Identification of People with Diabetes - Essay Example

Identification of people with diabetes There are more than 1.3 million people, who have been diagnosed with diabetes in England, and the number is increasing every year (Koopmanschap 2002). All of these people deserve the best care that we can offer. Nicholas and Brown (2002) affirm that, if diabetes goes undetected or untreated, or if the developed complications are not properly managed, it will have a devastating effect on the way people live. Koopmanschap (2002) emphasize that diabetes is one of the biggest causes of blindness in adults, kidney failure, biggest cause of amputation of the lower limb, and increasing the risk of stroke and coronary heart disease. For many years, the Diabetes UK has been urging the Government to establish active programs that will identify individuals with diabetes Type 2. Early identification ensures that individuals with diabetes receive proper treatment and care (William and Lucioni 2002). Healthcare professionals should target those individuals that are at risk of getting Type 2 diabetes as part of annual health checks, systematic case finding, and Cardiovascular Disease and Risk Management Programs (Ngugi and Lovelock 2003). Evaluation of the service The NSF was chosen with the aim of improving the quality of care that is provided to individuals with diabetes despite their origin (Egede, Nietert, and Zheng 2005). The standard 2 (DH 2001) shows that there is a firm evidence showing that, by assisting individuals improve their relationship with clinicians, provided with up-to-date information, disability and illness reduced, life expectancy increased, and the level of inequalities tackled (Grol 2012). Beckett, Peters, and Fletcher (2008) and Huang, Zhang, Gandra (2008) affirm that diabetes has been a challenge since 2001, when the NSF for diabetes set out its visions that aimed at empowering patients with diabetes and lay a framework or a foundation, which helps them become the major caregivers. Furman (2014) confirms that there have been several demonstrable improvements in the way services are delivered since the beginning of the delivery plan of 2003. The December, 2001 Diabetes Standards (DH 2001) is of great service of excellence, and they are built on a firm partnership with diabetes individuals (Buck, Wilson, and Ham 2005). Individuals with diabetes should expect greater and better services as these NSF standards are offered locally. The Department of Health, DH, has implemented effective interventions and good practices such as recommending the use of principal interventions such as personalized care models, structured education models, accessible records or patient-held records that will help facilitate the empowerment of these individuals (Egede, Nietert, and Zheng 2005). However, the services rendered are geographically variable, and there are increased numbers of people that have diabetes and still do not access to the established care standards (Newport and Hirsch 2011). Between 2006 and 2011 the diagnosed number of people living with diabetes in England increased by twenty five percent, from 1.9 million people to 2.5 million (Furman 2014). Alison (2007) estimates that there are up to eight hundred and fifty thousand people living with diabetes but, they are not aware. Petrack and Herpertz (2009), Newport and Hirsch (2011) and Beckett, Peters, and Fletcher (2008) say that diabetes is growing out of control, and the NHS is spending almost ten per cent of their budget on diabetes. This is attributed to the complications that are linked to diabetes such as blindness, kidney failure, stroke and amputation (Buck, Wilson, and Ham 2005). Levene and Donnelly (2007), Grol (2012), and Alison (2007) emphasize that the country is in a crisis state, and NHS and ministers must recognize this in order to prioritize prevention of diabetes and complication measures. There is no doubt we need to implement plans that are urgently needed to deliver the quality standards of NSF and NICE- Institute for Health and Clinical Excellence (Becket, Peters, and Fletcher 2008). Performance since 2001 According to Beckett, Peters, and Fletcher (2008), William and Lucioni (2002) and Koopmanschap (2002) the standard 2 (DH) shows that there is a firm evidence showing that, by assisting individuals improve their relationship with clinicians, supported by up to date information, disability and illness reduced, life expectancy increased, and the level of inequalities tackled. The December, 2001 Diabetes Standards is of great service of excellence, and they are built on a firm partnership with diabetes individuals. Individuals with diabetes should expect greater and better services as these NSF standards are offered locally. Grol (2012), Egede, Nietert, and Zheng (2005) emphasize that since the introduction of the NSF Standards in 2001, the issues that surround the prevention and management of diabetes have not been tackled successfully. Alison (2007) confirms that diabetes is still increasing along with associated complications and costs. Currently, there are approximately 2.9 people in UK that have been diagnosed with diabetes, and Furman (2014) confirms that, this number will increase to more than 5 million by 2025 if this trend continues. The figures from the DH data from 2009 and 2010 show that diabetes is approximately four times higher than combined cases of cancer in the UK (Newport and Hirsch 2011). In 2011, the National Health Service spent approximately £10 billion on diabetes almost £1 million hourly (Semb, Norman, and Flanagan 2012). Eighty per cent of the total NHS spending goes to manage the preventable complications. Boardman and Parsonage (2009) affirm that diabetes is associated with over twenty four thousand deaths every year. Half of these numerous deaths are due to the cardiovascular diseases that include stroke and heart attack (Furman 2014). The programs by NHS Health Checks are the vital way of identifying these people with and at risk of diabetes, yet by 2011 only half the programs of the NHS programs had been offered (Semb, Norman, and Flanagan 2012). Newport and Hirsch (2011) and Michael and Cousens (2013) confirm that the number of people with diabetes that are on ongoing care has increased in 2010, and the number that are identified early has increased from six per cent in 2001 to sixty nine per cent in 2010. The number of children is worse because ninety-six percent of the children are not receiving the annual checks that they require (Semb, Norman, and Flanagan 2012). This variability in the program has led to poor service delivery, which has led to a negative impact on the clinical result for people living with diabetes. Boardman and Parsonage (2009) say that this variability in service delivery has put these people at a greater risk of lowering their life quality, developing complications, and increased specialists care expenses. The Department of Health, DH, realized that there was a vital need for a systematic approach on ways to screen diabetes Type 2, and they formed a research in 2002 (Egede, Nietert, and Zheng 2005). The Diabetes Heart Disease and Stroke, DHDS, and National Screening Committee were established in 2002 to screen, test, and determine the result of performing the program in primary care and giving the targeted population the best and quality services (Grol 2012). The NSF standard 2 has developed over the years and it aims at developing, implementing, and monitoring strategies that aim at identifying individuals who are not aware that they has diabetes (Levene and Donnelly 2008). Individuals that are at risk of getting infected with Type 2 diabetes are targeted with the aim of finding their cases, performing annual health care checks. Levene and Donnelly (2008) affirm that there are more than 100, 000 individuals that have been diagnosed with diabetes. This is to say that that for every five minutes, one individual is infected. The DH and the National Screening Committee, NSC got feedback from the representatives that were taking the commissioned research, and the evidence showed that there was a need for an integrated model that combines diabetes and Cardiovascular Disease, CVD, to concentrate on the individual and to provide them with holistic care (Boardman and Parsonage 2009). The NSC recommended that diabetes ought to be in the Risk Assessment and Control Program, RACP, to include all people with high blood pressure, vascular disease, and diabetes receive risk reduction therapy, risk assessment to reduce the risk of coronary heart disease, stroke, and diabetes (Furman 2014). Grol (2012) and Beckett, Peters, and Fletcher (2008) affirm that testing for diabetes is included in the program and those individuals that are identified are placed in an active management program that supports and aims at reducing risks of contracting vascular disease. The NHS has frameworks that have enabled it improve the Standard 2 of diabetes: 1. Buck, Wilson, and Ham (2005) confirm that there is a national Implementation Plan for diabetes that has helped deliver the Standard 2 and practice the outcomes of NICE and National Service Framework according to the context the formed NHS. 2. Petrak and Herpertz (2009) affirm that the framework has called for a full implementation of the Health Checks that will see the increase levels of assessing and earlier identification diabetes. 3. Levene and Donnelly (2007) confirm that NHS has formed policies that have enabled increased awareness of detecting the signs and symptoms that will reduce cases of diabetes Type 2. 4. Becket, Peters, and Fletcher (2008) affirm that access to education has been improved for all people that are diagnosed with diabetes. 5. There is increased delivery of the nationally accepted care standards including the vital processes of care and services, which are outlined in the Healthcare Essentials that reduce complications and variability (Grol 2012). 6. Alison (2007) affirms that NHS has increased monitoring diabetes and outcomes that are within the Commissioning and Framework in NHS. 7. Koopmanschap (2002) show that the NHS has bettered provision and implementation of the NICE and NHS quality standards that have supported working in teams and provision of an integrated care through the established local delivery networks. Healthcare professionals should target those individuals that are at increased risk of getting Type 2 diabetes as part of annual health checks, systematic case finding, and Cardiovascular Disease and Risk Management Programs. Diabetes UK aims at implementing these initiatives to reduce the increasing number of individuals with complication during diagnosis, the number of individuals with undiagnosed diabetes, the effect on diabetes on NHS facilities, and the impact of people with diabetes (Levene and Donnelly 2008). The major role of the National Service Framework, NSF, for the diabetes standard is to empower patients with diabetes and lay a framework or a foundation, which helps them become the major caregivers. These frameworks recommend the use of principal interventions such as personalized care models, structured education models, accessible records or patient-held records that will help facilitate the empowerment of these individuals (Boardman and Parsonage 2009). The healthcare professionals must meet the laid down standards and help in the empowerment of diabetes patients. They must show that these standards work and they do not only dictate and instruct individuals on what is needed (Buck, Wilson,and Ham 2005). What must be done 1. The service frameworks that are provided by the NHS should be led by the needs of the locals (Egede, Nierter, and Zheng 2005). The services must be aimed at avoiding referral delay services. 2. Semb, Norman, and Flanagan (2012) affirm that specialists must provide psychological services that provide direct clinical care accompanied by psychological therapies, training, and education for the diabetes multi-disciplinary team. 3. Koopmanschap (2002) and Sinclair, Gadsby, and Penfold (2001) healthcare experts must provide psychological care for diabetes people and provide them with knowledge in the area of diabetes, and Boardman and Parsonage (2009) confirm that psychological and emotional care must be accepted as a routine component in managing diabetes. Egede, Nietert, and Zheng (2005), Alison (2007), and Levene and Donnelly (2007) affirm that supporting people with diabetes and helping them understand their condition is vital in the management of the disease. Beckett, Peters, and Fletcher (2008) emphasize that the adopted education programs, improved annual checks, improved care planning, and frequent diabetes advice are opportunities that identify the changes to treat and refer specialist services. Levene and Donnelly (2007) and Newport and Hirsch (2011) emphasize that national policies emerged due to the NSF Standard 2 for Type 2 diabetes. Levene and Donnelly (2008) affirm that the policies are designed to develop skills and confidence in managing the conditions of people with diabetes. The diabetes education and self-management for ongoing and newly diagnosed (DESMOND) provide an education framework for Type 2 diabetes. According to Buck, Wilson, and Ham (2005), achieving these goals demand real changes in the way that National Health Service provides care to people that has diabetes. The NHS urges various healthcare providers to initiate programs that screen individuals and help in identifying patients that risk contracting diabetes and help diagnose individuals and put them in early treatment and support (Beckett, Peters, and Fletcher 2008). Individuals that are at risk of getting infected with Type 2 diabetes are targeted with an aim of finding their cases, performing annual health care checks. Levene and Donnelly (2007) affirm that there are more than 100, 000 individuals that have been diagnosed with diabetes. This is to say that that for every five minutes, one individual is infected. There is the need to create and raise awareness among the population and to implement the targeted programs that will help in the identification of individuals that develop diabetes (Egede, Nietert, and Zheng 2005). The program will ensure the reduction of costly and devastating complications caused by coronary heart disease, foot disease, stroke, blindness, and renal disease (Furman 2014). The recommendations that are identified relate to the initial identification of individuals with high glucose in their blood and not diagnosis (Boardman and Parsonage 2007). Professionals and qualified healthcare personnel confirm the diagnosis of diabetes following the laid down testing procedures that are in line with WHO criteria (Buck, Wilson, and Ham 2005). Proper management will ensure that the individuals receive quality support and care. A research in 2007 conducted by NHS (Furman 2014) showed that 5000 people that have diabetes have the amputation in the United Kingdom. NHS embraces the increasing integration that exists between social and health care services. Efforts ought to be strengthened to ensure the integration between specialist and primary healthcare services are of high quality that build an individual (Boardman and Parsonage 2007). NHS highlights the crucial area that deals with the prevention, early diagnosis, pregnancy, and inpatient care (Huang, Zhang, and Gandra 2008). The Government is accountable to deliver the NSF standards, and they are also liable to challenge any agency or health sector that do not deliver services that will ensure diabetic individual receive quality healthcare. The NHS calls on the Government to carry out a national progress that reviews the implementation of the NSF standards (Grol 2012). They have to implement working programs that are accountable for the organization and service delivery for the individuals with diabetes. According to Grol (2012) and Huang, Zhang, and Gandra (2008), the United Kingdom Prospective Diabetes Study, UKPDS established that fifty percent of individuals that are diagnosed with diabetes are presented with retinopathy. The study established that the latent and long asymptomatic conditions can be detected and individuals can receive treatment before they develop complications (Grol 2012). The NHS is taking strict measures on health care givers that is not meeting the laid down standards that ensures diabetes individual receive the recommended treatment (Wild et al. 2003). The number of people getting diabetes is increasing at a very alarming rate, which puts pressure on the available resources and the specialists. Programs on retinal screening are placed to detect retinopathy and treat them as soon as they are detected (Levene and Donnelly 2007). Some programs are cancelled because they do not receive the necessary support from agencies and government (Furman 2014). Agencies and Government must conduct a thorough assessment and management of individuals with diabetes and who develop complications. Impaired glucose tolerance is linked to risk of premature cardiovascular diseases. Grol (2012) affirm that early management of impaired glucose can be used to reduced progression to diabetes (Grol 2012). Prioritization and increased awareness detailed in the policy initiatives, for example, developed General Medical Services, Pharmacy contracts, and the national diabetes framework have caused a positive impact the health sector in that professionals can detect people with diabetes (Koopmanschap 2002). The 2005 research by NHS proved that sixty percent of their localities have programs that detect individuals with diabetes (Alison 2007). Koopmanschap (2002), William and Lucioni (2002) and Alison (2007) confirm that diabetes needs to be tackled and that stakeholder must stem the rising cases of diabetes. This will help people to live longer with their condition. Alison (2007) affirms that we must overhaul our approaches to treating diabetes and care to help in the reduction in the rising cases of complications and expenses. The Government and the National Health Service must lead the way and emphasize on making tackling diabetes the top priority in health (Semb, Norman, and Flanagan 2012). The NHS must improve the way it conducts its risk assessment, manages its screening services, and create the best links between service delivery and the people. Sinclair, Gasby, and Penfold (2001) and Levene and Donnelly (2007) calls for the ending of delayed diagnosis services, the variations in provision of care countrywide, and calling for an end in the reduction of specialists services and posts, which are necessary to provision of effective and efficient management of diabetes. . Bibliography Alison, S. J 2007, Towards a minimum data set for intervention studies in type 2 diabetes in older people. J Nutr Health Aging, vol. 11, no. 6, 287-293. Beckett, N. S., Peters, R., & Fletcher, A. E 2008, The YVET Study Group. Treatment of hypertension in patients 80 years of age or older. N Engl J Med, vol. 358, no 78, 1887-1896. Boardman , J., & Parsonage , M 2009, Government policy and the National Service Framework for Mental Health: modelling and costing services in England. Advances in Psychiatric Treatment, vol. 15, no 8, 230-240. Buck, D., Wilson, T., & Ham, C 2005, Rising to the challenge: Will the NHS support people with long term conditions? BMJ 330: 657–61. BMJ , vol. 30, no. 56, 876-896. Egede , L. E., Nietert , P. J., & Zheng , D 2005, Depression and all-cause and coronary heart disease mortality among adults with and without diabetes. Diabetes Care, vol. 28, no. 81, 1338-1346. Furman, J 2014, 'The End of Diabetes: The Eat to Live Plan to Prevent and Reverse Diabetes,' New York: HarperOne. Grol, R. 2012, Preventing type 2 diabetes - risk identification and interventions for individuals at high risk (PH38). National Institute for Health Care Excellence, vol. 65, no 35, 34-89. Huang, E. S., Zhang, Q., & Gandra, N 2008, The effect of comorbid illness and functional status on the expected benefits of intensive glucose in older patients with type 2 diabetes: a decision analysis. Ann Intern Med, vol. 149, no 13, 16-44. Koopmanschap , M 2002, The CODE-2 Advisory Board. Coping with type 2 diabetes: the patient perspective. Diabetologica, vol. 43, no. 31, 18-26. Levene, S., & Donnelly, R 2007, 'Management of Type 2 Diabetes Mellitus: A Practical Guide, 2 ed.' Oxford: Butterworth-Heinemann. Michael, S., & Cousens, G 2013, 'There Is a Cure for Diabetes, Revised Edition: The 21-Day+ Holistic Recovery Program,' New York: North Atlantic Books. Newport, M., & Hirsch, C 2011, 'Alzheimer's Disease: What If There Was a Cure?' California: Basic Health Publications. Ngugi, A. S., & Lovelock, L 2003, Effectiveness of screening and preventing blindness due to diabetic retinopathy. Diabetic Medicine, vol. 20, no. 45, 185-198. Nichols , G. A., & Brown, J. B 2002, The impact of cardiovascular disease on medical care costs in subjects with and without type 2 diabetes. Diabetes Care, vol. 25, no. 32, 486-498. Petrak , F., & Herpertz, S 2009, Treatment of depression in diabetes: an update. Curr Opin Psychiatry, vol. 22, no. 13, 212-219. Pratley , R. E., & Rosenstock , J 2007, Management of type 2 diabetes in treatment-naive elderly patients: benefits and risks of vildagliptin monotherapy. Diabetes Care, vol. 30, no. 43, 3017-3025. Semb, S., Norman , J. C., & Flanagan , A. Y 2012, 'Type 2 Diabetes in Youth: A Growing Concern,' New Jersey: CME Resource. Sinclair, A. J., Gadsby, R., & Penfold, S 2001, Prevalence of diabetes in care home residents. Diabetes Care 2001, vol. 24, no. 54, 1065-1067. Wild , S., Roglic , G., Sicree , R., Green, A., & King , H 2003, 'Global burden of diabetes mellitus in the year 2000,' Geneva: WHO. William, R., & Lucioni, C 2002, Assessing the impact of complications on the costs of type II diabetes. Diabetologic, vol. 45, no. 54, 13-17. Read More