Category: Diabetes

Introduction

The chosen article Patients perspective on self-management: Type 2 diabetes in daily Life was written by Van Smoorenburg and colleagues, illuminating the issue of diabetes, focusing on keywords of diabetes mellitus, type 2 diabetes, and self-management. Managing diabetes mellitus is becoming more difficult for patients of all ages. Diabetes now affects almost 500 million individuals globally, and by 2040, that figure is projected to increase to almost 650 million (Van Smoorenburg et al., 2019). Type 2 diabetes patients are at significant risk of acquiring diabetes-related comorbidities, including renal disease, blindness, and cardiovascular disorders. Consequently, it is crucial to create and put into practice more effective and economical type 2 diabetes mellitus treatment methods.

Discussion

The active involvement of patients in their care is referred to as self-management. According to the article, self-management entails three different types of practices: medical management, such as taking prescribed medications and following dietary guidelines; behavioral management, such as modifying behavior while living with a chronic illness; and emotion regulation, such as coping with the desperation, apprehension, and hopelessness brought on by the chronic condition (Van Smoorenburg et al., 2019). Patients must be in charge of all these factors for the duration of their treatment because it is a chronic illness, and they only visit doctors periodically. In the study, ten diabetic patients receiving primary care in the Netherlands had semi-structured discussions, which were followed by self-management tasks. Researchers discovered that patients with newly diagnosed diseases engage in active self-care. Individuals do not perceive their disease-related behavior as self-management with time on, and there are no issues. They simply incorporated new regimens that accommodate diabetes into their everyday lives. With this understanding, support strategies may be created and put into use that best suit the requirements, interests, and capacities of patients with diabetes.

Conclusion

As a result, the reader can see that there is a problem through the statistics that indicates a rising trend of diabetes mellitus diagnosis. At the given moment, individuals who were diagnosed with type 2 diabetes and people at risk need information on self-management and the necessity of the three types, including behavioral, medical, and emotional management. In this sense, the possible solution to such an issue is becoming more engaged in ones own health and public awareness. The dissemination of this researched information might help by spreading awareness about diabetes and how dangerous it can be to the health of the patient.

Reference

Van Smoorenburg, A. N., Hertroijs, D. F., Dekkers, T., Elissen, A. M., & Melles, M. (2019). Patients perspective on self-management: Type 2 diabetes in daily life. BMC Health Services Research, 19(1), 1-8. Web.

Diabetes mellitus is one of the most common diseases and causes of death in the world. Much attention is paid to this disease in the public and healthcare as there are measures for its prevention; however, drawing attention to these measures leads to misconception. Most often, people perceive diabetes as a consequence of unhealthy eating habits and lifestyle, and while this statement is correct for Type 2 diabetes, it does not cover other types of the disease.

Unhealthy eating habits, obesity, and an inactive lifestyle are the most common associations with diabetes. These factors are among the main reasons for developing Type 2 diabetes mellitus, which is the most common type (Galicia-Garcia et al. 2). This disease is associated with dysfunction of the pancreas and the bodys resistance to insulin  hormone that ensures normal blood glucose levels (Galicia-Garcia et al. 2). However, Type 1 diabetes is most often not associated with a persons lifestyle, since it is caused by metabolic disorder due to lack of insulin production and is most often caused by genetic or auto-immune factors (Brinkman 500). Usually, this type of diabetes occurs in children, although it rarely manifests itself in adulthood. Another type of diabetes that is not lifestyle-related is gestational diabetes, which is caused by increased blood sugar in women during pregnancy (Gestational Diabetes). Therefore, this classification demonstrates that it is wrong to associate diabetes only with dietary habits and lifestyle and, especially, blame people with diabetes for their diagnosis.

In conclusion, diabetes is a metabolic disorder that results in high blood sugar levels for various reasons. Diabetes prevention measures lead people to believe that the disease is caused only by an unhealthy lifestyle, although this reason is only valid for Type 2 diabetes. However, the differences between types of diabetes need to be understood to avoid stigmatization of people with the disease and the possibility of it occurring in people with healthy lifestyles. Therefore, if people know the difference between the types of diabetes and its causes, they will be more protected from its complications.

Works Cited

Brinkman, Anne K. (2017). Management of Type 1 Diabetes. The Nursing Clinics of North America, vol. 52, no. 4, pp. 499511.

Galicia-Garcia, Unai, et al. Pathophysiology of Type 2 Diabetes Mellitus. International Journal of Molecular Sciences, vol. 21, no. 17, 2020, p. 1-34.

Gestational diabetes and pregnancy. Centers for Disease Control and Prevention, 2020, Web.

Scenario

J.S. is an 8-year-old male who is short in stature. His parents have become concerned as J.S. has been wetting his bed, drinking a lot of water, and appears sluggish. The doctor orders several blood tests after J.S.s urine test was positive for glucose and ketones.

Diseases That Should Be Ruled Out in This Patient

According to the symptoms that the patient is experiencing, it is possible to rule out diseases such as:

• Dehydration
• Anemia
• Diabetes mellitus.

The first and most apparent reason that indicates that the patient is drinking excessively is dehydration. Severe thirst and dry mouth on the background of unfilled fluid loss (with diarrhea or vomiting, profuse sweating) signal urgent restoration of water balance in the body. However, the patient has other symptoms that exclude the possibility of this disease. Anemia is a pathological condition characterized by a decrease in red blood cells and hemoglobin (the threshold level of iron-containing protein (hemoglobin) in the blood is less than 120 g/l) (Du et al., 2018). It occurs with nonspecific symptoms  it is impossible to say with certainty based on the manifestation that it is anemia. However, the patient will have low hemoglobin, which excludes the disease.

Diabetes mellitus is a disease characterized by the inability of the kidneys to reabsorb water and concentrate urine. It has, at its core, a defect in the secretion or action of vasopressin and is manifested by marked thirst and the excretion of large amounts of diluted urine (Hill-Briggs et al., 2021). It is determined by a fall rather than a rise in blood sugar levels, which contradicts the conditions of the case. Therefore, this type of diabetes is not characteristic of the patient who sought help.

Symptoms of Diabetes

Symptoms of diabetes develop depending on the stage of the process. The disease can evolve gradually or become an acute condition  a coma. To organize the signs of diabetes, they are divided into two categories: primary and additional. Firstly, it is necessary to focus on the study of the primary symptoms, the first of which is polyuria, which is frequent urination, increasing the volume of fluid excreted. It occurs since high levels of glucose increase osmotic pressure, which affects the work of the renal tubules. Moreover, diabetes can be the reason for such symptoms as:

• Polydipsia. With diabetes, an intense thirst is not associated with physical exertion or weather conditions. If in the usual mode of life, the patient notes a fierce appetite and frequent desire to drink water (Gupta et al., 2020). Such a clinical sign is associated with increased fluid loss.
• Polyphagia. A person is constantly hungry, and hunger and thirst are not connected with the surrounding conditions or increased loads. The reason is that more nutrients are spent, and their metabolism in the tissues is disturbed (Gupta et al., 2020). Glucose is in the blood but does not get into the cells. It affects the receptors; the body perceives the situation as a lack of glucose and increases the appetite to replenish the supply.
• Weight loss. As glucose metabolism is disrupted, the catabolism of fats and proteins increases. It leads to a decrease in body volume and weight. Losing weight occurs with increased appetite, which further increases it.

Considering all the symptoms is significant because only a comprehensive approach can provide effective treatment. Thirst is the first indicator that may signify the possibility of diabetes in this case. Moreover, the patient is only eight years old, and age must be evaluated when determining the most suitable treatment. Medical intervention should consider the symptoms and possible treatment risks, which can be done through a comprehensive diagnosis.

Diagnostic Methods

There are the following diagnostic methods for glucose metabolism disorders:

• Determination of blood glucose levels;
• Glucose tolerance test;
• Glycated hemoglobin determination;
• Urine tests for acetone and glucose and determination of their levels;
• C-Peptide test.

The blood glucose concentration determination shows how well insulin performs its function, whether the glucose is delivered to the cells or whether it is in the blood. A persons average blood glucose concentration is 3.3 -5.5 mmol/l (Cole & Florez, 2020). If the result is below the intermediate level, it is called hypoglycemia. It occurs with poisoning, functional disorders of the digestive tract, some liver and pancreatic diseases, diabetes mellitus, chronic liver, pancreatic pathology, hyperkalemia, and cerebral hemorrhage. The technique is indicated for the pathology of the liver, pancreas, and obesity to confirm or exclude diabetes and monitor its treatment.

The tolerance test is indicated when the blood glucose concentration is within critical limits. The test is performed in the morning, before meals, and no sooner than 8 hours after the last meal. The patient must be calm, without physical exertion or stress. Glycated hemoglobin is an indicator that can distinguish short-term hyperglycemia from the long-term course of pathological glucose metabolism (Alzahrani et al., 2019). The studys principle is based on detecting and measuring the amount of hemoglobin bound to glucose molecules irreversibly. The technique allows an evaluation of the last three months since that is how long an erythrocyte with altered hemoglobin remains in the blood (Alzahrani et al., 2019). Furthermore, the analysis shows how well the disease has been treated in the past and whether a correction is needed.

Urine examination in diabetes includes analysis of acetone and glucose levels. Assessment of the daily amount of urine is used to determine the total glucosuria in a day. Sometimes the study is divided into time intervals so that four portions of urine are obtained. A single urine sample is the standard procedure for deciding on glucosuria or excluding it. The C-peptide test is part of the diagnosis of diabetes because it is a product of carbohydrate metabolism and shows its quality in the body. As a rule, the level of this substance corresponds to the concentration of insulin in the blood (Alzahrani et al., 2019). A decrease in C-peptide accompanies insulin resistance and pancreatic islet pathology. Elevated concentration indicates the presence of type 2 diabetes, and reactions to glucose-lowering drugs may reveal the presence of insulinoma, insulin antibodies, neuroendocrine processes, and kidney problems.

The assignment of one research method depends on the stage of the process and the doctors recommendations. Combining different tests is desirable for the diagnosis to be complete and cover various aspects of carbohydrate metabolism. Quality diagnosis of diabetes allows starting treatment in time, which corresponds to the bodys condition. If blood glucose levels are stabilized and adhere to typical concentrations, several complications can be avoided.

Treatment and Prognosis

The choice of treatment methods for diabetes mellitus depends on the type of disease, but any form of the disease requires compulsory diet, exercise, and physical activity. Drug therapy is the treatment with insulin, from traditional subcutaneous injections at regular intervals to continuous subcutaneous administration of insulin into the patients body with the help of a medical device, an insulin pump. For the treatment of type 2 diabetes, antidiabetics-sugar-lowering drugs are used either orally or in combination with insulin therapy (traditional or with an insulin pump) (Abdoli, 2020). With optimal treatment and the correct regulation of blood sugar levels, the prognosis for diabetes and life expectancy is relatively favorable.

At the same time, the course of diabetes can be complicated by the development of specific body disorders. These include diabetic retinopathy, diabetic nephropathy, polyneuropathy, and atherosclerosis. Moreover, people with diabetes have several times the risk of heart stroke, myocardial infarction, and heart failure. If considering type 1 diabetes, preventive measures in the traditional sense are hardly practical since this type of diabetes is an autoimmune disease (Abdoli, 2020). Physical activity and a suitably chosen diet for type 2 diabetes are therapeutic and of great preventive value.

References

Abdoli, S., Hessler, D., Smither, B., Miller-Bains, K., Burr, E. M., & Stuckey, H. L. (2020). New insights into diabetes burnout and its distinction from diabetes distress and depressive symptoms: a qualitative study. Diabetes Research and Clinical Practice, 169, 108446. Web.

Alzahrani, A., Alghamdi, A., Alqarni, T., Alshareef, R., & Alzahrani, A. (2019). Prevalence and predictors of depression, anxiety, and stress symptoms among patients with type II diabetes attending primary healthcare centers in the western region of Saudi Arabia: A cross-sectional study. International journal of mental health systems, 13(1), 1-7. Web.

Cole, J. B., & Florez, J. C. (2020). Genetics of diabetes mellitus and diabetes complications. Nature reviews nephrology, 16(7), 377-390. Web.

Du, Y. T., Rayner, C. K., Jones, K. L., Talley, N. J., & Horowitz, M. (2018). Gastrointestinal symptoms in diabetes: Prevalence, assessment, pathogenesis, and management. Diabetes care, 41(3), 627-637.

Gupta, R., Ghosh, A., Singh, A. K., & Misra, A. (2020). Clinical considerations for patients with diabetes in times of COVID-19 epidemic. Diabetes & metabolic syndrome, 14(3), 211.

Hill-Briggs, F., Adler, N. E., Berkowitz, S. A., Chin, M. H., Gary-Webb, T. L., Navas-Acien, A., & Haire-Joshu, D. (2021). Social determinants of health and diabetes: A scientific review. Diabetes care, 44(1), 258-279. Web.

Description of the study

Digital health interventions for adults with type 2 diabetes written by Pal et al. (2018), is qualitative research that involved the data collected from four focus groups of twenty patients. This study aimed to determine the patients perceptions about the diabetes self-management education (DSME) limitation in meeting the needs of the individuals who have type 2 diabetes. Additionally, the enlightened authors focused on explaining the significance of digital health intervention (DHI) in enhancing the clients access to DSME and extending the kinds of health services that match the distinct patients needs. Thus, the findings of this assessment are applicable in bettering the supervision of diabetic individuals.

Qualitative methodology

The authors presented a detailed description of the qualitative methodology. After establishing four focus groups from two community centers, entrusted researchers used semi-structured discussions to collect data from the study participants before a multidisciplinary crew conducted the analysis. The people charged with evaluating the collected information used the Atlas Ti to manage the transcripts, code them, and facilitate the final information assessment. Notably, the North West London Research and Ethics Committee reviewed the study, indicating that the investigators upheld the desired ethical consideration (Pal et al., 2018).

For instance, the respondents received informed consent and, hence, participated in the study willingly. Research analysts applied Corbin and Strausss model to understand better the healthcare clients access to the benefits associated with the DSME. Unfortunately, although the investigation reports provided essential feedback for a sustainable health department, the scholars identified specific limitations that might question the final analytical findings reliability. For instance, a larger percentage of the partakers included those with experience in using computer-based tools for patients to use in monitoring their progress.

Reference

Pal, K., Dack, C., Ross, J., Michie, S., May, C., Stevenson, F., Farmer A, Yardley L, Barnard M, & Murray, E. (2018). Digital health interventions for adults with type 2 diabetes: Qualitative study of patient perspectives on diabetes self-management education and support. Journal of Medical Internet Research, 20(2), e40. Web.

The study of the PICOT question involves the search and systematization of sources to find the most relevant evidence. The Evaluation Table includes the date of creation, the conceptual framework, the design and method of the study, the sample and setting, the main variables studied, the way the data were measured and analyzed, and the assessment of the value of findings that are valuable for practice (Melnyk & Fineout-Overholt, 2018). All of these variables are important in assessing the relevance of a study and deciding whether articles should be included in the evidence base.

Before defining the criteria by which the selection of literature will be made, it is necessary to understand the main points implied by the PICOT question. The basis for answering the question is a study of the population, which in this question is black patients with type 2 diabetes. The proposed intervention will include the use of electronic health record alerts. An assessment of the outcome of the success of the intervention should be made in comparison to no intervention. The intended outcome will need to be quantified as pre- and post-intervention HbA1c levels. A period of time: a year after the intervention is needed to establish a clear time frame necessary for the intervention to be successful.

Answering the PICOT question requires an understanding of the literature selection criteria to strengthen the evidence base. All of these criteria are important for evaluation and analysis, but for a particular PICOT, there are more and less relevant ones. The first criterion measured is the year of publication. The study must be recent in order to provide up-to-date medical evidence. Research must not be older than 5 years to remain relevant (Melnyk & Fineout-Overholt, 2018). In this PICOT, this is an important criterion since electronic health records are a relatively new phenomenon.

After evaluating the year the paper was written, it is necessary to determine the conceptual framework and the design or method of the study. This PICOT question should be based on this criterion, as it is preferable to select quantitative studies that will provide the numerical evidence needed to support an assessment of the effectiveness of the intervention. The sample must be large enough for the study to be relevant for PICOT. In this case, patients diagnosed with type 2 diabetes should be included in the sample.

One of the important criteria will be the measured variables in the study. The identification of key study variables is necessary to evaluate the evidence for clinical decision-making (Melnyk & Fineout-Overholt, 2018). In order for a study to help answer the PICOT question, it is necessary to use studies in which the variable is HbA1c levels. The measurement and method of data analysis is essential to ensure an understanding of the research process and the validity of the findings (Melnyk & Fineout-Overholt, 2018). The results of the study are also important in helping to respond to PICOT, as they will provide evidence of the success or failure of such interventions. Assessing the value for practical application in general will help understand how the study can be used as an evidence base.

For the PICOT question on diabetes, the choice of sources should be based on criteria such as year of publication, sample, measured variables, outcomes, and value to practice. The year of publication will help select the most relevant research. The sample must match the PICOT question population. Measured variables should be related to the measurement of HbA1c. The results will support the answer to the question of the success of the study, and the assessment of value for practice will allow the selection of the most complete and evidence-based studies.

Reference

Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in Nursing & Healthcare: A guide to best practice (4th ed.). Wolters Kluwer.

Introduction

Type 1 diabetes is a major problem among young members of the population because they become infringed from their earliest years. Diabetes mellitus (DM) is a large group of complex metabolic diseases characterized by chronic hyperglycemia caused by impaired insulin secretion or action, or a combination of these disorders. Disruption of insulin secretion or a decrease in the response of tissues to insulin as part of complex hormonal processes leads to a disturbance in the effect of insulin on target tissues. The latter causes disorders of carbohydrate, fat, and protein metabolism. The same patient can simultaneously experience a violation of insulin secretion and a violation of its action. Type 1 diabetes is a form of autoimmune disease in genetically predisposed individuals in which chronically occurring lymphocytic insulitis leads to T-cell-mediated ²-cell destruction. Subsequently, one can develop absolute insulin deficiency, where one can observe the tendency to develop diabetic ketoacidosis. Although there is a scarcity of data regarding clinical trials and advanced care of type 1 diabetes among children, it is possible to implement prognostics by analyzing their insulin antibodies (IAA) and HbA 1c.

Literature Review

The general prevalence rate of type 1 diabetes is becoming more prominent among adolescents and children. According to the position statement, there is a significant increase in the occurrence rate among individuals aged 0 through 19 (Chiang et al., 2018). In other words, the problem is on the rise, but there is a lack of sufficient evidence regarding the pediatric aspect of advanced care. There is an evident scarcity in clinical trials among children and adolescents, which makes it more challenging to handle issues in a proper manner (Chiang et al., 2018). Autoimmune diabetes is characterized by the destruction of ß-cells, the presence of autoantibodies, absolute insulin deficiency, and complete insulin dependence.

The main reason for most of the manifestations of diabetes mellitus is the absolute deficiency of insulin in the case of type 1 diabetes mellitus. In addition, it may have insufficient action or inadequate secretion, as well as the lowered response of the hormone in the periphery. Due to the lack of insulin, there is insufficient use of glucose by insulin-dependent tissues, primarily the liver, muscle, and fat. Whereas in insulin-independent tissues, the polyol pathway of glucose utilization is activated with the formation of highly osmotic compounds of sorbitol and fructose. Due to an acute insulin deficiency, a state of energy hunger develops in the body. It manifests itself in a violation of the transport of glucose from the peripheral vascular bed to the cells of insulin-dependent tissues. This occurs due to catabolic processes aimed at resolving the created energy problem.

In addition, there is a severe course with a tendency for diabetic ketoacidosis, an association with genes of the major histocompatibility complex. Idiopathic diabetes also occurs with ²-cell destruction and a propensity for diabetic ketoacidosis. However, this happens without signs of an autoimmune process of specific autoantibodies and association with the system. Type 1 diabetes mellitus is characterized by chronic, immune-mediated destruction of ß-cells of the islets of the pancreas, which in most cases leads to absolute insulin deficiency. The damage of ²-cells occurs at different rates and becomes clinically significant when approximately 90% of the ²-cells are destroyed (Holt, Cockram, Flyvbjerg, & Goldstein, 2017). DM 1 is a multifactorial disease, however, the specific mechanisms of interaction between genetic predisposition, environmental factors, and the state of the immune system that underlie DM 1 remain unclear.

Autoimmune destruction of ß-cells is a complex, multi-stage process, during which both the cellular and humoral links of immunity are activated. The first to infiltrate the islets of Langerhans are monocytes and macrophages, which secrete pro-inflammatory cytokines and free radicals of oxygen, nitric oxide, hydroxyl radicals. Cytokines induce apoptosis  the programmed death of transformed or healthy cells, and nitric oxide and other radicals damage deoxyribonucleic acid of ß-cells (Holt et al., 2017). Given the low antioxidant enzymatic protection of ß-cells, free radicals cause denaturation of proteins with the destruction of ß-cells. T-lymphocytes activated by pro-inflammatory cytokines recognize denatured proteins and other products of ²-cell damage as antigens and are included in the insulitis formation.

Autoantibodies linked with type 1 diabetes are serological markers of autoimmune elimination of ß-cells. These include antibodies to glutamate decarboxylase (GADA), tyrosine phosphatase (IA2), insulin (IAA), and zinc transporter 8 (ZnT8A) (Endesfelder et al., 2018). There is an age-related dissociation in the appearance of these antibodies, where IAA and GADA are more often expressed in children under the age of 10, while IA2 and ZnT8A are more often shown at an older age. It is stated that there is a higher risk of DM 1 progression among children who developed IAA and IA-2A (Endesfelder et al., 2018). In addition, HbA 1c levels also can act as a strong predictor of the diagnosis of type 1 diabetes among children (Helminen et al., 2015). The value of anti-islet antibodies both in predicting type 1 diabetes and in differential diagnosis with other types of diabetes has decreased with the emergence of stronger markers.

Analysis

Based on the current literature, one can outline the stages of development of type 1 diabetes among children. The disease is an inextricable process that sequentially progresses through various identifiable stages until the onset of clinical symptoms, which made it possible to distinguish several stages of type 1 diabetes. Phase one is an autoimmune process that is characterized by the absence of clinical manifestations. Here there is a presence of signs of a ²-cell autoimmune process, determined by the prevalence of several positive titer marks of autoantibodies. At the same time, glycemic indicators do not exceed the norm, and there are no clinical manifestations of diabetes. The duration of the first stage can be months or years (Holt et al., 2017). At the second stage of diabetes mellitus 1, disorders of carbohydrate metabolism join the signs of a ²-cell autoimmune process.

The third stage is the onset of type 1 diabetes with the classic clinical presentation. These might include weight loss, polydipsia, and polyuria (Holt et al., 2017). Stage four is established diabetes, and many children with type 1 diabetes mellitus may experience partial remission of DM 1 soon after starting insulin therapy. The latter lasts from several weeks to six months, but remission of diabetes mellitus is temporary and does not mean a cure for diabetes. Complete remission is the cessation of insulin administration without worsening glycemic parameters.

Doses of insulin preparations and the scheme of administration are selected individually for each patient based on age, insulin action profile, and individual tolerance based on glycemic control data. Doses of insulin preparations and the scheme of their administration can vary significantly between patients with type 1 diabetes, including during the period of remission, doses of insulin preparations may be minimal, up to complete cancellation for a certain time. However, the final decision on the scheme and prescriptions depends strictly on the glycemic parameters and level HbA 1c. Patients or legal representatives should be advised to record data in self-control diaries indicating the date and time of blood glucose levels, insulin doses, carbohydrates taken, episodes of hypo- and hyperglycemia and other conditions (Holt et al., 2017). Self-monitoring data should be regularly analyzed by patients and parents, and are also necessary during visits to the attending physician for the timely assessment and correction of the treatment.

Dietary recommendations should be based on healthy eating principles and appropriate for all children, adolescents with type 1 diabetes, and their families to improve the results of diabetes control and reduce cardiovascular risks. Nutritional guidelines should be culturally, ethnically, and individually adapted and take into account the cognitive and psychosocial aspects of the child and family (Holt et al., 2017). Nutritional advice should be provided to the patient when managing both regular and unforeseen physical activity, and to achieve individual goals in competitive sports.

Conclusion

In conclusion, the current prevalence of type 1 diabetes among children is a major concern that needs to be addressed by increasing the current understanding of the issue. Although there are some data regarding the antibodies and prognostic approaches, one can observe the scarcity of clinical trials and developments regarding advanced care for the target population. Such care can be developed by regularly testing children for the presence of insulin antibodies and HbA 1c. In addition, the staging process allows the clinicians to properly assess a patients progression stage.

References

Chiang, J. L., Maahs, D. M., Garvey, K. C., Hood, K. K., Laffel, L. M., Weinzimer, S. A., & Schatz, D. (2018). Type 1 diabetes in children and adolescents: A position statement by the American Diabetes Association. Diabetes Care, 41(9), 2026-2044. Web.

Endesfelder, D., Castell, W. zu, Bonifacio, E., Rewers, M., Hagopian, W. A., & She, J. (2018). Time-resolved autoantibody profiling facilitates stratification of preclinical type 1 diabetes in children. Diabetes, 1, 1-38. Web.

Helminen, O., Aspholm, S., Pokka, T., Hautakangas, M.-R., Haatanen, N., Lempainen, J., & Veijola, R. (2015). HbA1c predicts time to diagnosis of type 1 diabetes in children at risk. Diabetes, 64(5), 1719-1727. Web.

Holt, R. I. G., Cockram, C., Flyvbjerg, A., & Goldstein, B. J. (Eds.). (2017). Textbook of diabetes. Hoboken, NJ: Wiley-Blackwell.

Introduction

In todays society, diabetes mellitus remains a severe public health problem, destructively affecting the patients metabolic activity as well as reducing the quality of life. However, it is not so much the phenomenology of diabetes as a developmental pathology of the body that is the focus of this essay, but rather the widespread belief that frequent eating of sugary foods can lead to diabetes. This belief may be heard significantly often by young children, who, due to inexperience and unformed eating behavior, may consume large amounts of sugary foods and sodas, which their caring parents or caregivers may scare the children with diabetes. The essay seeks to construct a reasoned position on this opinion and discuss the relevant evidence.

Thesis Statement

Consumption of sugary foods, regardless of volume, may not be a direct, reliable predictor for the development of type 2 diabetes, but it may pose some threats. Parentally promoted opinion, which should be viewed as a myth, should not be promoted because it is misleading.

The Concept of Diabetes

The primary point to be made is that diabetes is actually a group of diseases that differ in mechanisms. Type one diabetes is referred to as an inherited autoimmune disease that results in the inability to process glucose efficiently in the body, leading to spikes in blood sugar levels (CDC, 2022). Type 2 diabetes refers to a similar disease that is not formed as hereditary but in the course of the loss of pancreatic activity, leading to the same outcomes. Already from this perspective, it is clear that no matter how much sweets a child eats as a child, it will not affect the development of a hereditary disease because food does not determine genetics (Mullins et al., 2020). Thus, a child cannot develop type 1 diabetes just by eating sugary foods frequently, although it will undoubtedly affect their overall health and likely lead to obesity.

Effects of Sugar on Diabetes

Meanwhile, this parental caveat is based on the notion that excessive consumption of sugary foods alters specific metabolic processes in the body and causes the formation of type 2 diabetes. In fact, studies show that there is no strong link between sweet foods and type 2 diabetes (Diabetes, n.d.). Indeed, one should talk about acceptable limits for such consumption, and in the case of even excessive sugar in the diet, it is assumed that the child is not consuming this product in lethal amounts for the body. It is fair to admit, however, that there is some truth to this myth: frequent eating of sweets is more likely to lead to obesity in a child, which is a key developmental factor for type 2 diabetes (Hatta et al., 2022). In other words, one can say that every child who eats much sugar has an increased chance of obesity and, thus, diabetes, but one cannot say that this link is universal and unshakable. Hence, thin people can get diabetes, and at the same time, not everyone who is obese is necessarily vulnerable to diabetes.

Conclusion

This essay analyzed the common myth among parents that frequent consumption of sweets causes diabetes in children. In an effort to protect and limit their child, parents use this phrase without reflecting on how true it is. Admittedly, the semantic meaning of this belief on the part of parents constructs a specific link between sugar consumption variables and diabetes. However, research does not support the universality of this connection. Type 2 diabetes can indeed develop in obese children, but in such a case, parents should have advised children not only to limit their sugar intake but also to switch to vegetables, exercise, and water consumption. It is artificial sugar as the most frightening factor that is often used by parents to intimidate their child, which is not entirely correct in terms of the actual evidence.

References

CDC. (2022). What is diabetes? Centers for Disease Control and Prevention. Web.

Diabetes. (n.d.). Sugar and diabetes. Web.

Hatta, M., Horikawa, C., Takeda, Y., Ikeda, I., Yoshizawa Morikawa, S., Kato, N., & Sone, H. (2022). Association between obesity and intake of different food groups among Japanese with type 2 Diabetes Mellitus  Japan Diabetes clinical data management study (JDDM68). Nutrients, 14(15), 1-14. Web.

Mullins, V. A., Bresette, W., Johnstone, L., Hallmark, B., & Chilton, F. H. (2020). Genomics in personalized nutrition: Can you eat for your genes? Nutrients, 12(10), 1-23. Web.

Students who take part in the RN to BSN program are required to participate in academic activities such as conferences, seminars, morbidity and mortality meetings, or various committees. I chose to attend a conference on diabetes held by Baptist Health South Florida, a non-profit medical organization. It was held on Saturday, October 13, in the South Miami Hospital from 7:15 a.m. to 3:15 p.m., and I was present for its entirety.

The Goals of the Conference

Diabetes is a broad topic and cannot be explained in a single day, and as such, the discussion focused on several specific care topics. As stated in Educational objectives (2018), the themes of the conference were erectile dysfunction, use of oral agents, the state of the heart, diabetic nephropathy, management of the illness in the elderly, and CV outcomes. The goals were to improve the attendees knowledge of medical terms related to diabetes, educate them on the evaluation of risks, and prepare them for the overall treatment of patients affected by the condition. However, the conference is not recognized as an official educational event. No warranty related to the accuracy of the information is offered, and participants are cautioned to consider available scientific data before acting on what they have learned.

The Proceedings

The conference lasted for one day, and participants were advised to dress in comfortable business casual clothes. The timeline did not deviate significantly from Schedule (2018), and we listened to lectures read by Dr. Umpierrez, Dr. Feldman, Dr. Barreto-Torrella, and Dr. Ramasamy. There were breaks between the talks, during which we had lunch and visited the exhibits organized by specialists outside of the organization. Photography was forbidden during the conference, and the prohibition extended to the displays. The conference concluded on time, and the lecturers were available for follow-up questions and discussion.

Key Learnings

The conference featured a significant amount of valuable information on the treatment of patients with diabetes. The explanation on the initiation of insulin and the adjustment of therapy clarified the area, which I had not possessed enough knowledge about previously. I also learned about the care for elderly patients with diabetes, gaining an understanding of the approach that should be taken when caring for them. I also learned about the relationship between diabetes and cardiovascular outcomes, learning how to evaluate the additional risks patients with the condition face regarding cardiovascular disorders and the appropriate measures to reduce the probability. Overall, Ive learned a considerable amount of details and the reasoning behind the approaches used in the treatment of diabetes.

Future Professional Goals

I have not determined the specialization I intend to aspire to yet, but I will likely encounter patients with diabetes in my practice. This conference has helped me improve my understanding of the condition and the methods used in its evaluation and treatment. It did not grant me an officially recognized competency, and I intend to deepen my understanding of the illness, in which the knowledge Ive gained will significantly assist me.

Conclusion

I have attended a conference on the treatment of diabetes that was held in Miami on October 13, 2018. The activity covered various topics intended to educate attendees on the evaluation and treatment of the various aspects of the condition. I have learned a significant amount of information about diabetes, although it is not supported by any program competencies. The knowledge I have gained will likely be useful in my future career regardless of the path it will take.

References

Educational objectives. (2018). Web.

Schedule. (2018). Web.

Abstract

Type 2 diabetes mellitus is one of the most prevalent chronic diseases internationally. Some of the causes of T2DM include preventable factors like smoking, lack of physical exercise, and dietary habits. The objective of this paper is to determine the effects of nutrition on the development of T2DM. Data from prospective observational research shows that dietary patterns facilitate the management and prevention of T2DM. The quality of carbohydrates and dietary fats that people eat is more important than the amount of these macronutrients. The intake of saturated fats, red meat, white rice, and fried foods exposes people to the danger of contracting T2DM. The lack of nutritional experience in society is identified as one of the factors that contribute to high cases of T2DM. Nutritional patterns like the consumption of the Mediterranean diet help to improve a diabetic patients glycemic control. Physical exercise regulates the amount of glucose in the body. Pharmacological interventions like the administration of metformin boost a patients glycemic control. There is a need to sensitize the public on the importance of proper nutritional habits to reduce the cases of T2DM.

Introduction

Type 2 diabetes mellitus (T2DM) or what was previously referred to as adult-onset diabetes is the most prevalent type of diabetes among adults. The condition arises due to the inability of the body to utilize insulin accordingly (Thompson and Manore 12). At the onset, T2DM leads to the accumulation of glucose in the bloodstream, resulting in the deprivation of energy in the cells (Sami et al. 66). The condition can lead to lasting complications, if not managed at an early stage. The long-term impacts of T2DM include myocardial infarction, atherosclerosis, and stroke. According to Sami et al., among the causes of T2DM include physical inactivity and obesity (68). The lack of diabetes knowledge and control is a significant problem in societies internationally. A study conducted by Chrvala et al. found that many people do not realize that they have T2DM until when the condition becomes severe (933). Chala et al. cite a lack of awareness as one of the factors that hinder self-care among diabetes patients (934). Despite scientific studies citing a lack of physical exercise and obesity as the two major causes of T2DM, there is compelling evidence that nutrition has a significant role in the rise or control of the condition.

The number of people suffering from T2DM is expected to rise in the future. Scientists anticipate that at least 439 million people will suffer from the condition by 2030 (Sami et al. 69). Consequently, there is a need to sensitize the public on the measures that it can take to contain the situation. The objective of this paper is to highlight the contribution of nutrition to the development of T2DM. The paper will be of great help to individuals suffering from the condition. It will also be of significant value to nutritionists and health care providers who look after T2DM patients. It will assist these people in identifying the best diet for the patients. The paper will also ensure that the general public avoids dietary habits that might expose it to the dangers of contracting T2DM.

General Information

Link Between Nutrition and T2DM

The role of diet in the risk of T2DM was first documented by the Indians before the First World War. They realized that the condition was prevalent among the rich people who could afford flour, oil, and sugar (Sami et al. 68). Sami et al. state that the Indians noted that the rate of T2DM went down during the First and Second World Wars, an incident they attributed to famine and food scarcity (68). For instance, in Berlin, Germany, the number of deaths attributed to diabetes reduced from 23.1 to 10.9 in every 100,000 people (Sami et al. 70). Stevens et al. argue that North American and Japan, which did not experience food shortage, recorded no changes in the number of deaths that were associated with T2DM (321). A few studies have established a strong link between T2DM and high ingestion of fats and carbohydrates (Sami et al. 70). Conversely, most studies demonstrate a strong connection between the development of T2DM and the high consumption of sugar. Research by Stevens et al. sought to establish the correlation between T2DM and nutrition (322). The study sampled over 500 school-going kids from diverse ethnic backgrounds (Stevens et al. 324). The research found that increased intake of carbonated drinks contributed to the rise in the number of children suffering from obesity, which eventually exposed the kids to the dangers of contracting diabetes.

Research involving diabetic patients with varying levels of glycemic control was conducted. The study found no differences in the mean daily plasma glucose levels or diurnal glucose profiles (Feinman et al. 4). As with carbohydrates, there were discrepancies in the correlation between T2DM and dietary fats (Feinman et al. 4). The majority of prospective investigations have identified links between fat ingestion and the consequent danger of developing T2DM. In a research carried out at San Louis Valley, a total of 1000 participants who did not exhibit signs of suffering from T2DM were studied for four years (Feinman et al. 4). In this research, the investigators discovered a connection between fat consumption, reduced glucose tolerance, and T2DM (Feinman et al. 4). Another study investigated the association of the various nutrition constituents amid two categories of women. The study sought to determine the link between fiber plus sucrose, fat intake, and the danger of T2DM (Feinman et al. 5). After adjustments, the study found no correlation between sucrose, consumption of fat, fiber, or carbohydrates, and the danger of developing T2DM in the two groups.

Recent studies cite a connection between diabetes and obesity and the consumption of soft drinks. DiNicolantonio et al. allege that most soft drinks are manufactured with high degrees of fructose corn syrup that affects a persons body mass index (BMI) and blood glucose level, exposing them to the danger of developing T2DM (374). DiNicolantonio et al. maintain that soft drinks contain glycated chemicals that markedly augment insulin resistance (379). For years, physicians have argued that poor dietary habits predispose people to the risk of becoming obese. As DiNicolantonio et al. contend, the nutritional value and volume of food intake impact the development of T2DM (780). The increased consumption of fried foods, sweets, and red meat results in high cases of insulin intolerance and T2DM. On the contrary, the studies found no connection between the development of T2DM and the consumption of vegetables (DiNicolantonio et al. 379). A study carried out among Japanese women found that high consumption of white rice heightened the risk of them developing T2DM (Stevens et al. 328). The study highlighted the importance of sensitizing the public on the right diet and the need to change lifestyle.

There exists conflicting information about the connection between the development of T2DM and the consumption of fruits and vegetables. Wu et al. found that increased eating of vegetables and fruits was not related to a significant decline in the risk of developing T2DM (141). The latest systematic study by Wang et al. also examined the connection between T2DM and increased intake of fruits and vegetables (58). It was found that improved eating of green leafy vegetables and fruits contributed to a 14% decline in the danger of suffering from T2DM (Wang et al. 61). The eating of whole grain was found to exacerbate the risk of developing the condition. A study to determine the connection between consumption of coffee and the development of T2DM found that coffee intake lowered a persons risk of developing the illness (Chrysant 153). In spite of the information about a single food or nutrient analysis proving to be invaluable, it is hard to study the impacts of distinct dietary constituents independently since diet is an intricate entity. Thus, Wu et al. suggest the conduction of dietary pattern analysis to capture a picture of the whole diet and obtain comprehensive data about the nutritional causes of T2DM (143).

Nutritional Knowledge

As aforementioned, the lack of awareness about the causes and management of T2DM contributes to high cases of the condition worldwide. Yue et al. allude to nutritional awareness as an essential factor that impacts dietary habits among individuals (3). In research conducted by Yue et al., it was found that information about diabetic diet options influences a patients nutritional routines (7). The American Diabetes Association cites self-dietary supervision as an essential step towards equipping diabetic patients with skills regarding nutritional aspects, management, treatment, and complications that are associated with T2DM (Yue et al. 9). The study carried out in China found that individuals who were at a high risk of developing T2DM lacked the necessary dietetic information about their health condition (Yue et al. 11). Yue et al. found that more men than women consumed red meat without considering the dangers of such a dietary pattern (13). Moreover, it was discovered that most males and females consumed high amounts of white rice.

The lack of knowledge about the factors that contribute to the increased rate of T2DM is not a Chinese problem only. Studies conducted in the Gulf countries found that the population in these nations has limited nutritional knowledge of T2DM (Mohamed et al. 360). Mohamed et al. aver, In recent times in Saudi Arabia, food choices, size of portions and sedentary lifestyle have increased dramatically that resulted in high risk of obesity (363). Mohamed et al. discovered that the number of fast-food restaurants in Saudi Arabia and other Middle East nations continued to increase (365). High intake of junk food and lack of exercise among the Saudis contributed to most of them becoming overweight and facing the danger of contracting T2DM (Mohamed et al. 367). Moreover, most people from the Arab nations liked soft drinks with high-sugar contents (Mohamed et al. 367). Contrary to the past assumption that T2DM is a disease of the rich, it has been established that the condition is common among the poor, especially those who are not educated. The latter group lacks knowledge about proper dietary habits.

In spite of there being a lot of studies that illuminate the connection between nutrition and the development of T2DM, there is a need for additional research to investigate synergistic impacts of distinct constituents of different dietary patterns. Furthermore, comprehensive, large prospective investigations are required to explore the contribution of varied nutritional behaviors and food choices to the rise and management of T2DM among different populations. Such studies will be helpful in minimizing the rate of diabetes globally.

Application

Diabetes remains one of the most common chronic illnesses in the United States and across the globe. A study conducted in 2012 found that between 12 and 14% of Americans had detected or undetected type 1 or type 2 diabetes. Even though doctors have managed to reduce the complications attributed to T2DM, the illness is still a significant cause of disability. Moreover, T2DM contributes to the rise in expenses in the health care system. Thus, the study on the impacts of nutrition on the development of T2DM is of immense value to multiple stakeholders. They include health caregivers, nutritionists, patients, families, and policymakers among others. Patients have a duty to take control of their daily management of T2DM. They require monitoring the level of blood sugar, observing the recommended treatment procedures, engaging in physical exercise, and sticking to the right diet. The lack of experience in self-care makes it hard for diabetic patients to assume control of their wellbeing. This topic will be of interest to individuals with T2DM because it will enlighten them on the dietary routines that they should adopt to relieve themselves from the health problem. Moreover, it will encourage them to engage in healthy behaviors, which might protect them from developing long-term complications like stroke and myocardial infarction that are related to T2DM.

The number of kids who are obese continues to rise across the globe. This problem is attributed to poor feeding habits and a lack of physical exercise. This study will be of great importance to families, particularly those with young children. Doctors recommend the adoption of healthy dietary behaviors to protect children from becoming obese. Therefore, this topic will serve as an eye-opener to many families. It will educate them on the nutritional behaviors that expose their children to the risk of developing T2DM. In return, families will strive to change their feeding habits and lifestyles to protect children from the illness. The study will also be invaluable to policymakers. It will help them in formulating guidelines on the appropriate dietary patterns. Moreover, they will use the paper to develop self-management programs aimed at helping individuals with T2DM.

New cases of patients suffering from T2DM continue to emerge every day. Hence, there is no other better time to address the impacts of nutrition on the development of T2DM than now. The number of fast-food restaurants has increased significantly. Additionally, many schools allow canteens to sell junk foods. Consequently, kids are at great risk of becoming diabetic. It is time for stakeholders in the health care sector to come together to address the issue of dietary patterns and their contribution to the increase in the cases of T2DM not only among adults but also among children. It will help to improve nutritional patterns in most households, therefore protecting members from contracting diabetes. The study shows that most people lack knowledge about the dangers of unhealthy eating habits. It underscores the reason many men enjoy eating red meat and taking alcohol. Additionally, fruits and vegetables are not regarded as essential food items in many families. Thus, there is a need to address the role of nutrition in the development of T2DM. It will lead to families changing the perception that they have towards the products that they regard as staple foods.

The increased rate of cases of T2DM has raised an alarm, prompting stakeholders to initiate campaigns aimed at containing the health condition. In the United States, schools are discouraging the sale of junk foods and soft drinks in their canteens. Moreover, there are calls for the reduction of the number of vending machines that are located near schools. Statistics show that over 30.3 million Americans suffer from diabetes (Sami et al. 65). They also indicate that at least 84.1 million American adults are at risk of contracting the health condition. A study carried out in 2015 showed that over 400 million people had diabetes worldwide. These figures are scary and call for immediate response to address the situation. This topic will be of significant help in the campaigns aimed at changing the feeding programs in American schools. It will help in identifying healthy food items for children. Based on the statistics above, it is evident that this topic is very important. There is a need to create awareness of the dangers of T2DM and how to avoid the disease. This topic serves that purpose by identifying the dietary behaviors that put people at risk of contracting T2DM. It also enlightens them on the right nutritional habits.

Approaches/Treatments

The body of a person suffering from T2DM has challenges in changing glucose to energy due to the development of insulin resistance. There is no cure for T2DM. Nevertheless, it can be managed through physical exercise, changes in dietary habits, and regulating ones blood glucose level. Eating a balanced diet helps to manage a persons body weight and blood sugar levels. On the other hand, engaging in physical exercise facilitates the conversion of insulin into energy and lowers ones likelihood of suffering from heart disease (Colberg et al. 2069). The primary objective of T2DM management is to ensure that a patients blood glucose remains stable (4-6mmol/L). It protects a patient from developing complications that are associated with this health condition.

Nutritional therapists identify rigorous lifestyle interventions as the most effective approaches to managing T2DM. The objective of lifestyle interventions is to assist a person with T2DM to lose or maintain appropriate body weight. The intercession comes with other benefits, which include reduced chances of developing complications like urinary incontinence, depression, and sleep apnea. Various dietary patterns that are made up of diverse food groups help in the management of diabetes. An analysis of five randomized control trials (RCTs) in individuals with T2DM found that the intake of the Mediterranean diet contributed to improved insulin sensitivity and glycemic control (Salas-Salvadó et al. 921).

The study found that diabetic people who used Mediterranean diets did not require antihyperglycemic medications. A combination of Mediterranean diets and nuts or extra-virgin olive oil minimizes the risk of diabetic patients suffering from cardiovascular disease (Salas-Salvadó et al. 921). Research shows that the amount of fat intake does not expose a person to the risk of T2DM (Salas-Salvadó et al. 923). What matters is the type of fat consumed. Nutritionists discourage the use of saturated fats since they can cause complications like cardiovascular disease. A study carried out on women suffering from T2DM found that high intake of saturated fat put them at the danger of developing heart disease (Salas-Salvadó et al. 924). On the other hand, the consumption of long-chain omega-3 and fish protected them from coronary heart disease (Salas-Salvadó et al. 927). The reduced intake of saturated fat helps to improve a diabetic patients glycemic control.

At times, physical exercise and dietary patterns may not be adequate to manage T2DM. It is imperative to note that the health condition is progressive. Thus, as the disease advances, a patients pancreas becomes incapacitated, resulting in the accumulation of glucose in the body. If the condition is not managed, it reaches a point where patients are encouraged to use drugs to regulate the levels of glucose in their blood. The objective of introducing pharmacologic therapy is to enhance a patients glycemic control and protect them from developing long-term complications (Stevens et al. 329). The classes of drugs that are used to treat T2DM include sulfonylureas, biguanides, alpha-glucosidase inhibitors, and meglitinide derivatives among others. The only biguanide drug that is used to treat T2DM is metformin. As Sami et al. allege, Metformin lowers basal and postprandial plasma glucose levels (70). It works differently from other groups of oral antidiabetic drugs. Metformin reduces the production of gluconeogenesis and minimizes the assimilation of glucose in the intestines.

Expected Outcomes/Recommendations

Physical exercise is critical to persons with T2DM. Patients are encouraged to engage in numerous activities, which include walking, jogging, cycling, and swimming. Moreover, they can take part in resistance training such as weightlifting. The expected results of engaging in the physical exercise include the reduction in hemoglobin A1c (HbA1c) (should not exceed 5.7%), blood pressure, triglycerides, and insulin resistance (Colberg et al. 2069). Continued involvement in moderate-intensity exercise improves the pulse rate (120/min for young people and 100/min for old persons) of individuals with T2DM. Diabetic patients are expected to participate in physical exercise for at least 10 minutes after meals (Colberg et al. 2071). This should be done at least twice a day and between three to five days a week. T2DM is lifestyle-related, thus, there is a need to engage in physical activities throughout a patients life. This paper recommends getting off the bus before reaching ones destination and walking for the remaining distance. Moreover, people can use Life-corder or pedometers to monitor their daily participation in physical exercise.

The primary purpose of recommending the Mediterranean diet is to enhance a diabetic patients glycemic control including hemoglobin HbA1c, glucose level, and insulin resistance. The glucose level for an individual with T2DM should be between 70 and 130mmol/L before a meal and below 180mmol/L after eating (Salas-Salvadó et al. 926). Adherence to the Mediterranean diet is expected to result in improved postprandial glucose levels. Sleiman et al. found that daily consumption of 30grams of tree nuts for three months contributes to the reduction in the level of fasting glucose (3). It is imperative to control the amount of fat intake because it may contribute to one becoming overweight. One should understand that both saturated and unsaturated fats are rich in calories. Thus, their unregulated intake might lead to a person becoming obese. The basis of the Mediterranean diet is extra-virgin olive oil (Sleiman et al. 3). In spite of the oil is healthy, it should not be consumed in large amounts. Doctors recommend daily ingestion of between six and seven teaspoons of olive oil. For individuals who eat nuts, it is imperative to reduce the daily intake of olive oil. Failure to adhere to this may result in one becoming overweight, therefore being at risk of developing complications associated with T2DM.

The administration of metformin to diabetic patients is aimed at reducing the amount of postprandial and basal plasma glucose in the body. One of the expected outcomes of continued use of the drug is the improvement in HbA1c (to below 7%) in patients with T2DM. Moreover, patients who use metformin are expected to show significant weight loss. Adding metformin to insulin helps in weight loss in patients with T2DM. Additionally, the administration of metformin together with insulin for four years reduces the possibility of a diabetic patient suffering from macrovascular disease (Stevens et al. 329). Therefore, this paper recommends the sustained use of the drug after a T2DM patient starts to use insulin. A study conducted by the American College of Physicians (ACP) found that metformin is effective if administered together with additional drugs (Stevens et al. 330). Hence, this paper recommends the use of metformin together with drugs from classes such as thiazolidinediones, sulfonylureas, or dipeptidyl peptidase IV (DPP-4). Stevens et al. found that if used together with metformin to treat diabetic patients, sulfonylureas, thiazolidinediones, or DPP-4 help to lower the HbA1c level to 7% (330). The inclusion of a second drug assists in improving glycemic control.

Conclusion

This paper highlights the significant link between nutrition and the development of T2DM. High intake of saturated fats, sugar, and carbohydrates exposes people to the danger of developing this health condition. Additionally, the consumption of soft drinks with high fructose corn syrup contributes to people becoming obese and eventually suffering from diabetes. The nutritional value and the amount of food consumed influence the development of T2DM. The prolonged consumption of red meat, sweets, and fried foods results in the body developing insulin resistance.

There is no clear information regarding the link between eating fruits and vegetables and the development of T2DM. The review of numerous studies shows that the lack of knowledge about the causes of T2DM contributes to people suffering from the health problem. Indeed, most people have limited knowledge of the nutritional patterns that protect them from becoming diabetic. It underlines the reason people from the Gulf countries are yet to abandon the culture of eating junk foods. Diabetes is one of the most prevalent chronic illnesses around the globe. Thus, stakeholders in the health sector may have an interest in the topic of the impacts of nutrition on the development of T2DM. The topic is invaluable to families, policymakers, health care providers, and schools among other stakeholders. It helps to identify the dietary habits that can protect all people regardless of their age from developing T2DM.

Diabetes is a life-long illness that can be managed through appropriate dietary habits, physical exercise, and pharmacological therapy. Doctors encourage diabetic patients to engage in physical exercises like jogging, walking, and weightlifting among others. It helps to improve a patients HbA1c. On the other hand, nutritionists recommend the adoption of the Mediterranean diet, which helps to improve a patients glycemic control. Pharmacological intervention entails the use of drugs like metformin. The medicine helps to regulate the level of glucose in the patients body. A combination of metformin with other drugs improves glycemic control of a diabetic patient. Because diabetes has no cure, patients should be equipped with skills on how to manage the condition. Doctors should emphasize the strict observance of the prescribed dietary patterns. Patients must be encouraged to work on their nutritional habits as a way to protect them from developing long-term complications that are associated with T2DM. There is a need to introduce diet education in schools to prevent the likelihood of children developing T2DM due to poor feeding habits.

Works Cited

Chrvala, Carole A., et al. Diabetes Self-Management Education for Adults with Type 2 Diabetes Mellitus: A Systematic Review of the Effect on Glycemic Control. Patient Education and Counseling, vol. 99, no. 6, 2016, pp. 926-943.

Chrysant, Steven G. The Impact of Coffee Consumption on Blood Pressure, Cardiovascular Disease, and Diabetes Mellitus. Expert Review of Cardiovascular Therapy, vol. 15, no. 3, 2017, pp. 151-156.

Colberg, Sheri R., et al. Physical Activity/Exercise and Diabetes: A Position Statement of the American Diabetes Association. Diabetes Care, vol. 39, no. 11, 2016, pp. 2065-2079.

DiNicolantonio, James J., et al. Added Fructose: A primary Driver of Type 2 Diabetes Mellitus and its Consequences. Mayo Clinic Proceedings, vol. 90, no. 3, 2015, pp. 372-381.

Feinman, Richard D., et al. Dietary Carbohydrates Restriction as the First Approach in Diabetes Management: Critical Review and Evidence Base. Nutrition, vol. 31, no. 1, 2015, pp. 1-13.

Mohamed, Abdulaziz Al Dawish, et al. Diabetes Mellitus in Saudi Arabia: A Review of the Recent Literature. Current Diabetes Reviews, vol. 12, no. 4, 2016, pp. 359-368.

Salas-Salvadó, Jordi, et al. Protective Effects of the Mediterranean Diet on Type 2 Diabetes and Metabolic Syndrome. The Journal of Nutrition, vol. 146, no. 4, 2016, pp. 920-927.

Sami, Waqas, et al. Effects of Diet on Type 2 Diabetes Mellitus: A Review. International Journal of Health Sciences, vol. 11, no. 2, 2017, pp. 65-71.

Sleiman, Dana, et al. Effects of Mediterranean Diet in Diabetes Control and Cardiovascular Risk Modification: A Systematic Review. Frontiers in Public Health, vol. 3, no. 69, 2015, pp. 1-5.

Stevens, John W., et al. Preventing the progression of Type 2 Diabetes Mellitus in Adults at High Risk: A Systematic Review and Network Meta-Analysis of Lifestyle, Pharmacological and Surgical Interventions. Diabetes Research and Clinical Practice, vol. 107, no. 3, 2015, pp. 320-331.

Thompson, Janice, and Melinda Manore. Nutrition for Life. 4th ed., Pearson, 2015.

Wang, Ping-Yu, et al. Higher Intake of Fruits, Vegetables or Their Fiber Reduces the Risk of Type 2 Diabetes: A Meta-Analysis. Journal of Diabetes Investigation, vol. 7, no. 1, 2016, pp. 56-69.

Wu, Yili, et al. Fruit and Vegetables Consumption and Risk of Type 2 Diabetes Mellitus: A Dose-Response Meta-Analysis of Prospective Cohort Studies. Nutrition, Metabolism and Cardiovascular Diseases, vol. 25, no. 2, 2015, pp. 140-147.

Yue, Jiqiang, et al. The Prevalence, Awareness, Treatment and Control of Diabetes Mellitus in a Chinese Population. PLoS One, vol. 11, no. 4, 2016, pp. 1-14.

Navigating the Impact of Type 1 Diabetes

I was ten years old, sitting in a math class with all of my friends, when I got a devastating phone call. A call from my mother explaining with fear in her voice that my sister perhaps had got diabetes type 1. My grandmother picked me up and drove me to Karolinska Hospital, where I met up with the rest of my family. I still remember the doctor arriving in the waiting area and telling us that my little sister had type 1 diabetes. What was our family supposed to do now? None of us knew anything about the disease. However, we knew that we needed to adapt to a new routine in our everyday life, though how? Then I had assumptions that I necessarily not should have needed. Diabetes type 1 is a severe disease that must be taken more seriously and, above all, be informed about more in society to get rid of unintentional assumptions.

Words Describing Diabetes, Pixabay, 2016

The prominent assumptions about diabetes type 1 are that people get it because they are overweight and consume too much sugar. This assumption is far off from the truth and not correctly right. The reason behind the assumption is that people associate diabetes type 1 with diabetes type 2. Diabetes isn’t only one disease, but several different diseases.

Diabetes type 1 is a chronic, autoimmune, and incurable disease caused by insulin deficiency. Having type 1 implies that the body’s immune system attacks and destroys the insulin-producing beta cells in the pancreas. The hormone insulin is required to regulate blood sugar. Imagine hormones like keys. The insulin formed in the pancreas, produced in the Pancreatic islets of Langerhans, is used as an insulin key to open the cell, which causes the blood glucose to be transferred away from the blood to the cells where it’s converted into energy. Without insulin, the glucose flows past the locked cell causing high blood sugar levels. The information above is explained in Hjälpredan (2017), written by Karolina Janson and Lotta Skoglund. Therefore, insulin treatment is essential for people with type 1 diabetes to control their blood sugar.

However, type 2 diabetes is an insulin-resistance disease where the resistance to insulin is increasing; the keys are too few. Type 2 isn’t autoimmune and is caused mainly by obesity and the lack of physical activity. Compared to diabetes, type 1, people with type 2 still produce insulin and could get rid of the disease by changing their lifestyle. Eva Örtqvist, a senior doctor at Astrid Lindgren’s Children’s Hospital, showed, in a recent conversation, statistics that there are approximately 40 000 people total in Sweden who has type 1, whence 8 000 of these are under 18, and 400 000 people in total that have type 2. Explaining that it’s more common for people to have type 2 diabetes today in Sweden’s society, and therefore obesity and sugar are underlying reasons for the assumption that the same factors are causing type 1. Try to remember that diabetes type 1 and 2 have similar characteristics, though ultimately two separate diseases.

Graph showing the number of insulin pumps in different age groups, Swediabkids, Annual Report 2017

When I tell people that my sister has diabetes, the reaction I often face is, “I could never survive diabetes because I’m afraid of needles.” This is the view from one perspective of diabetes type 1 the only tool you have is a hammer, and thereby, you treat everything as if it was a nail. This is not an accurate assumption any longer. Even though there hasn’t been a fortunate discovery where scientists have found out what causes diabetes, more and more technology has advanced and improved. Comparing diabetes treatments today and ten years ago, there is a striking development. “Present-day,

65 % with diabetes type 1 under the age of 18 uses an insulin pump,” stated Eva Örtqvist. An insulin pump is an alternative treatment for insulin pens which can facilitate everyday life for the reason that fewer syringes are required. Instead of taking a syringe for each meal, only one every third day is needed. You may be wondering, how far has the development advanced today? Minimed670g, the first self-adjusting insulin pump system that both gasses and breaks down the intake of insulin, was recently launched. Freestyle Libre is a blood glucose meter that does not require lancets, test strips, and blood; instead, blood glucose is monitored using Bluetooth with remote control. This shows that diabetes is not a challenging disease to live with anymore; everything is about one’s own attitude.

A video produced by Barndiabetesfonden shows that a large percentage of adults have the assumption that people with type 1 diabetes live a normal life compared to healthy people. An assumption that a relative of someone with diabetes hoping was accurate, however, isn’t. Having diabetes means more responsibility and learning the symptoms when both low and high blood sugar decrease complications. Low blood sugar, or hypoglycemia, is when the blood sugar is under 3.0-3.5 mmol/l, which could lead to insulin coma. If left untreated, insulin coma could be fatal and, at worst, lead to death and permanent brain damage.

Hyperglycemia, the opposite of hypoglycemia, is when the blood sugar is too high. Too high blood sugar for too long can lead to both short-term and long-term complications. Kidney diseases, cardiovascular diseases, eye diseases, amputation of feet, and diabetic ketoacidosis are just a few examples of effects when you don’t treat the disease right. As a diabetic, you need to regularly keep control of the blood glucose levels to prevent the effects stated earlier. You can never turn a blind eye to the disease.

To conclude, it’s easy to have an assumption about a disease without knowing the whole truth about it. Therefore, we need to fight and combat assumptions with information and facts. Diabetes type 1 is a disease that is not similar to any other. It’s not possible to compare type 1 diabetes with type 2 diabetes any longer, the same as it’s not possible to compare different dementia diseases.

References:

1. Janson, K., & Skoglund, L. (2017). Hjälpredan: Diabetes typ 1. Familjeliv Media AB.
2. Örtqvist, E. (Personal Communication). Senior Doctor, Astrid Lindgren’s Children’s Hospital.
3. Swediabkids. (2017). Annual Report.