Evidence-based Prevention of Type 2 Diabetes
Diabetes and Heart Failure
A man was working out in the gym where I happened to have registered, we had a conversation, and he told me he started out a few weeks ago. Looking at him, I knew he needed the exercise because he was quite overweight, I asked him why he had to wait for so long before he decided to start working out and as he was about to tell me, he fainted. He was breathing so hard and sweating profusely before he fainted, I initially thought it was because of his work out, but then I looked into his gym bag and my little suspicion was confirmed. It was filled with sugar packs and a lot of juice as well as an instrument to measure his blood sugar. My gym friend suffered from hypoglycemia. Due to his weight, he is likely to have type 2 diabetes, while we had a chat, he told me he wished his mother and his uncles had attended the gym regularly that they are suffering from diabetes and he is attending the gym so that he does not be like them. The interesting thing about my gym friend is that he is trying to reduce his weight something he takes very seriously. The purpose of this paper is to provide my patient with the right plan for maintaining his healthy lifestyle as well as manage any underlying health conditions that might arise.Evidence-based Prevention of Type 2 Diabetes
Type 2 diabetes mellitus is a global health problem and individuals with this condition are at high risk of developing microvascular complications like retinopathy, neuropathy, and nephropathy and macrovascular complications like heart failure and myocardial infarction (DeFronzo et al., 2015). Type 2 diabetes is a chronic metabolic disorder mainly associated with other disorders like central obesity, hypertension, dyslipidemia characterized by elevated levels of low-density lipoproteins (LDL) cholesterol and triglycerides, and low level of high-density lipoprotein. It is a complex condition that combines insulin resistance with impaired pancreatic beta cell function leading to relative insulin deficiency (Nicki, Brian, & Stuart, 2010). The cause of insulin resistance is not clear, but it is understood that adipose tissues release free fatty acids that may induce insulin resistance as they compete with glucose as a fuel supply for oxidation in the muscles.
About 23.4 million people in the United States are known to have diabetes mellitus. Mortality from diabetes is related to increased cardiovascular events, and diabetic patients are at risk for sudden and non-sudden cardiovascular death (Parks-Chapman & Avital, 2018). The signs and symptoms of diabetes mellitus include prolonged wound healing, polyuria, polydipsia, polyphagia, visual disturbances, headache, nocturia, and unexplained weight loss. Complications could also arise from this disease like hypoglycemia primarily due to the continuous usage of antidiabetic drugs.
Type 2 diabetes is diagnosed by obtaining the patient’s history, physical assessment, Laboratory tests, other diagnostic tests like chest X-ray, electrocardiogram, and arterial blood gases. The laboratory tests include complete blood count, fasting blood glucose level, urinalysis, glycated hemoglobin. Treatment is mainly lifestyle modification. However, pharmacological therapy is also indicated depending on the severity of the patient’s condition. Metformin is a good drug for type 2 diabetes mellitus; some statins can also be administered to reduce the cholesterol level. A patient suffering from type 2 diabetes mellitus will present physically with obesity, dry feet, peripheral vascular abnormalities associated with peripheral neuropathy. Sometimes there might be some skin conditions like acanthosis nigricans, scars due to prolonged wound healing. The participant/patient presented with hypoglycemia, obesity, currently on metformin, family history of diabetes and hypertension, previous history of diabetes, essential primary hypertension, GERD, and hyperlipidemia. These are clear indicators for risk of type 2 diabetes.Evidence-based Prevention of Type 2 Diabetes
Type 2 diabetes mellitus is a chronic disease that can physically, financially, and emotionally strain the patient and his or her family. It is a global epidemic with an estimated 387 million people suffering from this disease worldwide (Naik, Dave, Stephens, & Davies, 2015). People suffering from type 2 diabetes mellitus are at significant risk of developing cardiovascular disease. Research has shown that the onset of retinopathy occurs 4-7 years before diabetes is diagnosed (Naik, Dave, Stephens, & Davies, 2015). The amount of money spent to take care of a person with type 2 diabetes mellitus is a burden for both the patient, the family, and the country. That is why research is being carried out to identify ways to prevent or delay the onset of type 2 diabetes mellitus. Diabetes prevention is mainly recommended for individuals at high risk of developing the disease. The best evidence prevention for the adult participant is Lifestyle intervention. It is a well documented comprehensive approach to correct the risk factors of type 2 diabetes mellitus. When carrying out this practice, it is important to set targets on what we want to achieve during and after this intervention has taken place. The targets can be grouped into long term and short term.
– to prevent the complications of the disease as well as comorbidities like heart failure and other cardiovascular diseases and to stay healthy enough to take care of the family.Evidence-based Prevention of Type 2 Diabetes
The short-term goals, however, are
- to reduce the weight by at least five percent,
- to reduce the intake of fat to less than 30 percent of total energy intake,
- to prevent episodes of hypoglycemia,
- to follow her diet regimen by increasing the dietary fibers, and
- to increase the level of physical activity.
The lifestyle intervention has been found to be successful in the prevention of type 2 diabetes (Naik, Dave, Stephens, & Davies, 2015). Several studies have shown the benefits of lifestyle intervention in preventing the onset of diabetes as well as its complications. It is cost effective and can be used in any primary care setting.
Implementation
The intervention is mainly focused on lifestyle modification following the diet regimen and increasing physical activity. First, the participant would be assigned a nurse who is going to monitor her diet regime. The diet regime would involve dietary fibers of more than 15 gram per 1000 kilocalories. It would be essential to involve the whole family, the patient/participants children should be involved. For the participant to maintain a proper diet regimen, I would encourage that she makes breakfast at home and try as much as possible to maintain the calorie intake that is required. The patient/participant should avoid eating fast foods as much as possible and should also drink water instead of sugary drinks. For exercise, I would advise that the participant should take a daily walk of at least 10 minutes to achieve the short-term goal of weight loss and as time goes on, the patient can increase the walk to at least 30minutes daily. Going to the gym would also be a good idea, one can arrange with a gym instructor that would give the participant a call whenever it is time for exercise, a schedule can also be set that aligns with the patient/participants free time. Furthermore, there would be days for a special meeting with the participant to check on his or her progress. One-on-one education once a week with the participant as well as a team education involving the physician, the nurses, dietician, and trainer or gym instructor.Evidence-based Prevention of Type 2 Diabetes
In order to encourage the participant, I would recommend some healthy lifestyle videos on youtube where other participants having the same condition have gone through and seen results. I would also recommend a group where people who are maintaining a healthy lifestyle meet and discuss their challenges and progress. Twice in a month, I would check on the participant’s body mass index (BMI), her lipid profile as well as her HbA1c to know her blood sugar level. Ask the participant a few questions to know if she is happy about her new routine. If the plan is unsuccessful, I will switch to another intervention like the pharmacological interventions (Naik et al., 2015).
Type 2 diabetes mellitus is a major global health problem and one of the leading cause of morbidity and mortality in the world. It is a metabolic syndrome associated with insulin resistance. A patient can be at risk of having diabetes mellitus due to genetics, poor lifestyle, and obesity. However, obesity is the leading cause of type 2 diabetes mellitus. There are various evidence-based interventions to prevent type 2 diabetes, and one of them is lifestyle intervention. The aim of this is to prevent individuals with the prediabetic condition from having type 2 diabetes, reduce the weight of the patient as well as follow a diet regimen that would ensure that the patient maintains a low blood sugar level to prevent comorbidities as well as further complications. Health is wealth. Therefore, it is essential that individuals maintain a healthy lifestyle in order to prevent money hemorrhaging diseases like diabetes mellitus and cardiovascular diseases.Evidence-based Prevention of Type 2 Diabetes