Category: Diabetes

Fay is a man of age 34 who works for a construction company. He is a smoker. Being an unskilled laborer, he has been deployed in the housebuilding sector where he assists the masons in such activities as ferrying building stones and bricks to the site. It was noted that Fay becomes extremely worn out while executing the tasks. During the task, Fay makes a countless number of short calls and often takes water irrespective of the time of the day or the prevailing weather conditions.

Fay has impairments as his body functions are distorted. Once the human body develops diabetes, it follows that a person will regularly experience increased hunger, increased urination as well as an increased desire to take water (Beckles, 2008; White et al., 2010). Notably, Fay’s participation is quite inappropriate as he experiences activity limitations and participation restrictions.

According to site managers, his participation is not adequate. His workmates are not aware of his condition and they often make fun of him whenever he makes short calls and demandingly seeks water. While sometimes he develops a violent nature against his workmates for making fun of him, he complains of being side-lined and therefore becomes depressed.

Intervention

The future of a diabetic person who has ignored medication is usually hit by serious complications (Egede et al., 2002; D’Antonio & Lewenson, 2010). If the condition is ignored, it follows that a person can also experience non-ending complications such as ketaocidiosis, hypoglycaemia and hyperosmolar coma among other complications.

Fay is suffering from diabetes mellitus and as such, an intervention is required. According to medics, the best intervention for diabetes is Nursing Intervention. Nursing intervention can be described as actions that a nurse undertakes in an effort towards furthering treatment for a patient. The targeted ICF aspects include the development of the patient’s participation (i.e. participation in activities to help in blood circulation and controlling the mood through engaging the patient in exciting events). In other words, nursing intervention helps improve environmental factors.

However, while nursing intervention is regarded as the most effective intervention for diabetes mellitus, there are risks that are associated with it. Thus, a diabetic person is known to be short-tempered and can get aggrieved by petty things (Wendy & Votroubek, 2010).

Since the risk of violence for the diabetic patient cannot be completely eliminated, it is necessary that mitigation strategies be identified (Wagner, 2001). One of the main violence mitigation strategies is as follows: the caregiver can make attempts of decoding communication patterns that are seemingly incomprehensible. In addition to this, the health care professional can seek both clarifications as well as validation from the patient.

Apart from this, the health care practitioner can orient the patient to reality as it is required with regard to all medical cases. In this strategy, the medical practitioner is required to call the patient by his name. Further, the caregiver is required to validate the communication aspects that are said to assist in differentiating the real from the unreal (Chalmers, 2007).

These strategies give a revelation on how other people perceive the patient, while the mandate of not comprehending their behaviour is readily accepted by the nurse. Also, the strategies, in some cases, help in restoring the patient’s functional communication patterns (Juall & Moyet, 2008).

The Inter-Professional Team

Physical health care providers also play a big role in giving care to diabetic patients. They work hand in hand with nurses in an effort towards trying to maintain or even restore the normal conditions of a person with diabetes. They are essential in the care process as they usually take the vital responsibility of engaging the patient in activities, both psychological and real time activities. The physical health providers, by involving the patients, help improve their body systems through blood circulation. Light activities are ideal as they help in proper circulation of blood in the body (Smith, 2000).

In addition to this, the Physical health care providers engage people with diabetic activities in light as well as exciting activities and as such, apart from improving the blood circulation, the diabetic people are able to overcome their short tempers (Peters, 2006). Through such an activity, the patient is usually immersed in the captivating nature of the activity and therefore, there will be no situation where the patient will develop temper.

Eventually, the patient can become more responsive and more active. Indeed, the patient will be craving for another day to become engaged in such activities and in the long run, the physical health care provider will have achieved his/her goal. Therefore, the patient’s participation can improve in a great way with regard to his body functions through these activities (Hall, 2008). Admittedly, physical health care provider can help the patient improve contextual factors (environmental as well as personal factors).

Characteristics of Professionalism

Professionalism is a term describing conduct and qualities that a profession should show. Medical care requires a high level of professionalism. Irrespective of whether faced with a difficult situation or not, a professional needs to maintain his poise. When conducting any kind of intervention on a diabetic case, a care giver should remember that it is a patient he/she is dealing with.

The professional ought to keep in mind that the patient is at times violent and as such, the care giver should not react violently to any violent sign or attack on him/her. Instead, the professional should maintain his/her calm and engage the patient in activities that will not offend the latter (Matt, 2002).

Adherence to a stricter code of ethics is a must for health care professionals. Regardless of whether a company has written codes or not, it is recommended that ethical behaviour should be exhibited. In nursing intervention, a medical practitioner should not at any time disclose unfolding information regarding the patient to a third party. However, he/she can disclose to the family members upon confirmation of the information (Beardsley, 2006).

Finally, reliability can also be regarded as one of professionalism characteristics. The society usually looks upon a professional to execute a job. As such, he/she is supposed to act in a prompt manner while ensuring that he/she keeps the promises timely. In nursing intervention, it is necessary that the nurse executes his/her duties well and ensure that the desired results are achieved (Matt, 2004).

In addition to this, a medical professional, during intervention, must be able to timely be getting the care process done and as such, he/she should not hold the patient in the care facility for a long time unless the patient’s condition has deteriorated and further care is necessary (Campbell & Bennett, 2002).

Person Centred Practice Strategies

Person centred practice is a term commonly used to describe a combination of approaches that are established in order to assist an individual (Nichols, 2007). One of the most effective strategies in terms of person entered practice is listening. In this strategy, the focus is usually on the patient and as such, the focus is on what the patient perceives to be important to him/her. In addition to this, the strategy makes an enquiry on how the patient lives (Solberg, 2007).

The health care professional should be able to listen to the patient, asking proper questions about physical conditions as well as life, emotions, relationships with others, etc.

One more strategy is team collaboration. Thus, the team of several health care professionals (nurse, physical health care provider, etc.), the care giver(s) and the patient should collaborate to work out a specific plan (Wilensky, 2004). This plan will include all meaningful details. Admittedly, the plan will be effective as all important details will be taken into account. This strategy is ideal as it ensures development of plans where the diabetic person as well as the caregiver can think together. Thus, the caregiver is able to introduce the necessary changes that will help restore the normal condition.

Professional Development

On-going education is a vital aspect for professional development. Educational activities usually come after formal training. Educational activities assist a person to maintain and develop knowledge, develop problem solving skills. It also expands a person’s technical skills. Health care professionals also learn progressive professional standards of performance (Norris et al., 2006).

Notably, training courses are not the only way to develop. Health care professionals should attend various workshops and conferences. Sharing experiences is an important part of any learning. Besides, it is necessary to acquire knowledge in diverse spheres. Thus, nurses should not attend courses for nurses only. It is important to be able to collaborate in inter-professional teams. Therefore, it can be effective to learn more about different health care services provided.

Mental discipline strategy is also essential as it helps a professional focus on the goals irrespective of whether he/she is experiencing hardships or uncontrollable events or not. By focusing on the goals, a person is able to develop since when he/she encounters hurdles, he/she is able to find ways to overcome them and therefore, he becomes familiar with ways to handle diverse problems. Thus, mental discipline development is a very effective strategy (Bagchi & Sreejayan, 2012).

References

Bagchi, D., & Sreejayan, N. (2012). Nutrition and therapeutic interventions for diabetes and metabolic syndrome. Waltham, MA: Academic Press.

Beardsley, R. S. (2006). Chair’s report of the APhA-ASP/AACP-COD task force on professionalization: Enhancing professionalism in pharmacy education and practice. Am. J. Pharm. Educ, 60(3), 26-28.

Beckles, G. L. (2008). Population-based assessment of the level of care among adults with diabetes in the U.S. Diabetes Care, 21, 1432-8.

Campbell, R. K., & Bennett, J. A. (2002). Assessing diabetes patients’ health care needs. Diabetes Education, 28(4), 49-50.

Chalmers, R. K. (2007). Contemporary issues: Professionalism in pharmacy. Tomorrow’s Pharmacist, 5(4), 10-12.

D’Antonio, P., & Lewenson, S. (2010). Nursing interventions through time. London, UK: Springer Publishing Company.

Egede, L. E., Zheng, D. & Simpson, K. (2002). Comorbid depression is associated with increased health care use and expenditures in individuals with diabetes. Diabetes Care, 25(8), 464-70.

Hall, R. H. (2008). Professionalization and bureaucratization. Am. Soc. Rev, 33(2), 104.

Juall, L., & Moyet, C. (2008). Nursing diagnosis: Application to clinical practice. New York, NY: Lippincott Williams & Wilkins.

Matt, D. (2002). Clinical practice guidelines for treatment of diabetes mellitus, expert committee of the Canadian diabetes advisory board. Canadian Medical Association Journal, 147(5), 19-92.

Matt, D. (2004). Nutrition recommendations and principles for people with diabetes mellitus. American Diabetes Association, Diabetes Care, 17(5), 14.

Nichols, K. K, (2007). Diabetic eye examination report. Optometry, 78(11), 588-95.

Norris, S. L., Chowdhury, F. M, & Van Le K. (2006). Effectiveness of community health workers in the care of persons with diabetes. Diabetes MED, 23(5), 44-56.

Peters, A. L. (2006). Quality of outpatient care provided to diabetic patients: A health maintenance organization experience. Diabetes Care, 19, 601-6.

Smith, M. C. (2000). Implications of ‘professionalization’ for pharmacy education. Am. J. Pharm. Educ., 34(5), 16-32.

Solberg, L. I. (2007). Crossing the quality chasm for diabetes care: The power of one physician, his team, and systems thinking. J Am Board Fam MED, 20(3), 299-306.

Wagner, E. H. (2001). Effect of improved glycemic control on health care costs and utilization. JAMA, 285(9), 182-9.

Wendy, L., & Votroubek, A. T. (2010). Paediatric home care for nurses: A family-centred approach. Burlington, MA: Jones & Bartlett Publishers.

White, L., Duncan, G., & Wendy, B. (2010). Foundations of adult health nursing. Belmont, CA: Cengage Learning.

Wilensky, H. L. (2004). The professionalization of everyone? Am. J. Soc, 70(4), 137-146.

Executive summary

According to the Health Care Cost Institute (HCCI), in 2016, the annual cost of insulin for a patient with type 1 diabetes amounted to $ 5,705, which is almost twice as high as in 2012 – $ 2,864 (Hargraves & Frost, 2017). As a result, some patients put their own health at risk. According to experts from the Yale Diabetes Center in New Haven, many people with diabetes are forced to reduce their intake of insulin-containing drugs due to their high cost. One in four diabetic patients took less insulin than doctors recommended due to the high price of the drug, which led to an increased risk of complications compared to those who used insulin-containing drugs regularly (Herkert et al., 2019). Inappropriate insulin intake in people with type 1 diabetes can be fatal, and in the case of type 2 diabetes, patients may have an increased risk of long-term complications (blindness, kidney failure, nervous system problems, and amputation).

Introduction

In recent months, it has become common in the United States that people with diabetes have reduced insulin intake because of its high cost. At the same time, daily insulin consumption increased from 2012 to 2016 by only 3% (Hargraves & Frost, 2017). The drugmakers say they need to periodically raise prices to offset the significant discounts they offer to buyers under their health plans. The current analysis looked at data from 15,000 patients with type 1 diabetes who were prescribed insulin at least once a year. As a result, it was found that from 2012 to 2016, the average price of insulin increased from 13 cents per unit to 25 cents. For an average patient, using 60 units per day, the daily cost increased from $ 7.8 in 2012 to $ 15 in 2016.

The study by Herkert and colleagues involved 199 patients with type 1 or type 2 diabetes. Of these, 51 people (25.5%) admitted to using less insulin due to financial difficulties (Herkert et al., 2019). Thirty-one patients who had reduced their insulin intake reported this to their doctor, and 15 of them switched to another less expensive drug. In patients who reduced the consumption of insulin-containing drugs, a deterioration in blood glucose levels was recorded.

According to the forecast of researchers from Stanford University, the number of people with type 2 diabetes who need insulin-containing drugs in the world will increase by about 79 million people by 2030, which will lead to a sharp increase in the need for insulin (Basu et al., 2019). The experts reviewed data from the International Diabetes Federation and 14 separate cohort studies, affecting more than 60% of people with type 2 diabetes worldwide. As a result of the analysis, it was found that the number of such patients will grow from 405.6 million in 2018 to 510.8 million in 2030 (at least by 20%). Given these data, it is estimated that the average amount of insulin used annually will increase from approximately 516.1 million packs of 1,000 vials to 633.7 million over 12 years.

Approaches

The price that the end consumer pays depends mainly on insurance coverage, so the price level is regulated not so much by the market as by the manufacturers themselves, especially since there are three major players in this market in the US – Sanofi, Novo Nordisk, and Eli Lilly. In addition to the main links in this chain (patient, pharmacy, insurance company, pharmaceutical manufacturer), it should also be remembered that insurance companies use intermediaries, drug benefit managers. Therefore, it is not surprising that experts consider the lack of transparency in mutual settlements to be part of the problem with this system (Conner et al., 2019). Plus, unlike many other countries, the US gives pharmaceutical companies the freedom to set prices. Thus, today Eli Lilly, Novo Nordisk, and Sanofi control 96% of the global market (Conner et al., 2019). The lack of competition has led to higher prices, which has created a problem of access to these drugs both in the United States and abroad, analysts say (Conner et al., 2019). Until a truly competitive market exists, it is difficult to say a fair price for this drug.

Conclusion and Recommendations

To address this issue, legislation needs to be passed to reduce the cost of prescription drugs. The government should also make changes to the insulin production process. It is also essential to keep an eye on the players in the market. It is possible and necessary to increase their number, but at the same time, the quality of the generics produced should be monitored very carefully. Since the rise in prices is essentially the initiative of producers, an important step towards solving the problem is the introduction of a price regulation policy.

References

Basu, S., Yudkin, J. S., Kehlenbrink, S., Davies, J. I., Wild, S. H., Lipska, K. J.,… & Beran, D. (2019). Estimation of global insulin use for type 2 diabetes, 2018–30: a microsimulation analysis. The Lancet Diabetes & Endocrinology, 7(1), 25-33.

Conner, F., Pfiester, E., Elliott, J., & Slama-Chaudhry, A. (2019). Unaffordable insulin: patients pay the price. The Lancet Diabetes & Endocrinology, 7(10), 748.

Hargraves, J., & Frost, A. (2017). Price of insulin prescription doubled between 2012 and 2016. Healthcare Cost Institute. Web.

Herkert, D., Vijayakumar, P., Luo, J., Schwartz, J. I., Rabin, T. L., DeFilippo, E., & Lipska, K. J. (2019). Cost-related insulin underuse among patients with diabetes. JAMA internal medicine, 179(1), 112-114.

Sandra Fernandes and Shobha Naidu’s journal illustrates the authors’ understanding of a significant topic in the nursing profession. “Promoting Participation in self-care management among patients with diabetes mellitus” article exposes readers to Peplau’s theory to understand the concept of interpersonal relationships. Fernandes and Naidu are qualified scholars who have the knowledge, experience, and skill to address healthcare matters. Fernandes is an Associate Professor of nursing with a master’s degree in the same profession. Similarly, Naidu is a health expert at the College of Nursing Pune in India. As such, the two authors meet the qualifications or requirements to author nursing-related reports and studies. Article 1 evaluates the effectiveness of Peplau’s theory in promoting the promotion of individual care for type II diabetes patients (Fernandes & Naidu, 2017). According to the study, diabetes mellitus is common among elderly persons and rare among youth.

In contrast, Michael Hall and Edward Tolhurst demonstrate their prowess in analyzing “nurses’ perspectives in supporting patients with diabetes mellitus.” In their article, Hall & Tolhurst (2020) incorporates the primary care setting to monitor people living with type II diabetes. According to the article, access to external support, communication, and extra attention to affected populations help nurses promote self-management among people diagnosed with type 2 diabetes. Reviewing both articles provides readers with the insights to highlight the main points, arguments, findings, strengths, and weaknesses of the nursing journal and article.

The statement problem is clearly stated in Fernandes & Naidu’s (2017) journal. At the beginning of the study, the authors familiarize their readers with the growing dangers of diabetes mellitus. According to the writers of article 1, type 2 diabetes was becoming a common public health threat. The experiment’s purpose is clear based on its title. Unlike in Fernandes and Naidu’s journal, it is not easy to locate the statement problem in Hall & Tolhurst’s (2020) article. The text-only provides an overview of care for individuals battling diabetes. Article 2 highlights the role of nurses in supporting people living with diabetes mellitus but unclearly identifies the statement problem. However, both articles are significant to nursing because they create awareness of managing diabetes mellitus.

Fernandes & Naidu (2017) is a recent journal published in the past five years. The journal is a recent study that incorporated primary and secondary sources. Nonetheless, the references incorporated in the work were only listed but not cited in the research. Inversely, Hall & Tolhurst (2020) is the most recent article that effectively cited and referenced primary sources throughout the work. Arguments in the article are properly stated and supported by the sources; as such, Hall & Tolhurst’s article was more articulate and convincing. A solid basis for the study is provided in both the journal and article based on the clear methods included in the experiments.

Even though Fernandes & Naidu’s work constituted primary and secondary research, the journal did not adequately define key concepts well as it appears in Hall & Tolhurst (2020). Hall & Tolhurst’s article defines the exclusion and inclusion criteria, demographic variables, and nursing assessments are defined in Hall & Tolhurst’s article. Theoretical frameworks formulate the basis of conceptual analysis; the component is missing in the international nursing journal, making it difficult to interpret the results.

Hall and Tolhurst provided the background, study objectives, and methodology and skipped the hypotheses segment. Qualitative research depends on independent and dependent variables to measure the changes in any experiment. It would be complicated to relate the nursing perspectives to self-management strategies within a primary setting without a clear thesis statement. The reverse is true in Fernandes & Naidu’s (2017) journal because the work uses interpersonal relationships to design a model of offering self-responsibility and care for patients with type 2 diabetes. In addition, the absence of an explicitly stated hypothesis and research question in Hall and Tolhurst’s article has been justified using study themes below the research methods.

The research methods and procedures incorporated in both texts indicate the coherent skills and knowledgeability of the authors on nursing concepts. For example, Hall and Co-researcher used a primary setting to undertake the experiment. Engaging individuals from the West Midlands region shows the surety of the scholars in awareness creation. Although the article implemented a methodology sector in it, the paper failed to use qualitative and quantitative data collection methods to support nurses’ perception of self-management and care of type II diabetes patients. The research design, population, sample, and data collection measures were associated in both papers, but Fernandes and Naidu (2017) inappropriately described the population and sample of the test. The international journal of nursing focused only on the demographic variables and failed to state the independent sample quality in the experiment. The generalization of self-care support in the journal shows the paper’s weakness in defending its thesis.

Hall and Tolhurst (2020) grouped its data in a single table, while Fernandes and Naidu (2017) incorporated numerous data sets to compare the viability of their hypothesis. The justification of the measurements in the first research article shows the importance of Peplau’s theory in promoting interactive relationships among patients. On the other end, the data collected in the second nursing journal shows the possibility of biases in the experiment. A single data set of participant characteristics shows no relationships between a primary setting and the states of type II diabetes populations. Data analysis and research findings supported the article and journal titles. Nevertheless, the sufficient information listed under the findings in Hall and the co-author’s work simplified the meta-analysis of the nursing evidence practice more than Fernandes and the partner. The article’s implications bring smiles to readers; the critique recommends students read the text and use the knowledge to boost their understanding of patient care. The research was reasonable and complete based on the findings and connections to its initial objectives of promoting self-awareness of diabetes and how to survive the public health threat.

Observing the structure of the qualitative research, it is evident that Hall and Tolhurst incorporated an in-depth phenomenon of interest. Comparing the procedures and results to the quantitative research, the critique chooses the second article over the journal. The article demonstrates its themes fluently and systematically, exposing readers to better positions of interpreting the significance of self-care management in a primary setting characterized by type 2 diabetes diagnoses. The study purpose in the article matches that of the research design, while the results in the nursing journal mismatched the quantitative variables to the original aim of the experiment.

The data analysis approach in the journal was not appropriate in the journal. Meaning Hall and the study partner organized the text in a standard research design. Recommending the article starts with formatting and citing information from primary and secondary sources. The reports in both the nursing journal and article adequately described how the actual analysis of the study process escalated. In article one, the evidence provided that elderly people are more vulnerable to type 2 diabetes. While article 2 concluded that the self-analysis of type 2 diabetes is complicated due to the disparities in people’s experience upon diagnosis with the disease.

References

Fernandes, S., & Naidu, S. (2017). Promoting Participation in Self Care Management among Patients with Diabetes Mellitus: An Application of Peplau’s Theory of Interpersonal Relationships. International Journal of Nursing Education, 9(4), 129-134. Web.

Hall, M., & Tolhurst, E. (2020). Nurse Perspectives on Supporting Self-Management of Type 2 Diabetes within a Primary Care Setting. Journal of Diabetes Nursing, 24(5). ISSN 2517-7753

Diabetes is a disease that occurs when the pancreas cannot produce enough insulin to regulate blood sugar. Diabetes is a global health concern, and according to the World Health Organization, in 2019, it directly contributed to 1.5 million deaths (World Health Organization, 2021). Diabetes can significantly impact the heart, kidneys, and blood vessels leading to other chronic problems. In the US, diabetes is costly to treat and has caused much physical, emotional and mental harm to the people and the families of those who have been affected by the disease.

Diabetes is a very prevalent health problem in the US. According to the Center For Disease Control (CDC), one in every ten people in the US has diabetes (CDC, 2022). On average, around 37 million people in the US have diabetes, and in 2019 alone, there were 1.4 million new cases of diabetes (CDC, 2022). Additionally, 96 million adult Americans have prediabetes, and eight out of every ten people do not know (World Health Organization, 2021). In 2020, it was reported that 48% of the population 65 years and above has diabetes (World Health Organization, 2021).

On 2022 March 28, a tweet by CNN stated that experts had found an unraveling connection between COVID-19 and diabetes. According to the tweet, a COVID-19 infection can lead to a higher risk for diabetes (CNN, 2022). This information will likely affect how people with prediabetes protect themselves against COVID-19. Earlier research only revealed that people with diabetes were at higher risk of COVID-19; now, it has also proved that people with COVID-19 are at higher risk of diabetes which shows the two diseases are interdependent. They are both risk factors for each other.

With the help of cell therapy, diabetes may be treatable. A disease that has imprisoned over 460 million people into longlife medication will finally be curable. The introduction of mini-pancreas, a bio-engineered miniorgan to enscapulate insulin-producing cells, promises to end the long-term chronic disease #EndDiabetesNow

References

World Health Organization. (2021). Diabetes. World Health Organization; World Health Organization: WHO. Web.

CDC. (2022). The Facts, Stats, and Impacts of Diabetes. Centers for Disease Control and Prevention. Web.

CNN (@CNN). (2022). Studies link COVID-19 infection with an increased risk of new diabetes diagnosis [Tweet]. Twitter. Web.

Demographics & Statistics

Juvenile diabetes, also referred to as Type 2 diabetes or insulin-dependent diabetes, describes a health condition associated with the pancreas’s limited insulin production (Bimstein et al., 2019). Insulin is a vital hormone the human body needs to facilitate glucose entry into cells to generate energy. The condition is characterized by the destruction of the cells that make insulin in the pancreas.

According to latest estimate, 34.2 million Americans have diabetes, representing 10.5% of the country’s population (Centers for Disease Control and Prevention (CDC], 2020). About 26.9 million individuals were diagnosed with the condition, including adults. About one in 500 Americans have juvenile diabetes, while approximately 80 people are diagnosed with the disorder each day (CDC, 2020). About 5 percent of individuals who have a family member (parent or sibling) this condition are likely to develop it (CDC, 2020). Eighty-eight million people were prediabetes, representing 1 out of 3 people. Prediabetes is a precursor to full-blown diabetes, but the condition has less severe signs and symptoms.

Risk Factors

The most common risk factor for juvenile diabetes is age. Juvenile diabetes is a health condition that is more common in children and young people who are under 20 years (Bimstein et al., 2019). Although Type 1 diabetes is usually diagnosed in children and adolescents, the condition can also develop in adults. The common appearance during childhood or adolescence explains why the condition is referred to juvenile diabetes. Furthermore, juvenile diabetes has been described as a hereditary health condition. This point implies that a diabetic person has a parent, sibling, or family members who have juvenile diabetes. The genetic makeup of diabetic patients predisposes their family members to the condition. Other risk factors include having traveling away from the equator and being white (Bimstein et al., 2019).

References

Bimstein, E., Zangen, D., Abedrahim, W., & Katz, J. (2019). Type 1 Diabetes Mellitus (juvenile diabetes)–A review for the pediatric oral health provider. Journal of Clinical Pediatric Dentistry, 43(6), 417-423.

Centers for Disease Control and Prevention. (2020). National diabetes statistics report.

Despite multiple attempts at managing some of the health issues that currently take priority in public health management, the foundational health concern of diabetes remains unresolved in the modern American community. Among vulnerable groups that are particularly susceptible to the threat of diabetes, one should mention the Hispanic population (Moreira et al., 2018). Therefore, to manage the problem of diabetes in the specified audience, a program geared toward increasing patient literacy, promoting awareness, and introducing tools for monitoring the exposure to diabetes in the target population will be developed.

Due to the active focus on prevention and threat management, as well as the active support of patients that have already developed diabetes, the program in question is believed to produce a noticeably positive effect on the levels of well-begin within the target community.

The program in question will target the local community so that it could assist not only Hispanic people with diabetes but also support those that have not yet developed the disorder despite the continuous exposure to it. In order to fully address the needs of Hispanic people at risk of developing diabetes, the program will be based on the SLP principles outlined in the paper by Scarinci et al. (2012). According to Scarinci et al. (2012), establishing a culturally relevant framework for assisting communities that are exposed to a particularly high level of a specific threat is critical.

Namely, the author specifies that the incorporation of culturally relevant tools such as intervention mapping (IM) produced strongly and unambiguously positive effects on the well-being of the target population (Vissenberg et al., 2017). Similarly, in the program at hand, the needs of Hispanic patients with diabetes will be considered through the prism of the key specifics of the community, as well as the cultural background of the patients.

In the course of the program, it is vital to encourage the development of key perceptions, enablers, and nurturers. Namely, those that encourage self-care behavior and allow patients to focus on the development of healthier lifestyles and a more reasonable dieting strategy should be considered throughout the implementation of the program. Specifically, apart from providing general information about the means of locating the symptoms of early onset diabetes, patients will be provided with the guidelines concerning the choice of dieting options (McCurley et al., 2017).

Therefore, patients will have to reconsider their current perceptions of nutrition and dieting choices so that they could build a healthier and a more effective approach toward reducing the aggravation of the condition in patients with diabetes, as well as preventing the development of the disease among those that are exposed to the disorder.

In addition, nurses’ perceptions of patient education, as well as their role of nurturers for the community, will need to be revisited. Namely, the existing communication channels between patients and nurses will be updated to promote a more advanced framework for information management and patient education. Finally, the influence of enablers such as media advertising fast food and other types of food that are potentially harmful to the target audience will have to be reduced, which can be done by promoting health literacy among patients using social media as the platforms for dispersing information (Wimer et al., 2017). Additionally, consultations for patients with diabetes, as well as free diagnostic tools for those that are exposed to the threat of diabetes development, must be provided.

At the same time, it is important to recognize the positive aspects of cultural empowerment that can assist patients in developing healthier lifestyles and accept the proposed changes in their dieting. Similarly, the elements of cultural empowerment that will contribute to a boost in the rates of patient education and the extent of patient-nurse communication must be acknowledged and incorporated into the program framework.

These elements of cultural empowerment will include constant feedback provided to patients and the opportunity for patients to share experiences and changes in their emotional perception of the problem with the nurse (Sofolahan-Oladeinde et al., 2017). The emotional rapport will play a paramount role in building positive reinforcement for patients to acquire the expected healthy habits and build diabetes-related knowledge. Thus, the gradual improvement in health literacy, wellbeing, and quality of life among community members can be expected.

Due to the lack of awareness concerning the causes and risks of diabetes development, as well as increased exposure to it in the target population, the proposed program aimed at increasing the rates of health awareness and introducing nurses to improved guidelines is strongly needed for the target community. The combination of focus on the needs of the community and the improvement in current guidelines, which, in turn, will enhance the efficacy of nurses’ performance.

The described measures will cause a drop in the levels of exposure to the threat of further aggravation of the condition, such as the emergence of comorbid issues such as pressure ulcers and chronic kidney disease. Thus, the needs of Hispanic patients with diabetes will b fully addressed, whereas nurses will be able to gain crucial new skills that they will continue to apply when managing the problem in question.

References

McCurley, J. L., Gutierrez, A. P., & Gallo, L. C. (2017). Diabetes prevention in US Hispanic adults: a systematic review of culturally tailored interventions. American Journal of Preventive Medicine, 52(4), 519-529. Web.

Moreira, T., Hernandez, D. C., Scott, C. W., Murillo, R., Vaughan, E. M., & Johnston, C. A. (2018). Susto, coraje, y fatalismo: cultural-bound beliefs and the treatment of diabetes among socioeconomically disadvantaged Hispanics. American Journal of Lifestyle Medicine, 12(1), 30-33. Web.

Scarinci, I. C., Bandura, L., Hidalgo, B., & Cherrington, A. (2012). Development of a theory-based (PEN-3 and health belief model), culturally relevant intervention on cervical cancer prevention among Latina immigrants using intervention mapping. Health Promotion Practice, 13(1), 29-40. Web.

Sofolahan-Oladeinde, Y. A., Iwelunmor, J. I., Conserve, D. F., Gbadegesin, A., & Airhihenbuwa, C. O. (2017). Role of healthcare in childbearing decision-making of WLHA in Nigeria: Application of PEN-3 cultural model. Global Public Health, 12(6), 680-693. Web.

Vissenberg, C., Nierkens, V., Uitewaal, P. J., Middelkoop, B. J., Nijpels, G., & Stronks, K. (2017). Development of the social network-based intervention “powerful together with diabetes” using intervention mapping. Frontiers in Public Health, 5, 334. Web.

Wimer, C., Shipman, D., & Lea, L. (2017). Diabetes: Health Literacy Education Improves Veteran Outcomes. Federal Practitioner, 34(1), 32-36.

The elaborated approach for researching heart failure is systematic and comprehensive to a large extent. However, it is possible to implement some improvements in order to achieve more precise results. As for the population, which is intended to participate in the research, I am convinced that there is the need to specify the patients who should be examined and monitored. For instance, patients should be divided into two groups. The first one should unite people who are at risk of heart failure. Studies show that men who are older than 65 years old and are diagnosed with diabetes or have obesity are prepossessed to heart failure (Inamdar & Inamdar, 2016). Other risk factors include Afro-American origin and adherence to destructive habits, such as smoking, drinking alcohol, drug abuse, and leading a sedentary lifestyle. The second group should involve people who have no significant prepossession of heart failure. This way, the result of the research may be accurate and comprehensive.

Another suggestion on research methods regards challenges of obtaining a sample. It is undeniable that there are considerable hardships with this aspect due to problems with patient cooperation. First of all, it is essential to explain to patients the reasons why they are required to follow particular recommendations with strong arguments. This will ensure the patients to be more accurate with this aspect. In addition, a sufficient solution could be asking patients to lead a diary, where they should record how they stuck to the requirements. This will not only motivate them to adhere to the recommendation deliberately but also supply more accurate results of the research. Moreover, patients will be able to trace the changes in their health state, which will allow them to adjust the treatment plan in accordance with their individual needs.

The strategy of focusing on precise age, in which children tend to be diagnosed with type 1 diabetes, may seem advantageous, as it will focus on the specialties of disease development among children. However, division only two age groups, namely from four to six years old and from ten to fourteen, may make the research limited (Couper et al., 2018). Therefore, it may be a beneficial solution to expand age groups. An alternative decision could be implementing the third group, which will unite children, aged from six to ten, who are at minimum risk (Couper et al., 2018). Such an approach will make the research will provide more comprehensive results and will be insightful for further exploration.

It is apparent that obtaining a sample may be challenging, especially when the research focuses on children. First of all, there is a range of ethical issues which should be taken into consideration. Therefore, choosing to follow all the requirements of experiments and research strictly has been the most effective decision. It will not involve both physical and mental harm for the young participants and allow them to explore the issue of the research properly. A sufficient solution has been to avoid sensitive themes in questionaries, which will not put pressure on children and maintain a convenient environment for them. In addition, in order to address the problems with obtaining a sample, some of the participants may be monitored in children’s hospital settings (Couper et al., 2018). This approach will allow us to notice any changes in the health state of children and explore them urgently. Moreover, it will considerable minimize all the hardships with obtaining a sample, as children will be monitored by professionals on a constant basis.

References

Couper, J. J., Haller, M. J., Greenbaum, C. J., Ziegler, A. G., Wherrett, D. K., Knip, M., & Craig, M. E. (2018). Clinical Practice Consensus guidelines 2018: Stages of type 1 diabetes in children and adolescents.Pediatric Diabetes, 19(27), 20-27. Web.

Inamdar, A. A. & Inamdar, A. C. Heart failure: Diagnosis, management and utilization. (2016). Journal of Clinical Medicine, 5(7), 62. Web.

Introduction

Diabetes Mellitus is one of the most common chronic diseases. There are two main types of diabetes: type 1 and type 2 diabetes, with the latter being more prevalent in adults. Type 2 diabetes (T2D) is a chronic disease where the body fails to regulate blood sugar properly. It may occur when the body is unable to produce enough insulin to regulate blood sugar or when the body resists insulin. T2D in adolescents is a major concern for the healthcare system. Adolescence refers to the age between 10 and 19 years.

Prevalence

The prevalence of T2D in adolescents has been increasing in recent years. According to a National Diabetes Statistics Report released by the Centers for Disease Control and Prevention, the estimated prevalence of the disease was 25 cases per 10,000 adolescents in 2017. This number is expected to keep rising if no intervention measures are implemented. As of 2019, about 210,000 Americans under the age of 20 years had diabetes, including both type 1 and 2. It is essential to note that the prevalence of diabetes is higher in racial and ethnic minorities, including Black, Hispanic, American-Indian, and Pacific Islander populations.

Cost of Treatment

The American Diabetes Association releases a report on the economic burden of diabetes every five years. The most recent report was released in 2017. The report does not differentiate between the costs that go into treating adults and those used to treat adolescents with diabetes. Additionally, the American Diabetes Association does not make a distinction between type 1 and 2 diabetes in terms of treatment costs. The estimated cost of treating type 1 and 2 diabetes in adult and adolescent populations was $327 billion in 2017. Of this cost, $237 billion goes into direct medical expenses. Consequently, it is estimated that diabetes costs healthcare 2.3 times the expenses that would be incurred without the disease.

Common Myths and Current Status of Understanding

T2D in adolescents is still widely misunderstood, with some people even denying that young people can develop T2D. This misunderstanding stems from the fact that T2D is sometimes referred to as adult-onset diabetes, which leads many to believe that it only affects adults. Another misunderstanding is that children and adolescents can outgrow diabetes. Diabetes is a chronic disease that can only be managed but not cured. Other people also think that T2D is not a serious illness in adolescents, which could make them fail to properly manage the condition if present. However, due to the increasing prevalence of T2D in adolescents, research in the area has also increased. In turn, more research into T2D in adolescents has improved the understanding of the disease.

Opinion

Even though research into the matter has increased in recent years, I think the current status of understanding T2D in adolescents is still lacking. For instance, it is still difficult to estimate the economic burden of T2D in adolescents independently from adults. More research is needed to properly understand the disease. I also think the cost of treating T2D is too high. It will overwhelm the healthcare system in the next few years, especially considering the damage caused by the ongoing COVID-19 pandemic. Since T2D is, in part, caused by an unhealthy lifestyle, it can be prevented. However, preventing the disease in adolescents is not an individual effort. It will take the combined effort of adolescents, parents, teachers, communities, and states to reduce the prevalence of the disease.

How to Move Forward

Needless to say, it is imperative to reduce the incidence of T2D. One way of doing this is by educating parents on the risk factors and preventative measures against diabetes. For instance, many mothers are not aware that breastfeeding can help reduce the risk of diabetes in babies and, later, in adolescence. Schools should also ensure that students get enough time for physical exercise. This is because inactivity is one of the risk factors for T2D. On a larger scale, the federal and state governments should ensure healthy foods are affordable to promote healthy eating, which reduces the risk of T2D. To reduce the cost of treating diabetes, the government should regulate the cost of insulin. Altogether, these measures will reduce the incidence of diabetes and lower the cost of treatment.

What Can You Do?

An individual can reduce their risk of developing T2D by improving their lifestyle. Firstly, one should exercise for at least one hour daily. In addition to exercising, a person should reduce the time spent in sedentary activities, such as watching television. Another way to decrease the likelihood of developing T2D is by consuming nutritious diets, such as the Mediterranean diet, which comprises fruits, vegetables, whole grains, and unsaturated fats. Consuming a healthy diet and exercising helps one to maintain a healthy weight. Being overweight or obese could increase a person’s risk of T2D. Lastly, one should get tested for diabetes in case of symptoms to start managing it early. Parents should assist their underage adolescents in following these guidelines.

Conclusion

Many young people develop type 2 diabetes, possibly because they are unaware of how to prevent it. Some believe that diabetes is an adult disease or a mild disease that an adolescent can outgrow. A proper understanding of T2D in adolescents will help reduce the incidence and prevalence of the disease. Adolescents should be aware of the risk factors that contribute to T2D because this knowledge might push them to modify their lifestyle to include regular physical exercise and a healthy diet. Consequently, this will decrease the cost of treating the disease in adolescents.

References

American Diabetes Association. (2018). Economic costs of diabetes in the US in 2017. Diabetes Care, 41(5), 917-928. Web.

Centers for Disease Control and Prevention. (2020). National diabetes statistics report 2020: Estimates of diabetes and its burden in the United States. Web.

Jensen, E. T., & Dabelea, D. (2018). Type 2 diabetes in youth: New lessons from the SEARCH study.Current diabetes Reports, 18(6), 1-7. Web.

Weisman, A., Fazli, G. S., Johns, A., & Booth, G. L. (2018). Evolving trends in the epidemiology, risk factors, and prevention of type 2 diabetes: A review.Canadian Journal of Cardiology, 34(5), 552-564. Web.

Introduction

Diabetes Mellitus is a chronic metabolic disorder that affects the patient’s hormonal and cardiovascular systems, resulting in increased morbidity and mortality rates (Dagogo-Jack, 2017). Although the disease is not as wide-spread as Type 2 diabetes mellitus (t2DM), its frequency of appearance in vulnerable populations increases by roughly 3% a year (Rowley et al., 2017). As it stands, t1DM constitutes about 5% of the entire world DM population, amounting to roughly 20 million reported cases worldwide (Rowley et al., 2017). The number of underreported t1DM cases is currently unknown. Management and maintenance of diabetic patients requires regular hospital visits. Many patients are either unwilling or incapable of reaching hospitals at such a basis. Telemedicine is the solution that could potentially increase the coverage and improve the situation for many t1DM patients in the world.

The Intervention

The solution proposed in the article written by Kotsani et al. (2018) is telenursing. Telenursing is comprised of a set of practices aimed at maintaining appropriate home care without the need to a hospital. These practices include consultation, review of blood analyses taken domestically, provision of training and advice required by patients to manage their symptoms, motivation and reinforcement, and information support on the subject of t1DM (Kotsani et al., 2018). The practice is rooted in Orem’s theory of self-management, and seeks to alleviate the pressure off of hospitals while empowering the patient to exhibit greater autonomy and encourage decision-making when managing one’s own health (Kotsani et al., 2018). In the scope of the reviewed study, the test group received weekly phone calls, received assistance in measuring glucose levels, and was instructed on how to lead a healthier lifestyle.

Population Selection Criteria

Population selection criteria was formulated in regards to the absence of knowledge on the subject as well as the prevalence of the disease among different age groups of people (Kotsani et al., 2018). Since diabetes studies are overwhelmingly focused on the elderly patients, and the average age of an individual with Type 1 DM is between 19 and 39 years old, that diapason was chosen to represent the majority of individuals receiving outpatient care (Kotsani et al., 2018). t1DM affects insulin intake, soliciting different ways of its management. Multiple daily injections (MDI) was the chosen method of self-care, as insulin pumps and continuous glucose intake procedures required less instructions or allowed for limited patient autonomy in the first place (Kotsani et al., 2018).

Chosen Population

The chosen sample included 94 participants, which were split into the intervention and control groups. The reasons why the control group was slightly smaller was because some participants were deemed ineligible or refused to participate (Kotsani et al., 2018). In the intervention group, the average participant age 26.35 years, and 27.63 years for the control group. The average length of enduring diabetes was about 15 years for both. Male and female representation was roughly equal, with 25-23 and 22-24 balance between the two cohorts (Kotsani et al., 2018). The majority of patients were unmarried and living with parents or housemates. Two thirds of the population were students or otherwise unemployed, with only one third having either a part-time or a full-time job. The average morning blood, pre-prandial, and post-prandial blood glucose levels were slightly increased in the intervention group, by roughly 20-30 mg/dl (Kotsani et al., 2018).

Research Findings: Control Group

Control group had patients whose overall glucose levels were lower by 20-30 mg/dl on average (Kotsani et al., 2018). They did not receive the telemedicine intervention reserved for the control group, and operated using the standard routine, which included infrequent visits to the hospital, and self-management of symptoms using the information received during those visits. While their glucose levels were lower than they were in untreated cases, they did not show any significant improvement in reducing glucose levels in one’s blood, throughout the intervention (Kotsani et al., 2018). Such results indicate a skill ceiling for patients trying to manage their symptoms unassisted, which cannot be overcome without additional support (Kotsani et al., 2018).

Research Findings: Intervention Group

Research findings for the intervention group showed remarkable results. Average glucose levels for morning blood sugar dropped from 120 mg/dl to around 93 mg/dl (Kotsani et al., 2018). Pre-prandial glucose levels have dropped from 148 mg/dl to 114 mg/dl, and post-prandial blood glucose levels dropped from 248 mg/dl to 193 mg/dl (Kotsani et al., 2018). These significant blood sugar level decreases were achieved in only 2 months, without invasive procedures or strong medical drugs. As it was discovered, the primary reasons for such results were the increased compliance of patients to the prescribed treatments, increased skill in administering glucose, and the adoption of a healthier way of life (Kotsani et al., 2018). These factors contributed to improvements in the quality of life for the majority of the patients.

Issues with Results

The results presented in the study by Kotsani et al. (2018) provide some evidence of effectiveness of telemedicine for t1DM patients. However, there are some limitations to the interpretation of the results. The primary issue is with the initial glucose levels in patients. It was shown that the test group had, on average, 20-30 mg/dl more glucose than the control group (Kotsani et al., 2018). While the achieved 30-40 mg/dl drop is impressive, it is only 10 mg/dl below the ‘baseline’ established by the control group (Kotsani et al., 2018). It is unclear whether the improvements would be the same had the baseline for the test group been lower. The main reason for the effectiveness of the intervention was associated with the disciplining effect on students and young people, who were found to have notoriously poor in time management and drug intake. It is unclear whether the results would be the same for adult, working, family members (Kotsani et al., 2018).

Conclusions

Based on the results of the study, it could be concluded that telemedicine results in a net improvement for t1DM patients aged 19-39. As it was shown, lifestyle choices and stressors associated with study and part-time work were the primary reasons why most patients did not comply very well with the prescribed treatments. Gender differences had very little effect on the outcomes. Telemedicine provided expertise, information, and a disciplining effect on the target population, resulting in a 30-40 mg/dl drop in blood glucose in all three measured parameters. While the exact scope of influence on the t1DM population is unclear, it could be concluded that telemedicine provides a relatively cheap and widely available option for hospitals to help manage and control outpatient treatment of t1DM patients in the surrounding communities.

References

Dagogo-Jack, S. (2017). Diabetes mellitus in developing countries and underserved communities. New York, NY: Springer International Publishing.

Kotsani, K., Antonopoulou, V., Kountouri, A., Grammatiki, M., Rapti, E., Karras, S.,… & Kotsa, K. (2018). The role of telenursing in the management of Diabetes Type 1: A randomized controlled trial. International Journal of Nursing Studies, 80, 29-35.

Rowley, W. R., Bezold, C., Arikan, Y., Byrne, E., & Krohe, S. (2017). Diabetes 2030: insights from yesterday, today, and future trends. Population Health Management, 20(1), 6-12.

Diabetes is a global burden with numerous complications that can be prevented with timely assessment and lifestyle modifications. There are two types of diabetes, type 1 is caused by failure of insulin production due to pancreatic insufficiency, and type 2 is caused by insulin resistance, resulting in chronically elevated blood glucose levels (Dendup et al., 2018). Type 2 diabetes mellitus (T2DM) is caused by genetic abnormalities associated with environmental factors (Bellou et al., 2018).

Such factors as a diet rich in processed meat and simple carbohydrates, physical inactivity, increased body mass index, and smoking was associated with the development of T2DM (Bellou et al., 2018). Indeed, all these factors can be controlled to prevent the development of diabetes and its complications, such as cardiovascular diseases, lower-extremity amputations, diabetic retinopathy, neuropathy, and renal disease (Harding et al., 2019). Timely risk assessment of diabetes helps to introduce appropriate lifestyle modifications to stop health deterioration.

Various diabetes risk assessment software has been developed to help people to monitor their health. For example, Siteman Cancer Center’s disease risk assessment online tool identifies current risk for some chronic illnesses, including diabetes. It evaluates a person’s dietary habits, physical activity, alcohol consumption and smoking, and family history of T2DM. After completing the questionnaire, I learned that my risk for the development of diabetes is above average. Furthermore, I received some recommendations for disease prevention, such as normalizing my weight, increasing whole grain consumption, and reducing food rich in refined starches in my diet. I found this tool helpful in determining my current state of health and identifying future goals for lifestyle modifications.

Overall, diabetes is a severe chronic disease that can be prevented by dietary and physical activity modifications. Addressing risk factors early in the disease course is crucial for stopping the progression of diabetic complications. Modern risk assessment tools allow identifying the current state of health and possibilities of developing the disease. Using Siteman Cancer Center’s disease risk assessment questionnaire, I determined that I have an increased tendency to develop diabetes. I will try to become more physically active and eat healthy to address these risks and prevent the development of T2DM in the future.

References

Bellou, V., Belbasis, L., Tzoulaki, I., & Evangelou, E. (2018). Risk factors for type 2 diabetes mellitus: An exposure-wide umbrella review of meta-analyses. PloS ONE, 13(3), 1-27. Web.

Dendup, T., Feng, X., Clingan, S., & Astell-Burt, T. (2018). Environmental risk factors for developing type 2 diabetes mellitus: A systematic review. International Journal of Environmental Research and Public Health, 15(1), 1-25. Web.

Harding, J. L., Pavkov, M. E., Magliano, D. J., Shaw, J. E., & Gregg, E. W. (2019). Global trends in diabetes complications: A review of current evidence. Diabetologia, 62(1), 3-16. Web.