Management of Type 2 Diabetes Mellitus Essay

Management of Type 2 Diabetes Mellitus Essay

Management of Type 2 Diabetes Mellitus Essay

This report will begin by describing what type 2 diabetes is and how it differs from type 1 diabetes. A short discussion on how it is diagnosed will be given. General non-pharmacological and pharmacological interventions to effectively manage type 2 diabetes will be discussed from a nursing perspective. This means that the roles of nurses in caring for patients with type 2 diabetes will be provided.Management of Type 2 Diabetes Mellitus Essay

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What is Type 2 Diabetes?

The National Institute for Health and Care Excellence (NICE) (2017) describes type 2 diabetes as a chronic metabolic condition characterised by insulin resistance. This is in contrast to type 1 diabetes which according to Diabetes.co.uk (2018) is an autoimmune disease where the person’s immune system attacks the beta cells in the pancreas which produce insulin. Insulin resistance means that the body is unable to efficiently use insulin and that there is inadequate production of insulin in the body which leads to high blood glucose level termed as hyperglycaemia (NICE 2017). Overtime, this can lead to complications. Common long term complications of type 2 diabetes include retinopathy, cardiovascular disease, nephropathy and neuropathy (Diabetes UK, 2017).Management of Type 2 Diabetes Mellitus Essay

How is it Diagnosed?

It is vital to highlight that the nursing management of type 2 diabetes must first begin with an actual diagnosis wherein a person is found to have type 2 diabetes. Common symptoms of type 2 diabetes include polydipsia (excessive thirst), polyuria (frequent urination), polyphagia (increased hunger), extreme tiredness and sudden loss of muscle mass (Diabetes.co.uk, 2018). So if a person experiences any of these symptoms, the best initiatory action is to advise the patient to seek medical help such as by setting an appointment with a GP. The GP will order a urine and blood test to check the level of the person’s blood glucose (National Health Service 2017).Management of Type 2 Diabetes Mellitus Essay

Nursing Interventions

Once type 2 diabetes has been confirmed, specific care interventions will be provided depending on the patient’s needs. This is consistent with NICE (2017) stating that the management of type 2 diabetes must be individualised. This implies providing care interventions that is tailored specific to the needs and circumstances of the patient and takes into consideration their personal concerns and preferences, comorbidities and risk from polypharmacy. Part of the individualised care should also include any disabilities which the person may have such as visual impairment (NICE 2017). The National Health Service supports this approach by stating under its Constitution that NHS services must be reflective of and should be coordinated and tailored according to the needs and preferences of patients and their families (Department of Health & Social Care 2015). From a nursing perspective, the Nursing and Midwifery Council (2015) declares under its Code the need for nurses to listen to and respond to the concerns and preferences of their patients. This is important because it will allow the nurses to identify and prioritise the type 2 diabetes-related needs of the patient and therefore provide specifically tailored and appropriate care interventions. In essence, this highlights the application of the patient or person-centred care in the nursing management of type 2 diabetes.Management of Type 2 Diabetes Mellitus Essay

The Royal College of Nursing (2018) supports this by declaring under its Principles of Nursing Practice that nurses must promote and provide care that puts the patients, their carers and families at the centre, helping them make informed decisions about their own care and treatment. A study by Williams et al., (2016) identified the patient-centred care approach as a potentially important factor in the positive self-care of people with type 2 diabetes.

One important role of nurses in helping patients with type 2 diabetes manage their conditions is to provide them with appropriate health education. NICE (2017) states that it is important to offer people with type 2 diabetes structured patient education at the time of their diagnosis with annual reinforcement and review. The NMC (2015) also supports this role by declaring that nurses must act in partnership with their patients to help the latter access relevant health and social care, information and support they require. Nurses must share with the patients, their carers and families, the information they want and need to know about their own health, care and on-going treatment in a manner that they can easily understand (NMC 2015).Management of Type 2 Diabetes Mellitus Essay

An important point that must be highlighted in this aspect of type 2 diabetes nursing management is the need for the nurse to deliver health education in an easy to understand manner. For instance, the nurse must avoid using medical terminologies and if this cannot be avoided, to use easy to comprehend analogies to ensure that patients understand the information given to them. This is important because according to Ali (2017) medical jargon is one common barrier to effective nurse-patient communication so it is imperative for nurses to avoid ambiguity and to use appropriate vocabulary and easy-to-relate analogies when explaining information. It can be argued that the compliance of a type 2 diabetic patient to the information provided to them will depend largely on whether the patient has in fact understood the information and has realised its significance in the effective management of their condition. A nurse’s role in delivering relevant health education may come in varied forms. It may be that the patient directly consulted with a diabetes specialist nurse or seek clarification from a registered nurse working in the GP clinic or hospital where the patient was diagnosed for type 2 diabetes or during follow up consultation.Management of Type 2 Diabetes Mellitus Essay

One important component of the health education for type 2 diabetes is lifestyle modification such as increased physical exercise. A study by Colberg et al., (2010) identified physical exercise as important in preventing the onset of type 2 diabetes as well as in its effective management to prevent complications. Another important component is dietary changes. NICE (2017) recommends providing dietary advice that is sensitive to the personal needs, cultural values and beliefs of the person. This is significant to ensure compliance of the person to the recommended dietary advice. Specific dietary advice includes high fibre diet, low glycaemic index sources of carbohydrates (e.g. fruits and vegetables, whole grains and pulses), low- fat dairy products and oily fish (NICE 2017). Food labelled suitable for diabetics should not be recommended (The British Dietetic Association 2018). In order to ensure correct dietary advice, it may be necessary to refer the patient with type 2 diabetes to other healthcare professional for proper advice such as a dietitian. NICE (2017) recommends that the individualised dietary advice should come from a healthcare professional with specific expertise and competence in nutrition. This implies that the role of a nurse in this aspect is to make appropriate referrals.Management of Type 2 Diabetes Mellitus Essay

Another crucial component of the nursing management of type 2 diabetes is on blood glucose management such as the time intervals in measuring HbA1c. It is a blood test that measures the amount of glucose present in the haemoglobin and provides an overview of the level of blood glucose in the last 2 to 3 months (Whettem 2012). The common target for HbA1c is between 6.5 to 7.5% (Whettem 2012). NICE (2017) recommends a 3 to 6 month interval depending on the needs of the patient. It is also vital to identify when self-monitoring of blood glucose should be done. NICE (2017) recommends that self-monitoring of blood glucose is generally not advisable unless the patient is taking insulin, there is evidence of hypoglycaemic episodes, is pregnant or planning to become pregnant or is “on oral medication that may increase risk of hypoglycaemia while driving or operating machinery”.Management of Type 2 Diabetes Mellitus Essay

The initial drug treatment for type 2 diabetes requiring medication is standard-release metformin (NICE 2017). Significant emphasis on the strict compliance to the prescribed medication along with the non-pharmacological interventions should be given to maximise the patient’s self-management of their condition. A study by Asante (2013) identified individualised self-management education, cue-dose training and use of adherence aids can help improve type 2 diabetes patients’ adherence to their treatment regimen ultimately resulting in and therefore prevent complications brought about by hyperglycaemia.

Conclusion

The nursing management of type 2 diabetes must be individualistic; hence, it must be tailored according to the specifically assessed needs of the patient. The patient’s care management should take into consideration the person’s own preferences and circumstances in keeping with the concept of patient-centred care. General nursing interventions include appropriate health education. This should be delivered in the simplest way possible to ensure full understanding of the information provided to the patient. The content of which should include lifestyle modification advice particularly on the increase of physical exercise and dietary changes as non-pharmacological means to manage blood glucose level. Referral to appropriate personnel may be necessary to give the best advice and information to the person with type 2 diabetes. Facilitating improved adherence to the treatment regimen such as the intake of metformin is also important to prevent complications.Management of Type 2 Diabetes Mellitus Essay

Type 2 diabetes is the most frequent form of the disease. Diabetes mellitus is where the body cells cannot use glucose properly for insufficient or level of resistance to the hormone insulin, which is produced by the pancreas. Diabetes can lead to serious complications over time if left untreated. The high blood sugar levels from uncontrolled diabetes can cause serious long-term diabetic problems. Eventually, they damage the insulin-producing beta skin cells of the pancreas, lowering insulin outcome.

Type 2 diabetes is also known as the non-insulin reliant diabetes which is the mostly found kind of diabetes on the globe. Type 2 diabetes is a lifelong chronic disease where there are high levels of sugars in the bloodstream. Diabetes is the effect of a problem in the manner your system makes or uses insulin. Insulin is needed to move blood sugar into cells, where it is stored and later used for energy. Patients suffering from type 2 diabetes usually do not respond effectively to insulin and their excess fat, liver organ, and muscle skin cells do not react properly to insulin either, which is called insulin resistance. Because of this, blood sugar is not able to enter these skin cells to be stored for energy. And when sugar cannot enter in the skin cells, high degrees of sugar build-up in the blood vessels. This is called hyperglycemia. Hyperglycemia is the specialized term for high blood sugar (sugar). High blood sugar happens when your body has too little insulin or when the body can’t use insulin properly.Management of Type 2 Diabetes Mellitus Essay

Type 2 diabetes usually occurs slowly and gradually over time and many people who have type 2 diabetes haven’t any symptoms initially or it may even take years. Some early symptoms of diabetes may include; bladder, kidney, skin, or other infections those that will be more consistent or heal little by little. You may experience some fatigue, cravings for food, and increased of thirst. Other important symptoms like increased urination, blurred vision, erectile dysfunction, and pain or numbness in the feet or hands. A hormone produced by the pancreas called insulin helps sugar in our bloodstream enter the skin cells of our bodies.

There are several exams that you can do in order to verify the medical diagnosis of type 2 diabetes. The physician can order a fasting plasma glucose test or informal plasma blood sugar. The fasting plasma sugar test (FPG) is the preferred method for diagnosing diabetes, since it is not hard to do, convenient, and less expensive than other tests, based on the American Diabetes Association. Before taking the blood sugar test, you won’t be allowed to eat anything for at least eight hours. They can also use the dental glucose tolerance test, for this test you have to fast over night, and the fasting blood sugar level is measured. You then have to drink a sugary liquid, and blood sugar levels are tested routinely for another several hours.Management of Type 2 Diabetes Mellitus Essay

Routine screening process for type 2 diabetes is normally recommended at this 45, particularly if you are chubby. If the email address details are normal then you should duplicate the test every 3 years. If the email address details are borderline, your physician will tell you when you should get back to retest. Screening process is also suggested for individuals under 45 and overweight particularly if you have cardiovascular disease or a family background of type 2 diabetes, or blood circulation pressure above 135/80.Management of Type 2 Diabetes Mellitus Essay

There is not any remedy for diabetes but it can be controlled, but it does require a lifelong dedication to blood sugar monitoring, healthy eating, regular physical exercise, possibly, diabetes medication or insulin therapy. The main goal of treatment is to first lower high blood sugar levels and the long-term goal of treatment is to avoid problems from diabetes. The main treatment for type 2 diabetes is to diet and exercise. Type 2 diabetes can essentially be controlled by carrying out a few steps; As long as you test and record your blood sugar, know when to eat and when to consume, how to have your medications if any are needed, and exactly how to recognize and treat low and high blood sugar levels. Normally it takes several months to get the hang of the basic skills but as the rest it’ll become second nature.Management of Type 2 Diabetes Mellitus Essay

There are several types of medication that can be prescribed by your doctor if exercise and diet does not keep the glucose levels at normal or near normal levels. A number of the drugs recommended help decrease your blood sugar in various ways, so therefore your physician may perhaps you have take more than one drug. Some of the most typical types of medication are the following: Alpha-glucose inhibitors (such as acarbose), Biguanides (Metformin), Injectable medicines (including exenatide, mitiglinide, pramlintide, sitagliptin, and saxagliptin) Meglitinides (including repaglinide and nateglinide), sulfonylureas (like glimepiride, glyburide, and tolazamide), and Thiazolidinediones (such as rosiglitazone and pioglitazone). Rosiglitazone may increase the risk of heart problems, so before you take this particular medication ensure that you discuss any possibilities of heart disease with your physician. These drugs may be given with insulin, or can be utilized alone. You might need insulin if you continue to have poor blood sugar control. It must be injected under the skin using a syringe or insulin pen device. Insulin cannot be taken orally. Women who have type 2 diabetes and be pregnant may be turned to insulin during their pregnancy even though breast-feeding since it is as yet not known whether hyperglycemia medications considered by mouth are safe for use of pregnancy.Management of Type 2 Diabetes Mellitus Essay

Although long-term problems of diabetes develop steadily, they can eventually be disabling or even life-threatening. Diabetes can result in much more serious problems after a long time. You can form attention problems, including trouble experiencing especially during the night, and light level of sensitivity, and you can even become blind. Your feet and skin can develop sores and microbe infections. After a long time your ft. or leg might need to be removed. Diabetes also helps it be harder to regulate your blood pressure and cholesterol. This can lead to a heart attack, stroke, and other problems. It makes it harder for the bloodstream to stream to your thighs and feet. The nerves within you can get damaged and distress, tingling, and loss of feeling. And because of nerve damage you could have problems digesting the meals you eat. You could feel weakness or have trouble heading to the bathroom. Nerve damage can also make it harder for men with an erection. High blood sugar levels and other problems can result in kidney harm. Your kidneys might not are well and they may even stop working. To be able to prevent problems from diabetes, you should visit your health care provider or diabetes educator at least four times per year and discuss any problems you are experiencing.Management of Type 2 Diabetes Mellitus Essay

You should always absorb the symptoms of Type-2. If you have a dry oral cavity, increased hunger, blurred vision, headaches, tiredness, and unexplained weight loss, then you have the most common symptoms. Usually do not ignore any of these symptoms and get medical assistance as soon as possible. Type 2 diabetes can be easy to dismiss, especially in the early stages if you are sensing fine. But diabetes influences many major organs, together with your heart, blood vessels, nerves, eyes and kidneys. Managing your blood sugar can help prevent these complications. Good management of your type 2 diabetes includes making use of your medicines exactly as your physician prescribes them, making smart food alternatives, and being bodily active. Always remember one thing “your system is your temple” and we should understand how to look after it and treat the body right so the body can be good to us in return.Management of Type 2 Diabetes Mellitus Essay

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