Long Term Conditions: A Case Study of a Patient Living With Type 2 Diabetes Mellitus - Essay Example

Running Head: DIABETES MELLITUS TYPE II Diabetes Mellitus type II Insert Introduction Diabetes mellitus is a medical condition that is also known as type II diabetes. This is a condition that affects most people within the global perspective due to poor cultural and duet practices that leads to unbalanced coordination between the metabolic systems. The number of people affected and infected by the condition is about 10% of the global population with about 2 million people from Europe. The Case Study is aimed at identifying various stages/ conditions and describing the long term experience in the nursing care and practices that are necessary in regards to the patient conditions at different stages of management. Being an incurable condition which can be managed for long period of time, it is adept that both the affected and infected get to understand the predisposing factors in order to handle the diabetic patient with the due procedure to balance their metabolic systems so that they could survive or longer than the perceived duration (Baker 2007, p.22). Diabetes Mellitus II Diabetes Mellitus is referred to as non-insulin-dependent diabetes and is more or less considered as an adult condition though research carried out so far indicates that the condition is not only affecting adults but also the youths of which to a larger extent inherited from the diabetic family lineage (Batty et al. 2007, p. 239). Essentially, the condition occurs when the pancreas fails to produce enough insulin to breakdown the body sugars and therefore the concentration of sugars in blood rises greatly. The condition can also be realized when the pancreatic juices and insulin that digests the sugars fails to be metabolized effectively (BBC 2011). When this occurs, the patient suffers from insulin deficiency, insulin resistance is evident and the patient as well experiences hyperglycemia (Bupa, 2004, P. 28). Obesity is one of the numerous factors that influence the rate of attack as it increases complications in the blood vessels, at this point the information can still be shared between the health workers and the community to ensure that each person adhere to the teachings on staying safe from long term conditions. However, not everybody would be able to understand and follow the teachings on staying healthy, some cultural believes influence the pandemic for instance some cultural practices dictates the kind of meals that men or women should feed on. Evidence of safe practice/attitudes We find than men are not allowed to eat some food in the presence of their families, so when they are away most of the time they prefers taking the kind of meals that they are not supposed to eat. Instead of dictating what people should eat culturally, they should embark on practices that enhances healthy living so that they could do away with diabetes mellitus II and the like which are caused through being predisposed to some unhealthy practices (American Diabetes Association 2007). Being a LTC, type II diabetes has far reaching effects on careers. Patients are rendered less active because they have to stick to certain lifestyles. They will be required to see medical professionals regularly for monitoring of their blood sugar concentrations and they will therefore be exempted from work many times. Pregnant mothers whose blood sugar is not regulated are at a risk of experiencing still birth or suffer other complications where the child may develop brain or central nervous system defects, asphyxia, respiratory distress, heart and kidney malformation and congenital heart disease. It is for these reasons that pregnant mothers should seek medical care regularly (McCulloch et. al, 2008). Patient’s/client’s confidentiality The long Term Conditions are many and includes heart diseases, diabetes, chronic obstructive pulmonary disease (COPD) and others. According to Diabetes.co.uk (2011), in UK, about 80% of primary health consultations and 75 % of emergency hospital admissions relates to long term conditions. This call for campaigns to enlighten people not only in Europe but globally on the risks involved in practicing poor habits that predisposes people to the numerous long term health conditions as well as short term conditions that results from same conditions and worse conditions that had been or are yet to be experienced (Khan A, et al., 2003, p. 24). However, most of the signs and symptoms related to the condition are likely to impact negatively on the people who are not experienced in dealing with diabetes mellitus II. You realize that insufficient or excessive sugar in the blood is a danger to their survival for instance, they are forced to manually balance their own diet so that the body function line any other normal person. Failure to perform the required procedure would worsen their health condition within a short time (Mezuk B, et al., 2008, p. 93). Balancing between hyper and hypoglycemia is not possible for a newly recruited nurse or elite without nursing expertise in long term management of such conditions. The stigma related to the conditions could be eliminated and instead the assisting nurses on home care health workers are advised to enlighten the people within the locality so that they may accept the patient conditions to enable positive perception within the families and community at large. The chronic conditions require confidentiality, most of the infected lose vision forcing the nurse to take care of everything including their bank details so that they could be assisted, This process is likely to continue as time goes by as they awaits for their final farewell which could either be within a long or short period depending on the care provided by the nurses (Baker 2007, p.25). Primary care for diabetic patient plays a major role in the management of the condition. However, most of the cases are detected at later stages when it requires a lot okf concern to suppress the condition (Khan A, et al., 2003, p. 29). Current studies have focused primarily on the increasing of the multidisciplinary nature of primary health. Nurse-led health services has been implemented in many health facilities in many countries but has remained of little concern in some other countries where the funding and the structure of primary care remains questionable. Management of LTCs has been prioritized in many health institutions and this has led to the development of models to perfect the care. The most widely used of such strategies is the Chronic Care Model (CCM) (Mezuk B, et al., 2008, p. 105). This model looks into six major areas and has found wide application n the management of LTCs due to its positive response in as far as the management of this condition is concerned. These six areas are: Patient self-management, delivery system redesign, provider decision support, clinical information systems, effective health system leadership, and Linkages to community resources ( Natasha & Shona 2011, p. 2) This model advocates for a more or less central model that takes into account the role of planned care. With this model, persons with existing LTCs are identified and are henceforth called regularly for educational information and screening programs. The model has enhanced health care by helping create a more proactive healthcare environment. It strengthens the self-care program that focuses more on the lifestyle of the individuals in respect to the nature and extent of the LTCs (Natasha, 2011, p. 18). The conditions that individuals get engaged into is characterized by more or less generalized symptoms that include excessive urinating, weight loss, constant thirst, blurred vision, extreme tiredness, occurrence of skin rush and slow wound healing (Casellini & Vinik 2007, p. 554). These characteristics however are general and they may be an indication of a different medical condition other than diabetes and it is therefore vital to see medical personnel for the correct diagnosis of the condition and prior treatment plan or management plan it in any case it turns that the condition is diabetes type II (McCulloch, 2008, p. 205). The diagnosis of diabetes mellitus type two can be done on either urine or blood samples. A fasting blood glucose test is performed initially followed by a second blood test known The second test is usually important and is conducted following borderline results with the first test and is a confirmatory test in order to confirm the patient’s glucose change over time (The Merck Manuals, 2010, p. 30). Some communities especially in Africa, this condition have been associated to curse. Many people believed that once an individual is confirmed to be diabetic they isolate the individual dying unless there are supernatural powers. Despite the cultural deeds, the cultural belonging also determines a lot. Being routed in their cultural practices for instance when individuals are sick they should not rely on traditional herbs for treatment, some of the patients tend to follow the dictates of their cultural beliefs and practices (Frye et al. 2009, p.2533 ). However, this belief has slowly died away and many communities now understand that this is just like any other medical condition. There exists fear in the individual that the condition or rather many of these LTCs will lead to deathbed especially considering that many cannot be cured. End of life as a matter of fact affects more of the persons thinking. The fear and anxiety associated with it are largely detrimental. The individual are affected psychologically and this cuts down their economic output. Many people suffering from LTCs become more dependent on others and the effect that this has on the general economy of the country cannot be overemphasized (Natasha & Shona 2011, p. 20). Relevant cultural and ethical issues Currently there exists no cure for type II diabetes and therefore management programs that aim at controlling the glucose levels either through prescribed medication or through lifestyle changes (Department of Health, 2005). Doctors also recommend that diabetics should confirm the required dietary habits in balanced diets and low sugar content foods. Such individuals are advised to only drink alcohol in moderation which is also a health hazard in regard to diabetes as a health issue. They are also advised to engage is do regular aerobics and especially for those who are overweight (Balk EM, et al., 2007, P. 180). This helps in burning excess calories in excess fat that lies below the skin and around blood vessels. Reduction of cholesterol have added advantage in eliminate other health condition like high blood pressure and cardiovascular diseases. The patients should also refrain from smoking as this only worsens the state and functions of cardiovascular and circulatory systems. There are also certain drugs that help in boosting insulin production and they should only be taken under prescription (Ripsin, Kang & Urban 2009). The elevating number of cases of diabetes type II has led to the development of more profound health and social care management policies to people suffering from the condition (England et al. 2009). These policies were aimed at achieving and maintaining healthy blood glucose levels within the body. Through Diabetes Control and Complications Trial (DCCT) which have shown that maintaining blood glucose close to normal by people suffering from diabetes abridged the risk of explicating related complications. However, several management policies have been devised (National Institute of Diabetes and Digestive and Kidney Diseases 2010). Apart from lifestyle changes and medication, food supplements including fiber and chromium have been found to be of immeasurable use in management of this condition. Relaxation techniques also lowers chances of contradicting to reduce depression or stress have also been proved to be important in management of this type of diabetes. Acupuncture has also helped in nerve repair for diabetes cases that result from nerve damages (Ripsin, Kang & Urban 2009). Food supplements are particularly important and especially those that have been proved to have blood sugar lowering effects. Chromium which is found in many food types including brewer’s yeast, liver, fish, some fruits, cheese vegetables and whole grains, have been found to heighten cell sensitivity to insulin (Balk EM, et al., 2007, P. 184) . Magnesium has been graded as an import factor that helps control blood sugar levels and it has been suggested that ample magnesium helps to meliorate insulin action in the body. High fiber diet has been said to lower average glucose in blood and improve cholesterol triglyceride levels in diabetes patients (Balk et al. 2007, p.2154). Another supplement by the name vanadium has been identified to assume the function of insulin. This is a trace mineral element which is found in soil and in many other foods lowers blood glucose levels to normal levels (Srivastava 2000, p.180). Dietary habits are an integral part in the management of LTCs. In this type of diabetes, Beta-carotene and vitamin C are major antioxidants. These food stuffs assist in reducing blood sugar levels to normal ranges by scavenging on free radicals rampant in blood of diabetics. Vitamin B6 and Biotin have approved blood glucose control capacities. Increased research has also shown that other substances including Coenzyme Q10, Niacin, and Omega-3 Fatty acids have been shown to boost cardiovascular health and therefore mitigate the likelihood of development of cardiovascular complications (University of Maryland Medical Center, 2011). Diabetic neuropathy is a condition that results to nerve damage and is characterized by extreme pain. Alpha-Lipoic acid and Gamma-linolenic acid improve nerve communication and reduces the adverse effects of diabetic neuropathy (Willett 2007). Acupuncture has as well been seen to reduce the effects of this condition by enabling release of natural pain killers. Also, many herbal extracts has pronounced importance in management of diabetes mellitus. Such include better melon, fenugreek seeds, gymnema, cinnamon and American ginseng (Baker et al. 2008, p.41) Recent developments in Information Technology have had great achievement in their applicability in management of LTCs. These developments have been integrated with the already existing nurse-led programs and together they have efficiently boosted up care in LTCs. In particular, some of these developments in IT have lowered the escalating work load on nurses. They have enabled the patients to attend to some of the less sophisticated health care practices without the presence of the nurses (Frye et al. 2009, p.2503 ). Conclusion Understanding LTCs in almost all aspects is important because as realized in the case of diabetes, they have far reaching adverse effects that can affect generations, communities and the society at large. The lessons that should be learned from the case study should be that the long term conditions are either hereditary of acquired from poor diet and lack of exercise among other factors. Hence everybody should be actively involved in any activity that acts as a source of relief from the fatigue of the daily chores The work of a nurse in helping mitigate the effects of diabetes mellitus as a LTC cannot be over emphasized. The nurse plays an important role in ensuring that the patients stick to healthy living habits as recommended by a physician. It is also the role of the nurse to administer any medications that may be prescribed for the patient by the doctor. Monitoring of the blood glucose levels is a daily routine for nurses in any particular hospital where care to this type of patients is undertaken. References American Diabetes Association, 2007, Diabetes Statistics, viewed 22 November, 2011, Baker, H. 2007, ‘Nutrition in the elderly: nutritional aspects of chronic diseases’, Geriatrics, Vol.62, no.9, pp. 21-5. Baker WL, et al.,2008, ‘Effect of cinnamon on glucose control and lipid parameters’ Diabetes Care. Vol.31, p.41. Balk EM, et al., 2007, ‘Effect of chromium supplementation on glucose metabolism and lipids’, Vol.30, p. 2154. Batty GD, et al., 2007, ‘Obesity and overweight in relation to mortality in men with and without type 2 diabetes/impaired glucose tolerance: the original Whitehall Study’, Diabetes Care, vol.30, no.9 pp. 2388-2391. 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