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Diabetes Assignment Case Study Paper

Diabetes Assignment Case Study Paper

Diabetes is a condition that impairs the body’s ability to process blood glucose, otherwise known as blood sugar.

In the United States, the estimated number of people over 18 years of age with diagnosed and undiagnosed diabetes is 30.2 million. The figure represents between 27.9 and 32.7 percent of the population.Diabetes Assignment Case Study Paper

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Without ongoing, careful management, diabetes can lead to a buildup of sugars in the blood, which can increase the risk of dangerous complications, including stroke and heart disease.

Different kinds of diabetes can occur, and managing the condition depends on the type. Not all forms of diabetes stem from a person being overweight or leading an inactive lifestyle. In fact, some are present from childhood.

Type

Three major diabetes types can develop: Type 1, type 2, and gestational diabetes.Diabetes Assignment Case Study Paper

Type I diabetes: Also known as juvenile diabetes, this type occurs when the body fails to produce insulin. People with type I diabetes are insulin-dependent, which means they must take artificial insulin daily to stay alive.

Type 2 diabetes: Type 2 diabetes affects the way the body uses insulin. While the body still makes insulin, unlike in type I, the cells in the body do not respond to it as effectively as they once did. This is the most common type of diabetes, according to the National Institute of Diabetes and Digestive and Kidney Diseases, and it has strong links with obesity.Diabetes Assignment Case Study Paper

Gestational diabetes: This type occurs in women during pregnancy when the body can become less sensitive to insulin. Gestational diabetes does not occur in all women and usually resolves after giving birth.

Less common types of diabetes include monogenic diabetes and cystic fibrosis-related diabetes.

Prediabetes

Doctors refer to some people as having prediabetes or borderline diabetes when blood sugar is usually in the range of 100 to 125 milligrams per deciliter (mg/dL).

Normal blood sugar levels sit between 70 and 99 mg/dL, whereas a person with diabetes will have a fasting blood sugar higher than 126 mg/dL.Diabetes Assignment Case Study Paper

The prediabetes level means that blood glucose is higher than usual but not so high as to constitute diabetes.

People with prediabetes are, however, at risk of developing type 2 diabetes, although they do not usually experience the symptoms of full diabetes.

The risk factors for prediabetes and type 2 diabetes are similar. They include:

being overweight
a family history of diabetes
having a high-density lipoprotein (HDL) cholesterol level lower than 40 mg/dL or 50 mg/dL
a history of high blood pressure
having gestational diabetes or giving birth to a child with a birth weight of more than 9 pounds Diabetes Assignment Case Study Paper
a history of polycystic ovary syndrome (PCOS)
being of African-American, Native American, Latin American, or Asian-Pacific Islander descent
being more than 45 years of age
having a sedentary lifestyle

If a doctor identifies that a person has prediabetes, they will recommend that the individual makes healthful changes that can ideally stop the progression to type 2 diabetes. Losing weight and having a more healthful diet can often help prevent the disease.

How insulin problems develop

Doctors do not know the exact causes of type I diabetes. Type 2 diabetes, also known as insulin resistance, has clearer causes.

Insulin allows the glucose from a person’s food to access the cells in their body to supply energy. Insulin resistance is usually a result of the following cycle:

A person has genes or an environment that make it more likely that they are unable to make enough insulin to cover how much glucose they eat.Diabetes Assignment Case Study Paper
The body tries to make extra insulin to process the excess blood glucose.
The pancreas cannot keep up with the increased demands, and the excess blood sugar starts to circulate in the blood, causing damage.
Over time, insulin becomes less effective at introducing glucose to cells, and blood sugar levels continue to rise.

In the case of type 2 diabetes, insulin resistance takes place gradually. This is why doctors often recommend making lifestyle changes in an attempt to slow or reverse this cycle.

Exercise and diet tips

If a doctor diagnoses a person with type 2 diabetes, they will often recommend making lifestyle changes to support weight loss and overall health.

A doctor may refer a person with diabetes or prediabetes to a nutritionist. A specialist can help a person with diabetes lead an active, balanced lifestyle and manage the condition.Diabetes Assignment Case Study Paper

Steps a person can take to embrace a lifestyle with diabetes include:

Eating a diet high in fresh, nutritious foods, including whole grains, fruits, vegetables, lean proteins, low-fat dairy, and healthy fat sources, such as nuts.
Avoiding high-sugar foods that provide empty calories, or calories that do not have other nutritional benefits, such as sweetened sodas, fried foods, and high-sugar desserts.
Refraining from drinking excessive amounts of alcohol or keeping intake to less than one drink a day for women or two drinks a day for men.
Engaging in at least 30 minutes exercise a day on at least 5 days of the week, such as of walking, aerobics, riding a bike, or swimming.Diabetes Assignment Case Study Paper
Recognizing signs of low blood sugar when exercising, including dizziness, confusion, weakness, and profuse sweating.

People can also take steps to reduce their body mass index (BMI), which can help some people with type 2 diabetes manage the condition without medication.

Slow, steady weight loss goals are more likely to help a person retain long-term benefits.

Using insulin

People with type I diabetes and some people with type 2 diabetes may need to inject or inhale insulin to keep their blood sugar levels from becoming too high.Diabetes Assignment Case Study Paper

Various types of insulin are available, and most are grouped by how long their effect lasts. There are rapid, regular, intermediate, and long-acting insulins.

Some people will use a long-acting insulin injection to maintain consistently low blood sugar levels. Some people may use short-acting insulin or a combination of insulin types. Whatever the type, a person will usually check their blood glucose levels using a finger stick.

This method of checking blood sugar levels involves using a special, portable machine called a glucometer. A person with type I diabetes will then use the reading of their blood sugar level to determine how much insulin they need.

Self-monitoring is the only way a person can find out their blood sugar levels. Assuming the level from any physical symptoms that occur may be dangerous unless a person suspects extremely low glucose and thinks they need a rapid dose of glucose.

How much is too much?Diabetes Assignment Case Study Paper

Insulin helps people with diabetes live an active lifestyle. However, it can lead to serious side effects, especially if a person administers too much.

Excessive insulin can cause hypoglycemia, or extremely low blood sugar, and lead to nausea, sweating, and shaking.

It is essential that people measure insulin carefully and eat a consistent diet that balances blood sugar levels as much as possible.

Other medications

In addition to insulin, other types of medication are available that can help a person to manage their condition.

Metformin

For type 2 diabetes, a doctor may prescribe metformin in pill or liquid form.Diabetes Assignment Case Study Paper

It contributes to:

lowering blood sugar
making insulin more effective

It can also help in weight loss. Having a healthy weight can reduce the impact of diabetes.

As well as diabetes, a person may also have other health risks, and they may need medication to control these. A doctor will advise the individual about their needs.

SGLT2 inhibitors and GLP-1 receptor agonists

In 2018, new guidelines also recommended prescribing additional drugs for people with:

atherosclerotic cardiovascular disease
chronic kidney disease

These are sodium-glucose cotransporter 2 (SGLT2) inhibitors or glucagon-like peptide-1 (GLP-1) receptor agonists.

For those with atherosclerotic cardiovascular disease and a high risk of heart failure, the guidelines advise doctors to prescribe an SGLT2 inhibitor.Diabetes Assignment Case Study Paper

GLP-1 receptor agonists work by increasing the amount of insulin the body produces and decreasing the amount of glucose that enters the bloodstream. It is an injectable drug. People may use it with metformin or alone. Side effects include gastrointestinal problems, such as nausea and a loss of appetite.

SLGT2 inhibitors are a new type of drug for lowering blood glucose levels. They work separately from insulin, and they may be useful for people who are not ready to start using insulin. People can take it by mouth. Side effects include a higher risk of urinary and genital infections and ketoacidosis.Diabetes Assignment Case Study Paper

Self-monitoring tips

Self-monitoring blood sugar levels is vital for effective diabetes management, helping to regulate meal scheduling, physical activity, and when to take medication, including insulin.

While self-monitoring blood glucose (SMBG) machines vary, they will generally include a meter and test strip for generating readings and a lancing device to prick the skin for obtaining a small quantity of blood.Diabetes Assignment Case Study Paper

Refer to the specific instructions of a meter in every case, as machines will differ. However, the following precautions and steps will apply to many of the machines on the market:

Make sure both hands are clean and dry before touching the test strips or meter
Do not use a test strip more than once and keep them in their original canister to avoid any external moisture changing the result.
Keep canisters closed after testing.
Always check the expiration date.
Older meters might require coding prior to use. Check to see if the machine currently in use needs this.
Store the meter and strips in a dry, cool area.
Take the meter and strips into consultations, so that a primary care physician or specialist can check their effectiveness.Diabetes Assignment Case Study Paper

A person who is self-monitoring diabetes uses a device called a lancet to prick the skin. While the idea of drawing blood might cause distress for some people, the lancing of the finger to obtain a blood sample should be a gentle, simple procedure.

Take the following precautions:

Clean the area from which the sample will come with soapy, warm water to avoid food residue entering the device and distorting the reading.Diabetes Assignment Case Study Paper
Choose a small, thin lancet for maximum comfort.
The lancet should have depth settings that control the depth of the prick. Adjust this for comfort.
Many meters require only a teardrop-sized sample of blood.
Take blood from the side of the finger, as this causes less pain. Using the middle finger, ring finger, and little finger may be more comfortable
While some meters allow samples from other test sites, such as the thighs and upper arms, the fingertips or outer palms produce more accurate results.
Tease blood to the surface in a “milking” motion rather than placing pressure at the lancing site.
Dispose of lances in line with local regulations for getting rid of sharp objects.Diabetes Assignment Case Study Paper

While remembering to self-monitor involves lifestyle adjustments, it need not be an uncomfortable process.

Diabetes mellitus refers to a group of diseases that affect how your body uses blood sugar (glucose). Glucose is vital to your health because it’s an important source of energy for the cells that make up your muscles and tissues. It’s also your brain’s main source of fuel.

The underlying cause of diabetes varies by type. But, no matter what type of diabetes you have, it can lead to excess sugar in your blood. Too much sugar in your blood can lead to serious health problems.

Chronic diabetes conditions include type 1 diabetes and type 2 diabetes. Potentially reversible diabetes conditions include prediabetes — when your blood sugar levels are higher than normal, but not high enough to be classified as diabetes — and gestational diabetes, which occurs during pregnancy but may resolve after the baby is delivered.Diabetes Assignment Case Study Paper

Symptoms

Diabetes symptoms vary depending on how much your blood sugar is elevated. Some people, especially those with prediabetes or type 2 diabetes, may not experience symptoms initially. In type 1 diabetes, symptoms tend to come on quickly and be more severe.

Some of the signs and symptoms of type 1 and type 2 diabetes are:

Increased thirst
Frequent urination
Extreme hunger
Unexplained weight loss
Presence of ketones in the urine (ketones are a byproduct of the breakdown of muscle and fat that happens when there’s not enough available insulin)
Fatigue
Irritability
Blurred vision
Slow-healing sores
Frequent infections, such as gums or skin infections and vaginal infections

Type 1 diabetes can develop at any age, though it often appears during childhood or adolescence. Type 2 diabetes, the more common type, can develop at any age, though it’s more common in people older than 40.Diabetes Assignment Case Study Paper

When to see a doctor
If you suspect you or your child may have diabetes. If you notice any possible diabetes symptoms, contact your doctor. The earlier the condition is diagnosed, the sooner treatment can begin.
If you’ve already been diagnosed with diabetes. After you receive your diagnosis, you’ll need close medical follow-up until your blood sugar levels stabilize.

Causes

To understand diabetes, first you must understand how glucose is normally processed in the body.Diabetes Assignment Case Study Paper

How insulin works

Insulin is a hormone that comes from a gland situated behind and below the stomach (pancreas).

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The pancreas secretes insulin into the bloodstream.
The insulin circulates, enabling sugar to enter your cells.
Insulin lowers the amount of sugar in your bloodstream.
As your blood sugar level drops, so does the secretion of insulin from your pancreas.Diabetes Assignment Case Study Paper
The role of glucose

Glucose — a sugar — is a source of energy for the cells that make up muscles and other tissues.

Glucose comes from two major sources: food and your liver.
Sugar is absorbed into the bloodstream, where it enters cells with the help of insulin.
Your liver stores and makes glucose.
When your glucose levels are low, such as when you haven’t eaten in a while, the liver breaks down stored glycogen into glucose to keep your glucose level within a normal range.Diabetes Assignment Case Study Paper
Causes of type 1 diabetes

The exact cause of type 1 diabetes is unknown. What is known is that your immune system — which normally fights harmful bacteria or viruses — attacks and destroys your insulin-producing cells in the pancreas. This leaves you with little or no insulin. Instead of being transported into your cells, sugar builds up in your bloodstream.

Type 1 is thought to be caused by a combination of genetic susceptibility and environmental factors, though exactly what those factors are is still unclear. Weight is not believed to be a factor in type 1 diabetes.Diabetes Assignment Case Study Paper

Causes of prediabetes and type 2 diabetes

In prediabetes — which can lead to type 2 diabetes — and in type 2 diabetes, your cells become resistant to the action of insulin, and your pancreas is unable to make enough insulin to overcome this resistance. Instead of moving into your cells where it’s needed for energy, sugar builds up in your bloodstream.

Exactly why this happens is uncertain, although it’s believed that genetic and environmental factors play a role in the development of type 2 diabetes too. Being overweight is strongly linked to the development of type 2 diabetes, but not everyone with type 2 is overweight.Diabetes Assignment Case Study Paper

Causes of gestational diabetes

During pregnancy, the placenta produces hormones to sustain your pregnancy. These hormones make your cells more resistant to insulin.

Normally, your pancreas responds by producing enough extra insulin to overcome this resistance. But sometimes your pancreas can’t keep up. When this happens, too little glucose gets into your cells and too much stays in your blood, resulting in gestational diabetes.

Risk factors

Risk factors for diabetes depend on the type of diabetes.

Risk factors for type 1 diabetes

Although the exact cause of type 1 diabetes is unknown, factors that may signal an increased risk include:Diabetes Assignment Case Study Paper

Family history. Your risk increases if a parent or sibling has type 1 diabetes.
Environmental factors. Circumstances such as exposure to a viral illness likely play some role in type 1 diabetes.
The presence of damaging immune system cells (autoantibodies). Sometimes family members of people with type 1 diabetes are tested for the presence of diabetes autoantibodies. If you have these autoantibodies, you have an increased risk of developing type 1 diabetes. But not everyone who has these autoantibodies develops diabetes.
Geography. Certain countries, such as Finland and Sweden, have higher rates of type 1 diabetes.
Risk factors for prediabetes and type 2 diabetes

Researchers don’t fully understand why some people develop prediabetes and type 2 diabetes and others don’t. It’s clear that certain factors increase the risk, however, including:Diabetes Assignment Case Study Paper

Weight. The more fatty tissue you have, the more resistant your cells become to insulin.
Inactivity. The less active you are, the greater your risk. Physical activity helps you control your weight, uses up glucose as energy and makes your cells more sensitive to insulin.
Family history. Your risk increases if a parent or sibling has type 2 diabetes.
Race. Although it’s unclear why, people of certain races — including black people, Hispanics, American Indians and Asian-Americans — are at higher risk.Diabetes Assignment Case Study Paper
Age. Your risk increases as you get older. This may be because you tend to exercise less, lose muscle mass and gain weight as you age. But type 2 diabetes is also increasing among children, adolescents and younger adults.
Gestational diabetes. If you developed gestational diabetes when you were pregnant, your risk of developing prediabetes and type 2 diabetes later increases. If you gave birth to a baby weighing more than 9 pounds (4 kilograms), you’re also at risk of type 2 diabetes.
Polycystic ovary syndrome. For women, having polycystic ovary syndrome — a common condition characterized by irregular menstrual periods, excess hair growth and obesity — increases the risk of diabetes.
High blood pressure. Having blood pressure over 140/90 millimeters of mercury (mm Hg) is linked to an increased risk of type 2 diabetes.Diabetes Assignment Case Study Paper
Abnormal cholesterol and triglyceride levels. If you have low levels of high-density lipoprotein (HDL), or “good,” cholesterol, your risk of type 2 diabetes is higher. Triglycerides are another type of fat carried in the blood. People with high levels of triglycerides have an increased risk of type 2 diabetes. Your doctor can let you know what your cholesterol and triglyceride levels are.
Risk factors for gestational diabetes

Any pregnant woman can develop gestational diabetes, but some women are at greater risk than are others. Risk factors for gestational diabetes include:Diabetes Assignment Case Study Paper

Age. Women older than age 25 are at increased risk.
Family or personal history. Your risk increases if you have prediabetes — a precursor to type 2 diabetes — or if a close family member, such as a parent or sibling, has type 2 diabetes. You’re also at greater risk if you had gestational diabetes during a previous pregnancy, if you delivered a very large baby or if you had an unexplained stillbirth.
Weight. Being overweight before pregnancy increases your risk.
Race. For reasons that aren’t clear, women who are black, Hispanic, American Indian or Asian are more likely to develop gestational diabetes.

Complications

Long-term complications of diabetes develop gradually. The longer you have diabetes — and the less controlled your blood sugar — the higher the risk of complications. Eventually, diabetes complications may be disabling or even life-threatening. Possible complications include:Diabetes Assignment Case Study Paper

Cardiovascular disease. Diabetes dramatically increases the risk of various cardiovascular problems, including coronary artery disease with chest pain (angina), heart attack, stroke and narrowing of arteries (atherosclerosis). If you have diabetes, you’re more likely to have heart disease or stroke.
Nerve damage (neuropathy). Excess sugar can injure the walls of the tiny blood vessels (capillaries) that nourish your nerves, especially in your legs. This can cause tingling, numbness, burning or pain that usually begins at the tips of the toes or fingers and gradually spreads upward.

Left untreated, you could lose all sense of feeling in the affected limbs. Damage to the nerves related to digestion can cause problems with nausea, vomiting, diarrhea or constipation. For men, it may lead to erectile dysfunction.Diabetes Assignment Case Study Paper

Kidney damage (nephropathy). The kidneys contain millions of tiny blood vessel clusters (glomeruli) that filter waste from your blood. Diabetes can damage this delicate filtering system. Severe damage can lead to kidney failure or irreversible end-stage kidney disease, which may require dialysis or a kidney transplant.
Eye damage (retinopathy). Diabetes can damage the blood vessels of the retina (diabetic retinopathy), potentially leading to blindness. Diabetes also increases the risk of other serious vision conditions, such as cataracts and glaucoma.
Foot damage. Nerve damage in the feet or poor blood flow to the feet increases the risk of various foot complications. Left untreated, cuts and blisters can develop serious infections, which often heal poorly. These infections may ultimately require toe, foot or leg amputation.Diabetes Assignment Case Study Paper
Skin conditions. Diabetes may leave you more susceptible to skin problems, including bacterial and fungal infections.
Hearing impairment. Hearing problems are more common in people with diabetes.
Alzheimer’s disease. Type 2 diabetes may increase the risk of dementia, such as Alzheimer’s disease. The poorer your blood sugar control, the greater the risk appears to be. Although there are theories as to how these disorders might be connected, none has yet been proved.
Depression. Depression symptoms are common in people with type 1 and type 2 diabetes. Depression can affect diabetes management.
Complications of gestational diabetes

Most women who have gestational diabetes deliver healthy babies. However, untreated or uncontrolled blood sugar levels can cause problems for you and your baby.Diabetes Assignment Case Study Paper

Complications in your baby can occur as a result of gestational diabetes, including:

Excess growth. Extra glucose can cross the placenta, which triggers your baby’s pancreas to make extra insulin. This can cause your baby to grow too large (macrosomia). Very large babies are more likely to require a C-section birth.
Low blood sugar. Sometimes babies of mothers with gestational diabetes develop low blood sugar (hypoglycemia) shortly after birth because their own insulin production is high. Prompt feedings and sometimes an intravenous glucose solution can return the baby’s blood sugar level to normal.
Type 2 diabetes later in life. Babies of mothers who have gestational diabetes have a higher risk of developing obesity and type 2 diabetes later in life.
Death. Untreated gestational diabetes can result in a baby’s death either before or shortly after birth.Diabetes Assignment Case Study Paper

Complications in the mother also can occur as a result of gestational diabetes, including:

Preeclampsia. This condition is characterized by high blood pressure, excess protein in the urine, and swelling in the legs and feet. Preeclampsia can lead to serious or even life-threatening complications for both mother and baby.
Subsequent gestational diabetes. Once you’ve had gestational diabetes in one pregnancy, you’re more likely to have it again with the next pregnancy. You’re also more likely to develop diabetes — typically type 2 diabetes — as you get older.
Complications of prediabetes

Prediabetes may develop into type 2 diabetes.

Prevention

Type 1 diabetes can’t be prevented. However, the same healthy lifestyle choices that help treat prediabetes, type 2 diabetes and gestational diabetes can also help prevent them:Diabetes Assignment Case Study Paper

Eat healthy foods. Choose foods lower in fat and calories and higher in fiber. Focus on fruits, vegetables and whole grains. Strive for variety to prevent boredom.
Get more physical activity. Aim for 30 minutes of moderate physical activity a day. Take a brisk daily walk. Ride your bike. Swim laps. If you can’t fit in a long workout, break it up into smaller sessions spread throughout the day.
Lose excess pounds. If you’re overweight, losing even 7 percent of your body weight — for example, 14 pounds (6.4 kilograms) if you weigh 200 pounds (90.7 kilograms) — can reduce the risk of diabetes.

Don’t try to lose weight during pregnancy, however. Talk to your doctor about how much weight is healthy for you to gain during pregnancy.

To keep your weight in a healthy range, focus on permanent changes to your eating and exercise habits. Motivate yourself by remembering the benefits of losing weight, such as a healthier heart, more energy and improved self-esteem.

Sometimes medication is an option as well. Oral diabetes drugs such as metformin (Glucophage, Glumetza, others) may reduce the risk of type 2 diabetes — but healthy lifestyle choices remain essential. Have your blood sugar checked at least once a year to check that you haven’t developed type 2 diabetes.Diabetes Assignment Case Study Paper

Diabetes is a disease in which your blood glucose, or blood sugar, levels are too high. Glucose comes from the foods you eat. Insulin is a hormone that helps the glucose get into your cells to give them energy. With type 1 diabetes, your body does not make insulin. With type 2 diabetes, the more common type, your body does not make or use insulin well. Without enough insulin, the glucose stays in your blood. You can also have prediabetes. This means that your blood sugar is higher than normal but not high enough to be called diabetes. Having prediabetes puts you at a higher risk of getting type 2 diabetes.Diabetes Assignment Case Study Paper

Over time, having too much glucose in your blood can cause serious problems. It can damage your eyes, kidneys, and nerves. Diabetes can also cause heart disease, stroke and even the need to remove a limb. Pregnant women can also get diabetes, called gestational diabetes.

Blood tests can show if you have diabetes. One type of test, the A1C, can also check on how you are managing your diabetes. Exercise, weight control and sticking to your meal plan can help control your diabetes. You should also monitor your blood glucose level and take medicine if prescribed.

Understanding blood glucose level ranges can be a key part of diabetes self-management.

This page states ‘normal’ blood sugar ranges and blood sugar ranges for adults and children with type 1 diabetes, type 2 diabetes and blood sugar ranges to determine people with diabetes.

If a person with diabetes has a meter, test strips and is testing, it’s important to know what the blood glucose level means.

Recommended blood glucose levels have a degree of interpretation for every individual and you should discuss this with your healthcare team.Diabetes Assignment Case Study Paper

In addition, women may be set target blood sugar levels during pregnancy.

The following ranges are guidelines provided by the National Institute for Clinical Excellence (NICE) but each individual’s target range should be agreed by their doctor or diabetic consultant.

Diabetes is a chronic disorder in which the body does not produce or use insulin effectively. It is not curable for most people, but treatments include medication, lifestyle adjustments, and management of diabetes’ various complications.

The main aim of diabetes treatment is to return blood sugar to a safe threshold and reduce the risk of complications while helping a person with diabetes to resume daily function.

In this article, we look at the treatments for types 1 and 2 diabetes, as well as the importance of insulin.

People can manage some cases of type 2 diabetes with lifestyle adjustments, so we also examine the steps a person can take in the early stages of diabetes to reverse its progression.Diabetes Assignment Case Study Paper

Medications

The main medication for managing type 1 diabetes is insulin.

Insulin

People with type 1 diabetes must take insulin, as the pancreas of a person with type 1 does not produce the hormone. Supplementary insulin helps the cells in the body to absorb glucose and use energy.

A person with type 1 diabetes will need to receive insulin at several points throughout the day. Some doses of insulin will occur before or after a meal. With type 2 diabetes, insulin is not always necessary.

However, a doctor may recommend taking it at certain times, such as while pregnant or during an extended hospital admission.

Self-monitoring can help an individual decide when to take insulin.

Insulin has several different delivery methods. The most common methods include the following.Diabetes Assignment Case Study Paper

Insulin pump: This delivers small, continuous doses of insulin throughout the day.

Needle and syringe: An individual draws insulin fluid from a bottle and injects a shot. The most effective location is on the stomach, but a person can also administer a shot into the upper arm, the buttocks, or the thigh.

Some people need several shots to return blood glucose to an ideal level. Others might only require one shot.

Pen: Some insulin pens are disposable, while others offer space for a replaceable insulin cartridge. They are costlier than needles but easier to use and resemble a pen with a needle instead of a nib.Diabetes Assignment Case Study Paper

Less commonly, people might use the following to administer insulin:

Inhaler: Some types of insulin can be breathed in as a powder from an inhaler device. Inhaled insulin can reach the blood faster than other types. However, it is only suitable for adults who have type 1 or type 2 diabetes.

Jet injector: This method delivers a fine, high-pressure spray into the skin instead of a needle injection.

Injection port: This contains a short tube that the person who needs insulin slots just beneath the skin. They would then inject insulin into the port with a pen or needle and syringe and fit a replacement every few days. An injection port gets around having to puncture the skin every day.Diabetes Assignment Case Study Paper

Medications for type 2 diabetes

A person with type 1 diabetes will always need insulin.

However, alongside lifestyle measures, such as a balanced, low-sugar diet and regular exercise, a person with type 2 diabetes might need to manage blood sugar in other ways.

Metformin is a key medication for type 2 that people take in pill form or as a liquid. It helps reduce blood sugar and make insulin more effective, as well as assisting weight loss, which can also reduce the effects of diabetes.Diabetes Assignment Case Study Paper

Other oral medications can also help reduce blood glucose in people with type 2 diabetes, such as:

alpha-glucosidase inhibitors, such as acarbose and miglitol, which slow the breakdown of starches into glucose after a meal and slows down the increase in blood sugar levels
biguanides, including metformin, which reduce the production of glucose in the liver and make muscle tissue more sensitive to insulin to improve the absorption of glucose
bile acid sequestrants (BASs), which reduce cholesterol and blood sugar and are safe for people who also have liver problems, as they do not enter the bloodstream
DPP-4 inhibitors, such as alogliptin, linagliptin, and saxagliptin, which help improve the binding of glucose to the blood without causing low blood sugar
meglitinides, such as nateglinide and repaglinide, which stimulate the release of insulin but might cause low blood sugar
SGLT2 inhibitors, such as canagliflozin and dapagliflozin, which help block the reabsorption of glucose in the kidneys, resulting in sugars leaving the body in the urine
sulfonylureas, including glimepiride, glipizide, and chlorpropamide which stimulate the release of insulin in the pancreas
thiazolidinediones, or TZDs, such as rosiglitazone and pioglitazone, which improve the function of insulin in the fat and muscle and slow glucose production in the liver
GLP-1 agonists-including albiglutide, dulaglutide, exenatide, liraglutide, lixisenatide, and semaglutide can help with weight loss and some decrease cardiovascular events Diabetes Assignment Case Study Paper

Some medications reduce blood sugar too much and cause hypoglycemia, or low blood sugar, if a person takes them outside of mealtimes. Speak to a doctor and assess the risk of this and other side effects when receiving a prescription.

A doctor may prescribe a combination of these medications if only taking one at a time is not having the desired effect on blood glucose. Not all of these drugs interact with each other, as they impact on different functions in the body.

Certain medications require an injection, such as GLP-1 receptor agonists, which reduce the glucose output of the liver and increase insulin production.

A person must also inject amylin analog, which a doctor would prescribe for use alongside meals to slow the movement of food through the gut and control glucose levels after eating.

Less common treatments

Some newer and more experimental treatments have demonstrated a positive effect on blood glucose and diabetes.

Bariatric surgery: Also known as weight loss surgery, this may help people with obesity and type 2 diabetes regain normal blood glucose levels

Research also suggests that this type of surgery might support people with type 1 diabetes in blood glucose control.

Artificial pancreas: An artificial pancreas, known as the hybrid closed-loop system, replaces glucose monitoring and insulin injections, measuring blood sugar levels every five minutes and automatically administering appropriate doses of insulin and glucagon.Diabetes Assignment Case Study Paper

Remote monitoring by medical professionals or parents and caregivers is also possible to ensure that the system stays working.

Mealtimes still require a manual adjustment to the amount of insulin but can allow people with diabetes to sleep through the night without waking to test blood glucose or reduce glucose using medicine.

Pancreatic islet transplantation: Islets are clusters of cells that produce insulin. The immune system of a person with type 1 diabetes attacks these.

Transplantation takes islets from a donated, functional pancreas and replaces destroyed islets in a person with type 1 diabetes.

This is an experimental treatment that is only available through enrolling in research studies.

Many insurance plans do not cover weight loss treatment or experimental methods, so speak to your provider before undergoing these procedures. Results vary and often depend on whether the person with diabetes takes insulin, how long they have had diabetes, and the extent of weight loss.Diabetes Assignment Case Study Paper

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Exercise

Physical activity is vital for using up spare glucose in the body and making the muscles more sensitive to insulin.

The American Diabetes Association (ADA) recommends getting 30 minutes of moderate-to-vigorous exercise on at least 5 days of the week.

Exercise can help reverse diabetes in its early stages and prevent heart-related complications in more severe presentations.

Aerobic exercise can support weight management, reduce blood glucose, and improve insulin use in the body.

Examples include:

brisk walks or long hikes
cycling, whether outdoor or using a machine
dance
water aerobics or low-impact aerobics classes
swimming
racquet sports
climbing the stairs
rowing
gardening

Strength training is also important, as improving muscle buildup increases how much glucose the body burns while it is at rest.

Activities that can improve muscle strength include:

lifting weights, either using machines, free weights, or household objects
resistance bands
calisthenics, such as squats, push-ups, or lunges
activities that involve high exertion, such as gardening

If a doctor finds ketones in the urine, it means that the body is burning fat instead of glucose. Excess ketones can be extremely dangerous, as the body cannot handle high levels of this waste product.Diabetes Assignment Case Study Paper

Do not exercise if ketones become apparent in the urine.

Diet

A person with diabetes can still eat the foods that they enjoy, just less frequently or in smaller portions.

Follow the advice of a doctor or dietitian, eat a varied meal plan that includes foods from all groups, and stick to the recommended amounts.

Some people with diabetes should eat at the same time each day, while others have a little more flexibility when it comes to the timings of meals. Portion size is also very important in people with diabetes. Speak to a dietitian about the best way to manage this.

The following are some of the best options in each food group for people with diabetes.

Conditions which can lead to diabetes

Some conditions, including genetic syndromes and surgery, can lead to high blood glucose levels and therefore diabetes.

Examples of such conditions include:

Glucagonoma – a condition in which the body produces too much of the hormone glucagon
Chronic pancreatitis – a condition which causes inflammation of the pancreas
Cystic fibrosis – a genetic condition that causes mucus to build up in the lungs and digestive system
Pancreatectomy – surgical removal of the pancreas

Conditions linked with type 2 diabetes

There are a number of conditions that are not necessarily a direct cause but are closely linked with type 2 diabetes.

Conditions closely linked with type 2 diabetes include:

Alzheimer’s disease – as noted above, this has been referred to as type 3 diabetes by some researchers
Polycystic ovary syndrome (PCOS) – a condition which can impact on fertility in women Diabetes Assignment Case Study Paper
Cushing’s Syndrome – a condition characterised by excess production of the hormone cortisol
Pancreatic cancer – has been linked with type 2 diabetes with some debate as to which condition may influence the other

Conditions linked with type 1 diabetes

Type 1 diabetes is an autoimmune disease, meaning that the body’s immune system mistakes its own cells for invading pathogens that need to be destroyed.

People with type 1 diabetes tend to have a higher risk of having other autoimmune diseases than the rest of the population.

Other autoimmune diseases include:

Coeliac disease
Rheumatoid arthritis
Addisons disease
Autoimmune thyroid disease

Diabetes mellitus is a chronic disease caused by inherited and/or acquired deficiency in production of insulin by the pancreas, or by the ineffectiveness of the insulin produced. Such a deficiency results in increased concentrations of glucose in the blood, which in turn damage many of the body’s systems, in particular the blood vessels and nerves.Diabetes Assignment Case Study Paper

There are two principle forms of diabetes:

Type 1 diabetes (formerly known as insulin-dependent) in which the pancreas fails to produce the insulin which is essential for survival. This form develops most frequently in children and adolescents, but is being increasingly noted later in life.
Type 2 diabetes (formerly named non-insulin-dependent) which results from the body’s inability to respond properly to the action of insulin produced by the pancreas. Type 2 diabetes is much more common and accounts for around 90% of all diabetes cases worldwide. It occurs most frequently in adults, but is being noted increasingly in adolescents as well.

Certain genetic markers have been shown to increase the risk of developing Type 1 diabetes. Type 2 diabetes is strongly familial, but it is only recently that some genes have been consistently associated with increased risk for Type 2 diabetes in certain populations. Both types of diabetes are complex diseases caused by mutations in more than one gene, as well as by environmental factors.Diabetes Assignment Case Study Paper

Diabetes in pregnancy may give rise to several adverse outcomes, including congenital malformations, increased birth weight and an elevated risk of perinatal mortality. Strict metabolic control may reduce these risks to the level of those of non-diabetic expectant mothers.

Impaired glucose tolerance (IGT) and impaired fasting glycaemia (IFG) refer to levels of blood glucose concentration above the normal range, but below those which are diagnostic for diabetes. Subjects with IGT and/or IFG are at substantially higher risk of developing diabetes and cardiovascular disease than those with normal glucose tolerance. The benefits of clinical intervention in subjects with moderate glucose intolerance is a topic of much current interest.Diabetes Assignment Case Study Paper

Symptoms

The symptoms of diabetes may be pronounced, subdued, or even absent.

In Type 1 diabetes, the classic symptoms are excessive secretion of urine (polyuria), thirst (polydipsia), weight loss and tiredness.
These symptoms may be less marked in Type 2 diabetes. In this form, it can also happen that no early symptoms appear and the disease is only diagnosed several years after its onset, when complications are already present.
Prevalence
Recently compiled data show that approximately 150 million people have diabetes mellitus worldwide, and that this number may well double by the year 2025. Much of this increase will occur in developing countries and will be due to population growth, ageing, unhealthy diets, obesity and sedentary lifestyles.
By 2025, while most people with diabetes in developed countries will be aged 65 years or more, in developing countries most will be in the 45-64 year age bracket and affected in their most productive years.Diabetes Assignment Case Study Paper
Diagnosis
WHO has published recommendations on diagnostic values for blood glucose concentration. The diagnostic level of fasting blood glucose concentration was last modified in 1999.
Treatment
The mainstay of non-pharmacological diabetes treatment is diet and physical activity.
About 40% of diabetes sufferers require oral agents for satisfactory blood glucose control, and some 40% need insulin injections. This hormone was isolated by Frederic Banting and Charles Best in 1921 in Canada. It revolutionized the treatment of diabetes and prevention of its complications, transforming Type 1 diabetes from a fatal disease to one in which long-term survival became achievable.
People with Type 1 diabetes are usually totally dependent on insulin injections for survival. Such people require daily administration of insulin. The majority of people suffering from diabetes have the Type 2 form. Although they do not depend on insulin for survival, about one third of sufferers needs insulin for reducing their blood glucose levels.Diabetes Assignment Case Study Paper
Insulin is unavailable and unaffordable in many poor countries, despite being listed by WHO as an essential drug. Access to insulin by those who require it is a subject of special concern to international health agencies and national health authorities.

Complications associated with diabetes mellitus

Diabetic retinopathy is a leading cause of blindness and visual disability. Diabetes mellitus is associated with damage to the small blood vessels in the retina, resulting in loss of vision. Findings, consistent from study to study, make it possible to suggest that, after 15 years of diabetes, approximately 2% of people become blind, while about 10% develop severe visual handicap. Loss of vision due to certain types of glaucoma and cataract may also be more common in people with diabetes than in those without the disease.
Good metabolic control can delay the onset and progression of diabetic retinopathy. Loss of vision and blindness in persons with diabetes can be prevented by early detection and treatment of vision-threatening retinopathy: regular eye examinations and timely intervention with laser treatment, or through surgery in cases of advanced retinopathy. There is evidence that, even in developed countries, a large proportion of those in need is not receiving such care due to lack of public and professional awareness, as well as an absence of treatment facilities. In developing countries, in many of which diabetes is now common, such care is inaccessible to the majority of the population.Diabetes Assignment Case Study Paper
Diabetes is among the leading causes of kidney failure, but its frequency varies between populations and is also related to the severity and duration of the disease. Several measures to slow down the progress of renal damage have been identified. They include control of high blood glucose, control of high blood pressure, intervention with medication in the early stage of kidney damage, and restriction of dietary protein. Screening and early detection of diabetic kidney disease are an important means of prevention.
Heart disease accounts for approximately 50% of all deaths among people with diabetes in industrialized countries. Risk factors for heart disease in people with diabetes include smoking, high blood pressure, high serum cholesterol and obesity. Diabetes negates the protection from heart disease which pre-menopausal women without diabetes experience. Recognition and management of these conditions may delay or prevent heart disease in people with diabetes.Diabetes Assignment Case Study Paper
Diabetic neuropathy is probably the most common complication of diabetes. Studies suggest that up to 50% of people with diabetes are affected to some degree. Major risk factors of this condition are the level and duration of elevated blood glucose. Neuropathy can lead to sensory loss and damage to the limbs. It is also a major cause of impotence in diabetic men.
Diabetic foot disease, due to changes in blood vessels and nerves, often leads to ulceration and subsequent limb amputation. It is one of the most costly complications of diabetes, especially in communities with inadequate footwear. It results from both vascular and neurological disease processes. Diabetes is the most common cause of non-traumatic amputation of the lower limb, which may be prevented by regular inspection and good care of the foot.
Prevention

Large, population-based studies in China, Finland and USA have recently demonstrated the feasibility of preventing, or delaying, the onset of diabetes in overweight subjects with mild glucose intolerance (IGT). The studies suggest that even moderate reduction in weight and only half an hour of walking each day reduced the incidence of diabetes by more than one half.Diabetes Assignment Case Study Paper

Diabetes is a serious and costly disease which is becoming increasingly common, especially in developing countries and disadvantaged minorities. However, there are ways of preventing it and/or controlling its progress. Public and professional awareness of the risk factors for, and symptoms of diabetes are an important step towards its prevention and control.Diabetes Assignment Case Study Paper

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