Research Topics: Diabetes Type 2

DIABNETES TYPE 2 EDUCATION IN NATIVE AMERICAN

DIABETES TYPE 2 EDUCATION IN NATIVE AMERICANS   INTRODUCTION   This study investigates the education of Native American regarding Type 2 Diabetes Mellitus. It explores how much knowledgeable Native Americans are about the disease as being such is one of the most important factors in the management of the disease. The aim of the study is to build a plan that would educate Native Americans about Diabetes Mellitus. In order to do so, the study also explores the barriers to healthcare and uncovers the best education approach to the group. The reason this topic is explored is because of the perception that minorities are uneducated and are often misinformed about the dangers of chronic diseases and how they can be managed. Furthermore, Native Americans have their own traditional practices in healthcare, which stands somewhat as a barrier for them to accept proper healthcare practices. Through this study, those issues will be explored. It will greatly help the Native Americans in understanding basic facts about diabetes and how it should be managed. The plan will be helpful in being able to penetrate deep into their culture and embed basic modern treatments and management of diabetes. BACKGROUND OF THE STUDY Diabetes is one of the most pervasive and worsening health problems facing the world today. The disease afflicts a broad swath of people, young and old. In the United States, there is at least 15.7 million people, have diabetes; of Credit:ivythesis.typepad.com

DIABNETES TYPE 2 EDUCATION IN NATIVE AMERICAN

DIABETES TYPE 2 EDUCATION IN NATIVE AMERICANS INTRODUCTION This study investigates the education of Native American regarding Ty...

DIABNETES TYPE 2 EDUCATION IN NATIVE AMERICAN

DIABNETES TYPE 2 EDUCATION IN NATIVE AMERICAN

DIABETES TYPE 2 EDUCATION IN NATIVE AMERICANS INTRODUCTION This study investigates the education of Native American regarding Ty...

Altered Health Status and Health Promotion

Altered Health Status and Health Promotion               Diabetes mellitus is a common disease affecting approximately 5% of the population (1995), and presents a life-long condition that affects almost every aspect of daily living. A number of factors are said to contribute to the onset of diabetes, including genetics, lifestyle, diet, other medical conditions and diseases, and the environment. One of the most common forms of diabetes to be encountered is the Type II Diabetes mellitus or the non-insulin dependent diabetes mellitus, which is caused by decreased sensitivity of target tissues to the metabolic effect of insulin (2000). As such, being one of the most common diseases in the population, the medical condition of a patient with this disease is to be examined.       The purpose of this essay is to explore the altered health status of Mr. Burdock (not his true name), who is suffering from Type II Diabetes mellitus. The client is 39 years of age, and was initially admitted to the hospital due to hyperglycemia, renal failure, gangrene, and blurred vision. The client is exhausted and lethargic, and confused as to time and place. Mr. Burdock is also complaining of blurred vision, thus, his wife, brought him to the hospital, as the client returned home from work and was acting unusually. Aside from hyperglycemia, hypertension, blurred vision, and renal failure seen in the client, it was also found out that the gangrene of the Mr. Burdock on the right foot has gone worse. The physician of the client has suspected that Mr. Burdock has Type II Diabetes mellitus, but results of tests and examinations have been unconvincing. In addition, the wife of the client states that the father of Mr. Burdock died from the same medical condition and its complications due to poor management and control. In this regard, the client has strong fears of dying the same way, as his father did. In this regard, based on the initial observation and his brief medical information, the medical and physical condition of Mr. Burdock would be examined and assessed. From the assessment of the client, outcomes, management, and conclusions would be made based on other health promotion issues.   Assessment Tools Used             It has been reported that any framework for assessment should be flexible and able to be adapted to a variety of circumstances, must be appropriate to the audience it is intended for, must be capable of balancing and incorporating the views of a number of carers, users, and agencies, and able to provide a mechanism for bringing different views together, while recognizing the diversity and variation within individual circumstances (2004). Based on such framework, several assessment tools have been used to examine the medical condition of Mr. Burdock. Initially, the client was asked to answer a questionnaire that would help the healthcare practitioner and the client himself to assess his medical condition. This questionnaire is the Diabetes Impact Measurement Scales or the DIMS, which contains 44 items, takes 15 to 20 minutes to complete, and divided into five categories, namely, Diabetes-specific symptoms, Non-specific symptoms, well-being, Diabetes-related morale, and social role fulfillment ( 2006). In addition, assessment of Mr. Burdock would also be done using the Diabetic Management Sheet, which contains all the necessary information regarding the medical condition of the client. This includes the diet and lifestyle of the client, medical history, the presence of complications, diabetes education, and foot assessment. To complete the complete nursing assessment of the client, several physical and laboratory tests have been done, including blood pressure examination, pulse rate, respiration, blood tests, and urinalysis. With such examinations and procedures, the medical condition of the client would be reviewed and assessed completely, thus, helping to arrive at substantial and effective diagnosis of the condition.   Outcomes of Assessment             From the series of tests and examinations done, it has found out that the blurred vision, lethargy and confusion, and the hyperglycemia of the client are manifestations of Type 2 diabetes mellitus. Such conditions are also supported with other findings, such as renal failure, severe inflammation of other body parts, hypertension, and the presence of the gangrene on the right foot. Specifically, the temperature of Mr. Burdock was 38 degrees Celsius or 101 degrees Fahrenheit, which means that the client has a fever, being over the standard temperature of 37 degrees Celsius (2006). Another support of the manifestation of his condition was the increase in blood sugar levels of 530 mg/dL, exceeding the normal blood glucose levels, which falls within the range of 80 to 120 mg/dL, thus, due to the extremely high glucose levels of Mr. Burdock, he was said to manifest hyperglycemia ( 2000). In terms of pulse rate and respiration, his pulse rate was 67 beats per minute and 15 respirations per minute. Such readings were normal as the normal pulse rate for adults ranges from 60 to 90 beats per minute, and normal respiration ranges from 12 to 18 respirations per minute ( 2004). Another manifestation that confirms the complication of the client was determined by his blood pressure levels, which read 160/90, indicating that Mr. Burdock has high blood pressure levels. This is because the standard blood pressure levels of adults must be lower than 140/90, and because the blood pressure level of Mr. Burdock exceeded the standard reading, he was said to have hypertension (2003). Pain was also determined as a manifestation of the complications of the client, being due to the presence of gangrene in his right foot. The gangrene was observed to have swellings and inflammations around the wound, with the presence of pus. Pain was also expressed by the client, as coming from his lower back, chest and lower abdomen. Such manifestations may confirm that the client has tendencies for hypertension and obesity and causes the increased risk for diabetes ( 2005). This may also indicate the urinary complication of his condition, which contains a high amount of glucose and cholesterol, with presence of blood. Blood in the urine of the client indicates that Mr. Burdock has hematuria, which may indicate damage in the kidneys (2003). Another physical condition of the client that indicates the severe condition of the client was his blurred vision, which was observed due to the client’s sensitivity to light and inflammation of the iris (2006). Such condition supports the claim for non-proliferative diabetic retinopathy, which may consist of retinal capillary microaneurysms, hemorrhages, and lipid exudates ( 2000). Such conditions enable the client to experience confusions and lack of alertness in consciousness and orientation, thus, lacking the informed and proper orientation of time and place.   Care and Management of Mr. Burdock             The primary care of Mr. Burdock was directed at the gangrene at his right foot, which was done by examining the presence of any or all of the following, namely, infection, ulceration, calluses, skin breaks, nail deformity, foot deformity, pedal pulses, and sensory. The presence of pus and inflammation on the gangrene of the patient was then managed through administering antibiotics and dressing the wounds. In addition, management of the gangrene was done through footwear assessment and education of the client, which would be helpful in lessening the pain and infection, and fever of the client. In relation to the pain felt by the client that stems from his chest, abdomen and lower back, analgesic drugs, both orally and intravenously was administered in order to help alleviate the pain felt by the client. This is also to help Mr. Burdock sleep and rest in the hospital. In managing the increase in blood pressure of Mr. Burdock, he was provided with smaller and titrated doses of anti-hypertensive drugs, given two to three times a day. Such has been done to directly lower the blood pressure of the patient, with regular checking throughout the day. In controlling blood sugar levels, Mr. Burdock was given an anti-hyperglycemic intervention, along with altering the diet of the client to reducing carbohydrate intake, and increasing vegetable intake. This was to help the client get used to the prescribed dietary plan suggested by the physician, thus, reducing the risk of Mr. Burdock to increase his blood sugar levels through food intake.             In relation to addressing and managing the renal failure and hematuria of the client, this involves the intravenous pyelogram or the x-ray of the urinary tract (2002) of the client to overrule other medical conditions. Dialysis of the client is also needed, which indicate the renal failure of Mr. Burdock. In managing the tendency of Mr. Burdock to suffer from diabetic retinopathy, continuous guidance, consistent education, and update of the condition of the client was done in order to provide him with relief from anxiety and depression. This also extends to the confusion and lethargy experienced by the client, thus, education and information regarding his condition was thoroughly provided so as not to present psychological and emotional traumas. Furthermore, management and care of the client was done through communication with the client, which provided him with the relevant and important information he must know regarding his condition. This is in observance of the right of a client to information, which would enable him to assess his condition based on the facts given to him.   Health Promotion Issues             Health promotion issues refer to the different interventions that can be used by the client and his friends and family in order to hasten the treatment and cure of his medical condition. One of the many health promotion issues or interventions that can be advised to Mr. Burdock is to modify his lifestyle and the lifestyle of his family or the persons he is living with in the household in terms of diet. Dietary modification means that he would be advised to control his food intake, with control in the number of calories per meal, the timing of food intake, and the amount or volume of food intake. In this regard, the use of a food diary or planner can be helpful in order to keep track of the client’s eating patterns and change of eating habits ( 2006). Another form of lifestyle modification is to avoid excessive alcohol and smoking, as these substances contribute to different complications. Last form of lifestyle modification in to engage in regular exercise in order to lessen effects of obesity and other complications, thus, involving management of the medical condition. Another health promotion issue to be taken note off is the education of the client and his family. This must involve attending seminars and focus group discussions in order to allow the client and his family to obtain updated and relevant information regarding his medical condition. Another health promotion issue to be advised is providing treatment options for the wounds of the client, thus, not always dependent and reliant on strong antibiotics, which can be used by the client for pain management. Another health promotion advice for the client is to undergo other forms of therapy, which are not only focused and directed on the diabetes of the client, but on other aspects of his individuality as well. Other forms of therapy that can be advised to Mr. Burdock include spiritual, emotional and psychological therapies that would be directed on providing the client with the right behavior and attitude in addressing the problems associated with his medical condition. In this regard, the support, understanding, and cooperation of the family of the client would be crucial in order for him to survive the situation. Another health promotion advice is to have consultations from physicians and other healthcare professionals regarding the updated and recent developments on right practices and approaches for the treatment of diabetes. In this regard, through communication, both the client and the healthcare professional are involved the proper treatment and approach for the disease. Last health promotion issue is to set short and long-term goals that would motivate the client and his family to have a positive light and approach on the disease. Setting goals would give the client hope to sustain his health and direct his energies and attention in his treatment and cure.   Conclusion             Based on the assessment and medical evaluation of Mr. Burdock, it can be concluded that the condition of his diabetes mellitus is already severe, due to the severity of his gangrene, the incidence of renal failure, high amounts of sugar in the blood, and hypertension. This means that complications can already be detected in his medical condition. This means that a wide range of therapy and treatment must be provided to the client. However, such treatments would not be effective as much without the self-control and education of Mr. Burdock and the support of his family and friends. As such, in order to attain maximum treatment, the client can utilize the different health promotion issues or advices provided for. Credit:ivythesis.typepad.com

Altered Health Status and Health Promotion

Altered Health Status and Health Promotion Diabetes mellitus is a common disease affecting approximately 5% of the popul...

Managing Type 2 Diabetes

Managing Type 2 Diabetes Introduction: Diabetes mellitus is a common disease affecting approximately 5 % of the population (1995).  Diabetes is a chronic life – long condition impacts upon almost every aspect of life. The two major forms of diabetes are type 1 (previously called insulin-dependent diabetes mellitus (IDDM) or juvenile-onset diabetes) and type 2 (previously called noninsulin-dependent diabetes mellitus (NIDDM) or maturity-onset diabetes) occurs after age 40, often between the ages of 50 to 60, and the disease develops gradually. Type 2 diabetes mellitus is caused by decreased sensitivity of target tissues to the metabolic effect of insulin. This reduced sensitivity is often referred to as insulin resistance. Type 2 diabetes usually need to change their lifestyle, but this can be difficult to do if the individual does not feel ill or the impact of not doing so does not have immediate repercussions. This syndrome like type 1 diabetes is associated with multiple metabolic abnormalities, although high levels of keto acids are usually not present in type 2 ( 2000). The frequency of diabetes in England is higher in men than in women. However, women with diabetes are at relatively greater risk of dying then men. This may be because of gender compounds other aspects of inequality. The key interventions underpinning the standards in this NSF are based on research evidence. The views and the experiences of people with diabetes, the work of the Audit Commission and the report of the Health Services Ombudsman have informed the development of this NSF. The typology below has been developed to distinguish between the different levels of supporting evidence. Levels of Evidence: Level 1: Meta – analyses, systematic reviews of randomized controlled trials, or randomized controlled trials Level 2: systematic reviews of case – control or cohort studies, or case – control or cohort studies Level 3: non – analytical studies, e.g. case reports, case series Level 4: expert opinion (in the absence of any above) Figure 1: Levels of Evidence Source: Department of Health: Modern standards and services The Diagram below summarizes the prevention and the management of diabetes.      Diagram 1: summary of the prevention and the management of diabetes Source: Department of Health: Modern standards and services Empowering people with diabetes: Standard 3 Aim: to promote self-reliance in attaining the best quality of life in managing diabetes type 2 Key interventions: <ul style="margin-top: 0in; margin-bottom: 0in" type="disc"> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> Structured education can improve knowledge, blood glucose control, weight and dietary management, physical activity and psychological well – being, particularly when it is tailored to the needs of the individual and includes skills – based approached to education (level 1).</li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> Personal care plans can help empower people with diabetes (level 4)</li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> Patient held/accessed records can facilitate self – care (level 4)</li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> Telephone or postal reminders (1998) prompting people with diabetes to attend clinics or appointments are an effective method in improving attendance (level 4) </li> </ul> Implications for service planning:             According to , A; level one evidence, patient’s satisfaction and knowledge improve when lifestyle interventions are delivered by primary care staff who have been trained to take a patient – centered approach (1998). The health care professional’s task is to develop a working alliance with the person with diabetes to enhance and support their capacity to self- care. The components of self- care include: adopting and maintaining a healthy lifestyle; self- monitoring; and concordance with medication (See Box 1). Box 1: components of diabetes Self – Care Lifestyle: <ul style="margin-top: 0in; margin-bottom: 0in" type="disc"> <li class="MsoNormal" style="text-align: justify; line-height: 150%"> Eating a balanced diet and other changes in eating habits, such as the timing of meals </li> <li class="MsoNormal" style="text-align: justify; line-height: 150%"> Regular physical activity </li> <li class="MsoNormal" style="text-align: justify; line-height: 150%"> Maintaining a healthy weight </li> <li class="MsoNormal" style="text-align: justify; line-height: 150%"> Smoking cessation </li> </ul> Self – monitoring <ul style="margin-top: 0in; margin-bottom: 0in" type="disc"> <li class="MsoNormal" style="text-align: justify; line-height: 150%"> Blood glucose self – monitoring and / or monitoring urine for glucose </li> <li class="MsoNormal" style="text-align: justify; line-height: 150%"> Monitoring for symptoms of hypoglycemia and hyperglycemia </li> <li class="MsoNormal" style="text-align: justify; line-height: 150%"> Monitoring for signs of long – term complications e.g. undertaking regular foot checks </li> </ul> Concordance with medication <ul style="margin-top: 0in; margin-bottom: 0in" type="disc"> <li class="MsoNormal" style="text-align: justify; line-height: 150%"> Oral hypoglycemic agents </li> <li class="MsoNormal" style="text-align: justify; line-height: 150%"> Other medications, such as antihypertensive drugs and lipid lowering drugs </li> </ul>   Box 1: Components of Diabetes Self – Care Source: Department of Health: national service framework for diabetes Diabetes Education should: <ul style="margin-top: 0in; margin-bottom: 0in" type="disc"> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> equip people with the confidence and competence to manage their day to day diabetes care</li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> provide people with diabetes with the necessary knowledge and skills to enable them to improve their blood glucose control and make the lifestyle changes necessary to reduce their likelihood of developing the complications of diabetes</li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> be tailored to the beliefs, attitudes and social environment of the individual, their capacity to learn, and their changing life circumstances, knowledge and treatment goals</li> <li class="MsoNormal" style="text-align: justify; line-height: 200%">  allow and enable people with diabetes to practice the skills required for effective self- care. See Box 2 for topics to be covered in education programmes for people with diabetes.</li> </ul> Box 2: Topics to be covered in education programmes for people with diabetes Nature of diabetes <ul style="margin-top: 0in; margin-bottom: 0in" type="disc"> <li class="MsoNormal" style="text-align: justify; line-height: 150%"> Significance and implications of a diagnosis of diabetes; the impact of diabetes </li> <li class="MsoNormal" style="text-align: justify; line-height: 150%"> Aims and different types of treatment </li> <li class="MsoNormal" style="text-align: justify; line-height: 150%"> Relationship between blood glucose levels, dietary intake and physical activity </li> <li class="MsoNormal" style="text-align: justify; line-height: 150%"> Short and long- term consequences of poorly controlled diabetes </li> <li class="MsoNormal" style="text-align: justify; line-height: 150%"> Nature and prevention of long – term complications </li> <li class="MsoNormal" style="text-align: justify; line-height: 150%"> Importance of annual surveillance for complications </li> </ul> Day – to – day management of diabetes ·         Importance of healthy lifestyle, especially physical activity, a balanced diet and smoking cessation ·         Importance of self – management ·         Self – monitoring – glucose monitoring or urine testing ·         Interpreting the results of self- monitoring and tests  of long – term blood glucose control ·         Importance of regular foot care, choice of footwear, foot hygiene, the role or podiatry ·         Importance of oral hygiene and regular dental check – ups Specific Issues: <ul style="margin-top: 0in; margin-bottom: 0in" type="disc"> <li class="MsoNormal" style="text-align: justify; line-height: 150%"> Other illness and diabetes – ‘sick day’ rules must be given to al people with diabetes; immunizations. </li> </ul> Living with diabetes <ul style="margin-top: 0in; margin-bottom: 0in" type="disc"> <li class="MsoNormal" style="text-align: justify; line-height: 150%"> Importance of carrying personal identification, such as Medic – Alert, and a warning card including the name, contact address and telephone number of a person who can help them </li> <li class="MsoNormal" style="text-align: justify; line-height: 150%"> Driving: notification of the DVLA and insurance company and the importance of avoiding hypoglycemia while driving </li> <li class="MsoNormal" style="text-align: justify; line-height: 150%"> Holidays </li> <li class="MsoNormal" style="text-align: justify; line-height: 150%"> Implications of diabetes for employment, life insurance and travel insurance </li> <li class="MsoNormal" style="text-align: justify; line-height: 150%"> Making best use of health care services: what care to expect; when to contact local services for what; how to get more information (NB people with diabetes are entitles to receive an annual free eye examination by an optometrist/ophthalmic medical practitioner; those receiving treatment with either tablets or insulin are exempt from paying prescription charges) </li> <li class="MsoNormal" style="text-align: justify; line-height: 150%"> Contacting other people with diabetes </li> <li class="MsoNormal" style="text-align: justify; line-height: 150%"> Information about Diabetes UK and other local support groups </li> </ul>   Box 2: Topics to be covered in education programmes for people with diabetes Source:  national service framework for diabetes Care of people with foot ulcers: 1. For a new foot ulcer, urgent (within 24 hours) assessment by an appropriately trained health professional should be arranged (level 4) 2. ongoing care of an individual with an ulcerated foot should be undertaken without delay by a multidisciplinary foot care team (level4). 3. The multidisciplinary foot care team should compromise highly trained specialist podiatrists and orthotists, nurses with training in dressing of diabetic foot wounds and diabetologist with expertise in lower limb complications. They should have unhindered access to suites for managing major wounds, urgent inpatient facilities, antibiotic administration, community nursing, microbiology diagnostic and advisory services, orthopedic / podiatic surgery, vascular surgery, radiology and orthotics (level D). 4. Patients who may benefit from revascularization should be referred promptly. 5. Patients with non-healing or progressive ulcers with clinical signs of active infection (redness, pain, swelling or discharge) should receive intensive, systemic antibiotic therapy (level 3). 6. In the absence of strong evidence of clinical or cost – effectiveness, healthcare professionals should use wound dressings that best match clinical experience, patient preference, and the site of the wound, an consider the cost of the dressing (level 4). 7. Wound should be closely monitored and dressings change regularly (level 4). 8. Dead tissues should be carefully removed from foot ulcers to facilitate healing, unless revascularization is required (level 2). 9. Total contact casting may be considered for people with foot ulcers unless there is ischemia (level 2). 10. For patients with foot ulcers or prevention amputation, healthcare professionals could consider offering graphic visualizations of the sequelae of disease, and providing clear, repeated reminders about foot care (level 2).     Dietary management: There is no one diet prescription for people with diabetes. Four possible alternative methods for planning diets use: 1) the Plate Model, 2) the Diabetic Exchange Lists, 3) Carbohydrate Counting, and 4) the Food Guide Pyramid. The Plate Method is a simple method for teaching meal planning. A 9-inch dinner plate serves as a pie chart to show proportions of the plate that should be covered by various food groups. This meal planning approach is simple and versatile. Vegetables should cover 50 percent of the plate for lunch and dinner. The remainder of the plate should be divided between starchy foods, such as bread, grains, or potatoes, and a choice from the meat group. A serving of fruit and milk are represented outside the plate.                 Figure 2: the plate method Source: Diet and Diabetes   The Diabetic Exchange Diets, in this food system the food is separated into six categories based on macro nutrient content (i.e., starch [cereals, grains, pasta, bread, beans, and starchy vegetables], meat and meat-substitutes, non-starchy vegetables, fruits, milk and fats). Individuals, with the help of a physician or dietitian, design a daily meal plan based on a set amount of servings from each category. The Food Exchange method allows a person to measure rather than weigh food. This saves time and encourages compliance. Any food may be substituted for another within the same food exchange list. As with other methods, all meals and snacks should be eaten at about the same time each day and be consistent in the amount of food consumed. The Carbohydrate Counting; some people choose to count the grams of carbohydrate in various foods, and adjust the amount of carbohydrate consumed during the day as a reflection of blood glucose levels. One choice from the starch, fruits, milk, or sweets and dessert list supplies about 15 grams of carbohydrate. Each selection is considered one carbohydrate choice. A meal plan outlines the number of carbohydrate choices a person may select for meals and snacks. This method requires great diligence with diet and blood glucose monitoring. The Dietary Guidelines/Food Guide Pyramid this provides a conceptual framework for selecting the kinds and amounts of various foods, which together provide a nutritious diet. The Pyramid focuses on variety and on reducing the amount of added fat and sugar in the diet. The bread/cereal, vegetable and fruit groups make up the base of the diet.                   Figure 3: The Food Pyramid Source: A guide for daily food choices   Psychological Interventions:             Depression is more common on people with diabetes than in the general population. The presences of microvascular and macrovascular complications are associated with a higher prevalence of depression and lower quality of life (1998). Remission of depression is often associated with an improvement glycaemic control (2000).             Antidepressant therapy with a selective serotonin reuptake inhibitor (SSRI) is a useful treatment in depressed patients with diabetes and may improve glycaemic control (2000); however tricyclic antidepressant may adversely affect metabolic control (1997).             Cognitive behavioural therapy (CBT) is a psychological treatment which attempts to find links between the person’s feelings and the patterns of thinking which underpins their distress. CBT, psychotherapy programmes and coping skills training are useful in treating depression in patients with diabetes (1995). However, CBT is less effective in patients with complications ( 1998).   Pharmacologic Management: New oral medications make these targets easier to achieve, especially in patients with recently diagnosed diabetes. Acarbose, metformin, miglitol, pioglitazone, rosiglitazone and troglitazone help the patient’s own insulin control glucose levels and allow early treatment with little risk of hypoglycemia. Two new long- acting sulfonylureas (glimepiride and extended-release glipizide) and a short-acting sulfonylurea-like agent (repaglinide) simply and reliably augment the patient’s insulin supply. Combinations of agents have additive therapeutic effects and can restore glucose control when a single agent is no longer successful. Oral therapy for early type 2 diabetes can be relatively inexpensive, and evidence of its cost- effectiveness is accumulating. (1999)             In particular, we may conclude that Diabetes per se is of need of long term rehabilitation since its incurable and has to be managed day to day through out the patient’s life in order to prevent further complications. Different strategies must be implemented with the use of multidisciplinary health care teams in order to manage it effectively since, there is proper referrals for a specific type of management. Credit:ivythesis.typepad.com

Managing Type 2 Diabetes

Managing Type 2 Diabetes Introduction: Diabetes mellitus is a common disease affecting approximately 5 % of the population (1995). Dia...

American Doctors must Emphasize Prevention for Disease such as Diabetes

DOCTORS GENERAL ADVICE FOR DIABETES PREVENTION         Doctors basic principles in teaching prevention at home or office is basically for those people who needs immediate attention before the presence of a certified medical professionals. These medical principles should be practiced carefully for safety and precautionary measures. Sometimes the presence of an adult is required so as not to provoke children to some unnecessary results or if adult is not present children should be taught to handle such safety basic principles.       There are many forms of diseases that may require immediate attention and if a person with diseases is capable enough to handle their situation then it is much better if they themselves know it. A person with diabetes who is alone at home should know the possible outcome of his disease or better still he should know the medication given by their physicist. This is essentially true if he experienced even the first signs or symptoms of disease that may usually occur from time to time.       Diabetes is a chronic disease that brought about by insufficient production or lack of insulin inside the body that result in excessive amount in glucose in the blood or urine. Or in layman’s term blood sugar increases. This is brought about by unhealthy lifestyle, imbalance diet, smoking and drinking. Type I Diabetes occurs in adults and children alike this is brought about by insulin production while Type II diabetes occurs mostly in adult which is brought about by increase in blood sugar. Diabetes can also occur severely in pregnant women that may cause a bit health problem upon delivery, diabetes in itself is a health problem.         First aid emergency treatments given by medical professionals are as follows:  ·         Daily insulin injection depending on the case or types of disease experienced by the person suffering such diseases. Mostly for type I diabetes ·         Medical prescription or use of drugs. Again depending on the disease experienced by the person. ·         Observing healthy lifestyle, balance diet and exercise can be a good cure for most types of diseases including diabetic patients. But then again it should also be prescribe by medical professionals. Mostly for type II diabetes       Chronic diseases like diabetes that has not been treated immediately may cause absolutely instant complications such as eye problem, kidney disease, Nervous problem, Heart disease, strokes and impotency disorder. If a person is not capable of treating themselves like the elderly then they should have someone on their side to take care on to. Or better still you may seek the help of a professional caregiver or nurse that can help at home or anywhere else the sick person may be. I recommend the services of the caregiver In the Philippines where caregivers give their full service to their client in treating such elderly and most of them are experience nurse.       In most cases a person in charge or the sick person, they should know the general or basic first aid treatment which can highly prevent emergency cases or that can supply the immediate needs for medical attention of the person involve. This treatment may be applicable according to the situation of a person. This is some sort of Good Samaritan principles. Again this requires caution on their part.       First and foremost keep all the medicine easy to reach or at hand. Keep track of its time schedule religiously when giving medicine to patient. For this may cause additional side effect if not properly followed. Also keep those emergency kits for basic necessity such as cotton, alcohol, towel, medicine etc. If possible memorize all the contact numbers of your doctors or hospitals that you visited to keep track of the person’s medical history. Or keep it on your phone at reach. There are many books and magazine that you can buy that contains good advice about such treatment if you have time to read all those then do so.       For the person who has severe diabetic diseases that experiencing stroke or heart attack are definitely needing quite riskier medical attention, you must reassure the person that you are there and help is on the way so as not to create panic and relax the person weary mind. Call medical professionals immediately. Let the person lay down with head and shoulders slightly elevated, loosen tight dresses for them to relax, do not give much about anything or something to eat or drink and do not allow them excessive movement until such time the doctor arrive or has brought them to the hospital.                                  Credit:ivythesis.typepad.com

American Doctors must Emphasize Prevention for Disease such as Diabetes

DOCTORS GENERAL ADVICE FOR DIABETES PREVENTION Doctors basic principles in teaching prevention at home or office is basically fo...

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