Diabetes Mellitus Case Study

Diabetes Mellitus is a modern day pandemic. There are nearly 3.5 million people who have been diagnosed with diabetes in the United Kingdom (DIABETES UK, 2016). There are two main types of diabetes that are a public health concern, type one and type two. Public health includes organised public or private measures put in place to prevent disease, promote health and prolong life in a population (WHO, 2016). Type 1 is an autoimmune disease where people have absolute insulin deficiency and this most commonly affects children and young adults, but can also occur in older adults, this is called latent autoimmune diabetes. In Type 1, the immune system targets the Beta cells in the islets of Langerhans within the Pancreas, insulin therefore cannot

Symptoms include: polyurea, polydypsia, fatigue, unexplained weight loss, thrush, slow healing of wounds and blurred vision (NHS Choices, 2016). There is a major link between obesity (BMI > 30) and increased age and therefore is mostly prevalent in older people (40 years and over) (Dunning, 2014). However, it should be noted that there is an increasing prevalence of type 2 diabetes in the younger population, especially in the UK (Dunning, 2014). Type 2 is usually treated with lifestyle changes, such as increasing physical activity, adopting a healthier diet, prescribed medication (for example – Metformin), or eventually insulin injections. If current trends continue, one in three people will be obese by 2034 and one in ten will develop type 2 diabetes (Diabetes UK, 2015). However, it is well known that diabetes can be prevented by making healthy lifestyle choices (Hicks, 2016). Nurses play a huge role in the prevention, treatment and after-care of diabetes, with a large focus on health promotion. They educate patients and their families about diabetes and treatments, and help them to understand why lifestyle modifications are needed. Also they provide support during this

As Type 2 diabetes imposes a huge burden on the public’s health, structured lifestyle programmes that include reducing daily calorie intake, increased physical activity, helping patients to lose weight and understand their medications can be used by nurses and other healthcare professionals to help control this public health issue (Green, Brancati and Albright, 2012). Effective management is vital in reducing morbidity in relation to diabetes and therefore primary prevention is a strategy used in order to do this (Green, Brancati and Albright, 2012). Randomised control trials (RCTs) have consistently shown that lifestyle modifications, such as caloric reduction and increased physical activity, lead to patients losing weight modestly and thus reduces the risk of Type 2 diabetes in adults, who are at high risk by 50-70% (Klein et al., 2004). In addition to the lifestyle changes that are needed in primary prevention, secondary prevention is where the diabetic complications are prevented by optimising glycaemic control and the treatment or prevention of co-existing risk factors (Dornhorst and Merrin, 1994). Tertiary prevention is the early detection and treatment of diabetic complications. This includes screening for diabetic retinopathy, nephropathy, cardiovascular and peripheral vascular disease (Dornhorst and Merrin, 1994). Important