Epidemiology and Management of Type 2 Diabetes in Australia

This paper discusses the epidemiology of type 2 diabetes in Australia, including prevalence, incidence, and morbidity rates. It also explores the pathophysiology of type 2 diabetes and provides nursing interventions and management strategies for patients.

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Introduction
As per the World Health Organization (2019), diabetes is a chronic health condition in
which affected individual are unable to develop adequate insulin in their body (type 1 diabetes)
or loses the ability to utilize the insulin within their body (type 2 diabetes). Within these, as per
the International Diabetes Federation (2019), type 2 diabetes is the most common diabetes
disorder which affected more than 90% of the patients that are affected with diabetes conditions.
This paper discusses one such case study of Jenny (58), who has been diagnosed with diabetes
type 2 and in the process mentions the epidemiology of the diabetes condition in Australia.
Further, with the description of its pathophysiology, the way the blood glucose level increases
would be discussed. Finally, the management of the patients with type 2 diabetes would be
discussed.
Epidemiology of type 2 diabetes
As per the Australian Government’s Australian Institute of Health and Welfare (2016), in
the year 2014 to 2015, 1 million adult Australians (5% of the total population) was affected with
diabetes type 2. Further, more than 16,400 people were died due to the diabetes condition and
within that more than 55% of deaths were associated with type 2 diabetes. Further the Australian
Institute of Health and Welfare also registered that the deaths and complications related to type 2
diabetes were higher in the remote areas of Australia than the metropolitan conditions. As per
Zheng, Ley and Hu (2016), the reason that majority of the rural areas are found to be affected
with diabetes is due to the presence of imbalance in socio- economic aspects. It was also seen in
the statistical data provided by Australian Institute of Health and Welfare (2019) as lower socio-
economic groups in Australian community were mostly affected with diabetic conditions with

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8% of the total population, comparatively 3% of high socio- economic population. Hence,
diabetes type 2 prevalence in Australian states and territories could be identified from these
statistical analysis of the data collected from Australian governmental websites.
The onset of diabetes condition would be observed when the pancreas of human body
becomes ineffective in utilising the developed insulin for the processing of the blood sugar and
hence, developed insulin resistance. As per Zheng, Ley and Hu (2016), the age of onset of
diabetes type 2 ranges from 45 years and above however, as per Thomas, Cooper and Zimmet
(2016) the occurrence of this condition could also be observed in younger generation and
adolescents as well as children in recent times. Further, the incidence of type 2 diabetes in
Australia was equal for both men and women as the number of males and females affected with
type 2 diabetes was similar, however, age specific rates of incidence was 1.5 times higher in the
male community than the females. Further, it was also noted that more than 91% of the diabetes
treatment in which insulin therapy was provided as intervention, was associated to type 2
diabetes. Further, it was also seen through the data collected from Australian Institute of Health
and Welfare (2019) that with increasing age, people acquired impaired diabetes condition and the
rate of disease prevalence is higher in the men of the community than the females. The
prevalence of type 2 diabetes included 100,000 patients of 80 to 84 year age, twice was observed
in the 50 to 54 age group and finally more than 8 times of the population associated with type 2
diabetes belongs to the 30 to 34 years of age. Hence, as per Zheng, Ley and Hu (2016), the
morbidity and mortality rate associated with type 2 diabetes in Australia were associated with the
lack of healthy literacy and in the year 2014, more than 1.3 million diabetes type 2 affected
patients were died.

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Pathophysiology of type 2 diabetes
In the case study provided, it was seen that Jenny (58) after suffering from critical
conditions associated to blurred vision, tingling sensation in her feet and developed fatigue,
visited a general physician. She also mentioned of frequent urination and increased thirst due to
which physician assessed her blood glucose level and elevated readings were obtained. Further,
thorugh different diagnostic process, she was found to be affected with type 2 diabetes. As per
Kahn, Cooper and Del Prato (2014), the symptoms that the patient developed in the course of her
disease progression indicated towards severe diabetic condition, for which the
pathophysiological analysis should be developed. The analysis is as follows:
In the type 2 diabetic condition, the body becomes unable to utilise the developed insulin
by the beta cells of the pancreas and hence, insulin resistance could be observed that increases
the need of more insulin for the management of increasing blood glucose level. Insulin resistance
is an adverse condition, in which the insulin present in the human body is ineffective in
determining glucose management hence hypoglycaemic condition is observed (Campia, Tesauro,
Di Daniele & Cardillo, 2014). Further, it is known that insulin and glucagon are human
hormones which are secreted after identification of high blood sugar so that regulation of blood
glucose level could be achieved. It regulated the blood glucose by storing them in the adjacent
fat cells in the form of glycogen so that whenever required, those glycogen molecules could be
used as a source of energy. However, due to excessive sugar in the type 2 diabetes, insulin
becomes inactive and affects the ability of pancreas to develop more insulin. Therefore, as per
Møller et al. (2014), due to impaired functioning of insulin and associated blood glucose
responsiveness, patient affected with type 2 diabetes gradually increases their blood glucose

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level and hence, Jenny was also found to have extreme level of blood glucose, which could be
observed in her diagnostic reports.
However, besides this, there are several other factors such as the genetic factor,
environmental aspects or stress, physiological disorders and increased fat content or increased
body fat is associated with type 2 diabetes. Further as per Zaccardi, Webb, Yates and Davies
(2016) fatigue is one of the crucial symptom due to which the quality of life of patient affected
with diabetes decreases. The pathophysiology of fatigue condition indicated towards the
constantly fluctuating blood sugar level and decreased consumption of glucose of bodily
functions and presence of obesity is one of the crucial conditions, due to which patients affected
with type 2 diabetes develops mental and emotional trauma. Besides these, the patient also
included symptoms associated with polydipsia or frequent thirst and polyuria or frequent
urination. As per Kautzky-Willer, Harreiter and Pacini (2016), with increased blood sugar level,
concentration of blood sugar increases and while processing the blood if the kidney accumulates
maximum sugar and becomes unable to process it. Therefore frequent urination and excessive
thirst are few of the healthcare conditions that are observed in the provided case study of Jenny.
Further as per Yoosefinejad et al. (2014), the tingling sensation in legs and fingertips are
associated with type 2 diabetes as Zaccardi, Webb, Yates and Davies (2016) mentioned that
majority of the type 2 diabetes patients develop tingling sensation due to the damage in their
nerve endings. Further it also causes burning and pain in the arm, hands and legs. Besides this,
the patient Jenny also developed blurred vision while assessing her health condition. As per
Kahn, Cooper and Del Prato (2014), due to increased blood glucose level in the blood stream and
tissues, the water content of eye muscles and other muscles decreases and hence, tissues of the

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eye muscle becomes unable to focus properly in any object. Hence, causes temporary or partial
blurred vision of the patient.
Further, as per Campia, Tesauro, Di Daniele and Cardillo (2014), if the healthcare
conditions are not regulated and proper intervention applied for patient condition, then
permanent blindness could be observed. Hence, this is the pathophysiology of the type 2 diabetes
that could be observed or diagnosed in the care process.
Management and nursing care of patients
The management of type 2 diabetes condition should focus on lifestyle, diet, physical
activity, and healthcare pharmacological interventions as the pancreas in type 2 diabetes works
with decreased efficiency and with proper interventions restoration of its activities could be
achieved (Harding et al., 2014).
The first intervention should focus on the application of pharmacological interventions so
that the pancreas could be stimulated for production and release of more insulin could be
achieved as well as the production and release of blood sugar from liver could be prevented
(Seuring, Archangelidi & Suhrcke, 2015). In this aspect the medications such as meglitinides
that regulates and increases the release of insulin from the pancreas and the Sulfonylureas that
regulates the level of insulin in the human body could be applied (Sjöström et al., 2014). Further
as per Scheen and Van Gaal (2014), application of Dipeptidyl-peptidase 4 inhibitors in the
patient condition provided in the case study would help to reduce her severe blood glucose levels
as it prevents the release of glucose form the human body (Baumeister, Hutter & Bengel, 2014).
As per International Diabetes Federation (2019), diet and physical activity are among
crucial healthcare aspects with the help of which people with severe diabetic condition could

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reduce their high blood glucose levels and risk of hypoglycaemia and subsequent obesity. As per
Dempsey et al. (2016), patients should be provided with low carbohydrate and high fat and
protein rich diet so that her body could train itself to utilize protein and fat as the sole source of
energy and in the course, utilizes all the stored glycogen for the generation of energy. Further, it
was also observed that with increased physical activity, management and improvement in the
patient condition is observed and in case of Jenny, application of physical exercise would help
her to control her increasing blood glucose level. As per Colberg et al. (2016) with increased
physical activity, Jenny would be able to increase her energy utilization and in the process with
aerobic exercises, her mitochondrial density would increase and she would be able to increase
her insulin activity. Further, as per Li et al. (2015), physical inactivity, fatigue and decreased
muscle strength related healthcare conditions associated with type 2 diabetes would be decreased
with application of resistant training and strength training. Hence, application of different type of
exercises helps to reduce the physical inactivity and increase the patient’s ability to control the
glycemic index and the associated increased blood glucose level (Hausenblas, Schoulda &
Smoliga, 2015).
Patient education and diabetes literacy would be one of the most effective healthcare
management strategy as the interventions, that has been mentioned in the previous sections,
requires complete determination and involvement of the patient in the care process. As per
Møller et al. (2014), to implement diet and physical activity interventions, the primary aim
should be making the patient aware of the intervention ad describe its importance so that
effective treatment could be provided to the patients (Hausenblas, Schoulda & Smoliga, 2015).
Hence, this would be included in the care process of Jenny so that she could be provided with
diet and physical activity related training and education, This would help her to manage her

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healthcare condition, lower her blood glucose level and increase affinity towards application of
healthcare interventions (Balk et al., 201. Therefore, patient education would be one of the
healthcare interventions that would be applied for the nursing care and management process of
the patient Jenny or any other patient who is suffering from chronic conditions of type 2
diabetes.
These above-mentioned interventions and management strategies are important for the
implementation in healthcare condition of patients as Balk et al. (2015) mentioned several long
term complications due to elevated blood sugar level. In the study, it was mentioned due to
increased blood sugar level, severe risk of cardiovascular condition and neurological damage
could be observed (Colberg et al., 2016). Further with increased blood glucose level, patients
develop skin infections, diabetic foot ulcers and in severe cases amputation of body parts are
observed. Hence, these are the complications to overcome which patients should be provided
with effective healthcare interventions and management interventions.
Conclusion
Type 2 diabetes mellitus is one of the crucial conditions around the world, increasing
healthcare complications for the patients and increasing their mortality and morbidity rates. In
this aspect, the Australian demographics and stats of diabetes condition, its prevalence,
incidences, age and gender specific distribution and morbidity and mortality rates were
discussed. Further, in alignment of the provided case study of Jenny, this paper provided a
detailed pathophysiology of the health condition. Finally, thorugh detailed analysis of the nursing
interventions and patient management aspects, the paper provided a holistic description of type 2
diabetes and associated aspects.

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References
Australian Institute of Health and Welfare. (2019). Diabetes snapshot, Type 2 diabetes -
Australian Institute of Health and Welfare. Retrieved from
https://www.aihw.gov.au/reports/diabetes/diabetes-snapshot/contents/how-many-
australians-have-diabetes/type-2-diabetes
Balk, E. M., Earley, A., Raman, G., Avendano, E. A., Pittas, A. G., & Remington, P. L. (2015).
Combined diet and physical activity promotion programs to prevent type 2 diabetes
among persons at increased risk: a systematic review for the Community Preventive
Services Task Force. Annals of internal medicine, 163(6), 437-451. DOI: 10.7326/M15-
0452
Baumeister, H., Hutter, N., & Bengel, J. (2014). Psychological and pharmacological
interventions for depression in patients with diabetes mellitus: an abridged Cochrane
review. Diabetic Medicine, 31(7), 773-786.DOI: https://doi.org/10.1111/dme.12452
Campia, U., Tesauro, M., Di Daniele, N., & Cardillo, C. (2014). The vascular endothelin system
in obesity and type 2 diabetes: pathophysiology and therapeutic implications. Life
sciences, 118(2), 149-155. DOI: https://doi.org/10.1016/j.lfs.2014.02.028
Colberg, S. R., Sigal, R. J., Yardley, J. E., Riddell, M. C., Dunstan, D. W., Dempsey, P. C., ... &
Tate, D. F. (2016). Physical activity/exercise and diabetes: a position statement of the
American Diabetes Association. Diabetes care, 39(11), 2065-2079. DOI:
https://doi.org/10.2337/dc16-1728

10BACHELOR NURSING ASSIGNMENT
Dempsey, P. C., Larsen, R. N., Sethi, P., Sacre, J. W., Straznicky, N. E., Cohen, N. D., ... &
Dunstan, D. W. (2016). Benefits for type 2 diabetes of interrupting prolonged sitting with
brief bouts of light walking or simple resistance activities. Diabetes care, 39(6), 964-972.
DOI: https://doi.org/10.2337/dc15-2336
Harding, J. L., Shaw, J. E., Peeters, A., Guiver, T., Davidson, S., & Magliano, D. J. (2014).
Mortality trends among people with type 1 and type 2 diabetes in Australia: 1997–
2010. Diabetes Care, 37(9), 2579-2586. DOI: https://doi.org/10.2337/dc14-0096
Hausenblas, H. A., Schoulda, J. A., & Smoliga, J. M. (2015). Resveratrol treatment as an adjunct
to pharmacological management in type 2 diabetes mellitus—systematic review and
meta‐analysis. Molecular nutrition & food research, 59(1), 147-159. DOI:
https://doi.org/10.1002/mnfr.201400173
International Diabetes Federation. (2019). International Diabetes Federation - Type 2 diabetes.
Retrieved from https://www.idf.org/aboutdiabetes/what-is-diabetes/type-2-diabetes.html
Kahn, S. E., Cooper, M. E., & Del Prato, S. (2014). Pathophysiology and treatment of type 2
diabetes: perspectives on the past, present, and future. The Lancet, 383(9922), 1068-
1083.DOI: https://doi.org/10.1016/S0140-6736(13)62154-6
Kautzky-Willer, A., Harreiter, J., & Pacini, G. (2016). Sex and gender differences in risk,
pathophysiology and complications of type 2 diabetes mellitus. Endocrine reviews, 37(3),
278-316.DOI: https://doi.org/10.1210/er.2015-1137
Li, R., Qu, S., Zhang, P., Chattopadhyay, S., Gregg, E. W., Albright, A., ... & Pronk, N. P.
(2015). Economic evaluation of combined diet and physical activity promotion programs

11BACHELOR NURSING ASSIGNMENT
to prevent type 2 diabetes among persons at increased risk: a systematic review for the
Community Preventive Services Task Force. Annals of internal medicine, 163(6), 452-
460. DOI: 10.7326/M15-0469
Møller, J. B., Pedersen, M., Tanaka, H., Ohsugi, M., Overgaard, R. V., Lynge, J., ... & Ueki, K.
(2014). Body composition is the main determinant for the difference in type 2 diabetes
pathophysiology between Japanese and Caucasians. Diabetes care, 37(3), 796-804. DOI:
https://doi.org/10.2337/dc13-0598
Scheen, A. J., & Van Gaal, L. F. (2014). Combating the dual burden: therapeutic targeting of
common pathways in obesity and type 2 diabetes. The lancet Diabetes &
endocrinology, 2(11), 911-922. DOI: https://doi.org/10.1016/S2213-8587(14)70004-X
Seuring, T., Archangelidi, O., & Suhrcke, M. (2015). The economic costs of type 2 diabetes: a
global systematic review. Pharmacoeconomics, 33(8), 811-831. DOI:
https://doi.org/10.1007/s40273-015-0268-9
Sjöström, L., Peltonen, M., Jacobson, P., Ahlin, S., Andersson-Assarsson, J., Anveden, Å., ... &
Näslund, I. (2014). Association of bariatric surgery with long-term remission of type 2
diabetes and with microvascular and macrovascular complications. Jama, 311(22), 2297-
2304.
Thomas, M. C., Cooper, M. E., & Zimmet, P. (2016). Changing epidemiology of type 2 diabetes
mellitus and associated chronic kidney disease. Nature Reviews Nephrology, 12(2),
73.DOI: https://www.nature.com/articles/nrneph.2015.173

12BACHELOR NURSING ASSIGNMENT
World Health Organsation. (2019). Diabetes - World Health Organsation. Retrieved from
https://www.who.int/news-room/fact-sheets/detail/diabetes
Yoosefinejad, A. K., Shadmehr, A., Olyaei, G., Talebian, S., & Bagheri, H. (2014). Effects of
whole-body vibration on a diabetic type 2 patient with peripheral neuropathy. DOI:
http://hdl.handle.net/11400/1373
Zaccardi, F., Webb, D. R., Yates, T., & Davies, M. J. (2016). Pathophysiology of type 1 and type
2 diabetes mellitus: a 90-year perspective. Postgraduate medical journal, 92(1084), 63-
69.DOI: http://dx.doi.org/10.1136/postgradmedj-2015-133281
Zheng, Y., Ley, S. H., & Hu, F. B. (2018). Global aetiology and epidemiology of type 2 diabetes
mellitus and its complications. Nature Reviews Endocrinology, 14(2), 88.DOI:
https://www.nature.com/articles/nrendo.2017.151