Causes and Treatment of Diabetes - Essay Example

?DIABETES Background Diabetes is an increasingly concerning disease for those in the UK, as rates of diabetes have climbed in recent years to rival those of the US, where diabetes is a serious threat to public health. In the UK, “Of more than 42,642 people who were newly diagnosed with the disease between 1996 and 2005, just over 1,250 had the "insulin-dependent" type 1 diabetes, and more than 41,000 had later-onset type 2 disease, which is linked to lifestyle” (UK, 2010). In our bodies, the pancreas produces a hormone called insulin, which is used to help our cells absorb glucose from our blood. This glucose is then used as fuel for energy which we use to live our lives. Diabetics have too much glucose in their blood because their pancreas is producing insufficient amounts of insulin, or none at all. When there is inadequate insulin glucose cannot enter their body’s cells, and so builds up in their blood and is unable to be used as fuel. In some cases, the patient’s body is producing enough insulin but it is not working properly. This is known as insulin resistance. The two most common types of the condition are Type 1 diabetes and Type 2 diabetes. Diabetes is a complicated disease that medical professionals and scientists are just beginning to understand in terms of its causes. Although symptoms and treatment options are more clear, there are also a multiplicity of these, as well as different types of diabetes. The more common type is Type 2, so the current report focuses mainly on this type. Basically what both types share, in that they are related, is a defining feature of diabetes itself: in cases of diabetes, the body cannot handle or regulate its own blood glucose levels. Glucose, which is given to the body in the form of sugar, is what causes the body to have energy required for tasks of everyday life. This report looks primarily at the causes of diabetes as well as some common treatments today, with a focus on developing more patient-centered care in the UK to address this growing problem, and provide more respect for unique needs of minorities. Patient needs In terms of person and health, the core concepts of healthcare work, these are very interrelated. To me, person means centering on the client. Patient-centered communication is the key to social work implementation and focus, but there are healthcare settings that have different policies. In a client-oriented method, a facility could have different types of patients whose needs differ. This is an increasingly salient option in a setting in which patient attenuation has become a watch-word, and patient attenuation is another facet of the modern healthcare organization that tends to unify rather than divide care priorities. For example, accounting for patient needs it is a major part of safety at healthcare institutions. Uniting concepts of person and health, one can look at how resistance can particularly impact care of facility residents, by examining morbidity and mortality rates. Diabetes mellitus exists when a patient has a deficiency of insulin or the resistance to insulin in their system, and it may result in symptoms such as an inordinate amount of urination and the patient’s being constantly thirsty as well as other problems. These symptoms are common to diabetes mellitus, but in the case of diabetes insipidus, another type of diabetes, there is no insulin deficiency. Changes in policy In healthcare in the UK generally, a shift towards patient-centered policy has occurred in recent years. To avoid resistance as counterproductive, a patient-centered approach is used, basically, that concentrates on the ways in which patients can help themselves by finding solutions that improve their health and construction of reality. This is a basically optimistic assumption that object relation has as its impetus, in that the patients are expected to be cooperative and provide meaningful solutions that are assumedly more direct and experiential than an interruptive codified presentation that is staff-centered. In this method, the healthcare worker is encouraged to accept patient definitions of problems without a lot of reorganizing. Making fast ethical decisions on a realistic paradigm can also help improve communication levels between family, caretakers, healthcare workers and others a positive terms. The interstices of hypertension, diabetes, and increased risk for cardiovascular disease is another subject that has resulted in changes of policy in regards to diabetes care. One effective treatment in this regard that reduces risk factors in patients with diabetes is that of BP maintenance and control. “Because most patients in trials of antihypertensives have ended up having to take 2 or 3 drugs to achieve BP control, guidelines usually suggest several appropriate drug classes. The ACP guidelines state that ACE inhibitors and thiazide diuretics should be first-line therapy in most patients with diabetes” (Pasternak and Snow, 2003). This type of intervention has also shown strength in clinical trials and studies. The question of a socio cultural difference in the perception of health intervention points towards the need for a culturally sensitive response. However, “Despite significant efforts over the past several years, health disparities continue to exist, particularly among minority groups. Interventions aimed at eliminating these disparities should include ensuring cultural competence among health care providers and improving health literacy among patients” (Mullins et al., 2005). Current trends A current dimension of the problem of diabetes in the UK is that even as healthcare quality is being denied to many marginalized populations, diabetes is becoming more and more preventable and easily treated. “Angina, congestive heart failure, diabetes, and hypertension are chronic conditions that are frequently used as relevant markers in evaluations of potentially preventable hospitalizations, because they can often be managed successfully in an ambulatory care setting with appropriate and timely primary care, thereby limiting the need for hospitalization” (Davis et al., 2003). This shows another dimension to the problem. In another study, the authors “observed a drastic difference in insulin sensitivity among the different ethnic groups and observed that their [beta]-cell function compensates for the prevailing insulin sensitivity. The difference in the prevalence of abnormal glucose tolerance in different ethnic groups could be a result of differences in insulin sensitivity” (Chiu et. al, 2000). The question often remains in this type of study, however, whether it is a base insulin sensitivity difference that determines the condition, or whether it is the other way around, with the disease itself being the main independent variable. This is not to say that all socio-cultural interpretations lack scientific value; nor is it to say that all scientific interpretations of the problem lack substantive human interest. The statistics are fairly clear, but the reasons are what give commentators more problems in terms of categorizing the issues and making them causally clear. As one source notes, “Substantial progress has been made toward identifying population-based risk factors in the development of type 2 diabetes that may explain these ethnic disparities around the world. Although these diabetic risk factors appear to operate in all ethnic groups, whether specific groups are inherently different in the ways they respond to these risk factors is unknown” (Chiu, et. al, 2000). Perhaps the most interesting research on the subject presents unknowns explicitly as such, not tying them down to hypotheses, and points towards new directions and factorial combinations that can lead to greater understanding of the problem, as well as a greater understanding of what can be done to reduce risk factors and make forward progress. Self-care Self care is definitely an option, especially for Type 2 diabetes, and may even reverse or eliminate the need for medication and BP maintenance. “This is an exciting time to be involved in the management of diabetes in primary care. We are being asked to take on more responsibility for organising and providing the medical care of people with diabetes. This brings challenges, opportunities and responsibilities” (Brown, 2007). One of the key aspects of treatment today is behavioral and lifestyle modification. People with diabetes are advised to watch lifestyle choices such as diet, exercise, smoking and other risk factors, which can effect glycemic (blood sugar) control and lower the risk factors of loss of limbs or blindness developing. Obesity is also a risk factor for diabetes that can be partially controlled by lifestyle changes. Generally, the literature on the disease seems to agree that self-care interventions are appropriate for patients with diabetes, particularly those interventions that are organized around the behavioral method of intervention. In this method, attention is paid to making substantial and positive changes in client behavior and perception of their illness, in terms of their ability to control and combat diabetes in individual and group formats. Overall, it is important to, “Reinforce the importance of regular follow up, including health care provider follow up, yearly dilated eye exam, yearly random urine test, dental care, A1C every 3 moths, request foot exam with every medical visit, blood pressure and cholesterol as needed” (Diabetes, 2001, 1). This shows agreement of the protocol and literature through evidence based practice. Perhaps the most important intervention, however, involves the intake of insulin in the diabetic. “This is essential for people with type 2 diabetes. If you need insulin, you can't get by without it. Follow your doctor's orders very carefully. If daily injections are hard for you, ask about an insulin pump. You can also ask about getting insulin via an inhaler. If your body makes insulin, you may need to take diabetes pills that either help your body respond to insulin better or help you make more insulin” (Type 2, 2007, 1). Knowing how to treat patients with diabetes in a way that reduces their risk factors for other complications is also a very important and necessary topic. Information for diabetics There is a lot of information available to diabetics, both in journals and on the internet. The most valuable information highlights the need for professional medical supervision. “It's very important to take medications for type 2 diabetes exactly as your doctor advises. Don't take any other medicines unless you first check with your doctor. Don't forget that type 2 diabetes increases your risk of heart disease even more than in people who don't have diabetes” (Type 2, 2007, 2). Clearly, healthcare environments are the environments, regarding appropriate care and identification, which are integral to focusing on client change and progress. In terms of practical application, the future of treating diabetic patients to reduce their risk factors for cardiovascular disease and coronary heart disease looks bright, especially in the field of drug intervention. New drug trials have shown that diabetic patients who have increased risk factors for cardiovascular disease with associated obesity are also coming under the locus of pharmacological intervention that is proving increasingly effective in reducing these risk factors. “Most experts use metformin in obese patients with diabetes because this agent does not increase appetite or cause weight gain. Increased use of the thiazolidinediones—pioglitazone or rosiglitizone—may be on the horizon, because this class of antidiabetic agent appears to favorably affect lipid abnormalities” (Pasternak and Snow, 2003). In terms of the present, the abovementioned modifiable and non-modifiable risk factors remain at the center of how to treat patients with diabetes and reduce their risk for cardiovascular disease, in terms of drug therapy, diet, and lifestyle change. REFERENCE Brown, A. et al. (2003). Health behaviors and quality of care among minorities with diabetes. Journal of Public Health 93(10). Brown, M (2007). Issues concerning optimal diabetes care. Diabetes and Primary Care. Chiu, K.C., Cohan, P., N.P. Lee, et. al (September 2000). Insulin Sensitivity Differs Among Ethnic Groups With a Compensatory Response in [beta]-Cell Function. Diabetes Care. Davis, S., Liu, Y., and G.H. Gibbons (2003). Disparities in trends of hospitalization for potentially preventable chronic conditions during the 1990s. Journal of Public Health 93(3). Johnson, R (2001). Health Promotion: A theoretical overview. The Journal of Theory Construction and Testing. Mullins, C. L Blatt, C Gbarayor et al. (2005). Health Disparities. American Journal of Health Systems. Pasternak, R., and V. Snow (2003). Reducing cardiovascular risk in patients with diabetes. JAAPA 16(11). Diabetes (2007). http://www.emedicinehealth.com/diabetes/article_em.htm Diabetes UK (2010). http://www.diabetes.org.uk/ Type 2 Diabetes—Causes, Symptoms, Treatments (2007). http://www.webmd.com/content/article/63/72133 UK rates of diabetes soar (2009). http://news.bbc.co.uk/2/hi/health/7905734.stm Read More

 

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