Diabetes mellitus is a rather severe group of diseases that may occur in both children and adults. This condition affects the way ones body uses glucose and may lead to excess sugar in the blood, which typically results in serious health problems (Mayo Clinic Staff, 2020). Due to the fact that not all patients diagnosed with diabetes, as well as their families, are aware of the possible complications and necessary actions to prevent them and improve the situation, education strategies are essential (Mayo Clinic Staff, 2020). The need to increase awareness of diabetes causes and treatment is the reason why precisely this disease is chosen for this study. Thus, the purpose of this paper is to identify and describe the three learners, describe the educational setting for these audiences, and include learner assessment.
Patients
The first learning audience is patients who are diagnosed with diabetes mellitus. Since there is a necessity to improve their condition and make sure that their treatment works, it is incredibly essential to educate them about all the nuances of this disease (Markowitz et al., 2018). Most patients do not have a medical education, and their developmental levels are usually normal. At the same time, their average readiness to learn may be estimated as high. Since diabetes mellitus is a specific disease that prevents them from living a normal life, most clients will be eager to learn how to lead a healthy lifestyle and decrease the possibility of complications. The educational location for patients is an ambulatory care setting since there are fewer distractions for them.
There is an extended number of educational approaches and techniques that are used by medics to teach patients. One of them is the teach-back method, which is proved to be effective and used by many professionals (Yen et al., 2019). This technique is based on the assumption that repetition of the recently heard information is the best way to understand and remember it (Yen et al., 2019). Thus, during patient teach-back, the first step is for a clinician to provide the necessary knowledge about diabetes treatment and complications prevention. A medical worker should recommend a specific lifestyle that will allow the patient to feel better and have improvements (Yen et al., 2019). Then, the clinician should ask the patient to repeat the information and recommendations in their own words (Yen et al., 2019). While synthesizing health instructions, a client will demonstrate whether they actually comprehend them. For example, in case there are voids in their knowledge, medical workers should repeat the information, focusing on those moments that the patient forgot.
Families
The second audience that has to be educated about diabetes is the families of patients. According to researchers, a systematic approach to teaching clients requires including family members (Amirehsani et al., 2019). An ambulatory care setting is also preferable for educating relatives. Usually, only adult members of patients families are required to be instructed. They typically have higher education and an average level of development. What is more, they are generally interested in learning about diabetes since it is their purpose to help a member of their family (Markowitz et al., 2015). Moreover, considering the fact that they spend more time with the client than medical workers do, and it is easier for them to make sure that instructions are followed, educating family members becomes especially necessary. Several efficient approaches to teaching relatives of people diagnosed with diabetes exist in current medical practice. One of them is the COPE model that is based on creativity, optimism, planning-learning, and expert information (Houts et al., 1996). This approach is exceptionally efficient in making family members effective problem solvers.
Medical Staff
Finally, the third audience to educate about diabetes and its complications, as well as the ways to deal with patients diagnosed with this disease, is medical staff. It is especially necessary for clinicians to learn how to teach their clients about the nuances of a new lifestyle they have to lead. What is more, it is essential to be aware of the ways to check whether a patient follows all recommendations and instructions and, in case they do not, be able to explain the necessity of doing it. The staff has medical education and is interested in learning since clinicians purpose is to save peoples lives and treat them in the most effective way.
According to Parent et al. (2016), patient- and family-centered care (PFCC) is an efficient approach that emphasizes humanity and empathy, as well as partnership and communication with families and clients. It is crucial for medical workers to be in touch with the patients since such an approach increases the chances of their conditions improving. What is more, ensuring that staff is aware of diabetes nuances and is able to educate clients and their relatives is also important. PFCC is focused on teaching physicians to assist families and patients in translating information into care-oriented and helpful knowledge (Parent et al., 2016). The educational setting is typically clinical encounters (Parent et al., 2016).
References
Amirehsani, K. A., Hu, J., Wallace, D. C., Silva, Z. A., & Dick, S. (2019). Hispanic families action plans for a healthier lifestyle for diabetes management. The Diabetes Educator, 45(1), 87-95.
Houts, P. S., Nezu, A. M., Nezu, C. M., & Bucher, J. A. (1996). The prepared family caregiver: A problem-solving approach to family caregiver education. Patient Education and Counseling 27(1), 63-73.
Markowitz, J. T., Garvey, K. C., & Laffel, L. M. B. (2015). Developmental changes in the roles of patients and families in type 1 diabetes management. Current diabetes reviews, 11(4), 231-238.
Mayo Clinic Staff. (2020). Diabetes. Mayo Clinic. Web.
Parent, K., Jones, K., Phillips, L., Stojan, J. N., & House, J. B. (2016). Teaching patient- and family-centered care: Integrating shared humanity into medical education curricula. AMA Journal of Ethics, 18(1), 24-32.
Yen, P. H., & Leasure, A. R. (2019). Use and effectiveness of the teach-back method in patient education and health outcomes. Federal Practitioner, 36(6), 284-289.
Diabetes is one of the major metabolic diseases, which affects a large portion of the population. It is a severe systemic heterogeneous disease in which absolute or relative insulin deficiency develops. Diabetes is an endocrine disease characterized by a syndrome of chronic hyperglycemia, which is a consequence of insufficient production or action of insulin, which leads to the disruption of all types of metabolism. Insulin deficiency initially causes a violation of carbohydrate metabolism, which ultimately leads to damage to all functional systems of the body. There are two main forms of the disorder, such as autoimmune type 1 and insulin-resistant type 2.
Causes
The problem can be caused by random autoimmune errors or viral infections, as well as genetics. The main causes are diet and lifestyle, where a person systematically overconsumes sugary or glucose-containing foods. Type 2 diabetes tends to occur in older people, and the incidence rates increase with age. In addition, there is an increasing number (1) of type 2 diabetes patients who suffer from this form of diabetes during adolescence. Most of these cases are due to poor diet, excess weight, and lack of physical activity. Along with the provided facts, the genetic component plays a significant role in the development of diabetes. At the same time, while there are no other risk factors, the most significant risk factor is obesity. There is a direct link between obesity and type 2 diabetes, and this is equally true for both children and adults.
Problems
Diabetes causes a wide range of health problems, which can also lead to or be risk factors for cancers. One of the most immediate and direct consequences of both types of diabetes is elevated blood glucose levels. Such a state can lead to a wide range of metabolic disturbances and imbalances. Which eventually results in high levels of morbidity. A recent study (2) claims that macrovascular or cardiovascular complications are the main cause of death among people who have diabetes. In the case of microvascular factors (2), lower limb amputations are the primary elements of burden, which poses both physical and psychological harm. Apart from cardiovascular issues, cancer and end-stage renal disease (2) are the main concern, which is common among diabetic patients. Therefore, such an array of deadly metabolic disturbances can be identified as central problems.
Symptoms
Diabetes is one of the diseases, which have several symptoms, and they can substantially vary in overall prominence. For example, thirst and frequent urination can be a sign of the disease, and it can also be accompanied by an uncontrollable feeling of hunger (3). Another indicator of diabetes can be manifested in low energy and fatigue as well as a sudden worsening of vision, such as blurry eyesight. In addition, skin cuts might take more prolonged periods to heal and regenerate. Lastly, one might have numbing, painful, or tingling (3) sensations in the distal ends of the limbs. Therefore, if a person exhibits some or all these symptoms, he or she should seek out medical attention to conduct a proper diagnosis.
Types of Diabetes
It is important to note that the given manifestations of diabetes primarily differ in terms of causes. Type 1 disease is the result of a persons immune system targeting the cells in the pancreas, which produce insulin. Therefore, the evidence suggests (4) that affected individuals are not capable of producing sufficient amounts of the hormone to properly regulate the blood glucose level. In other words, insulin supplementation can improve the overall condition of these people. However, type 2 diabetes (4) is the result of a person becoming resistant to insulin, where more than normal levels of the hormone are generated. It means that the cells are not responsive to adequate levels of insulin, which is why the pancreas overcompensates by secreting more amounts of the hormone.
Cure
It is important to consider the fact that treatment measures might differ based on the typological feature of the disease. In the case of type 1 diabetes, the main issue lies in the inability of a persons pancreas to produce sufficient amounts of insulin. Therefore, the most optimal strategy revolves around supplementation of the hormone from outside sources. However, the key problem with type 2 diabetes is the notion of insulin resistance, where cells are unresponsive to the effect of the regulator. Thus, the curing procedures might begin with the introduction of lifestyle and dietary changes to reduce daily sugar consumption as well as decrease obesity level. In the more complicated cases, insulin therapy might be needed to achieve the required degree of responsiveness from the cells.
Statistics
Moreover, it is essential to take statistical data into account to have a more complete understanding of the scope of diabetes. Diabetes mellitus is a global problem that has only grown over the years. Statistics show (5) this disease affects 415 million people worldwide, which is 6-7 percent of the total population of the Earth. The main reason for the growth of the disease is a radical lifestyle change. According to statisticians (6), if the situation remains on its course, by 2025, the number of diabetics will double. The highest incidence rate was found among residents of the United States (6), where about 20 percent of the total population of the country suffers from diabetes. Type 1 diabetes is usually diagnosed in patients under 30 years of age, while women are much more likely to get sick. The disease of the second type develops in people over 40 years old and almost always occurs in obese people with increased body weight. Therefore, the given issue is an epidemic, which affects all nations, and thus, it requires the highest level of attention.
Conclusion
In conclusion, diabetes mellitus is a group of endocrine diseases that develop as a result of an absolute or relative deficiency of the hormone insulin. As a result, hyperglycemia develops, which is a persistent increase in blood glucose. The disease is characterized by a chronic course and disruption of all types of metabolism, such as carbohydrate, fat, protein, mineral, and water-salt. With diabetes mellitus, the formation of glycogen in the tissues decreases, as a result, the sugar content in the blood rises and it begins to be excreted in the urine. The development of diabetes mellitus is promoted by impaired central nervous regulation, eating disorders, excessive consumption of carbohydrates, infectious diseases, and hereditary predisposition. The consequences of the disease can be tumors, inflammation, and sclerotic changes in the pancreas. The treatment can depend on the manifestation of diabetes, but the most severe cases require insulin.
References
DeFronzo RA, Ferrannini E, Zimmet P, Alberti G. International Textbook of Diabetes Mellitus. Hoboken: John Wiley & Sons; 2015.
DeFronzo RA, Ferrannini E, Zimmet P, Alberti G. International Textbook of Diabetes Mellitus. Hoboken: John Wiley & Sons; 2015.
Harding JL, Pavkov ME, Magliano DJ, Shaw JE, Gregg EW. Global Trends in Diabetes Complications: A Review of Current Evidence. Diabetologia. 2019;62: 3-16. Web.
Holt T, Kumar S. ABC of Diabetes. Hoboken: John Wiley & Sons; 2015.
Goldstein BJ, Mueller-Wieland D. Type 2 Diabetes: Principles and Practice. Boca Raton: CRC Press; 2019.
Chatterjee S, Khunti K, Davies MJ. Type 2 diabetes. The Lancet. 2017;389(10085): 2239-2251. Web.
CDC. National Diabetes Statistics Report, 2020. Web.
Type 2 diabetes mellitus is a serious metabolic condition that is affecting large portions of the population and growing at an increased rate. The disease affects virtually all demographics but is associated with overweight and obesity as risk factors. Individuals with type 2 diabetes typically have issues with dietary patterns and appropriate nutrition which impacts glycemic control and results in cell inflammation and organ deterioration in the long-term with a wide range of health consequences such as heart disease, cancer, and neuropathy. Strategies to improve nutritional intake in order to prevent or manage type 2 diabetes focus on patient education and public health programs which emphasize dietary habits. Nutritional quality, particularly in diets with more wholegrains, legumes, and fruits/vegetables are effective in creating weight loss, and subsequently glycemic control for the management of diabetes mellitus. The issue of type 2 diabetes prevalence is just as much cultural as it is health-associated. There must be targeted programs and policy aimed at addressing the underlying problems such as high sugar content in modern foods, emphasis on prepackaged foods, and access to fresh foods among high risk populations. These and other measures discussed in this paper are aimed at potentially decreasing type 2 diabetes incidence and reduce the health and socio-economic burden of the disease on the population.
Type II diabetes mellitus (referred periodically in this paper as simply diabetes) is a non-infectious chronic disease that is becoming increasing prevalent around the world. Type II diabetes has severe health impacts with both short- and long-term consequences as well as being linked to a variety of other highly dangerous conditions such as heart disease, stroke, cancer, Alzheimers disease, and others. Unlike type I diabetes which is based on biological and genetic factors, type II diabetes is more associated with behavior and nutrition, although genetics and environmental factors play a role. More than 90% of diabetes mellitus cases are caused by insulin resistance that forms as a result of overweight/obese body composition ad inactive lifestyle. Evidence suggests that in most cases unhealthy weight is caused by nutritional disbalance and inappropriate eating habits. Therefore, drawing connections, the purpose of this research is to investigate the impact of nutrition on the development of Type II diabetes mellitus.
The disease is extremely widespread, affecting more than a third of the population, and being the 7th leading cause of death due to various stemming health complications. This has led to many experts in medicine and public health to dub diabetes and the associated obesity as an epidemic and crisis (Tavernise, 2015). The prevalence and seriousness of the disease is why this topic is critical to research and discuss. The nature of the condition is that it does not manifest physically until much later through diabetes-related retinopathy, neuropathy, heart disease, or kidney disease, all of which are interrelated (CDC, 2019) However, as soon as a patient reaches of a prediabetic status, the metabolic changes are beginning to have an accumulating effect that later has a destructive effect that is much more difficult if at all possible to address medically. Diabetes mellitus in every sense of the phrase is a silent killer which makes it absolutely critical to recognize and identify the disease early and proactively begin to manage or prevent it. Nutrition, accompanied by other lifestyle choices, is the primary factor in preventing or managing type II diabetes.
The research presented in this paper will benefit virtually everyone, ranging from individuals seeking to know more about Type II diabetes and how to prevent it, to medical professionals that may change their approach to treatment and recommending this as patient-education literature. Type II diabetes, or even the threat of it, is a widespread disease, and more people should become aware of it to stop the epidemic of this non-infectious condition. Recognizing the impact of nutrition on diabetes goes beyond personal choices, it is a national problem which affects virtually everyone. Therefore, anyone ranging from businesses in the food industry, institutions providing food to people at any given time (such as schools) to policymakers can benefit from the information to direct their course of action in preventive measures. The goal of this paper is to research relevant and clinically accurate information regarding the impact of nutrition on development of Type II diabetes and present the information in a comprehensive manner to be utilized in a variety of contexts which can help to prevent or treat the disease.
General Information
Diabetes mellitus, also known as Type II diabetes, is a chronic metabolic disease which affects the production and use of insulin in the body facilitating the uptake of glucose (blood sugar). Type II diabetes occurs when ²-cells are unable to produce sufficient insulin to keep up with demand, characterized by insulin resistance. Insulin resistance develops with ectopic fat presence in the liver and muscle, as well as accumulating in the pancreas which leads to the decline of ²-cells functionality and eventual death. Therefore, obesity is the major and primary risk for type-2 diabetes in combination with complex genetic and environmental etiology. Factors for onset type-2 diabetes may differ between individuals and race/ethnicity, as there are different, personal ectopic fat thresholds at which insulin resistance and ²-cells deterioration occurs. Insulin sensitivity decreases with obesity and increases with weight loss, making prediabetes or early onset Type II diabetes potentially reversible (Skyler et al., 2017).
Figure 1: A diagram showing the biological development and progression of diabetes (Skyler et al., 2017) Diabetes has experienced steady growth among the population over the decades, associated with multiple factors including ecological, lifestyle, and nutrition of developed countries in modern day. According to the CDC (2017), 30.3 million Americans are living with Type II diabetes, and another 84.1 million have prediabetes, a condition where insulin resistance and other metabolic factors are beginning to be affected but have yet to reach the levels for clinical diagnosis of diabetes mellitus. It should be noted that potentially as many as 7.3 million people are undiagnosed. The total population of the U.S. living with diabetes exceeds 10.5%.
Traditionally, type 2 diabetes has been present in individuals of older age, but in recent years, there has been an increased incidence in youth. Approximately 210,000 Americans under the age of 20 are diagnosed with diabetes, or about 0.25% of that age group. Older age is correlated with risk of developing diabetes as one in four Americans over the age of 65 is diagnosed, or 26.8% (American Diabetes Association, 2020). Certain racial and ethnic groups such as African Americans, Hispanics/Latinos, Asians, and American Indians are more prone to developing the condition due to a mixture of genetic factors, lifestyle, and culture. Males are slightly more affected by Type 2 diabetes with 6.9% prevalence in comparison to 5.9% for females (Skyler et al. 2017). Geographically, the disease has significant variance, with South-East Asia and Australia having the most diagnosed adults of over 153 million, while North and Latin America have the highest incidence rates of 1 in 8 adults affected. Low socioeconomic status such as low education, low occupation, and low income can increase the risk of developing type II diabetes by 30-41% (Skyler et al., 2017).
Figure 2: Distribution of Type II diabetes diagnoses by race/ethnicity
Due to the extensive prevalence and health impacts of diabetes mellitus, there is an inherent socioeconomic burden. The estimated cost of diagnosed diabetes for the United States in 2017 was estimated at $327 billion, $237 billion of which were direct medical costs and $90 billion in reduced productivity. Based on cost category analysis, diabetes accounts for 1 in 4 health dollars spent in the U.S., with $16,750 annual average medical expenditures per patient with diabetes (American Diabetes Association, 2018).
The etiology of type 2 diabetes mellitus is complex despite being such a common disease. It is associated with a variety of irreversible risk factors such as age, race, and genetics, but also strongly correlates with controllable and reversible activities such as diet, exercises, and behaviors the likes of smoking and alcohol use. Therefore, while nutrition is not the only contributing factor alongside physical activity, diet is regarded as the major impactful factor for development of type 2 diabetes around the world. Research has consistently identified a positive correlation between high intake of sugars such as carbonated drinks and added sugars popular in modern urban and developed societies and development of diabetes mellitus. Less consistent data but still important is the correlation between consumption of fats and carbohydrates in developing diabetes (Sami et al., 2017). As discussed earlier, obesity and ectopic fat deposits contribute to insulin resistance and hypoglycemia which define type 2 diabetes. Food intake is directly linked to obesity, both in volume of food as well as the composition and quality of the diet. Dietary compositions consisting of high intake of red mead, sugar, and fried foods result in an increased risk of insulin resistance and type 2 diabetes (Panagiotakos et al., 2005). Therefore, nutrition plays a highly critical role in the development and subsequent management of type 2 diabetes in order to regulate blood glucose levels and weight management to improve quality of life.
Application
The primary audience for this research are individuals who have been diagnosed with type 2 diabetes or have clinically recognizable prediabetes both groups have the opportunity to modify nutritional and dietary habits in order to prevent, manage, or potentially reverse the condition. A significant challenge for stakeholders such as clinicians, is that the among patients, diabetes awareness is commonly very low. This applies to all populations, but some groups such as lower socioeconomic status, minorities, or elderly individuals may have very little understanding about the disease. Knowledge on the topic is critical to achieve better compliance with medically prescribed therapy, including changes to lifestyle and diet management (Sami et al., 2017). Meanwhile, a study by Magurova et al. (2012) found that providing diabetes education to patients increases the awareness of the disease and notably improves quality of life. Therefore, the research has significant applicability in clinical practice as a tool for patient education and awareness that improves adherence and dietary changes.
However, the unusual high prevalence for a non-communicable disease and rapidly growing rates of prevalence, particularly in populations that are typically health indicate that diabetes mellitus is a public health concern. It is an issue that should be addressed quickly as many public health experts deem to be a public health emergency that is on par to reach 642 million cases globally by 2040 and place a heavy burden on society and health systems (Al-Lawati, 2017). Everyone that is at risk of developing type 2 diabetes or has been diagnosed should shift priority to nutritional management due to its impact on the disease which is, as noted, progressive in its effects on human health. Meanwhile, the public health concern has prompted most developed countries to set national goals in reducing the burden of diabetes mellitus and improve quality of life and care for those who are diagnosed or at risk. This includes the United States, with objectives under its Healthy People 2020 initiative to reduce annual number of new cases, mortality, and control of symptoms for those who are diagnosed (HealthyPeople2020, n.d.). The importance of this topic is largely due to the critical nature of the growing incidence rates of diabetes mellitus, including in developing countries, vulnerable communities, and younger ages being affected. If left poorly managed, over time, this will translate into extreme burdens for society with overextended health systems, extreme medical costs, and socio-economic consequences (Tabish, 2007).
The topic of nutrition comes into play because the epidemiological and demographic patterns seen with type 2 diabetes are a consequence of social norms and behaviors in dietary habits. The rise in popularity of fast foods, added sugar, and other products have led to the epidemic of obesity or unregulated glucose, eventually inciting hypoglycemic individuals with type 2 or prediabetes diagnoses. High quality, fresh, and healthful diets are hard for many people to obtain, particularly in non-affluent areas (the concept known as food deserts where communities lack access to fresh foods, provided only with options of prepackaged and processed foods) (Sklaroff, 2012). At the macrolevel, the rising rates of the disease are attributed to a range of factors including urbanization, computerization, and shifts in food production that focus on longevity and processing of foods in order to be safely distributed along extended supply chains. At the same time, this has led to increased accessibility to unhealthy foods, further exacerbated by the franchising business models that led to emergence of fast food restaurants combined with cultural dietary preferences to promote high calorie content in large portion sizes (Let et al., 2014). Type 2 diabetes may be a personal health struggle, but it is a societal issue that is driven in part strongly by the status quo of promoted dietary practice in modern American culture.
Approaches/Treatments
The approach to management/prevention and treatment of type 2 diabetes requires examination of both the factors of nutritional strategies at the individual patient level and then a more comprehensive public health and policy levels. Decades of research on diabetes mellitus found the fundamental importance of individual nutrients and dietary patterns in the prevention and management of the disease. Similarly, just like the cause of type 2 diabetes, it is not single food items but rather application of food pattern techniques that ultimately result in the biological response and health results in prevention or treatment of the condition. Diets which are rich in fruits, vegetables, legumes, and wholegrains while moderating red meat, sugar, and alcohol consumption are associated with improving glycemic control and blood lipids. Diets such as Mediterranean, vegan, DASH, and others can be tailored to personal and cultural preferences to achieve the necessary results. When utilizing nutrition in the treatment of diabetes mellitus, it is vital to consider that quality of nutrients such as dietary fats and carbohydrates is more critical than quantity, and diets with appropriate calories needs for weight control will have successful impact on diabetes prevention or management (Let et al., 2014).
Public health interventions using the principle of glycemic risk stratification which targets high risk individuals (obese and presence of impaired glucose tolerance) are generally effective. The primary approach for public health is to prevent or mitigate modifiable risk factors in the population such as dietary habits, weight loss, and physical activity. Various examples of public health initiatives take the research basis mentioned in this paper regarding nutrition, dietary pattern structuring, and physical activity to achieve targeted outcomes. Public health programs are typically community-based with oversight and sponsorship form the government, health organizations, and local healthcare institutions. In the context of modern-day technology and the ongoing COVID-19 pandemic, delivery of programs for lifestyle change has been done online via telehealth and other Internet-based services to effectively reach more people. Public health programs, especially ones which are targeted, well-developed, and supported long-term have a moderate success rate of achieving 4-10% weight loss and improving dietary habits for high-risk individuals (Gruss et al., 2019). The evidence clearly suggests that lifestyle interventions, focused on nutrition and dietary patterns alongside physical activity are effective in preventing and delaying type 2 diabetes while being cost-effective in real-world contexts.
However, the long term economic, social, and personal consequences of type 2 diabetes make a viable case to have measures become policies aimed at prevention of disease incidence rates. Policies should focus on four primary aspects. First, there should be nationwide promotion and evaluation of healthy lifestyle programs, such as ones described above with a focus on prevention and treatment of obesity as well as nutritional guidance and active lifestyle. This is the responsibility of the public health sector aimed at translating evidence-based findings into practical and accessible programs. Second, health agencies should aim for early identification of subjects at risk of developing type 2 diabetes, including screenings for gestational diabetes, BMI, and other contributing factors in order to begin clinical interventions. (Steyn et al., 2004). Third, policy should aim at creating healthy products alongside the agricultural sector and private sector companies to shift the food practices in production that contribute to widespread popularity of prepackaged meals. Finally, policy should be targeted with legislative action at macro factors discussed earlier, such as regulation of food industry, improving access to healthy foods in impoverished communities, and general national efforts at reducing rates of obesity and improving dietary patterns and habits (Bergman et al., 2012). From a policy perspective approach, it requires the cohesive collaboration of three sectors clinical, public health, and government regulation alongside the private sector in order to create effective programs and synergies to address the prevention of type 2 diabetes on a macro level.
Expected Outcomes/Recommendations
This section will focus on two expected outcomes, individual and from a public health perspective if appropriate measures are taken in improving nutritional intake and dietary patterns. For an individual patient, the expected outcome as a result of treatment and lifestyle changes is a combination of weight loss and lowering of glucose levels. Weight loss is measured via several tests including standard weight in, BMI, and a body composition test. The target is 7% of body weight loss in a year and those with impaired glucose tolerance, to reach HbA1c of <6%, preferably under 5.6% for normal indicators (Wilding, 2014). Such outcomes are realistic and possible in combination of diet for glycemic control alongside recommended 150 minutes of physical activity per week. Patients adhering to said lifestyle changes report significant improvements in glycemic index and weight loss, an indicator of increased insulin sensitivity and a remission/prevention of type 2 diabetes.
The key objective and data point from a public health perspective is to reduce the annual number of newly diagnosed cases of type 2 diabetes mellitus. This is the primary objective for the Healthy People 2020 initiative in the United States, which had set a 10% improvement goal for a 10-year period and had exceeded it going from baseline 8 cases per 1000 to 6.5 per 1000. The expected outcome is that further decrease is possible, with the objective to reach 5 cases per 1000 by 2030 (Healthy People, 2020). There have been significant improvements in public health awareness in the U.S. population, and a perceived change in dietary patterns towards healthier alternatives and diets. Many fast food and dining locations have also begun offering fresh and healthy options in light of population dietary changes and demands, gradually shifting the country away from the fast-food culture (Poinski, 2020). There is still significant progress to be made, and problems experienced by lower socioeconomic classes in terms of access to food are not fully resolved. However, the general popular trends are valuing a significantly healthier nutritional choices which has a long-term impact on type 2 diabetes prevalence.
The primary recommendation is for public healthy policy to continue strong measures in targeting underlying factors which impact the nutritional intake of Americans. This ranges from public education about nutrition and diabetes to policies which further regulate food industry and begin to reduce the levels of added sugar content particularly in non-sweet foods. Other elements which have had success such as legally reducing portion sizes and promoting healthy lifestyle interventions are valuable from a massive public health perspective. The ongoing COVID-19 pandemic has critically hindered the possibility of the overburdened healthcare sector to help patients with chronic conditions effectively. However, the pandemic also made many people to consider their health and wellness, which provides ample opportunities for public health and government to step in with appropriate guidance and information.
Conclusion/Summary
Type 2 diabetes mellitus is a serious metabolic disease which is characterized by insulin resistance and wrought with negative complications for short- and long-term health. The disease is caused by a wide range of genetic, environmental, and behavioral factors, but the majority of cases are associated with overweight and obesity. The disease is becoming prevalent around the world, impacting virtually all populations, including typically healthy individuals such as young people, which creates significant concern for the health burden of the disease in the population. This paper discusses the importance of nutrition in managing or preventing type 2 diabetes, examining all perspectives ranging from individual patients to public health and policy. The underlying cause of higher weight causing type 2 diabetes is a consequence of modern-day lifestyles which emphasize lack of physical activity and inappropriate nutrition. Addressing this issue through patient treatment and public health programs and policy has shown and will have further potential in improving dietary habits in the population and reducing incidence of type 2 diabetes.
References
Al-Lawati J. A. (2017). Diabetes Mellitus: A local and global public health emergency! Oman Medical Journal, 32(3), 177179. Web.
Bergman, M., Buysschaert, M., Schwarz, P. E., Albright, A., Narayan, K. V., & Yach, D. (2012). Diabetes prevention: global health policy and perspectives from the ground. Diabetes management (London, England), 2(4), 309321. Web.
CDC. (2017). New CDC report: More than 100 million Americans have diabetes or prediabetes. Web.
CDC. (2019). Put the brakes on diabetes complications. Web.
Magurova, D., Majernikova, L., Hloch, S., Tozan, H., & Goztepe, K. (2012). Knowledge of diabetes in patients with type 2 diabetes on insulin therapy from eastern Slovakia. Web.
Sklaroff, S. (2012). Diabetes affects millions; Society should not stigmatize its victims. The Washington Post. Web.
Skyler, J. S., Bakris, G. L., Bonifacio, E., Darsow, T., Eckel, R. H., Groop, L., Groop, P.-H., Handelsman, Y., Insel, R. A., Mathieu, C., McElvaine, A. T., Palmer, J. P., Pugliese, A., Schatz, D. A., Sosenko, J. M., Wilding, J. P. H., & Ratner, R. E. (2017). Differentiation of Diabetes by pathophysiology, natural history, and prognosis. Diabetes, 66(2), 241255. Web.
Diabetes which is medically referred to as diabetes mellitus is a metabolic disorder that occurs due to the lack of production or action of insulin in the body. Insulin is a hormone that enables blood sugar in form of glucose to generate energy in the body. It is a lifelong condition that results from high sugar levels in the body. Diabetes is rapidly becoming a global concern and the United States is also feeling the pinch of the disease in its population. The condition is becoming a national epidemic so rapidly that currently it is considered the sixth cause of death in the United States.
Medical Terminology
Diabetes Mellitus: Scientific term used to refer to Diabetes.
Metabolic Function: Chemical reactions responsible for maintaining normal body functions.
Insulin: It is a hormone responsible for metabolism. It promotes the absorption of glucose.
Hormone: A chemical substance that controls and coordinates activities in the body.
Deficiencies: Lack of something such as nutrients in the body.
Glucose: The main type of sugar in human bodies.
Gestational Diabetes: Type of diabetes that affects women during the gestation period.
Type 1 Diabetes: Results from the bodys inability to produce insulin.
Type 2 Diabetes: This Causes the blood sugar levels in an individuals body to rise much higher than normal.
Cholesterol: Type of lipid in organic value.
Infant Mortality: Rate of deaths of infants.
Life Expectancy: A measure of the time a person is expected to live.
Oral Medication: Medications that are taken orally.
Diagnosis: A process of determining which disease a person has contracted.
Condition: An abnormal state of health that interferes with the normal functioning of the body.
Complications: Negative consequences of a disease or condition.
Prevention: Decreasing the burden of disease.
Administer: Give medication.
Re absorption: Process in which water is reinstated into the blood circulation.
Resistance: A disease or disease-causing microorganism not responding to medication.
Lipid: A micro-biomolecule that is non-soluble.
Undiagnosed: Unable to detect or not detected.
Nausea: Being in a state of dizziness.
Fatigue: A state of general body weakness.
Infection: Invasion of the body by a microorganism.
Background
Studies done by the American Diabetes Association (ADA) found that diabetes has not only cost the American population its health but also its economy. An approximated 174 billion dollars is used in treating diabetes according to a report by the American Diabetes Association in 2007 (Hendrikus, 2017). Recent statistics by the Center for Disease Control and Prevention (CDC) indicate that this figure has grown up to an estimated 245 billion dollars annually in terms of the cost of treating diabetes in the United States. The CDC also estimates that 23.1 million people have been diagnosed with diabetes in the United States and about 7.2 million have diabetes but remain undiagnosed (Centers for Disease Control and Prevention. National diabetes statistics report, 2017).
Causes
Medically Diabetes is used collectively to refer to several diseases inhibiting characteristics such as increased levels of blood sugar in the body. Some of the causes are linked to the increased levels of glucose may include deficiencies in both the production and action of insulin (Moulder and Lahesmaa, 2016). A significant number of diabetes may have both abnormalities in the production and the action of insulin (Hendrikus, 2017). Insulin is tasked with converting blood glucose to a form of carbohydrate referred to as glycogen which can be stored in the body. An abnormality in either the production or action of insulin, therefore, leads to high blood glucose levels in the body.
Types of Diabetes
The most common types of diabetes include type 1 and type 2 diabetes and gestational diabetes. The latter is the most prevalent in women especially during pregnancy as it causes high blood sugar levels in both the pregnant woman and the baby. The chances of women with a history of gestational diabetes developing type 2 diabetes in the future are quite high. This type of diabetes is common in minority populations in the United States where most women cannot afford to access health services (Hendrikus, 2017). Type 1 diabetes, on the other hand, results from the bodys inability to produce insulin. A patient suffering from type 1 diabetes, therefore, relies on routine insulin injections so as the body is supplied with the lacking insulin.
Type 2 diabetes is the most common form of diabetes diagnosed in many patients. Statistics from the Center for Disease Control and Prevention (CDC) have also indicated this type of diabetes as the most prevalent in the United States (Misra and Hattersley, 2016). Type 2 diabetes causes the blood sugar levels in an individuals body to rise much higher than normal. It causes insulin resistance which means that body would not be able to utilize insulin to support the high blood glucose levels (Moulder and Lahesmaa, 2016). The results of the lack of proper use of the insulin in the body is a probable strain on the pancreas due to overworking that may lead to its destruction therefore most people with this form of diabetes use direct insulin injections. More than 95% of the people diagnosed with diabetes in the United States have type 2 diabetes. It is prevalent among adults through a worrying trend of children being diagnosed with type 2 diabetes has been growing in the recent past (Hendrikus, 2017). Some of the commonly known causes of type 2 diabetes include excess body fat, high blood pressure or cholesterol, a history of gestational diabetes, and having a close family member with the condition.
Symptoms
Some of the common symptoms associated with diabetes include nausea and increased fatigue, skin, vaginal, and bladder infections (Kim, 2019). One of the most notable symptoms that can be observed in the early stages of diabetes is increased thirst as well as the increased tendency to produce urine. Tests on diabetes patients have also confirmed the presence of glucose in the patients urine which is often linked with high levels of blood glucose which then spills over into the urine (Misra and Hattersley, 2016). This causes the kidneys to be overworked as it involves increased water re-absorption which in turn leads to high levels of production of urine resulting in thirst.
Treatment
Intensive treatment of glucose, close monitoring of lipid levels and blood pressure in individuals with diabetes minimize the risk of developing diabetes. The therapeutic intervention also could help reduce the complications related to diabetes. Patients with type 2 diabetes can prevent diabetes-related complications by applying relevant lifestyle changes as well as taking oral medication (Kim, 2019). These lifestyle interventions may include a change of diet and regular exercises to ensure the loss of excessive fats and weight. Early effective management of the disease can reduce diabetes-related complications and increase the life expectancy of individuals with diabetes (Wong, 2014). Unfortunately, diagnosis in most patients is done when it is too late to administer any effective treatment or prevention.
Despite huge investment in healthcare, the United States still lags behind compared to other developed counties in terms of health matters such as infant mortality and life expectancy which are key factors in determining the success or failure of healthcare systems in a country. Although it performs relatively better in terms of delivery of diabetes care, the United States needs to focus on the delivery of diabetes care to the minority populations and the aging who studies by both the America Diabetes Association (ADA) and the Center of Disease Control and Prevention (CDC) have linked with most cases of diabetes in the country.
In conclusion, diabetes remains among the top ten leading causes of death hence measures to reverse its effects on populations have to be initiated by both the stakeholders in healthcare and the government. There is also a need to create awareness about the disease, its prevention, and treatment as studies have revealed that more than half of all diabetes cases are undiagnosed.
References
Hendrikus, Hulst. 2017. Diabetes Mellitus and Perioperative Glucose Control: Not One, but Two Types of Diabetes. International Journal of Diabetes, (4), 5-16.
Kim, Nam. 2019. Diabetes Mellitus, Still Major Threat to Mortality from Various Causes. Diabetes & Metabolism Journal, 43 (3): 273-275.
Misra, Shivani, and Hattersley Andrew. 2016. Monogenic Causes of Diabetes. Diabetes & Metabolism Journal, 11 (13): 241-261.
Moulder, Robert, and Lahesmaa Riitta. 2016. Early Signs of Disease in Type 1 Diabetes. Pediatric Diabetes, 17 (12): 43-48.
Wong, Vincent. 2014. Diagnosis of Gestational Diabetes Mellitus: Where Are We at? International Journal of Diabetes & Clinical Diagnosis, 1 (1): 1-4.
Everyone knows that American society is challenged by a variety of diseases. Some of them could be predicted, controlled, and treated, and some illnesses remain incurable because even the most advanced technologies are not effective and helpless. Diabetes is one of such public health concerns, with no particular cure. People should live with this disease, and researchers find it necessary to investigate this field, make contributions, and follow recent studies and events to clarify if there are any positive changes. To get prepared for diabetes, it is important to learn diabetes triggers, causes, complications, and other characteristics. Besides, one must know that low-income communities are under threat of having diabetes and suffer from its outcomes.
In this presentation, an understanding of diabetes is one of the initial tasks. It is not only a chronic disease that is frequently observed among US citizens, as well as around the whole globe. Diabetes changes many lives and appears without warning in patients of different ages, races, and ethniticies. Its main characteristics include a high level of sugar (glucose) in the blood.
At this moment, about 30 million Americans are diagnosed with diabetes, and about 24% of diabetics are not diagnosed due to poor care management, the lack of resources, and poor awareness of its complications (Chow et al., 2018; Cohen et al., 2017). Sugar enters the bloodstream with food people take, the stomach makes insulin to control the amount of glucose. Diabetes is when the body lacks insulin, and glucose does not reach the cells, which causes health problems.
Topic Problem
There are many reasons why the prevalence of diabetes among low-income communities is chosen as a topic problem for this project. First, diabetes is one of the diseases with no specific cure to be offered to patients. Therefore, the healthcare system (including organizations and individuals), as well as the government, are involved in developing care plans and diagnostic tools. Second, patients are in need of treatment, health experts recommendations, and care management. However, not all American communities have equal access to effective treatment, and many people are not able to control this disease. Finally, self-management is an obligatory step for diabetic patients, and low-income communities are not always ready for it.
Low-Income Communities
Financial inequality remains a serious problem for many people worldwide. In the United States, there are many low-income communities due to a variety of reasons. These people are more likely to stay undiagnosed and unaware of diabetes threats, thus contributing to the development of complications and morbidity rates. When this disease is revealed in a low-income person, it is usually hard to manage it. The problems among the chosen group of people depend on such factors as the level of education, weak access to healthy food, and poor knowledge about diabetes.
Diabetes Triggers
Although it is impossible to cure diabetes, there is always an opportunity to predict it and maintain a healthy lifestyle. For example, much attention is paid to learning the triggers of this disease. Cohen et al. (2017) and Gittelson and Trude (2017) consider obesity (or excess weight) as one of the potential threats for people. As a result, it is recommended to manage dietary habits and control the quality of food. Similar concerns are developed around such triggers as the environment. Besides, if there is diabetes in a family, such a history is also a risk factor for the population. Finally, the presence of high blood pressure may be a cause of the pre-diabetic condition and the reason for regular assessments.
Food-Related Issues
The choice of food predicts the development of diabetes in low-income communities. To avoid obesity-related problems, people should use healthy food and deal with existing feeding barriers. Unfortunately, the representatives of underserved communities do not have access to the resources with healthy food (Gittelson & Trude, 2017). They are obliged to change their food shopping behaviors in relation to their geographical locations, abilities, and other financial and social factors (Cohen et al., 2017). In addition, in low-income communities, people suffer from poor quality of stores where they can buy food products. Therefore, researchers underline the importance of changing living conditions and the quality of food for poor people to predict diabetes.
Drugs for Patients
The absence of a cure does not mean the absence of drugs that may be used by patients to control their health conditions. In their study, Chow et al. (2018) discuss the basic medications for diabetes. They include (Chow et al., 2018):
Metformin belongs to a group of biguanides, the goal of which is to control the level of sugar produced by the liver and decrease it to the normal limits.
Insulin is probably the most well-known drug people remember when they hear about diabetes because its purpose is to replace its lack in the body.
Sulfonylureas introduce one of the oldest group of medications to help patients and stimulate pancreas for more insulin production.
Sodiumglucose cotransporter-2 inhibitors are not always cheap, but their property is to remove glucose from the body.
Meglitinides belong to a group of drugs, the cost of which is prohibitive in some countries, but its ability to release insulin is unique.
Lack of Medications
The prevalence of diabetes among low-income populations can also be explained by the lack of medications for people. Multiple studies aim at investigating the availability of medications for populations, regardless of their social statuses or education levels (Chow et al., 2018). Unfortunately, financial affordability cannot be ignored, and physical, as well as social factors, must be determined. There is an extensive gap between accesses to medications in low- and high-income communities.
Chow et al. (2018) share statistical data about the most evident differences: if 100% of high-income communities can allow metformin to control diabetes, only 64% of low-income families can afford the same drug. A more serious situation is observed with insulin: 93% for high-income people, and only 10% for low-income communities (Chow et al., 2018). Such a lack of medications turns out to be a critical public problem.
Risks for Pregnant Women
In low-income communities, pregnant womens predisposition towards diabetes is another topic for discussion in this presentation. McGuire et al. (2015) identify several critical risk factors for the chosen group of people, including economic instability, poor knowledge about the disease, nutrition problems, and stresses. Poverty is a synonym for the unstable economic and financial situation in a family, and when a woman gets pregnant, a number of questions about how to protect the baby financially occur. In addition, women want to know as much as possible about diabetes but lack credible resources and professional support. Finally, nutritional and psychological problems determine womens behaviors and contribute to diabetes. In general, these risks can be divided into three main groups: economic, psychological, and personal factors.
Economic Problems
One of the current problems many pregnant women face when they discover their pregnancy is the necessity to deal with economic challenges. Their social instability, temporary unemployment, the possible economic crisis in the country, and unexpected financial concerns influence the condition of a woman and changes in the organism. Thoughts about the required baby products and food show that they may become unable to allow regular examinations and a chance to diagnose the disease at its early stage (Yee et al., 2015). As a result, these problems lead to difficulties in buying medications and controlling the development of the disease during pregnancy.
Psychological Factors
When a woman is expecting a baby, she has to be ready for a number of changes in her behavior and mood. However, in the majority of cases, it is impossible to get prepared for this condition. In addition, such women face increased responsibilities in their families and in society. It is expected that pregnant women take care of their health and avoid unfavorable environments. However, in low-income communities, the quality of life and working conditions do not usually meet all the health standards. Therefore, the necessity to follow healthy eating plans and finding a balance between preferences and recommendations provoke new stresses, which contribute to diabetes in some way (Yee et al., 2015). To find help, women address different sources but find insufficient motivation because of differences between their financial opportunities.
Personal Concerns
The burden of diabetes management among pregnant women may take different forms. However, female self-efficacy is harmed due to a variety of questions that occur in the womans head. For example, there is the fear of the unknown and the necessity to know as much as possible about possible diseases and potential threats (Yee et al., 2015). Self-management is an obligation to take care of everything, but pregnant women face barriers to be properly motivated and accommodated. Food habits provoke body changes and poor control of glucose in the body. Diabetes can easily progress due to female personal concerns and illogical thoughts. Finally, diabetes management requires control, but pregnancy is a period where the characteristics of control are underestimated.
Effects of Interventions
The prevalence of diabetes in low-income communities contributes to the creation of new areas of interest for researchers. The analysis of interventions that can be available to all people is developed, proving that professional help is necessary. Berg et al. (2016) and Nelson et al. (2017) focus on support programs to relieve diabetes burden. Mayberry et al. (2016) introduce the worth of mHealth applications for disadvantaged adults in the form of FAMs (phone coaching to support self-care). Nelson et al. (2017) investigate the quality of help offered by community health workers (CHWs). The enhancement of self-rated health is observed if people with low incomes choose at least one of the interventions, cooperate with health experts, and report about their problems.
Communication & Cooperation
Treatment and disease management are usually characterized by increased cooperation between doctors, patients, and their families. Mayberry et al. (2016) underline the importance of communication for diabetic patients due to several reasons. First, talks about diabetes serve as a positive factor in understanding the burden. Second, doctors improve patients knowledge about the disease and its risks. Finally, it is always possible for patients to learn and identify diabetes symptoms and choose a treatment plan. At the same time, cooperation between patients and doctors is effective in diabetes treatment because professional support is offered, complications are controlled and prevented, and interventions are introduced and analyzed.
Benefits
Taking into consideration the information from the studies, diabetes remains a serious problem for the global population, but people are able to recognize this threat. Low-income communities are at risk of having this disease, but they learn what they can do to predict its development. People cooperate with doctors and other healthcare employees to improve their knowledge and manage diabetes on their terms. There are many interventions to relieve diabetes burden, and families with low incomes could have access to some of them. It is always possible for all people to control their health and manage diabetes.
Risks
Despite the intention to help patients with diabetes, there are many obstacles and barriers to low-income communities that must be solved. Weight-related risks due to the lack of healthy food access increase peoples chances of becoming diabetic. Financial problems reduce their opportunities to buy necessary medications and manage diabetes in the most appropriate way. Finally, even if doctors and professional organizations are involved in the discussion of diabetes interventions, people from low-income communities are not always interested in improving their knowledge about disease management due to the existence of other social, personal, or economic problems.
Conclusion
In general, diabetes is one of the most complex and unpredictable diseases. Its prevalence among low-income communities continues growing and challenge millions of people around the globe. In this presentation, special attention was paid to several issues, including the essence of the disease, its triggers, and problems poor people face when they are diagnosed with diabetes. Many interventions are developed to manage diabetes at different levels, and families with low incomes should use their chance. They may improve their awareness of diabetes, predict complications, and manage their health independently. At the same time, such risks as the lack of motivation, money, or knowledge cannot be neglected in todays world.
References
Chow, C. K., Ramasundarahettige, C., Hu, W., AlHabib, K. F., Avezum, A., Cheng, X., Chifamba, J., Dagenais, G., Dans, A. Egbujie, B. A., Gupta, R., Iqbal, R., Ismail, N., Keskinler, M. V., Khatib, R., Kruger, L., Kumar, R., Lanas, F., Lear, S&. Yusuf, S. (2018). Availability and affordability of essential medicines for diabetes across high-income, middle-income, and low-income countries: A prospective epidemiological study. The Lancet Diabetes & Endocrinology, 6(10), 798-808. Web.
Cohen, A. J., Richardson, C. R., Heisler, M., Sen, A., Murphy, E. C., Hesterman, O. B., Davis, M. M., & Zick, S. M. (2017). Increasing use of a healthy food incentive: A waiting room intervention among low-income patients. American Journal of Preventive Medicine, 52(2), 154162. Web.
Gittelsohn, J., & Trude, A. (2017). Diabetes and obesity prevention: Changing the food environment in low-income settings. Nutrition Reviews, 75(Suppl. 1), 6269. Web.
Mayberry, L. S., Berg, C. A., Harper, K. J., & Osborn, C. Y. (2016). The design, usability, and feasibility of a family-focused diabetes self-care support mHealth intervention for diverse, low-income adults with type 2 diabetes. Journal of Diabetes Research, 2016, 113. Web.
Nelson, K., Taylor, L., Silverman, J., Kiefer, M., Hebert, P., Lessler, D., & Krieger, J. (2017). Randomized controlled trial of a community health worker self-management support intervention among low-income adults with diabetes, Seattle, Washington, 20102014. Preventing Chronic Disease, 14. Web.
Yee, L. M., McGuire, J. M., Taylor, S. M., Niznik, C. M., & Simon, M. A. (2015). I was tired of all the sticking and poking : Identifying barriers to diabetes self-care among low-income pregnant women. Journal of Health Care for the Poor and Underserved, 26(3), 926940. Web.
This paper contains a description and analysis of vulnerability and an appropriate holistic care plan for a 50-year-old male with type 2 diabetes. According to the Nursing & Midwifery Council (NMC) (2018), a nurse has a duty of confidentiality to those who receive care, so the patient will be named Jack. Today, millions of people are aware of diabetes mellitus and the inability to cure this disease, with the exception of type 2 diabetes. In Scotland, the number of diabetic patients has dramatically increased in the past decade, and approximately 5.6% of the population of all ages live with type 2 diabetes (Scottish Diabetes Data Group, 2018, p. 8). About 190,800 people were registered with type 2 diabetes in 2008 and 267,500 in 2018. Additionally, about 27,500 individuals with type 1 diabetes were registered in 2008 and 32,800 individuals in 2018 (Scottish Diabetes Data Group, 2018). Type 1 diabetes is a chronic disease caused by a failure to produce insulin in pancreatic cells or respond appropriately to insulin (Galicia-Garcia et al., 2020). This metabolic condition challenges people whose bodies cannot make the necessary hormone, resulting in blood glucose levels (Scottish Public Health Observatory, 2019). Diabetes is managed by taking insulin regularly and never missing blood sugar check-ups. As for type 2 diabetes, one of the optimal approaches is an oral medication.
One of the main rationales for using this long-term condition is that despite the intention to manage diabetes, it remains a leading cause of death among people of all ages. According to the World Health Organization (2021), in 2019, 1.5 million deaths were directly related to diabetes, while 2.2 million deaths were indirectly related (high glucose levels). Therefore, the goal of choosing diabetes is to enhance an understanding of this condition and develop an effective care plan for diabetic patients. People who have diabetes spend more time in hospitals and require improved inpatient and outpatient care (Nikitara et al., 2019). Personal and healthcare needs are increased due to diabetes, and nurses have to pay attention to patient education, holistic care, and support. Nurses work with diabetic people to examine facilitators and barriers in care, promote health, manage the disease process, prevent complications, and explain self-management basics (Nikitara et al., 2018). This paper focuses on a particular person with diabetes to investigate this vulnerability and introduce a holistic approach to care.
Vulnerability and Resilience
Vulnerability is a commonly used but not adequately defined term in health care. Many scholars and researchers have recently demonstrated their interest in understanding vulnerability and its relation to care quality (Clark & Preto, 2018). Clark and Preto (2018) explain vulnerability as a characteristic of the human condition of being harmed physically or emotionally. Illnesses and diseases like diabetes prove peoples physical vulnerability and lead to emotional instability (Boldt, 2019). Jack has diabetes and needs to monitor his health carefully. Risk factors of diabetes vary, depending on the type of the condition. For example, in one-third of diabetic cases, diabetes vulnerability is due to genes, while two-thirds are due to environmental factors (Masharani, 2021). The genetic risk is recognized in the HLA locus (type 1 diabetes) and TCF7L2 (type 2 diabetes) (Masharani, 2021). Several relatives in Jacks family have already been diagnosed with diabetes, which increases the risk of having the same diagnosis with time.
Genetic factors are not the only risks for Jack and people with similar conditions. Many healthcare providers can identify diabetes at an early stage. If humans cannot change their genes and natural predisposition to a disease, environmental causes of diabetes are recognized and managed to reduce the chances of developing diabetes at an early stage (Angi and Chiarelli, 2020). Eating habits are associated with weight changes and obesity-related problems from childhood (Angi and Chiarelli, 2020). The quality of physical activities also contributes to obesity and the likelihood of adverse cardiovascular outcomes and uncontrolled hypertension (Dendup et al., 2018). Jack does not control his eating habits and consumes fat and high-calorie products. His body mass index is already above normal, but Jack does nothing to change the situation but lives with obesity and body-related changes. However, increased thirst and appetite, frequent urination, weight changes, and fatigue are the early symptoms of diabetes (Kahanovitz, Sluss and Russell, 2017). Jack could not differentiate between the outcomes of obesity and the signs of insulin deficiency because of poor knowledge about diabetes.
Despite examining early signs, genetic factors, and the environment, the current life-long condition is, in some cases impossible to cure, and individuals need additional support to improve resilience and develop appropriate self-management and lifestyle modifications. In nursing care, resilience is a critical concept that shows a persons ability to continue functioning and meeting objectives despite the existing challenges (Barasa, Mbau and Gilson, 2018). Resilience proves the necessity of diagnosing a disease, following a treatment plan, managing the condition, and not initiating new problems and complications. Jack does not want to give up on his life and tries not to forget about the basics of his treatment. Jack neglected the necessity to evaluate family history because of limited knowledge about diabetes management, which is a significant protective factor in the care process (Lv et al., 2020). Jacks resilience lies in his family support and the improvement of individual behaviors linked to microenvironments like his colleagues and neighbors (Angi and Chiarelli, 2020). The elimination of junk food and communication with family members are resilient protective factors for Jack.
Many theories may promote positive changes in managing a persons diabetes, and one of them includes Eriksons stages of psychosocial development. This theory was introduced in the middle of the 1900s to reflect Freuds development theory and the role of social dynamics in human life. The theorist proved that it was possible to achieve positive development by learning specific outcomes at a particular age, like confidence at school or care for middle adults (Erikson and Erikson, 1997). Adults aged between 40 and 65 years should be ready to take care of people or thoughts during this period and contribute to their well-being by any possible means (Erikson and Erikson, 1997). If diabetes is a chronic condition that contributes to the persons disability status and makes him vulnerable, the chosen theoretical framework allows an understanding of adults capabilities for self-management (Perry et al., 2015). Diabetes is a challenging condition for all individuals, and the application of the eight stages of psychosocial growth should help create a holistic care approach.
Jacks experience and diabetes management may be considered through eight stages in Eriksons theory of development. According to Eriksons theory of development, an adult person should properly understand and experience such feelings as fidelity, hope, and confidence in any activity. In case there is a conflict between what has to be achieved and what is achieved at the moment, a person should address an expert and find support to make the necessary improvements (Erikson and Erikson, 1997). First, regarding his age, Jack is at his generativity vs. stagnation crisis.
Generativity is associated with making commitments, developing relationships, and contributing to improved living conditions (Erikson and Erikson, 1997). Stagnation is a pathology when a person cannot find an appropriate way to contribute to development and maturity due to a lack of interest, no properly taken efforts, or self-centredness (Erikson and Erikson, 1997). Thus, Jack is in his stagnation stage when he does not want to take some steps and change his health. He demonstrates no interest in developing himself, which means Jack could possibly make some mistakes or failures in the past.
Second, it is necessary to investigate each stage of development, starting from trust vs. mistrust and understanding hope (Erikson and Erikson, 1997). The development of an appropriate care plan is critical for Jack and his diabetes management tactics. A person with type 2 diabetes is at risk of getting several severe conditions that challenge human health, including kidney failure, cardiovascular diseases, neuropathy, blindness, and mortality (Cole and Florez, 2020). Sometimes, previous stages of development may be reviewed but never neglected to make sure that all psychosocial skills are used.
Appropriate Care
At this moment, Jack should be educated on the diet standards to be maintained because obesity contributes to diabetes, challenges blood sugar level monitoring, increases blood pressure, and provokes new heart problems. Communication and social support are critical elements in any care plan where nurses cooperate with patients and their families. As such, there are two main aspects of health, obesity and sugar blood levels, that may be affected by diabetes and managed by nursing care (Scottish Intercollegiate Guidelines Network, 2017). Lifestyle management depends on the patient and his readiness to cooperate with the nurse.
In Jacks case, diabetes is complicated in terms of reversion, and the goal of a care plan is to manage the symptoms, monitor the level of blood sugar, and predict the growth of adverse conditions. According to Helgeson, Van Vleet and Zajdel (2020), older age is associated with less psychological diabetes distress. In other words, with age, people know how to live with diabetes, what habits to avoid, and what decisions to make. Jack needs education on diet standards like the avoidance of carbohydrates and sugar that slow the absorption process and complicate maintaining glucose levels (Kahanovitz, Sluss and Russell, 2017). Drink and food alternatives exist, and Jack could hear about some of them due to his age and diabetic experience.
In addition to individual resilience and responsibility, the role of nurses in a holistic care plan is vital. As a part of a healthcare team, a nurse works with a doctor and coordinates the patients healthcare needs (National Institute for Health and Care Excellence, 2015). Although the nurse is not able to watch what Jack eats all the time, communication helps underline the main aspects of the food environment (Lawler et al., 2019). Some nurses have special prescribers for medicines and counsel about self-management (Nikitara et al., 2019). At the same time, sometimes trust is less for nurses than doctors from the patients side. Therefore, oral recommendations and emotional support are expected from nurses in most cases.
Some people do not know how to make the necessary calculations, and that is how the nurse contributes to a holistic care approach (cited in Nikitara et al., 2019). For example, the HbA1c test shows the average blood sugar level in the last six months, and some tests require people to fast for a certain period (Kahanovitz, Sluss and Russell, 2017). In diabetes care, nurses perform the role of educators to help people understand their new condition, the specifics of the disease, possible complications, and complications (Lawler et al., 2019). Diabetic nurse specialists usually inform how often to monitor the blood, and nurses remind and motivated not to miss the deadline and report the results. Diabetes is a chronic condition, but it is possible to live with it and establish some fashionable trends.
From the environment focus, physical activity is an element of a weight-loss program for the diabetic person. A low level of activity is one of the severe vulnerabilities of a person that is explained by increased television viewing time and reduced sleep (Angi and Chiarelli, 2020; Linder et al., 2018). Therefore, Jack has to be introduced to different physical activities and aerobic exercises that do not contradict other health recommendations (Scottish Intercollegiate Guidelines Network, 2017). Physical activity resources include swimming, running, cycling, and walking (Dendup et al., 2018). In this case, a nurses role is not only in accompanying the patient but also raising awareness and giving clear instructions on how exercises are related to diabetes management. Inpatient care depends on nurses and an understanding of their roles. If inadequate information, delays in data exchange, and the lack of diabetes knowledge may prevent self-management success (Nikitara et al., 2019). Jack needs more information about the two concepts, diabetes and physical activity, and the nurse is the most reliable and nearest source.
Conclusion
Personal learning from this task has improved my understanding of diabetes as a chronic condition that makes an individual vulnerable across the lifespan. A holistic care approach was offered to Jack because it was necessary to combine self-management steps like regular physical activities or blood sugar level monitoring and cooperate with a nurse to be educated and counseled properly. Diabetes may be provoked by genetic and environmental factors, and if Jack cannot influence genetics, he can manage the activities. Although diabetes does not have a cure, certain recommendations may facilitate patients conditions and predict adverse outcomes. In this scenario, a 50-year-old man does not recognize his obesity as a problem for his health and a contributor to diabetes. Therefore, the nurse had to educate and motivate Jack not to neglect physical activity and the necessity of monitoring blood sugar levels regularly. Student nurses could use this case and understand that not all people know enough about diabetes and its monitoring details. Many healthcare practitioners are involved in diabetes diagnosis, management, and treatment, but nurses are the sources of education, communication, and support.
Erikson, E. H., & Erikson, J. M. (1998) The life cycle completed (extended version). WW Norton & Company.
Galicia-Garcia, U., Benito-Vicente, A., Jebari, S., Larrea-Sebal, A., Siddiqi, H., Uribe, K. B., Ostolaza, H., & Martín, C. (2020) Pathophysiology of type 2 diabetes mellitus.International Journal of Molecular Sciences, 21(17), 6275.
The patients with the diagnosis of Diabetes type 2 require complex care of the professionals in different spheres, of the so-called diabetes care team, as the psychological, sociological and physiological causes of the disease are interconnected and interdependent, and it is impossible to separate them. The care plan is to be aimed at reducing the patients weight, working out the balanced diet and creating the conditions for providing social and psychological support to the patients, involving the family and social institutions.
Investigating the reasons for Graces diagnosis it should be noted that most of them could be avoided and the disease could be managed on the pre-diabetes stage. Goldstein, Muller-Wieland (2007) noted that It is estimated that the risk of type 2 diabetes attributable to obesity is as great as 75 % (p. 60). But the obesity, in this case, has sociological and psychological roots; on one hand, the change in the accustomed way of life, when her husband died, resulted in the shift of her consciousness, while she was unable to compensate for the loss of the dearest person and isolated from the rest of the world, unable to identify the new social role of a widow.
The stress itself could play an important role in the case report, as it changes the level of blood sugars and is dangerous in pre-diabetes conditions. Goldstein and Muller-Wieland (2003) stated that Psychological stress has significant effects on the metabolism of individuals without diabetes by increasing counter-regulatory hormones, which could result in elevated blood sugars, among other impacts (p. 69).
The stress became only one more precondition for the diagnosis, besides gender, age and eating habits. The ethnicity, inheritance and cultural level appear to be the optional pre-conditions of type 2 Diabetes. Sinclair (2009) noted that It is well documented that the prevalence of diabetes varies among the different ethnic groups, and this difference is also evident in older people living in the same country (p. 14).
The son ignored the mothers condition, neither supporting her morally nor caring for her health. Arriving once a month and supplying the ready meals means that he was indifferent to his mothers feelings and general state, while the early diagnosis could help, type 2 Diabetes requires a certain period of time to develop and can be diagnosed at early stages. Fox and Kilvert (2007) noted that Obesity is linked to insulin resistance, a root cause of Type 2 diabetes and insulin resistance occurs many years before diabetes itself begins. After a few years, people with type 2 Diabetes nearly always need to use insulin (p. 6).
In other words, the disease is of progressive character and requires intervention as early as it is possible; the diagnosis demonstrates the patients negligence of ones health and ignorance of the relatives.
Type 2 Diabetes is associated with a certain lifestyle, behavioral and demographic characteristics of the population. Aging, obesity and lack of physical activity are among the main factors causing type 2 diabetes. Goldstein and Muller-Wieland (2007) noted that Several characteristics of the western lifestyle predispose to overnutrition and obesity, which in turn increases the risk of developing insulin resistance and type 2 diabetes particularly in individuals or populations with a genetic predisposition for diabetes (p. 59). It means that Grace, who is 70, has a BMI of 32 and is overweight, has all the pre-conditions for the diagnosis of type 2 Diabetes.
She was gaining weight due to her depressed condition after her husbands death, while Brill (2007) noted that women who gained between 24 and 44 pounds (11 to 20 kg) (over a fourteen-year period) had five times the risk of developing diabetes (p. 27). The depressed condition led to the development of the disease, gaining weight, while the symptoms of the disease worsened the situation, depriving her of physical activity and the ability to buy the foods for a balanced diet. The fact, that her son brought her sweet things and ready meals, proves that the members of the family lack knowledge about the balanced diet and these were the family eating habits and disregard of the others needs that resulted in disease.
The diet is to be rich in carbohydrates, containing beans, starchy vegetables, fruit, dairy products, combining them with proteins, containing meat, eggs, soy products. Goldstein and Muller-Wieland (2007) noted that There is support for the suggestion that foods rich in slowly digested starch or high in fiber might be protective (p. 60). The significance of the balanced diet is to be explained to Grace and her son as it can reduce the risk of the diseases progress.
Goldstein and Muller-Wieland (2007) noted that A number of studies have demonstrated improvements in metabolic parameters after interventions aimed at reducing energy intake and increasing physical activity, suggesting that it may be possible to reduce the incidence of type 2 diabetes (p. 59). Diet is a very important means of managing the patients condition, but it should be as close to her eating habits as it is possible, in order not to provide additional psychological pressure. Lack of physical activity is interconnected with the factors of excess weight and social support, not less important for the patients with the type 2 diabetes diagnosis.
Staying at home, unable even to go shopping, Grace was not utilizing the energy received from food, her muscles were atrophied and she had no opportunity to communicate with other people, feeling depressed and helpless. At the present moment, it is advisable for Grace to choose a suitable program and do the physical exercises, corresponding to her present-day condition. Physical activity is to improve her general state and provide opportunities for communication with the outer world, with the other patients in the group or the instructor. Though not taking pills or insulin injections may be regarded as doing nothing by the uninformed people, following the advice of the nutritionists and choosing the exercise program may help Grace to manage type 2 Diabetes.
The effective care plan should involve the social institutions, the family members and motivate Grace to participate in her treatment. The psychological aspect is very important considering the patients with type 2 Diabetes. Krentz and Bailey (2005) noted that Helping the patient to understand and contribute fully to the management of their condition ( empowerment ) through education and support measures is a valuable means of realizing diabetes control and other objectives (p. 53).
It is important for all the participants of the Diabetes team to be aimed at the positive results and motivate the woman to take pains for her recovery. Communicating with her will not only inform her of the symptoms and the ways to manage them but will also compensate for the lack of communication and socialize the isolated woman. Weiner and Freedheim (2003) noted that Depression is directly associated with obesity, physical inactivity, and treatment noncompliance (p. 198).
The depressed condition, caused by the symptoms of the disease may prevent the diabetes team from the successful implementation of the care plan and it will reduce the care plan effectiveness significantly. At the same time as cited in Weiner and Freedheims work (2003) Bradley (2000) noted that Identifying depression in diabetes can be problematic since somatic symptoms of depression usually included in assessment scales are often similar to the somatic symptoms of diabetes (p. 198) It is difficult to differentiate between the symptoms of the type 2 Diabetes and the depression itself, it is the evidence for the complex character of the disease.
Besides the work of the specialists, the patients should be provided with social support, as in this particular case the womans isolation appeared to be one of the pre-conditions of the diagnosis, but the role of the social institutions can not be underestimated. Weiner and Freedheim (2003) noted that Patients with diabetes may be in special need of both instrumental and emotional support to allow them to maintain appropriate levels of adherence and psychological adjustment (p. 199). The family environment is one of the most important factors, as the family members are expected to care for the regimen of the patient and encourage them to struggle against the difficulties of their condition. Unfortunately, Grace was deprived of both of the factors and the present care plan is aimed at improving the situation.
The most important points of the care plan for the patients with the diagnosis of type 2 Diabetes are the balanced diet, rich in carbohydrates, and the exercise program, the social support of the family members and the diabetes team, while the emphasis should be put onto the patients education, psychological condition and feelings.
References
Brill, Marlene. (2007). Diabetes. Twenty-First Century Books.
Fox, Charles and Kilvert, Anne (2007). Type 2 Diabetes. 6-th edition. Health Class.
Goldstein, Barry and Muller-Wieland, Dirk. (2003) Textbook of Type 2 Diabetes. Martin Dunitz.
Goldstein, Barry and Muller-Wieland, Dirk. (2007) Type 2 Diabetes: Principles and Practice. 2-nd edition. Informa Healthcare.
Krentz, Andrew and Bailey, Clifford. (2005). Type 2 Diabetes: In Practice. 2-nd edition. Royal Society of Medicine Press Ltd.
Sinclair, Alan (2009). Diabetes in Old Age. 3-rd edition. John Wiley and Sons.
Weiner, Irving, Freedheim, Donald, Nezu, Arthur et al. (2003). Handbook of Psychology: Health Psychology. John Wiley and Sons.
Most people with diabetes cannot take care of themselves, so they need outside help. In the presence of a complicated form of the disease, professional care is required. The main tasks of care are the systematization of medication intake, preparing a competent diet, providing moderate physical activity, and monitoring the maintenance of personal hygiene. This work contains recommendations on caring for patients with diabetes mellitus, mainly providing a warm welcome to the patient in the clinic.
First, it is worth describing the primary measures for caring for a diabetic patient. Diabetes mellitus can cause serious complications, including interruptions in the work of the heart, and kidneys, blurred vision, increased blood pressure, vascular disorders, and damage to nerve fibers. In these situations, it is often necessary to amputate the limb. However, it is possible to significantly reduce the risk of complications if specific standards are met. These include:
Measurement of blood sugar level;
Following a balanced diet;
Moderate physical activity (for example, daily walks in the fresh air);
Compliance with personal hygiene measures;
Specialized patient care.
These steps are the basis of care for any patient with diabetes and warn him against complications.
The results of many studies on compliance issues demonstrate how much the doctors ability to build the proper dialogue with the patient affects the effectiveness of the prescribed therapy. There are areas of medicine that are most sensitive to the relationship of trust between doctor and patient (Deniz et al., 2021). So given that Sammy has a deep fear of needles, our clinic can help her overcome it. Our medical workers are professionals and will be able to build a dialogue with the patient properly. Moreover, they will be able to connect with her, so that she can trust us and overcome her fear of acupuncture. Our medical workers will be interested in her wishes before the procedure. Moreover, we will provide her with a psychotherapist who will be able to work with her on this fear and overcome it.
High blood pressure causes damage to blood vessels, and excess cholesterol reduces the quality of life of any person. When it comes to diabetics, the chances of developing atherosclerosis of the vessels increase. Together, these factors raise the risk of serious complications, such as stroke or myocardial infarction. To maintain normal cholesterol and sugar levels, you must strictly adhere to the prescribed diet, eat only healthy foods, provide daily physical activity, and take medications prescribed by your doctor. Thus, unfortunately, Sammy will have to refrain from eating her favorite macaroni and cheese, which is detrimental to her health.
Another important factor influencing the patients condition is stress control. Prolonged excitement can disrupt the production of hormones, which reduces the level of insulin or the sensitivity of tissues to it. To prevent this situation, the patient needs to get enough sleep. It is also recommended to take a course in relaxation therapy. In our clinic, we can provide these conditions, which will allow Sammy to reduce the effects of stress.
Thus, once in our clinic, Sammy automatically falls into the hands of professionals who care about her health and mental state. Our staff will try their best to improve Sammys condition. Control, prevention, diet, healthy sleep, and other healthcare methods will be provided at the highest level. As mentioned earlier, a well-structured dialogue between the patient and the attending physician is the key to the success of the prescribed therapy.
Response one. Danielle, I appreciate that you got straight to the point by identifying type two diabetes as a lifestyle disease. The Centers for Disease Control and Prevention (CDC, 2019) confirms that most of the people prone to this condition have prediabetes. Among 88 million Americans, who have prediabetes, 80% are not aware of this fact (CDC, 2019). A simple blood test can confirm the high level of sugar, thus motivating an individual to take prevention measures. I agree that regular physical activity and a well-balanced diet can prevent or delay the diseases onset. However, you did not mention the significance of diabetes self-management education that has demonstrated patients improved health outcomes (Chester, Stanely & Geetha, 2018). Self-management education involves the participation of a primary care physician who can motivate and support individuals. As a result, patients learn how to count carbohydrates, build an exercise schedule, and monitor blood sugars.
Response two. Eric, I find your in-depth explanation of the endocrine system and pancreas very well thought. The human body depends on the energy that is converted from sugar. If the pancreas does not produce enough insulin, the sugar stops saturating the cells. At the same time, this redundant information does not contribute to answering the core question. I agree with your argument about Adult Onset Diabetes caused by inappropriate life choices and lousy eating habits. I believe you have established a clear connection between insulin resistance, blood pressure, and kidneys malfunction. Even though you mentioned the main preventive measures, I would also underscore that it is vital to raise awareness about prediabetes symptoms. The risk factors are being overweight, being 45 years or older, having a close relative with type 2 diabetes, and being physically inactive. Moreover, certain ethnic groups, including African Americans, people of Hispanic descent, and Native Americans, are in the risk group.
References
Chester, B., Stanely, W. G., & Geetha, T. (2018). A quick guide to type 2 diabetes self-management education: creating an interdisciplinary diabetes management team. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 11, 641645.
Exercise helps people maintain better control over blood glucose levels and aids in weight loss, which are significant risk factors for diabetes. Physical activity alleviates typical health difficulties among elderly diabetics, such as poor balance and flexibility. Regular exercise is critically essential for effective glucose management. Understanding how type 2 diabetes elevates blood glucose levels shows how exercise might be beneficial. The pancreas produces the hormone insulin, which allows cells to take glucose from the blood and utilize it as an energy source. As a remedial measure, the pancreas generates more insulin to stimulate the cells response. In contrast, blood glucose levels progressively increase when the pancreas cannot keep up with the required rate. This essay will analyze significant facts on the interlinkages between metabolic outcomes, physical activity levels in patients with type 2 diabetes, and strategies to promote patient engagement in physical activity.
Evidence-Based Review of the Role of Physical Activity in the Management of Type 2 Diabetes
Working out relieves the symptoms of type 2 diabetes in several ways. It raises insulin sensitivity, enabling the cells to use any insulin present more effectively and absorb glucose from the blood (Pan et al., 2018). In addition, because of the contractions that occur during exercise, muscle cells can take in glucose even when insulin is not present in the body. The effects of exercise on blood glucose levels remain for approximately 24 hours after a physical activity session (Pan et al., 2018). Aerobic training has been shown to reduce blood pressure, triglyceride levels, and the results of the A1C test, which measures the blood glucose level on average over the previous two to three months (Delevatti et al., 2019). Diabetes is a factor that increases the likelihood of having inadequate muscle strength.
Increasing ones muscular mass and strength through resistance training is an effective way to combat this effect. Stretching activities improve a persons flexibility and range of motion, while balance training lowers the danger of falling and makes walking more efficient. Tai chi has improved balance, increased quality of life, and minimized diabetes symptoms that damage the neurological system (Pan et al., 2018). Detraining produces a rapid decrease in muscle capillary density, oxidative capacity, lipid metabolism, and insulin signaling proteins, all of which were augmented by regular training (West & Bell, 2021). Even without a drop in body mass, strength training, and aerobic exercise both produce changes in skeletal muscle, adipose tissue, and the liver that are related to enhanced insulin action.
Case Study on the Levels of Physical Exercise Among Diabetics in Saudi Arabia
According to the International Diabetes Federations projections for 2020, Saudi Arabia will have slightly more than 34.8 million people, and the prevalence of adult diabetes is now 18.3%. According to the International Diabetes Federation, Saudi Arabia has the sixth-highest number of newly diagnosed cases of type 1 diabetes each year (Alzahrani et al., 2019). According to the WHOs 2016 Diabetes Country Profile for Saudi Arabia, 67.7% of women and 52.1% of men in the adult population of Saudi Arabia were not physically active (Alzahrani et al., 2019). The rate of physical inactivity among the general population of Saudi Arabia is 66.6%, with men having a rate of 60.1% and women having a rate of 73.9%.
Counseling on physical exercise decreases cardiometabolic risks and protects against non-communicable diseases. Alahmed and Lobelo (2019) concur that primary care is the optimal setting for physical activity guidance. Alahmed & Lobelo (2019) note that despite the high incidence of inactivity-related non-communicable diseases in Saudi Arabia, few surveys have explored physical activity counseling in healthcare settings in the region. Therefore, more studies should be done in Saudi Arabia regarding physical exercise while advocating for patients who have diabetes to exercise more.
Changes in Behavior and Policy to Increase Patient Participation in Physical Activity
Doctors should therefore begin evaluating physical activity as a crucial sign if they urge patients to engage in more significant physical activity. Implementing a national approach in which patients are asked how many minutes per week they engage in physical activity is one strategy that has the potential to raise exercise rates in Saudi Arabia significantly (Widmann et al., 2019. Medical practitioners should communicate to patients the importance of maintaining at least 150 minutes of physical activity per week (Yang, 2019). The primary motivation for a person to engage in physical activity should be to improve their health. As previously said, engaging in physical activity has numerous favorable effects on ones health (Widmann et al., 2019). Some patients may require instruction on how to be physically active and reminders to be physically active. Behavioral interventions have been shown to significantly increase the quantity of physical activity, resulting in better management of diabetes and body mass index.
Patients lives are challenging, and they confront numerous obstacles that prohibit them from engaging in physical activity. Physicians need to collaborate on creating environments that facilitate physically active activities. Adults and children would unquestionably benefit from having access to more possibilities for physical activity, which may be promoted by establishing venues dedicated to such pursuits and broadcasting information about their locations. These community-wide projects can build multidisciplinary teams that focus on utilizing community resources to encourage physical exercise in our living, learning, working, and playing environments.
Conclusion
Physical activities are critical because they increase the rate at which glucose is broken down in the body. For people with diabetes, making healthy lifestyle changes that include participating in more physical activities is of the utmost importance. It is the responsibility of those who practice medicine to devise guidelines that make it obligatory for people to participate in sports and other forms of physical activity by educating patients on the value of working out.
