Diabetes Type 2 Management in Adults Essay
Diabetes type 2 management in adults
1. Literature Review ( I need 2 pages)
submit the Literature Review section of your proposal. Each week you have been adding to your growing body of evidence to support your problem and proposed innovation to address the problem. The review of literature is a critical, analytical summary and synthesis of the current knowledge of your research topic. Thus it should compare and relate different theories, findings, etc., rather than just summarize them individually.Diabetes Type 2 Management in Adults Essay
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Writing the Literature Review (Part Two): Step-by-Step Tutorial for Graduate Students
Theoretical Framework 1 page
2 :Overview and Guiding Propositions(s) Described in Theory
3 :Application of Theory to Your Study’s/Project’s Focus
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Diabetes Mellitus refers to diseases characterized by high glucose concentrations in the blood caused by malfunction in insulin secretion, insulin action, or both (Mahan and Escott-Stump, 2004, page 794). In the United States, the incidence of diabetes continues to increase. According to the Centers for Disease Control and Prevention (2008), a total of 23.6 million children and adults (or about 8% of the population) have diabetes in the year 2007. In the year 2007, the estimated cost of diabetes is $174 billion (American Diabetes Association, 2008, p. 596).Diabetes Type 2 Management in Adults Essay
Generally, the two types of diabetes are type 1 (previously called insulin-dependent diabetes mellitus) and type 2 diabetes (previously called non-insulin-dependent diabetes mellitus). Type 1 diabetes occurs in 5-10% of all diagnosed cases of diabetes. It is primarily caused by the destruction of the pancreatic ß-cells, causing insulin deficiency which results in hyperglycemia, polyuria, polydipsia, weight loss, dehydration, electrolyte disturbance, and ketoacidosis. Meanwhile, type 2 diabetes is the more prevalent type (90-95%) that usually occurs to person older than 30 years, but it may still develop in any age. This type develops gradually, and usually goes undetected (Mahan and Escott-Stump, 2004, pp. 794-797).Diabetes Type 2 Management in Adults Essay
In the management of type 2 diabetes, the key is in understanding the disease condition in order to address the health-related problems that come along with it. As the disease is analyzed, interventions could be applied in order to prevent further complications and to address any change or additional requirement of the body. Studying the disease condition includes tackling the organs affected, etiology/risk factors, and the pathophysiology.
In studying diabetes, it is important to understand the role of insulin in the body. Insulin is a hormone produced in the pancreas, by the specialized ß-cells (Mathur, 2008). Insulin is responsible for helping the glucose in the blood (from the digestion of food) to enter and be used by the cells of the body. If the ß-cells fail to produce insulin or if the cells of the body are unable to efficiently use insulin (insulin resistance), an abnormal increase in blood glucose (hyperglycemia) happens.
In most cases, hyperglycemia in type 2 diabetes is caused by a combination of ß-cell failure and insulin resistance. The development of this condition is often caused by the following factors as identified by Mahan and Escott-Stump (2004): genetic factors/race, pre-diabetes, history of gestational diabetes, obesity, and increased adiposity (pp. 797-798).Diabetes Type 2 Management in Adults Essay
Researches have shown that certain race, specifically those belonging in the minority, are of high risk of developing diabetes. In addition, it is seen in populations that are products of urbanization. The possible explanation would be the related changes in diet, physical activity, and increased obesity, brought about by urbanization. Another explanation is the development of the “thrifty” gene among Native people that result in higher extraction of fat from small amounts of food, and in this time of high-fat processed food, this gene could lead to obesity and diabetes (Mahan and Escott-Stump, 2004, p. 795).
Meanwhile, pre-diabetes refers to a condition wherein the glucose level in the blood is higher than normal, but not yet high enough to be diagnosed as diabetes. This includes people who have impaired fasting glucose (IFG) and impaired glucose tolerance (IGT). This condition should be closely monitored because this could lead to type 2 diabetes, as well as heart disease and stroke (Centers for Disease Control and Prevention, 2008).Diabetes Type 2 Management in Adults Essay
Obesity and increased adiposity are the most common risk factor of type 2 diabetes. In fact, the increase in cases of type 2 diabetes is attributed to the increase prevalence of obesity (Klein et al., 2004, p.257). According to Mahan and Escott-Stump (2004), increased fatty acid leads to decrease in insulin sensitivity at the cellular levels (page 797).
Complications of diabetes develop as a result of the abnormal blood glucose levels and the defective metabolism of carbohydrates, proteins and fats. The Center for Disease Control and Prevention (2008) identified the complications of diabetes in the U.S. as the following: heart disease and stroke; high blood pressure; blindness; kidney disease; and nervous system disease; amputations; dental disease; and complications during pregnancy.Diabetes Type 2 Management in Adults Essay
The main objective in the management of diabetes mellitus is controlling the blood glucose levels and normalizing the metabolism of carbohydrates, proteins, and fats in order to prevent the occurrence of complications. For individuals with type 2 diabetes, nutritional management therapy (MNT) is used since they are not dependent on insulin for blood glucose control. The goal of MNT is to meet the nutritional requirements of diabetic individuals while maintaining their normal blood glucose. The key is in the proper planning of diet and proper selection of food items. A diabetic diet should be similar with a normal diet. The diet for the diabetic persons should not be restricting, instead in should be liberal, allowing an individual to eat what he wants, but in moderation. Also, it should be individualized and simplified to increase an individual’s acceptance of the diet (Kelly, 2003, p.859). However, the main difference would be the careful distribution of the carbohydrates within the day to prevent abnormal rise or decrease in the blood glucose levels (Mahan and Escott-Stump, 2004, pp. 801-803).Diabetes Type 2 Management in Adults Essay
Another management would be lifestyle change including exercise. For obese people, proper diet and exercise is necessary for them to reach their normal nutritional status. This is important since a normal nutritional status improves glycemic control and obesity tends to lower blood glucose control (Klein et al., 2004, p.258). Exercise also helps in maintaining normal blood glucose levels, improves in insulin sensitivity, reduce cardiovascular risk factors, and control weight (Mahan and Escott-Stump, 2004, p. 807). The exercise should be based on the person’s age, interest, level of physical activity, and control of blood glucose levels. During exercise, it should be important to monitor blood glucose before, during, and after the exercise, to prevent hyperglycemia or hypoglycemia. The exercise should also be planned with appropriate diet for more controlled blood glucose levels (Mahan and Escott-Stump, 2004, p. 809).Diabetes Type 2 Management in Adults Essay
Individuals with type 2 diabetes are not dependent to medications to control their blood glucose levels. However, oral glucose-lowering medications could be used by individuals with type 2 diabetes that have problems controlling their blood glucose levels with MNT alone. Mahan and Escott-Stump (2004) has identified four classes of oral medications (pp.809-810). First is insulin secretagoues (sulfonylureas and meglitinides) that stimulate insulin secretion from ß-cells; second is biguanides (metformin), wherein some types decrease hepatic glucose production, some increase insulin secretion, and some improve insulin sensitivity; third is thiazolidinediones (pioglitazone, rosiglitazone) that improve peripheral insulin sensitivity; fourth is alpha-glucosidase inhibitors (acarbose, miglitol) that delay carbohydrate absorption (pp.809-810). Individuals with type 2 diabetes may also require insulin use, like in cases of acute injury, infection, surgery, pregnancy, and other emergency events that require immediate normalization of blood glucose levels. Moreover, if normal levels of blood glucose cannot be maintained through MNT and oral medications, insulin could be used.Diabetes Type 2 Management in Adults Essay
The most effective management for type 2 diabetes is the combination of proper nutrition, lifestyle improvements, and proper medical administration. Furthermore, a team of health care professionals consisting of doctors, dietitians, nurses, and other health professionals should lead in promoting healthy lifestyle to manage diabetes through nutrition education and medical awareness.
Diabetes is a health condition that is developed when sugar level in the blood increases above normal levels. The two major types of diabetes are type 1 diabetes and type 2 diabetes. Type 2 diabetes is more prevalent than type 1 diabetes. This essay discusses some of the most frequently asked questions about type 2 diabetes through a sample dialogue between a patient and a doctor.Diabetes Type 2 Management in Adults Essay
Patient: What is type 2 Diabetes and how is it developed?
Doctor: Type 2 diabetes can be described as a complication in the metabolic processes characterized by a relative shortage of insulin and high levels of glucose in the blood (Barnett, 2011). It differs from type 1 diabetes where there is a complete deficiency of insulin caused by destruction of pancreatic islet cells.
In addition, type 2 diabetes is more common in adults unlike type 1 diabetes which is prevalent amongst young people. The typical symptoms of type 2 diabetes include: recurrent urination, excessive thirst, and persistent hunger (Wilson &Mehra, 1997).Diabetes Type 2 Management in Adults Essay
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Type 2 diabetes is caused by a mixture of lifestyle and hereditary factors. Even though some factors, like nutrition and obesity, are under individual control, others like femininity, old age, and genetics are not. Sedentary lifestyle, poor nutrition and stress are the major causes of Type 2 diabetes.
Particularly, excessive consumption of sugar and fats increases the risk of infection. Genetic factors have been linked to this condition. For instance, research indicates that if one identical twin is infected, there is a 90% probability of the other twin getting infected. Nutritional condition of a mother for the period of fetal growth can as well lead to this condition. Inadequate sleep is associated with Type 2 diabetes since it affects the process of metabolism (Hawley & Zierath, 2008).Diabetes Type 2 Management in Adults Essay
Patient: How is type 2 Diabetes transmitted?
Doctor: Type 2 diabetes cannot be transmitted from one individual to another, since it is not caused by micro-organisms that can be spread. Instead, it is a health condition where the body is unable to create sufficient insulin to maintain the blood sugar level.
Nevertheless, a child from diabetic parents is likely to develop the complication due to genetic inheritance. According to Hanas & Fox (2007), there are some genes that may result in diabetes. As in 2011, research showed that there are more than thirty-six genes that increase the risk of type 2 diabetes infection.Diabetes Type 2 Management in Adults Essay
These genes represent 10 per cent of the entire hereditary component of the complication. For instance, a gene referred to as TCF7L2 allele, increases the probability of diabetes occurrence by 1.5 times. It is the greatest threat amongst the genetic invariants. Children from diabetic parents are, therefore, likely to get infected since genes are transferrable from parents to the offspring.
Patient: How is type 2 Diabetes treated?
Doctor: The first step in the treatment of type 2 diabetes is consumption of healthy diet. This involves avoiding excessive consumption of foods that contain sugar and fats as they are likely to increase the levels of sugar in the blood. In addition, getting involved in physical activity and losing excessive weight are also important.Diabetes Type 2 Management in Adults Essay
These management practices are recommended because they lower insulin resistance and improve the body cells’ response to insulin. Eating healthy food and physical activity also lower the level of sugar in the blood. There are also pills and other medications that can be injected when these lifestyle changes do not regulate the blood sugar (Roper, 2006).
Type2 diabetes pills function in different ways. Some pills work by lowering insulin resistance while some raise the level of insulin in the blood or decrease the rate of food digestion. Even though the non-insulin injected medicines for this condition work in complex ways, essentially, they lower the levels of blood glucose after injection.
Insulin injection treatment basically raises the insulin level in the blood. Another treatment for type 2 diabetes is weight loss surgery that is recommended for obese people. This treatment has been proved effective since most of the patients can maintain regular levels of sugar in their blood after surgery (Codario, 2011).
Multiple prescriptions can be applied in controlling the levels of blood sugar. Actually, combination treatment is a popular remedy for Type 2 diabetes. If a single therapy is not sufficient, a health care provider may prescribe two or more different kinds of pills.Diabetes Type 2 Management in Adults Essay
For instance, individuals with type 2 diabetes have high fat levels in the blood and high blood pressure. Therefore, doctors can prescribe medicines for treatment of these conditions at the same time. The kind of medication prescribed depends on the health condition of the patient (Ganz, 2005).
Patient: What are the chances of survival?
Doctor: Diabetes is one of the major causes of deaths in the United States each year. Statistics indicates that it contributes to approximately 100,000 deaths every year. In the United States, there are over 20 million reported cases of diabetes, the majority being Type 2 diabetes. Proper remedy including change of lifestyle and medications is known to improve the health condition of a patient. If properly used together, lifestyle changes and medication can increase the chances of survival of a patient by up to 85 per cent (Rosenthal, 2009). Diabetes Type 2 Management in Adults Essay