Kg003 Improving Diabetes Management - Assessment Answers

Answer:

Disease or disorder

This paper aims to discuss the key factors associated with diabetes. According to the doctors diabetes is mainly referred to the consequence of diabetes mellitus (DeFronzo et al., 2015). The condition is described as the combination of various metabolic diseases that lead to high blood sugar (glucose). The consequences of diabetes may occur due to inadequate production of insulin or due to the poor response of cells to insulin, or in some cases both. Common sufferings such as frequent urination, increasing hunger and thirst are associated with diabetes (Tattersall, 2017). The disease can be classified into three major types such as type 1 diabetes, type 2 diabetes and gestational diabetes (American Diabetes Association, 2014). Type 1 diabetes mainly occurs when the pancreas fails to produce adequate amount of insulin and the prevalence has been found to be 10% (Zimmet et al., 2016). 90% of diabetes cases are associated with type 2 diabetes which causes due to the inability of cells to response to the insulin or insulin resistance and gestational diabetes affects the women during the period of pregnancy (Goldstein & Müller-Wieland, 2016). Further the disease has become global concern as it may lead to severe cardiovascular risk (Tattersall, 2017).

Detailed Pathophysiology

The main consequence of diabetes is the high blood sugar or glucose. Glucose is mainly obtained by the absorption of food, glycogen breakdown and storage in liver and glucose production through non-carbohydrate elements by gluconeogenesis. In this regards insulin play an important role in order to maintain the glucose balance in the body. It could inhibit the gluconeogenesis or glycogen breakdown and stimulate glucose transport and its storage as glycogen (DeFronzo et al., 2015). Insulin plays the instrumental role in the glucose uptake by muscle, adipose tissue and liver from blood in order to produce energy. Thus, poor absorption or storage of glucose occurs due to lack of insulin or insulin resistance which lead to various metabolic issues such as poor protein synthesis, high blood glucose and other disarrangements in metabolism. Hence, insulin deficiency or insulin sensitivity of the receptors is considered as the main reason of diabetes (Tattersall, 2017). Additionally, high blood glucose affects the reabsorption by kidney thus increases urination along with the excretion of glucose. It results in loss of blood volume and dehydration that increases thirst (Goldstein & Müller-Wieland, 2016).

Behavioural or Psychosocial Related Issues

Beside the above discussed physical issues there are some psychosocial factors that are associated with diabetes. For example, emotional distress or depression has been found to be related with diabetes and risk of diabetes increases by 37 to 60% due to depression (Zimmet et al., 2016). However, the related psychosocial factors are not limited to diabetes, in addition, anxiety, panic disorder and post traumatic stress have been found to be associated with diabetes (Hackett & Steptoe, 2016). Whereas, such poor mental health is considered as risk factor of diabetes, similarly, diabetes may cause mental disorder known as diabetes distress due to the stress of diabetes management (Feinkohl et al., 2015). In most of the cases, patient with diabetes have been found to develop eating disorder as well (Hackett & Steptoe, 2016). Furthermore, high blood sugar has significant effect on the mood of the patient that leads to rapid changes in mood. Such condition affects the lifestyle and social participation of the patient in an effective manner (Feinkohl et al., 2015).

Genetics or Genomics

Brunetti, Chiefari & Foti, (2014) have indicated that diabetes can be hereditary. However, diabetes in the parents does not guaranteed that the child will develop diabetes, but increases the risk of diabetes. It is difficult to identify the genes that are responsible for the genetic transmission of diabetes (Tattersall, 2017). Study conducted by Brunetti, Chiefari & Foti, (2014) has informed that there are certain variants that increases the risk of diabetes such as HLA-DQA1, HLA-DQB1, and HLA-DRB1 genes. Such genes belong to the human leukocyte antigen that helps to differentiate between body proteins and foreign proteins. The variations known as haplotypes such as HLA-DQA1, HLA-DQB1, and HLA-DRB1 increase inappropriate response to beta cells and damages this insulin producing cells. Thus, individual with these variants are more susceptible to diabetes, especially type 1 diabetes (Tattersall, R. B. (2017).

Related nursing process

In order to provide adequate treatment it is important to diagnose the disease at early stage. The available diagnosis process includes demonstration of fasting plasma, plasma glucose and glycated haemoglobin (American Diabetes Association, 2014). Diabetes is a chronic condition and complete cure process is not available, however, with effective nursing intervention the disease could be managed. For example, effective diet, adequate physical activities, weight loss lifestyle modification such as quit smoking and alcohol intake and anti-diabetic medication could help to maintain normal blood sugar level (Inzucchi et al., 2015). In this regards it is important to educate he patient about self-management to increase their active participation in treatment (Coppola et al., 2016). Such interventions could help to manage diabetes in an effective manner.

References

American Diabetes Association. (2014). Diagnosis and classification of diabetes mellitus. Diabetes care, 37(Supplement 1), S81-S90. Retrieved from https://doi.org/10.2337/dc14-S081

Brunetti, A., Chiefari, E., & Foti, D. (2014). Recent advances in the molecular genetics of type 2 diabetes mellitus. World journal of diabetes, 5(2), 128. Retrieved from https://dx.doi.org/10.4239%2Fwjd.v5.i2.128

Coppola, A., Sasso, L., Bagnasco, A., Giustina, A., & Gazzaruso, C. (2016). The role of patient education in the prevention and management of type 2 diabetes: an overview. Endocrine, 53(1), 18-27. doi:10.1007/s12020-015-0775-7

DeFronzo, R. A., Ferrannini, E., Alberti, K. G. M. M., Zimmet, P., & Alberti, G. (Eds.). (2015). International Textbook of Diabetes Mellitus, 2 Volume Set (Vol. 1). John Wiley & Sons. Retrieved from https://books.google.co.in/books?hl=en&lr=&id=h5WDBgAAQBAJ&oi=fnd&pg=PA211&dq=DeFronzo,+R.+A.,+Ferrannini,+E.,+Alberti,+K.+G.+M.+M.,+Zimmet,+P.,+%26+Alberti,+G.+(Eds.).+(2015).+International+Textbook+of+Diabetes+Mellitus,+2+Volume+Set+(Vol.+1).+John+Wiley+%26+Sons.&ots=r3TSFMJqe1&sig=q0bClyUPvjnCBH0hYnzOBeAi1wM#v=onepage&q&f=false

Feinkohl, I., Price, J. F., Strachan, M. W., & Frier, B. M. (2015). The impact of diabetes on cognitive decline: potential vascular, metabolic, and psychosocial risk factors. Alzheimer's research & therapy, 7(1), 46. Retrieved from https://doi.org/10.1186/s13195-015-0130-5

Goldstein, B. J., & Müller-Wieland, D. (Eds.). (2016). Type 2 diabetes: principles and practice. CRC Press. 2^nd  edition. 13-452. Retrieved from https://books.google.co.in/books?hl=en&lr=&id=dMKc6OTvX3EC&oi=fnd&pg=PP1&dq=+Type+2+diabetes:+principles+and+practice.+&ots=Bur_JZShoW&sig=wFDo8gCEHmur2fmcPJJZZ9RD-QE#v=onepage&q=Type%202%20diabetes%3A%20principles%20and%20practice.&f=false

Hackett, R. A., & Steptoe, A. (2016). Psychosocial factors in diabetes and cardiovascular risk. Current cardiology reports, 18(10), 95. doi: 10.1007/s11886-016-0771-4

Inzucchi, S. E., Bergenstal, R. M., Buse, J. B., Diamant, M., Ferrannini, E., Nauck, M., ... & Matthews, D. R. (2015). Management of hyperglycemia in type 2 diabetes, 2015: a patient-centered approach: update to a position statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes care, 38(1), 140-149. Retrieved from https://doi.org/10.2337/dc14-2441

Tattersall, R. B. (2017). The history of diabetes mellitus. Textbook of diabetes, 1-22. Retrieved from https://doi.org/10.1002/9781118924853.ch1

Zimmet, P., Alberti, K. G., Magliano, D. J., & Bennett, P. H. (2016). Diabetes mellitus statistics on prevalence and mortality: facts and fallacies. Nature Reviews Endocrinology, 12(10), 616. Retrieved from https://www.nature.com/articles/nrendo.2016.105