Diabetes: Causes, Symptoms, Management And Care

Gail is a 49-year-old Aboriginal woman. Gail spent her first 14 years at La Perouse Mission Church where many young Aboriginals girls were housed, she was isolated from her family and was not allowed to practice any cultural traditions. When she turned 14 she was placed in a “white folks” household where she worked for 4 years as the house maid. At age 18 she was able to leave her employment and worked most of her life in the kitchen of a small golfing club on the nearby coastline. Gail had 3 children to her husband who she met while working at the golf club.

Provide a response for the following questions based on the case scenario 1 (Q 1 – 6)

1. List what needs to be holistically assessed for a person with a history of diabetes.

Diabetes is a chronic health problem. Around 37.3% adults suffer from diabetes around the world (Calliari et al., 2020). Condition of diabetes is caused when the human body could not use the insulin hormone properly, which leads to hyperglycemia. As diabetes is not associated with proper symptoms, individuals sometimes cannot understand signs and symptoms. Such signs and symptoms are frequent and normal such as an increase in the urine output, increased hunger, vision issues, weight loss and not the healing of wounds. The management of diabetes is a multifunctional approach which is controlling of the risk factors such as obesity, high blood pressure, smoking and dyslipidemia in compliance with the patient’s psychological, social, spiritual well-being. As per evidence-based nursing, management of diabetes can be done by lifestyle modifications which include physical activities, yoga intervention and nutritional therapies and medication management, which include intake of medication and external insulin if required. In order to provide patient-centred care, self-monitoring practices can also be implied.  Due to the critical case of diabetes, holistic care is very much essential with well-defined goals. The tests are the indicators to understand if the individuals have diabetes or not. These include tests such as Glycated Hemoglobin (A1C) tests and fasting glucose tests (Park & Pastakia, 2018).

2. What situations during a holistic assessment might be ideal for providing patients with further information?

A holistic assessment is conducted solemnly on the basic physical health status (Aravossis et al., 2019). Gail seemed very confused during admission, which is one of the side effects of diabetes. Gail needs to be provided with patient-centred care in compliance with a holistic approach.

3. What should you do if you identify a known diabetic in a drowsy unarousable state?

It is very much essential to call for medical help or an ambulance and make sure that the patient is admitted to the hospital safely (Brady et al., 2022).

4. When would you need to modify the client’s care plan?

The care plan is modified based on improvement in patients (Dooley et al., 2022). After the continuous assessment, if the patients do not show any form of improvement, then modification in the care plan becomes an integral part.

5. What is the purpose of documenting any client uptake of services or health promotions?

Health promotion activities are defined as the method of taking control over own health (Magnavita, 2018). These activities are difficult to document. However, such is done to understand the factors directly linked with the health outcome of the patients. The aim of such documentation is to broaden the existing information of the patients.  Management And Care For Diabetes Essay Paper

6. Discuss blood and urine tests associated with diabetes by completing the following table.

Different Types Of Tests Associated With Diabetes

You are an EN who has been employed in the role of Diabetic educator in a local medical service that provides primary health care and supports the three surrounding Aboriginal and Torres Strait Islander communities of the North Coast of NSW.

In your role you are responsible for assessment and monitoring; educating diabetic clients on the importance of self-management of diabetes; informing and liaising with diabetes care services and follow-up with multidisciplinary team.

The need for a specific diabetic educator in the medical service was due to the increasing number of recorded diagnosed diabetics requiring health care. As part of your specialised training in Diabetes you are aware of the following:

· In 2012–13, around one in twelve (8.2%) Aboriginal and Torres Strait Islander people had diabetes mellitus and/or high sugar levels in their blood or urine.

· Aboriginal and Torres Strait Islander rates for diabetes/high sugar levels were between three and five times as high as the comparable rates for non-Indigenous people in all age groups from 25 years and over.

· Based on age standardised proportions, Aboriginal and Torres Strait Islander people were three times as likely as non-Indigenous people to have diabetes/high sugar levels (rate ratio of 3.3)

· Modifiable risk factors including diet, exercise, waist girth and smoking require culturally-appropriate educational interventions placed within a Medicare or otherwise public-funded avenue in order to be accessible to all Australian Aboriginal diabetic patients. The management of diabetes involves prevention or delay of complications, as well as detection and treatment of complications as they arise, thus necessitating a multi-disciplinary team approach to life-long patient care.

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Provide a response for the following questions based on the case scenario 2 (Q 7 -12)

7. what are the underlying environmental and social factors contributing to diabetes in the Australian general population and specifically higher rates of diabetes experienced by Aboriginal and/or Torres Strait Islander people?

8. Provide a brief summary of diabetes care services in the Australian health care environment and sources of available funding for diabetes related services and specific resources for Aboriginal and Torres Strait Islander people with diabetes. (Min 100 words)

In Australia, there are several services available in order to take care of diabetic aboriginal and Torres Strait Islander people. The Medicare benefits schedule (MBS) provides subsidiaries for the care of the patients (Beks et al., 2021). The national diabetes services scheme (NDSS) provides services to the person diagnosed with diabetes. Aboriginal community-controlled health organizations (ACCHOs) also help the patients suffering from diabetes.  Management And Care For Diabetes Essay Paper

9. Where would diabetic educators research current, relevant and accurate information on evidenced-based best practice for diabetes care?

The research educators can find relevant education details in the online databases, which are as follows: PubMed, google scholar and CIHNAL libraries. Government websites such as the world health organization website and centres of disease prevention can be used to take relevant statics about diabetes and its control measure

10. Why is it important to provide and explain complex information about diabetes to clients, carers and family members relating to self-management and check their understanding?

It is important to provide proper and complex information to the clients for self-management of diabetes. The self-management of diabetes is extremely essential in order to keep track of activities and healthy habitats (Villalobos et al., 2020). The individuals need to adhere to the seven self-care behaviours, which are consuming healthy foods, which include fruits and vegetables, monitoring the blood sugar level, indulging in several physical activities, glycemic control, mitigating the substance consumption level and conducting activities with good problem-solving skills.

11. Part of your role in the management of people with diabetes is to liaise with specialists and referring agencies. List the type of specialist you might seek a referral for and how you would liaise with these referring agencies.

The Role Of An EN In Diabetes Education

The roles of specialists in managing diabetes:

1. The physicians- The physicians help the person with diabetes by conducting daily check-ups and recommending tests which later would be analyzed and refer medications according to the medication.
2. The pharmacist- The pharmacist will help the individual with the recommended medication from the physicians.
3. The registered diet- They would help the individual with person-centred diets.
4. The registered nurses- They would check on the condition of the patients on a daily basis and also guide the patients for self-management of diabetes (Nikitara et al., 2010).

12. In your role of diabetic educator what should you teach clients in relation to self-management?

The diabetes educators help the patients to control and manage their diabetes status (Kumar et al., 2018). They receive special training and education regarding the management of diabetes. I would teach the individual the benefit of medications and help to manage the side effects of the medications. I would encourage the individuals about the benefit of adopting healthy habits and as well as explain about the benefit of proper meal planning. I would help them to develop good skills in the management of stressful situations. Overall, I would explain to them how to self-manage diabetes.

References

Aravossis, K. G., Kapsalis, V. C., Kyriakopoulos, G. L., & Xouleis, T. G. (2019). Development of a Holistic Assessment Framework for Industrial Organizations. Sustainability, 11(14), 3946. https://doi.org/10.3390/su11143946

Beks, H., Versace, V. L., Zwolak, R., & Chatfield, T. (2021). Opportunities for further changes to the Medicare Benefits Schedule to support Aboriginal Community Controlled Health Organisations. Australian Health Review. https://doi.org/10.1071/AH21234

Bonger, Z., Shiferaw, S., & Tariku, E. Z. (2018). Adherence to diabetic self-care practices and its associated factors among patients with type 2 diabetes in Addis Ababa, Ethiopia. Patient preference and adherence, 12, 963–970. https://doi.org/10.2147/PPA.S156043

Brady, V., Whisenant, M., Wang, X., Ly, V. K., Zhu, G., Aguilar, D., & Wu, H. (2022). Characterization of Symptoms and Symptom Clusters for Type 2 Diabetes Using a Large Nationwide Electronic Health Record Database. Diabetes Spectrum. https://doi.org/10.2337/ds21-0064

Calliari, L. E. P., Krakauer, M., Vianna, A. G. D., Ram, Y., Barbieri, D. E., Xu, Y., & Dunn, T. C. (2020). Real-world flash glucose monitoring in Brazil: can sensors make a difference in diabetes management in developing countries?. Diabetology & Metabolic Syndrome, 12(1), 1-7. https://doi.org/10.1186/s13098-019-0513-z

Casadei, G., Filippini, M., & Brognara, L. (2021). Glycated Hemoglobin (HbA1c) as a Biomarker for Diabetic Foot Peripheral Neuropathy. Diseases, 9(1), 16. https://doi.org/10.3390/diseases9010016

Coccia, F., Testa, M., Guarisco, G., Di Cristofano, C., Silecchia, G., Leonetti, F., … & Capoccia, D. (2020). Insulin resistance, but not insulin response, during oral glucose tolerance test (OGTT) is associated to worse histological outcome in obese NAFLD. Nutrition, metabolism and cardiovascular diseases, 30(1), 106-113. https://doi.org/10.1016/j.numecd.2019.08.001

Dooley, M. J., Simpson, K. N., Simpson, A. N., Nietert, P. J., Williams, J. D., King, K., & McElligott, J. T. (2022). A Modification of Time-Driven Activity-Based Costing for Comparing Cost of Telehealth and In-Person Visits. Telemedicine and e-Health. https://doi.org/10.1089/tmj.2021.0338

Evans, J., Canuto, K., Kelly, R., Caperchione, C., & Macniven, R. (2021). Physical activity interventions to prevent and manage type 2 diabetes among Aboriginal and Torres Strait Islander peoples: a systematic review protocol. JBI evidence synthesis, 19(1), 177-183. doi: 10.11124/JBIES-20-00060

Kumar, S., Moseson, H., Uppal, J., & Juusola, J. L. (2018). A diabetes mobile app with in-app coaching from a certified diabetes educator reduces A1C for individuals with type 2 diabetes. The Diabetes Educator, 44(3), 226-236. https://doi.org/10.1177%2F0145721718765650

Li, Y., Teng, D., Shi, X., Qin, G., Qin, Y., Quan, H., … & Shan, Z. (2020). Prevalence of diabetes recorded in mainland China using 2018 diagnostic criteria from the American Diabetes Association: national cross sectional study. Bmj, 369. https://doi.org/10.1136/bmj.m997

Magnavita, N. (2018). Obstacles and Future Prospects: Considerations on Health Promotion Activities for Older Workers in Europe. International Journal of Environmental Research and Public Health, 15(6), 1096.  Management And Care For Diabetes Essay Paper