Type II Diabetes: Health Inequalities and Nursing Role

This report discusses the health inequalities related to Type II Diabetes in the UK and the role of nurses in promoting self-care management. It explores the prevalence of diabetes, public health interventions, and the responsibilities of nursing teams. Recommendations are provided to improve awareness and participation in diabetes management programs.

2 Type Diabetes

Table of Contents
ABSTRACT....................................................................................................................................1
INTRODUCTION...........................................................................................................................1
MAIN BODY...................................................................................................................................2
CONCLUSION...............................................................................................................................4
REFERENCES..............................................................................................................................6

ABSTRACT
Increasing Diabetes patient especially of type II, has become one of the concerning
health issue in front of Health-care Departments of UK and entire world. It mainly
causes due to excessive weight of an individual, family history and poor lifestyles. This
would arise threat for long-term life-expectancy due to severe complications like heart
attack, stroke and more. Therefore, prevention of Type 2 diabetes and promoting self-
care management becomes a key area for health promoters, where more work needs to
be done in order to meet the standards. For this purpose, a number of educational
programs like Diabetes self-management education programmes has been run in UK,
that includes the pattern describes in the National Service Framework model. This
strategy has moved up the agenda for reducing diabetic patients rate, by setting the
targeted interventions to reduce the Type 2 diabetes in future and its threat on
individuals, their families and the NHS. For execution of such educational and
prevention programs, nursing team which includes a group of medical professionals and
nurses, contributes the major role, to provide guidance and care of diabetic patients. But
still due to less participation of people, in England and other areas of UK, expected
result of running such programs are not still obtained. So, it is recommended to NHS
and other organisations that deal in same sector, to work as multi-disciplinary team, with
a comprehensive and effective care plan, to deliver expected result.
INTRODUCTION
Public health defines as the art of promoting health and protecting wellbeing of
people, by preventing them from illness. Through the efforts of health organisation and
efforts of society, it becomes possible to prevent people from prolonged disease.
Hereby, health equality refers to a key element of social justice, where collaboration of
government, society and health agencies organisation help in developing health policies
(Rawshani and et. al., 2018). This would improve the health of public regardless of
ethnicity, social class, income and gender, by promoting healthier lifestyles. There are
two types of diabetes predominantly seen that are type 1 and type 2 diabetes. Type 1
occurs when body of an individual does not produce any insulin. While type 2 diabetes
1

disease is caused when enough insulin which is required to function properly, does not
produce. Therefore, under such case, cells do not react with insulin and causes a
number of health problems (Dendup, Feng, Clingan and Astell-Burt, 2018). It includes
stroke, heart disease, kidney failure, blindness and more, that reduces the long term life
expectancy as well.
The present report is going to make a report on health inequalities, that still exist in
UK, due to poor lifestyle of people. The topic hereby, chosen is Type II Diabetes,
because this has become a focal point within health care systems in worldwide manner,
due to high prevalence as well as severity of secondary complications. To understand
this topic about how such a prolonged disease can be managed, role of nurses and
perspective of patients both are taken. Under this assignment, discussion over public
health issue i.e. prevalence of diabetes type 2 (mellitus) is done, by exploring data
about health inequalities both at national and local manner. Along with this, frameworks
of public health intervention which give guidance to medical professionals for standards
of care is also being critically analysed. Furthermore, critical evaluation is done on roles
and responsibilities of nurses in promoting health and diabetes management.
MAIN BODY
Today, near about 90% people are suffering diabetes, that creates complications
and reduces the life expectancy up to 10 years. There are currently 4.7 million people
are facing problems related to diabetes in UK, where most cases are identified with
Type 2 disease (4.7 million people in the UK have diabetes, 2019). As per statistical
figure, one in ten over age 40, are now living with this disease. Hereby, rapid increase in
obesity rates consider as one of the main driver of arising this health issue, in all over
the world (Wimalawansa, 2018). In context with UK, three in every five adults are
overweight or suffering from obese, where excessive weight is the single most risk
factor that developing the Type 2 diabetes. Another factors that contribute to this risk
from one individual to other includes family history, ethnicity and age (Garber and et. al.,
2017). So, in majority of these cases, type 2 diabetes is generally treated with changes
in poor or unhealthy lifestyle, like healthy eating, weight loss if overweight and doing
physical exercise more. The symptoms that shows the early signs of Diabetes 2,
includes going to the toilet again and again, feeling more thirsty and tired than usual
2

(Perkovic and et. al., 2019). Along with this, losing weight without any cause,
complications with kidneys, eyes, feet and nerves also show early symptoms of
diabetes of Type 2.
Type 2 Diabetes defines as a metabolic disorder which results in increase in glucose
level in blood, that is also known as Hyperglcemia (Rawshani and et. al., 2017). This
disease causes a serious medical condition for a person, that requires insulin or anti-
diabetic medication, for keeping the level of blood sugar in the body under control
(Bjerregaard and et. al., 2018). However, it has evaluated that development of type 2
diabetes as well as its complications can be also prevented if it is early detected so that
timely treatment can be provided. As per estimation, potential threat of type 2 diabetes
may increase from 4.7 million to over 5.5 million by 2025 (Trikkalinou, Papazafiropoulou
and Melidonis, 2017). So, this problem considers as one of the biggest challenge in
front of Public Health Education of England, that forces to undertake serious actions for
creating awareness among people about this disease. For this purpose, Diabetes self-
management education programmes (DSME) as public interventions have been
developed in UK, for educating and empowering the patients how to control of own
conditions (Seferović and et. al., 2018). It includes Expert Patent Program or X-PERT,
Diabetes Education and Self-Management to diagnose symptoms of Diabetes and
more. These programmes provide guidelines for self-management, reducing the high
risk of complications and to cope from both physical and mental conditions of diabetes
(Neal and et. al., 2017). Along with this, such programmes are developed appropriately
by considering age of all groups i.e. below 40 and adults of above 40. This type of
public interventions helps NHS and other health agencies to provide necessary
information to their patients (Akash, Rehman and Liaqat, 2018). This would enable them
in managing their own diabetes care and share problems with others. With the help of
professionals, people can prepare diet chart, weight lost in case of overweight, blood
glucose control and more, that proves in effective diabetes care. However, this program
proves as a cornerstone in promoting the well-being (Weickert and Pfeiffer, 2018). But
as per, Healthcare commission, it has been found that at local level, people in England
are not much aware about potential threat of obesity and other factors that causes
Diabetes type 2. Programs that facilitate effective self-management and control of
3

diabetes are not run properly (Jaganathan, Ravindran and Dhanasekaran, 2018). Along
with this, to promote self-management, National Service Framework for diabetes has
been established in 2013, in UK (Huntriss, Campbell and Bedwell, 2018). It has set out
a vision for NHS and other health organisations in diabetes management, by developing
good policies and intervention plans for providing best treatment and care to such
affected patients.
To provide proper care in diabetes management, nurses and health professionals
play the main role in promoting self-care (Hu and et. al., 2018). Nursing teams are likely
to come directly into contact with patients that are having any symptoms of through
screening, maintaining as well as supporting people to deal with same. The main roles
and responsibilities of nursing team includes urine monitoring, early detection of disease
type 2 diabetes, blood glucose monitoring, oral and injective therapies, identifying and
providing treatment of hyperglycaemia etc. They also provide support and help to
patients in developing their self-care and personalised care plans (Zhang and et. al.,
2018). Nurses are also helped in bringing awareness among people about how to cope
from mental health issues when they are affected by diabetes, like depression and
anxiety. Therefore, role of Diabetes Specialist Nurses (DSNs) in hospitals are crucial in
providing and promoting good patient care (Larsson and et. al., 2018).
CONCLUSION
It has been concluded from this entire report that growing rates of diabetes patients
especially of Type II, arise the biggest challenge for NHS and Public Health England, in
terms of maintaining life quality and enhancing life expectancy of people. Many health
inequalities are existed within society, due to heavy weight or obesity and improper
intake of foods. However, many frameworks and policies have been developed in UK to
promote self-care management of diabetes, where nurses contribute main role in
helping people to control sugar level in body and cope up with other complications of
diabetes. But still, less participation of people arises difficulties in front of NHS to
promote diabetes management. For this purpose, it is recommended to health care
organisations to provide proper training to medical or nursing team first, about in-depth
knowledge of diabetes. This would help them in providing good support to people
having chronic disease, to manage and prevent from same. Along with this, by
4

collaborative working as a multi-disciplinary team, would encourage people to increase
their participation in awareness programs.
5

REFERENCES
Books and Journals
Akash, M. S. H., Rehman, K. and Liaqat, A., 2018. Tumor necrosis factor‐alpha: role in
development of insulin resistance and pathogenesis of type 2 diabetes
mellitus. Journal of cellular biochemistry. 119(1). pp.105-110.
Bjerregaard, L. G., Jensen, B. W., Ängquist, L., Osler, M., Sørensen, T. I. and Baker, J.
L., 2018. Change in overweight from childhood to early adulthood and risk of
type 2 diabetes. New England Journal of Medicine. 378(14). pp.1302-1312.
Dendup, T., Feng, X., Clingan, S. and Astell-Burt, T., 2018. Environmental risk factors
for developing type 2 diabetes mellitus: a systematic review. International
journal of environmental research and public health. 15(1). p.78.
Garber, A. J., Abrahamson, M. J., Barzilay, J. I., Blonde, L., Bloomgarden, Z. T., Bush,
M. A., Dagogo-Jack, S., DeFronzo, R. A., Einhorn, D., Fonseca, V. A. and
Garber, J. R., 2017. Consensus statement by the American Association of
Clinical Endocrinologists and American College of Endocrinology on the
comprehensive type 2 diabetes management algorithm–2017 executive
summary. Endocrine Practice. 23(2). pp.207-238.
Hu, Y., Zong, G., Liu, G., Wang, M., Rosner, B., Pan, A., Willett, W. C., Manson, J. E.,
Hu, F. B. and Sun, Q., 2018. Smoking cessation, weight change, type 2
diabetes, and mortality. New England Journal of Medicine. 379(7). pp.623-632.
Huntriss, R., Campbell, M. and Bedwell, C., 2018. The interpretation and effect of a low-
carbohydrate diet in the management of type 2 diabetes: a systematic review
and meta-analysis of randomised controlled trials. European journal of clinical
nutrition. 72(3). pp.311-325.
Jaganathan, R., Ravindran, R. and Dhanasekaran, S., 2018. Emerging role of
adipocytokines in type 2 diabetes as mediators of insulin resistance and
cardiovascular disease. Canadian journal of diabetes. 42(4). pp.446-456.
Larsson, S. C., Wallin, A., Håkansson, N., Stackelberg, O., Bäck, M. and Wolk, A.,
2018. Type 1 and type 2 diabetes mellitus and incidence of seven
cardiovascular diseases. International journal of cardiology. 262. pp.66-70.
Neal, B., Perkovic, V., Mahaffey, K. W., De Zeeuw, D., Fulcher, G., Erondu, N., Shaw,
W., Law, G., Desai, M. and Matthews, D. R., 2017. Canagliflozin and
cardiovascular and renal events in type 2 diabetes. New England Journal of
Medicine. 377(7). pp.644-657.
Perkovic, V., Jardine, M. J., Neal, B., Bompoint, S., Heerspink, H. J., Charytan, D. M.,
Edwards, R., Agarwal, R., Bakris, G., Bull, S. and Cannon, C. P., 2019.
Canagliflozin and renal outcomes in type 2 diabetes and nephropathy. New
England Journal of Medicine. 380(24). pp.2295-2306.
Rawshani, A., Rawshani, A., Franzén, S., Eliasson, B., Svensson, A. M., Miftaraj, M.,
McGuire, D. K., Sattar, N., Rosengren, A. and Gudbjörnsdottir, S., 2017.
Mortality and cardiovascular disease in type 1 and type 2 diabetes. New
England Journal of Medicine. 376(15). pp.1407-1418.
Rawshani, A., Rawshani, A., Franzén, S., Sattar, N., Eliasson, B., Svensson, A. M.,
Zethelius, B., Miftaraj, M., McGuire, D. K., Rosengren, A. and Gudbjörnsdottir,
6

S., 2018. Risk factors, mortality, and cardiovascular outcomes in patients with
type 2 diabetes. New England Journal of Medicine. 379(7). pp.633-644.
Seferović, P. M., Petrie, M. C., Filippatos, G. S., Anker, S. D., Rosano, G., Bauersachs,
J., Paulus, W. J., Komajda, M., Cosentino, F., De Boer, R. A. and Farmakis, D.,
2018. Type 2 diabetes mellitus and heart failure: a position statement from the
Heart Failure Association of the European Society of Cardiology. European
journal of heart failure. 20(5). pp.853-872.
Trikkalinou, A., Papazafiropoulou, A. K. and Melidonis, A., 2017. Type 2 diabetes and
quality of life. World journal of diabetes. 8(4). p.120.
Weickert, M.O. and Pfeiffer, A. F., 2018. Impact of dietary fiber consumption on insulin
resistance and the prevention of type 2 diabetes. The Journal of nutrition.
148(1). pp.7-12.
Wimalawansa, S. J., 2018. Associations of vitamin D with insulin resistance, obesity,
type 2 diabetes, and metabolic syndrome. The Journal of Steroid Biochemistry
and Molecular Biology. 175. pp.177-189.
Zhang, X. L., Zhu, Q. Q., Chen, Y. H., Li, X. L., Chen, F., Huang, J. A. and Xu, B., 2018.
Cardiovascular safety, long‐term noncardiovascular safety, and efficacy of
sodium–glucose cotransporter 2 inhibitors in patients with type 2 diabetes
mellitus: a systemic review and meta‐analysis with trial sequential
analysis. Journal of the American Heart Association. 7(2). p.e007165.
Online
4.7 million people in the UK have diabetes. 2019. [Online] Available Through:<
https://www.alad-americalatina.org/number-of-people-with-diabetes-reaches-4-
7-million/>.
7