1.2. Four Diabetes Case Study

Chronic elevated glucose in blood (hyperglycemia) with disturbances metabolism of protein, fat and carbohydrate resulting from disorder in insulin secretion, insulin action, or both. (1) Expected to increase diabetic patients by 2025 to approximately 300 million people in the worldwide (2) In ancient times it was difficult to identify diabetes as the ability of patients to heal weak, the researchers think the diabetes resulting from defect in the bladder and kidneys are the cause of diabetes. (6)

Summarize the epidemiological findings for relationship between PA and this disease in terms of mode, duration, intensity (be sure to address dose response)

In Scotland alone there are 268,154 people with diabetes and a staggering 21,428 of these individuals are living in Tayside. (Sci-diabetes, 2013). In this essay, a patient has been selected with a long term health condition and their journey through the national healthcare system will be explored following their diagnosis of type 2 diabetes. Through the use of evidence based practice, the underlying pathophysiology and nursing management of type 2 diabetes will be examined to give a better understanding of the complexity of the long term condition and the lifestyle changes that have to be considered when diagnosed with diabetes.

Diabetes: There has been an increase in diabetes (pre-diabetes and diabetes) in the ethnic groups of African-Americans (AA) Hispanics, native Americans, and Asian American than any other population (Woo and Wynne, 2012). The annual cost to care for diabetic patients is greater than 174 billion and is the leading cause of blindness, end-stage renal disease and lower extremity amputations (Woo and Wynne, 2012).

In 2011-2012 approximately 95% of people with diabetes were aged 35 years or more and over 50% were aged 65 years (AIHW, 2015). This trend does seem to be changing with more young children being diagnosed with Type 2 Diabetes. The cause of this is seen to be the increase of obesity caused by food choices and inactivity. Data also shows that only half of Australians with diabetes were controlling their blood glucose levels and so within 20 years over 3 million Australians will be diagnosed with diabetes. The impact of lifestyle can be challenging for the individual as well as those around because it requires a change in diet which does take more time in planning and preparing meals and can make eating out and socialising challenging because

Though above eighty five percentages of patients with T1DM deficit positive family history for the disorder, there is highly familial clustering with a mean prevalence of six percen in siblings compared to 0.4% in the US white people. The familial clustering can be calculated as the ratio of the risk to siblings over the disorder prevalence in the people (Hyttinen 2003).

What are the effects of diabetes on other organs? Diabetes could affect the heart because the high levels of glucose in the blood, according to The National Heart, Lung, and Blood Institute “high levels of glucose in your blood can damage the walls of your arteries and make them more likely to develop fatty deposits” (National Heart Lung and Blood Institute March

Type II diabetes is a chronic condition with high blood glucose level in the body which cause ineffective insulin production (American Diabetes Association, 2016)). As his nurse practitioner, I would use the hemoglobin A1C screening tool to diagnose him for type II diabetes. Hemoglobin A1C is a screening tool that is used to measure patients’ blood sugar level within the past two to three months (American Diabetes Association, 2016). The patients are not required to fast for this test. The fasting plasma glucose is another screening tool which requires the patient not to eat for eight hours before the test (American Diabetes association, 2016). Once individuals A1C is equal to or greater than 6.5% they or have a fasting plasma blood of 126mg.dl

Q1. Compare the incidents of diabetes within each region of the U.S. for the past year and identify which state has the highest burden of this disease.

Thank you for your support of the diabetic clinic disease management pilot. I would like to further discuss the results based on the p value. As you may know the p value represent the probability or chance of a random outcome. An example would be the toss a a fair coin. The probability of heads would be 50% or 0.5. The error would be around the number of tosses. If there was only two tosses and both heads, the probability of heads would not be 100%. In research the usual probability (p value) is 0.05. That means the likelihood of the experiment outcome to be due to chance alone is 5 out of 100 times. In the clinic pilot the p value used was 0.01. The likelihood of the results were due to chance was 1 in a hundred.

Darker side of diabetes: A rather negative side of being diabetic is that, this disease generally triggers cardiovascular diseases. Heart failure, stroke or coronary artery diseases are usually the outcomes of diabetes. Patients often lose their life to such conditions than any other. Cardiovascular diseases are bound to happen to a diabetic patient, hence it is recommended to control the risk factors leading to them.

Over time, diabetic patients can affect the heart, blood vessels, eyes, kidneys, and nerves. The adults with diabetic will be at risk of getting heart attacks and stroke because of micro vascular and macro vascular involvement. Cases associated with decreased lower blood circulation and neurological damage (nerve damage) increase the likelihood of foot ulcers with infection and infiltration leads to lower limb amputations. Diabetes may be responsible for 2.6% of global blindness. Diabetic is a major cause of kidney failure

Besides this, insulin pumps are not more effective than injections at helping people with type 1 diabetes control their blood sugar levels and people with type 2 diabetes can control their glucose level by following a healthy meal plan and losing excess weight and by taking medications. The medications will often change during the course of the disease for each person. Insulin also is usually used with type 2 diabetes to control glycaemia (National Diabetes statistics report, 2014). The people have sufficient training could be highly beneficial, if they receive full training to self-manage their condition. The regardless of setting, communicating the information and skills for supporting that are mandatory to promote effective coping and

"Diabetic neuropathy is a type of nerve damage that can occur if you have diabetes II. High blood sugar (glucose) can injure nerve fibers throughout your body, but diabetic neuropathy most often damages nerves in your legs and

The final analysis was done with the data of 236 type 2 diabetic patients in MR and HR categories based on KDIGO classification with dyslipidemia and hypertension and they were followed up for the period of one year. Of 236 patents, 115 patents were followed up intensively. The demographic, anthropometric details of the study population were presented in table 1. In both the groups’ majority of the participants were males with the diabetic duration of 12.2 and 11.5 years in group I and Group II, respectively. Majority of the patients were on mixed diet (non vegetarians). Presence of family history of diabetes (group I: 65.28 %; group II: 53.91%) family history of diabetic nephropathy (group I: 11.39 %; group II: 12.9 %) and