Caring for the Person with Diabetes - Assignment Example

CARE OF THE PERSON WITH DIABETES Introduction Type II diabetes or the non-insulin dependent diabetes (NIDDM), is the type of diabetes that affect most patients. Its prevalence is high compared to type I diabetes. Unlike the type I diabetes where the body does not produce any insulin, Type II diabetes patient produces insulin but the body cannot utilize it. It may not be enough or the body may not be sensing the percent of the insulin in the cells. This lead to fluctuation of the blood sugar in the body as it is not well utilized in the body. (Tierney, 2002) Unlike in the past where diabetes was seen as deadly disease the led to loss of life, the approach to diabetes has been changing with new discoveries. In this case there has been a changing approach in the management of the disease both at home and in the hospital. Unlike in the past where patients were tied to a lifetime of use of insulin the management of the disease has been improved and some patients can use the insulin for a short time and with improved management of the disease, they can stop using the insulin for the time the condition seems stable. This management has been archived through the use of diet and exercise. (Carr, 2001) Obesity and type II diabetes One of characteristics of type II diabetes is the gain in weigh unlike in type 1 diabetes. Type II diabetes usually occurs from 14 years and one of the predisposing factors to the condition is obesity and overweight. This is a condition where there is excess fat that is concentrated around the waist and the abdominal origins. (Wasko, 2007) This abdominal fat is usually active normally and it secrets a number of hormones or the adipose kinase which have been shown to impair with glucose tolerance of the body. 55% of all the patients with type II diabetes have been diagnosed with obesity. However the occurrence of the disease has also been linked to aging and family history of the condition. Abdominal fat and other body reserve fats usually result from increased consumption of calories which leads to a positive energy balance in the body. Cousins, 1997) However there is usually consumption of more calories than the body requires and therefore there is excess energy that is stored as fat in the body. Body fats are accumulated in many parts of the body but the abdominal organs remain one of the favourable sites to store these fats. Overweigh individual usually experience a lot of complication with debates being one of the complications. Overweight in diabetes makes the management of the disease complicated and therefore is usually important to check on the weight from time to time. But loosing weigh remains one of the most effective ways to treat the disease. (Langer, 2002; Bailey, 1995) NIDDM is linked with development of other complications which actually comes due to the obese condition. It progresses to renal failure due to the diabetic nephropathy. It may also progress to vascular disease or the coronary disease which are closely linked with overweight and obesity. (Stratta, 1998) Diabetic retinopathies may lead to impairment of vision while diabetic neuropathy may lead to loss of sensation. There have also been a number of liver damages which is associated with non-alcoholic steatohepatitis which can also be caused by diabetes. (Babcock, 2004) Management of the diseases In the past there have been more emphasise of the condition with us of hypoglycaemic drugs which have been helping the body to cope high blood sugar or hyperglycemias. Oral ant diabetic drugs have been the primary way that has been used in order to treat the condition and in extreme cases patients also put on insulin injections. (Brown, 2000) In the beginning insulin production is impaired in the condition and therefore ant diabetic drugs like sulfonylurea can be used to improve the condition. This also helps to regulate inappropriate release of glucose by the liver and at that same time attenuate insulin resistance although this is to some extent. But his has been found to increase the damage of the patient as oral drugs sometime fails and may lead to further impairment of the section of beta insulin which will further necessitate insulin therapy through ht use of insulin injection. Therefore it has become increasing important to manage the condition otherwise from the onset in order to avoid covariance on drugs. (Collins, 1998) Weight loss As we have stated the leading cause of Type II diabetes is overweight which is directly linked to diet. Diet plays an import role in the weigh statue of the person and the type of diet consumed directly results to the weight status of the person. Regulation of weigh is important in order the condition as weight loss leads to the increase in insulin sensitivity and overall improving on the mobility and other risk factors. (Anderson, 2000) Regulation of body weight will help a diabetic person avert other complications that are associated with the disease as we listed above. Reduction in the weight of the body is the first step that can help to regulate diabetic condition. Diabetic patients are advised to low bout 1 pound a week. This can be achieved through consuming a diet with at least 1,000- 1,200 kilocloaers per day for women while for men it should be between 1,200-1,600 Kcal/day due to their high body metabolic demand. Management through diet The aim of any nutritional regime that is aimed at addressing the issue of obesity should be to reduce the amount of calories and match them with the level of physical activity in order to have a balance energy balance in the body. However it should also be aimed at supply the body with important nutrients in order to spare the immune system of the body. This means that the nutritional regime must be able to reduce the weight of the body without resulting to other complications in the process. The diet has to be balanced but it has to be limited in the amount of calories that are consumed. The diet should be closely linked to the diet plan that should match the level of physical activity. The diet should also help to address other complication that arises due to diabetes like heart disease. It should be multi faced in order to address the problem of weigh and at the same time aders the issues. Although there are many approaches that can be taken to aders the issue of diabetes, the overall aim for the nutritional regime should be to reduce body weight and other complications that comes as a result. We should understand that there is not diet regime that can be claimed to a single diabetic regime but there have to be a nutritional plan that has been set on goals. In this case the goal of the plan has to be to address the issue of obesity and lead to loss of weigh without compromising the health status for the body. Therefore it should be a plan that will constitute of health eating habits. It will need to address the problem of blood glucose as the main goals and then reduced the level of caloric intake in order to deal with the problem of overweight. The first goal should therefore be to address hypo and hyperglycaemias. Then it should address the use of loss of weight. A good type II diabetic diet should follow the following guidelines: Carbohydrates should provide from 45%-65% of the daily calories. Carbohydrates are the main contribution of blood sugar and therefore they have to be regulated for the purpose of reducing the amount of glucose in the body and also for the purpose of loosing weight. The kind of carbohydrates that should be chosen should be whole in nature and refined carbohydrates should not be used. This is because refined carbohydrate taxes the body as they are digested very fast and therefore they put insulin demand to the roof. This leads to increased level of sugar in the body since the body cannot absorb the sugar at the same rate as it is produced. The food chosen should also be very high in fibre as fibres helps to bind glucose and release it slowly at a rate that the body can abuser. Therefore the type and the amount of carbohydrates that is used by the body are also very important. In a simple way plate method to account for the amount of carbohydrates that is to be taken it should account for a third of the plate while the rest two third should be accounted for by proteins and vegetables. Whole grains therefore remain the best kind of carbohydrate that has to be taken. (Kiehnm, 1996) On the choice of carbohydrates, the frequency of consumption is also important it is good to avoid snacking on carbohydrates a lot since they will lead to increased amount of sugar in the body. Patients are also advised to monitor the amount of carbohydrates they eat in a day though counting the number of meals. Fats should provide for 25-35% of the total calories in a day. Fats should not be ignored neither should they be over emphasized altogether. There are two kinds of fats and that kind of fat that has to be use also matter a lot. Monosaturated fat which can be obtained form olive oil, peanut, canola oils, avocado, and others and the Omega-3 polo saturated fat for fish, flaxseed, walnuts and other are the best type of fats. These fats have less cholesterol and therefore are associated with less incidences of heart disease. On the fats, the amount of saturated fats from animal sources like red meat and butter should be limited to less lean 7% of the total fat taken per day. This means that one should select lean meat which contains less fat. On the choice of dairy products, choose non fat or the low-fat dairy products. Dairies contribute also of fats to the body and therefore they should be reduced. The amount of trans-fat or the hydrogenated fat hat is found in snacks, fries, and baked products should also be reduced or not consumed altogether since these foods lead to increased blood glucose. (Miller, 1999) Protein should contribute about 12-20 percent of the daily calories intake. However this may vary depending on the need of each patient. There should be a lot of care taken when consuming proteins especially from animal source. Patients with kidney disease should limit the amount of proteins that they consumer to less than 10% of the calories in a day. The best sources of protein include fish, soy and skinned poultry. Red meat should be taken in moderation. Management through exercise Exercise is important since they help to complement the diet approaches that have been taken in weight loss. Sedentary habits like watching TV and other have been making a great contribution to the risk of obesity and diabetic costing. Therefore regular exercise is one of the most important approaches that can help to manage the condition and lose weight. It is recommended that one should engage in exercise for at least 30 minutes four days in a week. However, daily exercise is also recommended. It is evident that adults who engage in exercise for some few hours a week have less chances of developing diabetes. Prolonged low intensity exercise that will lead to burning of the extra body fat are helpful in losing weight unlike short high intensity exercise that uses current energy in he body. Therefore exercise like walking at a panting pace, swimming, cycling and others which are prolonged, moderate and of low intensity are very useful to help in weight loss plan. Thereof aerobic exercise should be used as one of the more important tool for improving glycaemia control. (Richard, 2007) Exercise plays many functions in the body. First they help to increase body sensitivity to insulin which helps to increase the amount of glucose that is absorbed from the body. They help to increase the amount of insulin that is produced by the pancreas. Exercise also helps the body to burn the extra calories which leads to weight loss. They also help to stretch body muscles which assist the body to become more flexible. (Chandallia, 2000) References Anderson, R. (2000). Chromium in the prevention and control of diabetes. Diabetes Metab, 26 Babcock, M. (2004). Client education: theory and practice. Mosby Bailey, T. S. (1995). Examination of diabetic. AJM, 78 Brown, J. (2000). Diabetic model. New York: Willey Carr, C. (2001). Type II diabetes. Journal of Medicine, Vol. 4(2) Chandaria, M. (2000). Benefit of exercising patient with type 2 diabetes. New England Journal of Medicine, 342 Collins, I. (1998). Diabetes management. London: McMillan. Cousins, L. (1997). Complication in diabetes. Oxford University Press Kiehnm T. (1996). Benefit of high carbohydrates, higher fibre diet on hyperglycaemia diabetic control. American Journal of Clinical Nutrition, Vol. 29 Langer, O. (2002). When diet fails: Insulin oral hypoglycaemic agents. The Journal of Maternal-Fetal & Neonatal medicine, Vol. 11(2) Miller, B. (1999). Diets with low glycaemia index: theory to practice. Nutritional Today, 34 Richard, B. (2007). Diabetic solutions. New York: Little Brown and company Stratta, R. (1998). Pancreases complication in diabetes. Journal of Medicine, 355 Tierney, L. (2002). Medical diagnose and treatment. New York: McGraw-Hill Wasko, H. (2007). Risks of diabetes. JAMA 298 Read More