Diabetes Type 2
Type 2 diabetes can be described a one of the most common forms of diabetes that exists today. It need to be understood that what happens to an individual when he suffers from type 2 diabetes is that he would not be able to produce enough insulin, which is needed for the body in order to be able to use sugar effectively, or perhaps his cells would ignore the insulin that his body is producing. It would help to remember the important fact that it is sugar that provides energy for the body, and unless the sugar is absorbed and taken in to the body and to the blood and thereafter to the cells by the insulin, the individual would suffer from glucose build up. This can be extremely dangerous for the person, who is stated to be suffering from the dreaded Type 2 diabetes. Two major problems are caused by the disorder: the cells may become starved for energy, as the energy is not processed in a proper manner. On the other hand, the higher levels of blood glucose may end up harming the internal organs of the person, causing great irreversible damage to the eyes, kidneys, nerves and heart. (American Diabetes Association, 2007a)
Immediately after one has been diagnosed with type 2 diabetes, one cannot help but feel a sense of panic, but the fact is that the disease is easily manageable and people with diabetes have lived full and healthy lives, without any major complications, provided they manage the disease well. The generally prescribed goals for a diabetic patient would be 80 to 120 before meals, while a level of 140 could mean an impending danger. Experts state that exercise may be one of the most effective means of minimizing the risk of type 2 diabetes complications. (Valentine; Biermann; Toohey, 1998) a proper diet, leading to an optimum weight is also very important in diabetes management, and it is an undeniable fact that obesity would cause several risks to one’s health, chiefly among them being cardio vascular disease, risk for blood pressure, and diabetes. (Ezrin; Kowalski, 1999)
The link between type 2 diabetes and heart disease is close indeed. Statistics show that almost two out of three people with diabetes die due to heart diseases, because of the simple fact that people with diabetes are at risk for developing coronary heart diseases, which are caused by a narrowing of the blood vessels that carry blood to the heart. The risks however can be lowered significantly if the individual were able to keep the ‘ABC’s of his diabetes on target, thereby preventing the complications that accompany the disease. While ‘A’ stands for a-1-C, which refers to the blood sugar test with a ‘memory’, in which one’s average diabetes or sugar levels are kept recorded to be available whenever necessary. According to the American Diabetes Association, it would be best for a diabetic to maintain an a-1-C average of about 7. (American Diabetes Association, 2007b)
An individual’s blood pressure is an indication of the force of blood inside the blood vessels. This means that when the pressure of blood is high, the heart would have to pump that much harder to cope with the additional burden, and the ADA recommends an optimum blood pressure level of about 130/80 mmHg. Cholesterol on the other hand, reveals to the individual the amount of fat that he is carrying in his blood. While HDL cholesterol would help protect the heart, LDL cholesterol would lead to a clogging of one’s blood vessels, leading to heart disease. When the a, Band C. are kept within the prescribed parameters, a type 2 diabetic patient would not have any difficulty in managing his disease well, and he would therefore be able to lead a life of which he remains in control at any given time. (American Diabetes Association, 2007b)
Dorothy Oren, a nursing professional, has developed a ‘Self-care’ model for self-care and management of a disease, by the patient. This model details three systems that traditionally exist within this professional nursing practice model, and they are the compensatory system, the partially compensatory system, and the educative-development system. Self-care, as described by Dorothy Oren, is a vitally important requirement for a patient, for him to be able to sustain life as well as health. It is a generally accepted theory that it is when a patient actively participates in his own care and disease management or recovery that quicker progress would be made, and when the patient gains a certain amount of competency in this regard, and then this would have a direct and long lasting effect on his longevity. (Mayo, 1997) nurse can assist the patient in achieving credibility and competence in self-care, while basic health education would help an individual to be informed, motivated and encouraged to actively participate in maintaining a healthy lifestyle. As defined by Steiger and Lipson, 1985, self-care refers to those “activities initiated or performed by an individual, family or community to achieve, maintain or promote maximum health,” and self-care can indicate that competency which would remain in continual development throughout the patient’s life, even if he had special needs. The basic goal of patient self-care would be to empower a patient, as well as his family, into remaining constantly aware of his disease, and the ways and means in which he would be able to manage the disease well, so that it remains in control at any given period of time. (Mayo, 1997)
Type 2 diabetes can be managed through a variety of different treatments: pharmacological as well as non-pharmacological. However, it may be up to the patient to help himself with self-care, so that his disease remains under control, and so that it does not affect his internal organs adversely, over the long run. A physician has the option of using either pharmacological or non-pharmacological treatment choices for his patient. He could prescribe lifestyle changes as well, in conjunction with a strict exercise regimen. Whatever he may decide, it is considered the physician’s duty to make sure of offering his patient high quality and cost effective treatment, which would facilitate blood glucose control to optimum levels and also reduce the array of symptoms and complications that are generally associated with type 2- diabetes. Proper management of diabetes would no doubt dramatically reduce the morbidity and the mortality rates that are normally associated with type 2 diabetes. Non-pharmacological therapy for diabetes would include meal planning and physical activity. (Webb; Lipsky; Shamoon, 2000)
Diet and exercise can in fact be extremely important in managing diabetes, and experts recommend vital lifestyle changes for those patients who may need lipid regulation to manage their blood glucose levels. For such people, the first priority would be to effectively reduce the patient’s intake of saturated fats in his diet, as well as to reduce the LDL levels by better managing the cholesterol levels. The ATP III recommends that the patient must have a higher intake of total fat, which consists of monounsaturated fats and unsaturated fats. These would help lower the triglyceride levels, and also raise the HDL levels for the patient. (Hirsch, 2006)
Pharmacological treatment on the other hand concentrates on drug therapy to bring one’s blood sugar levels under manageable levels and under control. The American Diabetes Association recommends that one must take into consideration the patient’s glycemia when using pharmacological treatment options to control his diabetes. Drug classes that would work better towards lowering the important function of glucose-lowering or perhaps work better within the combination therapy used for diabetes is generally recommended by experts. It is important to note that even if a patient does indeed start off with non-pharmacological treatment for his diabetes management, that is, making lifestyle changes and also bringing in changes in his diet, he would have to start on pharmacological therapy at the earliest, if he were to hope to live a full and healthy life after his diagnosis. (Hirsch, 2006)
Today, as more and more experts have come to the realization that diabetes education for the patient, as well as for his family can become an important component in learning how to manage diabetes, more and more patients are recognizing the need to bring in vital changes in their diet and lifestyle, so that they may be able to manage their disease in a more effective and efficient manner. Diabetes education aims at changing the behavior of the patient, and to promote self-management on a large scale. This means that the basic role of the diabetes educator has changed form being an ‘expert’ who would give out important information, to that of a ‘facilitator’, who would help his patient learn what he needs to know about his disease, and its management. (“The need for diabetes education,” n. d.)
Diabetes can be psychologically and behaviorally traumatic for the patient, especially when it is initially diagnosed. It is at this time that familial and spousal support can be extremely important, especially when the patient is himself undergoing adjustment problems to the medication, his lifestyle, and to his diet. One must remember that poor coping skills would render the patient more susceptible to diabetes related complications, and also have an adverse impact on self-care. It is in order to counter this that individuals and their families are advised to undergo regular screening procedures, so that psychological and related problems could be handled at the very outset, instead of allowing them to fester, thereby putting the patient at greater risk. Anxiety, eating disorders, and depression can be some of the more serious complications created by untreated psychological traumas related to diabetes and its diagnosis. (“Psychological aspects of diabetes,” 2003) Community resources can be very helpful indeed for a patient who may feel depressed and anxious; when he meets others who are like him, it would automatically help in alleviating some of these psychological symptoms that aggravate his disease. (“Community Resources for patients with diabetes,” 2007)
To conclude, it must be said that type 2 diabetes may be common enough, but for the patient who has been diagnosed with the disease, it can lead to great stress and trauma. These can be alleviated to a certain extent through familial support and self-care, but all the same, drugs and non-pharmacologic treatment and pharmacotherapy can be used in the treatment as well. Managing diabetes must be learned, and if the patient is trained in taking care of his disease after the requisite changes in diet, lifestyle and medicines, there is no reason why he cannot lead a long, full and happy healthy life.
American Diabetes Association. (2007a) “Type 2 Diabetes” Retrieved 4 November, 2007 at http://www.diabetes.org/type-2-diabetes.jsp
American Diabetes Association. (2007b) “Diabetes, heart disease and stroke, taking care of your heart” Retrieved 4 November, 2007 at http://www.diabetes.org/type-1-diabetes/well-being/taking-care-heart.jsp
Ezrin, Calvin; Kowalski, Robert E. (1999) “The type 2 diabetes diet book” McGraw-Hill
Hirsch, Irl B. (2006, Sep) “Pharmacological treatment for diabetes” DOC News, vol. 3, no. 9, p. 5.
Mayo, a. (1997) “Portfolio professional nursing” Retrieved 4 November, 2007 at http://members.aol.com/annmrn/nursing_portfolio_I_index.html
N.A. (2007) “Community Resources for patients with diabetes” Retrieved 4 November, 2007 from http://www.healthcentral.com/diabetes/community.html
N.A. (n. d.) “The need for diabetes education” Retrieved 4 November, 2007 at http://www.worldwidediabetes.com/system/html_site/education/role/de_need.htm
N.A. (2003) “Psychological aspects of diabetes” Clinical Practice Guidelines. Retrieved 4 November, 2007 at http://www.diabetes.ca/cpg2003/downloads/psychological.pdf
Valentine, Virginia; Biermann, June; Toohey, Barbara. (1998) “Diabetes Type 2 and what to do”
Webb, Michele R; Lipsky, Martin S; Shamoon, Harry. (2000) “Treatment options for Type 2 diabetes, American Academy” Retrieved 4 November, 2007 at http://www.aafp.org/PreBuilt/monograph_diabetestreatment.pdf
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