005). One of the most important professional diabetes is provision of dietary advice. It is advisable that patients of diabetes should be assessed by a registered dietician. Practising nurse should then take up the role in ensuring that the patient understands the importance of the diet and following it to the latter. Another important professional service is the continuous care that involves those who have newly be diagnosed with diabetes like Sarah to frequently attended reviews on metabolic control, cardiovascular risk, over and above, long term complications (Kaku, 2010). Further follow up appointment should be offered to focus on the issue which emergence unpredictably. Through this, patients like Sarah and others that fall under this group of Type 2 Diabetes are able to control and manage the disease in a professional manner with much assistance from those who are specialised in specific areas in relation to the disease (MacKinnon et al., 2007). 1.9 Evaluation of education strategies towards effective self management of diabetes In relation to Sarah’s condition, it is important that she goes through education strategies that allows her to effectively self manage type 2 diabetes. Through education strategy, she will be able to take the much control on her situation on a day to day basis (Vileikyte and Boulton, 2011). If anything the more Sarah knows about her own diabetes, the easier it becomes to handle it. She should be able detect any problem through self examination, for instance examining their feet regularly to determine if there are unusual feelings in relation to diabetes (LeRoith, et al, 2004). Additionally, she should have a knowhow on managing diabetes or when to seek help. For instance, in case she develops chest infection, flu or any other complication. Of importance to note is that asking the question during consultation is help in managing type 2 diabetes. It is also advisable to read widely on diabetes as the reading materials give more information and educates more on the disease (Mackinnon et al., 2003). 1.10 Evidence based knowledge related to the assessment, treatment and management based on the best practice With reference to the Case study, it is evident that Sarah has been diagnosed with Type 2 Diabetes which is mostly prevalent in the world. The most important thing for Sarah is to start her medication immediately to avoid any complication of the situation. She should follow her medication to the later and ensure that she engages herself in regular exercise to keep her glucose level balanced in reference to her condition. Diets, which are low in fat but high in fibre, are advised as they control the blood pressure, and cholesterol levels (Vileikyte and Boulton, 2011). Besides, Sarah should have sound knowledge of her condition as it assists her in managing her condition in term of what to eat and the positive handling of own self. Through this, Sarah is certain that she will be able to control the disease at best as the disease is not curable at present. 1.11 Conclusion The Case Study revolves around middle –aged patient who has been diagnosed with symptoms of Type 2 Diabetes. Diabetes is a group of metabolic disorders that are characterised by a chronic hyperglycaemic condition resulting from inadequate action of insulin. Apparently, type 2 diabetes is caused by a combination of genetic factors that are related to the secretion of insulin, resistance of insulin and ecological factors like lack of exercise, over eating and aging. Besides, type 2 is a disease that is caused by multi factors that entail multiple genes and environmental factors, which vary depending with the situation. Of importance to note is that since it is a family disease proper dieting and monitored exercise assist in delayed onset of the condition or better still the disease may not occur at all. Word count (2503) Bibliography; Anderson, C. and Braun, C., 2007. Pathophysiology: functional alterations in human health. Philadelphia: Lippincott Williams & Wilkins. Barnett, A., 2011. Type 2 diabetes. Oxford: Oxford University Press. Burant, C. et al., 2004. Medical management of type 2 diabetes. Alexandria, Va.: American Diabetes Association. Calpis, I and Frangopoulos,S.,2012. Type 2 diabetes: causes, treatment and preventive strategies.[Hauppauge] New York : Nova Biomedical, Nova Science Publishers, Inc. Clark, M., 2004. Understanding diabetes. Chichester, England; Hoboken, NJ, USA: John Wiley & Sons. Davidson, J., 2000. 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