Living with Diabets - Essay Example

LIVING WITH DIABETES AT HOME AND AT THE WORK PLACE Introduction Diabetes is a condition characterized by excessive blood glucose leading to excretion of excess glucoses in urine giving the urine a characteristic sweet taste a condition clinically referred so as glycosuria. Other symptoms of diabetes include increased frequency of urination, feeling thirsty, and feeling dizzy and sometimes patients may go into a coma or even death if the patient does not seek treatment in good time. Persons suffering from increased blood glucose are often referred to as diabetics. Diabetes manifests itself in two conditions which are diabetes insipidus (commonly referred to as type I diabetes) and diabetes mellitus (type II diabetes). In type I diabetes, the urine is not sweet, the term insipidus is actually a Latin word meaning without taste the main cause of this condition is kidney or pituitary gland damage of failure. The onset of this disease therefore is during childhood. Patients suffering from this type of diabetes are prone to the development of ketoacidocis and therefore insulin therapy is essential for the survival of the patient. It arises due to the loss of beta cell of the islets of Langerhans of the pancrease that are responsible for the production of insulin leading to reduction in insulin production. In some instances the term Insulin Dependant Diabetes Mellitus (IDDM) can be used interchangeably with type I diabetes. Diabetes type I consists of almost 10% of all diabetic patients. Life adjustments programs including exercises and change of diet don't improve the condition because damage has already been caused. Type II diabetes is also referred to as non-insulin dependent diabetes mellitus often abbreviated as (NIDDM) it is often commonly reported in African Americans, Asian Americans and the aged populations. This type is often associated with obesity in this case the deposition of fat around the abdominal organs that are around the waste without subcutaneous fat make patients prone to development of insulin resistance. The onset of this condition is during adulthood and is characterized by hyperglycemia (increased blood glucose) as a result of low production of insulin from the pancrease and insulin resistance or overproduction of glucose for example during breakdown of glycogen. Insulin is important in the body as it enables the body to use the glucose obtained from diet to produce energy thus in most diabetic patients there is a general feeling of weakness due to lack of energy for the body. Lack of insulin can cause two main effects in the body first the body cells are starved of energy and secondly the increase in concentration of blood glucose may lead to damage of eyes and heart muscles. During insulin resistance the body cells do not respond to the presence of insulin in the blood. In a normal individual once food is taken in through the gut the macromolecules in the food are broken down by intestinal enzymes into small micro molecular units for example glucose that can be readily absorbed in the body. Diabetes is often as a result of lack of exercise and therefore in most cases associated with countries from the western or developed world. Normally type II diabetic patients are less prone to development of ketoacidosis however they are likely to develop non-ketoacidonic hypoglycemia which is quite dangerous. Type II diabetes can lead to organ damage an most notably the cardiovascular system. Diabetes type II often remain unnoticed for several years because its conditions are commonly mild however its long-term effects may be lethal and therefore necessitating frequent clinical checkups to detect the disease at an early stage and most importantly is important to make sure that the body is maintained healthy by doing lots of exercise. Analysis of the problem Imran, a middle aged man of forty years who recently went for a medical checkup, was found to be diabetic. He was diagnosed of having non-insulin depended diabetes which is commonly referred to as type II diabetes. As a result of this condition Imrans's pancrease does not secrete enough insulin therefore his body cells are starved of glucose despite its presence in blood he therefore has to take artificial insulin in form of tablets or medicinal tablets that will stimulate his beta cells of the pancrease to start secreting insulin these tablets can either be sulfonylurea, malgitinides, (these stimulate production of insulin), biguanides, thiazolidinediones, (reduce glucose production in the liver) or alpha-glucosidase inhibitors (inhibit the breakdown of starch such as bread, pasts, table sugar and potatoes) As a result of his condition Imran should do modification to his current diet so as live with his current clinical situation. The modification should be aimed at reducing intake of glucose or any other glucose equivalent that is capable of increasing blood glucose after digestion. In addition, he has to go for regular blood test to monitor the concentration of his blood glucose concentration in reference to normal blood glucose levels which is 180mg/dl, so as to monitor his body's response with regard to the drugs that he is being given. He is also required to attach GP result for biomedical checks and lifestyle advice for every three months. Currently Imran Body Mass Index (BMI) units is 33. (BMI is a measure of the weight of an individual divided by the square of his height). However, it is becoming increasing difficult for Imran to fit into the new lifestyle. In an electronic factory where he works he is especially finding it difficult to adapt because of the nature of the job having irregular hours. Consequently, he finds himself feeling tired most of the time because his blood glucose control is poor. The people around him try to help him in his condition more especially his wife in carrying out the daily chores but she does not quite understand the cause of the disease nor does she understand the likely consequences of the condition affecting Imran. Even to Imran the condition seems to be quite new and does not exactly know what strategies to take to manage his condition. At his work place Imran has made them aware of the condition that he has recently been diagnosed of his workmates can only sympathize with him because like his wife they too do not know the implications of the disease including the cause of the disease. As a result they cannot advise him appropriately on the steps to take in managing the disease. Consequently, the management at his work place, though they have an excellent plan of improving the health welfare of their employees they still don't realize what the agency of the condition that Imran's situation: requires immediate attention. Therefore, the whole scenario surrounding him poses great danger because the agency of his condition should be a priority which none of the people surrounding him do not seem to realize. Another difficult scenario that makes solving of Imran's problem difficult is based on the fact that he has always depended on subsidized prizes of food that are offered at the canteen of his work place. Therefore, it is quite difficult for him to depend on the high prized foods that are sold at normal retail shops. Additionally, most of the foods offered at the canteen are fatty in nature mostly rich in carbohydrates and starch which he should at all costs avoid at this stage because they are likely to increase his blood glucose levels and therefore pose his more danger. It is also to Imran's knowledge that he should reduce his body weight so that to march his BMI units. However, he recently broke his leg and therefore cannot engage in a vigorous exercise therefore he has to look for alternative means of reducing body weight. Likely causes of the condition (type II diabetes) The exact cause of diabetes is unknown to physicians. But the major cause is attributed to genetic factors. However, there are some factors that can increase the risk of an individual getting exposed to type 2 diabetes. Some of the main causes that may put Imran in such a situation include: Weight: currently Imran's lifestyle is dependent on the subsidized fatty food in the canteen at his work place. There is therefore a likelihood that he consumes a lot of carbohydrates and fatty leading to a lot of blood glucose which in the presence insulin is converted to fat that is deposited below the skin and other organs leading to higher BMI as a result. Inactivity: The work conditions at Imran's work do not seem to give him the freedom to organize his work well including doing exercise because of irregular hours and considering the nature of his work of an electronic it can be argued that he does not get enough exercise. Therefore all conditions put Imran at a great risk of being prone to diabetes type 2. Another factor that may be contributing to Imran's situation is age. Its has been recorded that the risk of getting type 2 diabetes increases with age and one is more prone to the condition when he reaches the age of forty. It assumed that at these older ages people exercise less and less as compared to younger ages consequently these people tend to lose muscle mass and gain weight at these ages. Imran's eating habits that involve food with high fat content are likely to have exposed him to a condition where his blood glucose level is high than normal a condition called prediabetes, however, this high glucose level is not high enough to be classified as type 2 diabetes. This condition leads to diabetes if untreated and may be as well the reason for Imran's condition. The role of genetics can not be underestimated in Imran's situation. Usually type 2 diabetes runs in a family. The probability that Imran could inherit the condition from his parents is estimated to be 1 out of 7 if the disease was diagnosed in his parents before they reached the age of fifty and 1 out of 13 if they were diagnosed after the age of fifty. Consequently, the probability of him getting the disease from his parents is higher if it is found out that it was his mother who was suffering from the disorder. Consequently, if both his parents were suffering from the disease then there is a probability of 1 in two that the disease of genetic origin. It has also been found out that there are many genes involved in diabetes and a mutation in one or a few of the genes involved in diabetes would increase the risk of one developing the condition. In some cases it has been seen that some populations have a unique gene called the "the thrifty gene" whose function is to regulate hormonal fluctuations to accommodate the changes in food supplies during the high and low season. It is believed that these hormones increase resistance to insulin and promote efficient storage when the food supply low and have an opposite effect during the season when food is in plenty. With modern industrialization food is available throughout the year and the effect is that the hormone has become harmful to fat. In many cases for people who have the gene running in their families are prone to the development of diabetes type 2. If Imran has the gene and with his eating habits dependent on high carbohydrate supply there is likelihood that it might be the cause of the condition. The social factors that put Imran at a high risk are his social class. He is used to his class of workers where they have to eat at the canteen at the work place where the meals are subsidized. It would have been quite difficult for him to separate himself from his workmates during the time of the meals even if he was aware of the danger that may be waiting from the consumption of foods containing high content of carbohydrates. Complications and consequences that may arise from diabetes type II The complications arising from the development of diabetes are very complicated and can cause damage of an individual's important body organs and sometimes can lead to death. Some of the major complications that may arise from the condition affecting Imran include: Kidney disease; the kidney is an indispensable organ in the body whose major function is to remove waste products from the body this is achieved through several blood vessels that act as filters. One of the causes that have been identified for the breakdown of function of the kidney is the development of diabetes leading to development of kidney disease. The medical reason behind this is that the high levels of blood sugar make the kidney filter a lot of blood exposing the kidney to a lot of hard work. Due to this extra work it reaches a point where the filters get exhausted and a result lead to the leakage of useful micronutrients in the body for example important proteins. This condition however can be checked if diagnosis is done in the early stages of the disease. If the condition is allowed to complicate the patient may at the end require a kidney transplant or require that his blood be filtered by a machine. Another complication that Imran may develop is heart disease and stroke. Most patients suffering from diabetes are at a greater risk of developing complications associated with poor circulation, heart attack and stroke. Eye complications: Imran is in the danger of developing an eye problem as compared to a person who does not have diabetes. Eye complication are varied and include glaucoma a condition in which there is increased pressure in the blood capillaries of the eye specifically in the anterior chamber this lead to slow down in the drainage of the aqueous humor. Vision is gradually lost as a result of blood vessels that carry blood to the retina and the optic nerve get pinched as a result of the increased pressure. As there may be treatment to the condition Imran may be caused to undergo surgery to correct the problem. Another eye complication that can arise as a result of Imran's is retinopathy in which capillaries more so those at the back of the eye form pouches leading to blockage of blood vessels. Consequently the vessels loose their ability to control the passage of materials between the blood and the retina leading to leakage of substances to the macula, where focusing occurs this can lead to impairment of vision causing blindness. Imran is also likely to suffer from damage of nerves a condition called diabetic nephropathy. Nerves normally carry signals to and from the brain. Nerve damage can occur either to a single nerve or to a group of nerves the effect of this is that he may at times experience sudden general weakness or sudden pain for example in front of a thigh or any other part can be affected. Consequently, diabetes can lead to compressed nerves that eventually lead to the blockage of transmission of a nerve impulse to or from the brain. Usually nerve damage can be hard to recognize. Another complication that Imran may be exposed to is skin damage. For diabetic type 2 patients one of the very first signs that one is suffering from the condition includes skin damage. Skin complications range from itchy skin, dermopathy, necrobiosis, bacterial infection, to fungal infection and diabetic blisters. However, he can get medication because most of the skin problems are treatable. Imran may also suffer from depression complications this is because he may feel separated from his fellow workmates and his wife because of the extra work. In addition complications such as nerve damage and tension with his doctor may make him feel frustrated. Diabetes type 2 can have serious effects on the sexual life of Imran. Sex is an important part of a marriage subject to be affected by the condition. As the condition progresses Imran may suffer from impotence commonly referred to as erectile dysfunction. When a man suffer from this condition is impossible to keep an erection. This is attributed to the fact that the blood vessels and nerves around the penis get destroyed. If the condition is detected in good time there is always treatment for the condition. Recommendations In contrast to the common perception that diabetes patients menus in most cases constitute specialized and costly foods Imran can easily eat healthfully on a small budget that requires only small investment on foods that match the diabetic requirement which are mainly aimed at reducing blood sugar level. Any food that Imran take in is likely to increase blood glucose level and therefore can affect his general health. There are several tips to eating right and these include: To help keep his insulin and sugar levels steady Imran should try and eat at almost the same time each day. Losing weight if he is overweight will go along in reducing the blood glucose levels. Losing even as little weight as 5 to 15 pounds is recommended. Engaging in exercise for example gardening or a walk around his homestead will help him reduce weight this will help the body to better use insulin. It will also help reduce cholesterol levels and reduce the risk of developing a heart attack. It will also make his feel less anxious. He should strictly adhere to eating three times a day. He may also take a snack when he is taking medicine or insulin. Any other time he should as much as possible he should avoid taking snacks unless he is to involve to in vigorous exercise which is unlikely due to his broken leg. In case Imran was smoking or drinking initially, it would be better to his health to stop as soon as possible. Drinking on an empty stomach for example puts him at a risk of a drop of his blood sugar. Conclusions Having been recently been diagnosed with diabetes Imran is no doubt living with a lot of fears, anger, denial and frustration. However, he should realize he is not alone he should visit a health professional and get advised appropriately. In addition interacting with people who suffer from the same condition to share experiences will help him to cope. References King H., Rewers M, (1993), Global Estimates for Prevalence of Non-Insulin dependant diabetes mellitus and imposed glucose tolerance in adults. Oxford: Blackwell science. Read More