Diabetes- Improving Health Outcome

The objective of this literature is to critically assess the condition of and communication criteria involved within multidisciplinary team for management of diabetes and its complications for patients who are at a risk of fall. According to Deakin et al (2005), Diabetes is a terminal condition such that a series of coordinated metabolic ailments result in high glucose levels in the blood. The uncontrollably high blood sugar level could be brought about by insufficient insulin secretion in the body or failure of relevant body organs and cells to recognize the insulin produced. Functionally, insulin is a hormone in the body required to regulate amount of sugar in the blood by getting attached to glucose and entering the cell. The elderly are predisposed to potential cases of both chronic and acute cardiovascular variations of the condition. In the developing countries for instance, a study reports an increase in type 2 diabetes mellitus that are mostly on an earlier offset. Therein, it is accompanied by its associated complications. In this case, a patient 82 years old John Smith (pseudo name (NMC, 2017)) was diagnosed with multiple co morbidities, poorly controlled blood pressure and type 2 diabetes mellitus. The symptoms presented that are synonymous with type 2 diabetes include fatigue, blurred vision and frequent infections and the factors that might contribute to his condition include his diet as most diabetes cases are due to poor dietary habits. The family history puts him as high-risk individual for diabetes.

Communication develops from the need to exchange information between John, his wife and the physician responsible for his health at any given moment. Communication between humans is quite complicated and notably multifaceted. There are associated skills, desired attitudes and other techniques to be comprehended for effective communication to be actualized. Interpersonal communication improves relationships with family and friends and enhance the quality of physical and emotional health of the patient (Inzucchi et al., 2012). In this respect, communication bridges interdisciplinary discussions involving bioethics, medicine and sociology among others. How John and the physician corelates is an integral element of best medicine practice and is a tool through which healthcare is dispensed.

The subject condition under review presents the need for high-end therapeutic awareness. This could be achieved by providing both practical and theoretical aspects of support to John so that his choices are always informed and are based on knowledge and other abilities. Interaction between John and the physician requires the expert to take up crucial responsibilities. They span from showing empathy, to use of creatively structured questions, to attentive listening skills, to use of and ability to pick up on non-verbal cues, clarification of important points, to effective planning and management, to maintaining silence, to establishing of a common language of communication in this case English, to assessment of John’s comprehension skills and making of informed decisions with the guidance of the patient (McGil & Felton, 2007). The quality of health John receives is abundantly reliant on the information he presents to the physician. The information helps create a diagnosis portfolio which is a function of their relationship throughout the consultation. Communication between all teams is key in the care of John and avoiding unnecessary tension which could result from miscommunication. As such, listening attentively is a crucial skill that should be mastered by all parties to realize good care.

We study the concept of multidisciplinary diabetes health care which is listed as a collective team approach to enhancing glycaemia management and healthy living by keeping complications at bay among diabetes patients (C Codispoti, 2004) and providing diabetes support, education and care. John has type 2 diabetes, hypertension, stage 4 chronic kidney disease and peripheral neuropathy. These conditions require a team of specialists to help manage John’s conditions. These patients include: General practitioner whose consultation touches on monitoring glucose levels in the blood and prescribing medication based on these assessments. The advice could be given to John, his wife or the nurse responsible him. Also involved is the endocrinologist who is specialized in the glands of the endocrine (hormone) system. A diagnosis of type 2 diabetes necessitates the attention of endocrinologist to constantly examine the endocrine system.

Credentialed diabetes educator who will help educate John and his wife on type 2 diabetes will be involved in in addressing the stages of diabetes throughout the lifespan of the patient. Dietician who provides informed dietary input to John from an expert’s viewpoint while weighing in on some factors like the lifestyle lead, prescribed medication and nutrition preference and exposure. John is in stage 4 CKD so he will be referred to a dietician because diet in an important part of treatment. John has peripheral neuropathy resulting from type 2 diabetes. Also, he will need the expertise of a podiatrist who help with management of diabetes to help avert complications related to the foot.

John will need a nurse to perform vital checks and help in administering medication. The nurse can also help educate John and his wife on aspects of managing diabetes such as foot care. The nurse reports changes on John’s condition to the doctor.

John is also responsible in helping manage his condition. The condition self-care dictates that the sick to change several aspects of his lifestyle and diet with the help of friends, family and healthcare personnel. This support helps sustain the confidence of the patient in himself thereby causing a change in his behavior as relates with his medication. Self-care include the following habits; healthy feeding habits, taking physical fitness exercise, close management of blood glucose levels, strict compliance with the medical prescription, good cognitive skills and adoption of behavior with reduced risks (Diabetes Educ 2008 May-Jun; 34(3):445-9). These self-care habits are aided by his wife who ensure the required activities are followed and provide John with love, care and support.

Insulin is the hormone that tracks and manages flow of glucose into the body cells. The type 2 diabetes could manifest in either one of the two common ways. The body could fail to recognize the functional effects of the insulin. Otherwise, the insulin produced could be used but could not be produced in enough quantity to sustain the desirable glucose balance. The associated symptoms and signs of this condition take a considerably long time to show. It could take years to detect. Symptoms include; more frequent rate of thirst, development of sores which take time to heal, sudden weight loss, and blurred vision, increased rate of urination and frequent feeling of hunger. Then, there is the blackening of skin (mostly in the neck and armpit).

Assessment of John showed that he had significant postural drop which could be associated with ageing and low blood pressure. However, this is an indication of neuropathy which is as a result of type 2 diabetes. Neurological examination revealed that John’s right lower limb and left lower limb showed grade 3 and grade 4 feebleness respectively. This shows that John has peripheral neuropathy. This condition is caused mainly by diabetes. The patient also had unsteady gait further emphasizing that he has peripheral neuropathy which is an effect of diabetes. His blood sugar level was 7.1 mmol/L which is higher than that of a healthy person. This is suggesting that diabetes could be the cause. His water low score was 18 which is very high compared to normal standards.

Assessment of John showed that he had significant postural drop which could be associated with ageing and low blood pressure. However, this is an indication of neuropathy which is as a result of type 2 diabetes. Neurological examination revealed that John’s right lower limb and left lower limb showed grade 3 and grade 4 feebleness respectively. This shows that John has peripheral neuropathy. This condition is caused mainly by diabetes. The patient also had unsteady gait further emphasizing that he has peripheral neuropathy which is an effect of diabetes. His blood sugar level was 7.1 mmol/L which is higher than that of a healthy person. This is suggesting that diabetes could be the cause. His water low score was 18 which is very high compared to normal standards.

The population of patients living with diabetes has risen drastically from 108 million to 422 million from 1980 to 2014 respectively (NCD, 2016). This translates into an increase from pervasiveness of about 4.7% to 8.5% from 1980 to 2014 respectively among those who have attained the age of majority. This pervasiveness is rising steadily in low and middle-income states. Diabetes caused about 1.6 million deaths in the year 2016. In 2012, the number stood at about 2.2 million. Statistically, John is at a higher risk of being diabetic due to his old age. Shrewd management can help reduce risk of exposure and they include; the members of a special dedicated healthcare team can guide John to gain insight into the fundamentals of diabetes care. However, the greater responsibility of the condition lies solely with John and his wife. Others include choosing healthy eating habits and taking part in physical therapy of exercise according to the advice of the expert. They have to keep a strict and healthy check on their weight. They need to ensure constant consultations with the doctor and comply with his advice.

John’s blood vessels are vulnerable to high blood pressure and diabetes attacks. It is therefore important that he keeps his cholesterol intake in check. High cholesterol causes damage by possibly constricting the blood vessels further aggravating the effects of high blood pressure. The resultant effect is a stroke, a heart attack or other related complications. The remedy revolves around frequent medical check-ups including but not limited to prescribed diabetes check-ups .It is important to ensure patient’s vaccines are administered promptly. Diabetes invites opportunistic diseases which can be prevented by vaccination. Vaccines pneumonia inoculation. John should master his stress whenever it affects him and know how to stick to his diabetes care. He should know his limits and try not to have a lot of expectations in life. He could find a way of integrating additional sleep into his regiment and always seek emotional and psychological support from the family.

John’s blood vessels are vulnerable to high blood pressure and diabetes attacks. It is therefore important that he keeps his cholesterol intake in check. High cholesterol causes damage by possibly constricting the blood vessels further aggravating the effects of high blood pressure. The resultant effect is a stroke, a heart attack or other related complications. The remedy revolves around frequent medical check-ups including but not limited to prescribed diabetes check-ups .It is important to ensure patient’s vaccines are administered promptly. Diabetes invites opportunistic diseases which can be prevented by vaccination. Vaccines pneumonia inoculation. John should master his stress whenever it affects him and know how to stick to his diabetes care. He should know his limits and try not to have a lot of expectations in life. He could find a way of integrating additional sleep into his regiment and always seek emotional and psychological support from the family.

Diabetes leads to psychological effects. Diabetes causes feelings of depression, anxiety and anger. These feelings have an impact in John’s overall quality of life. Depression might worsen the condition of John and lead to further complications. Diabetes can lead to death. This can occur if John fails to follow all the prescribed precautions keenly or he doesn’t realize the severity of his condition till it is very late.

Physiotherapy can be useful for John as it can help him achieve a healthy weight. Physiotherapy can help him avoid fatigue by getting him in the habit of exercising regularly. Some of John’s medication can be adjusted to help him cope with the condition much better. For instance, amlodipine could be replaced by nocte. Introduction of vitamin D tablets help John’s body absorb calcium and phosphorus and this helps in improving his posture and fatigue reduction. This helps with regular exercise to keep fit.

Finally, the patient could get examination from a podiatrist to educate him on any problems associated with the feet. The podiatrist can help him manage his peripheral neuropathy.

Conclusion

Diabetes is a major health threat disease that affects a large population of people such as John Smith. It affects both gender and all the different age groups. It occurs as a result of insulin secretion disorder. However, it can be managed with special treatment and care, disciplined self-care undertaking in nutrition, medication and relevant physiotherapy among the patients. Early discovery is key and helps with quality healthcare and a better promise of quality life. Failure to manage diabetes effectively can lead to complications most of which have been addressed above. Diabetes is easily managed with proper care and medication.

References:

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