Understanding Diabetes and its Prevention

This assignment focuses on various aspects of diabetes, including its causes, types, and preventative measures. It examines gestational diabetes and its prevalence trends, explores the role of HbA1c in diagnosis, and discusses the importance of early treatment for type 2 diabetes. The document also highlights community-based diabetes programs and environmental factors potentially contributing to type 1 diabetes.

Running head: CHRONIC CONDITIONS PREVENTION AND MANAGEMENT 1
Diabetes
Author
[Institution]
Author Note

CHRONIC CONDITIONS PREVENTION AND MANAGEMENT 2
Abstract
Diabetes Mellitus is among the chronic diseases in Florida which are affecting millions of people
in the world. The worst thing is that some individuals can acquire diabetes genetically.
However, studies have proven that a lot of individuals can now avoid receiving diabetes. This
one can happen through education and lifestyle modifications. This paper strives to discuss a
framework commonly applied for the prevention or management of diabetes. The paper will also
look at the conditions, signs, and symptoms of diabetes. With the same, it will also critically
review the implementation of the available management plans such as care plan.
Keywords: Hyperglycemia, Nurse Practitioners, prevention, Hemoglobin, Insulin, Diabetes

CHRONIC CONDITIONS PREVENTION AND MANAGEMENT 3
Diabetes
Diabetes is likely to be the worst epidemic in human history. In the past, people used to
underestimate it as a global public health issue, but now the world can no longer ignore it. With
the general issues of diabetes, diabetes mellitus is the chronic condition that affects the endocrine
system. The primary characteristic of this disease is the presence of high levels of glucose within
the blood stream which occurs due to either low level of insulin or resistance (Bagchi &
Sreejayan, 2012). Insulin is a type of a hormone that is produced by the pancreas, and this
hormone enters the bloodstream through specialized cells called beta cells to the (Bagchi &
Sreejayan, 2012). There are three different types of diabetes.
One of them is diabetes type 1 which results from total lack of insulin. This diabetes is
discoverable at childhood or during adolescent years. The study of (Rønningen, 2015) revealed
that this diabetes has an autoimmune disorder that destroys the beta cells of the pancreas.
Nevertheless, the work also showed that a proper administration of insulin could stop this
destruction.
The other type of diabetes known as diabetes type 2. According to
(Psychoneuroimmunology, 2011), type 2 diabetes, is associated with low levels of insulin and
obesity. The victim's body produces low or no insulin which doesn't completely work on
lowering glucose level in the blood stream. The study work also explains that genetic factors can
play a part in carrying diabetes type 2 to the offspring. In most cases, this research found that
individuals whose parents had type two diabetes had three times chance of developing the same.
Lastly, there is gestational diabetes. This one happens when the body doesn't use insulin
efficiently. The study report by (American Diabetes Association, 2015) explains that gestational
diabetes occurs in women during pregnancy times. Further, the study reveals that gestational

CHRONIC CONDITIONS PREVENTION AND MANAGEMENT 4
diabetes does not rely on either previous diabetic history or genes. Besides, women who get
gestational diabetes have higher chances of developing diabetes type 2. On the other hand, their
babies may end up becoming obese when they grow up.
Diabetes Statistical Data in Florida
This paper will primarily rely on diabetes statistical data the state of Florida. Diabetes
remains to be a severe health problem in the state of Florida. For instance, looking at
Hillsborough County, their total population in 2013 counted to 1.292 million citizens. According
to (CDC, 2013), in in Hillsborough County, there were 99,443 people that tested positive
diabetes disease in 2013. By the look of the data between the year 2016, the deaths resulting
from diabetes and its related complications counted to 302 individuals out of 100,000 people
(Florida Department of Health, 2017). In particular, between 2012 and 2014, the data showed
that about 34,405 people out of per 100,000 were hospitalized suffering from either diabetes or
its related complications. That was the study of (Florida Department of Health, 2017).
In the same gap of between 2012 and 2014, the study reported diabetes amputation
statistics counting to an estimate of 346 out of 100,000 individuals. Another point to note is that
despite adequate education to the public, there is a notable overall upwards trend as people
transition from pre-diabetes into diabetes. The study observed that the primary cause of this
development is mainly overweight issues, genetics, and noncompliance with exercise and a
healthy diet plan. This study of (Florida Department of Health, 2017) recommended that
Floridians must make necessary lifestyle changes.

CHRONIC CONDITIONS PREVENTION AND MANAGEMENT 5
Social and Culture Effects on Diabetes
Chronic diseases are closely linked to aspects of life like social and cultural backgrounds
in the society. For example, some people believe that patients with type 2 diabetes have
problems like high levels of stress which that affect even the way the deal with their friends.
Such disease hypotheses cause these people to change their personalities, even to the extent of
altering their self-identity. The work of (Watve, 2013) states that some hypothesis can even force
patients to live in solitude.
On the other hand, there are also some cultural beliefs with hypotheses that influence the
strategies laid out for the disease management. That is, different cultures have different beliefs
concerning certain diabetes symptoms, causation, treatment and other outcomes. For instance, in
a country like Florida where there are different groups of people, Hispanic cultural belief would
be different from African-American beliefs. For instance, Indian-American people in Florida
may still hold their perception that diabetes results from unconscionable eating of sweets (Gulati,
& Misra, 2014). There are also other communities who believe that eating bitter herbs and
vegetables can help in reducing blood sugar. All these hypotheses that may affect the disease
management either positively or negatively. Following this, some studies suggest that there is a
great need to understand the patient's cultural beliefs and find out whether such beliefs conflict
with biomedical science.
Diabetes Descriptive Epidemiologic Breakdown
As discussed above, problems within the endocrine system are the primary causes of
diabetes. In particular, the body either develops a resistance to insulin or it doesn't effectively use
insulin. According to (American Diabetes Association, 2014), there are estimated costs of above

CHRONIC CONDITIONS PREVENTION AND MANAGEMENT 6
245 billion dollars that American people spent in the year 2012 on diagnosing diabetes.
However, the study found that these costs rise due to other complications associated with
diabetes. The research revealed that people with diabetes are also likely to experience other
conditions like heart disease, kidney disease/failure, stroke, vision loss, amputations, in addition
to deaths.
In the mentioned estimates, (American Diabetes Association, 2014) found that about 1.4
million people start diabetes diagnosis every year. Looking at the age of the victims, the CDC
found that the most affected people in America are adults within 20 years old or older. The CDC
data between 2010 and 2012 that between that out of the total population in America, 15.9
percent of the diabetic people were American Indians and 13.2 percent were African Americans.
On the side Hispanians, 12.8 of them had diabetes. Asians were 9 percent, and 7.6 percent were
Caucasians (CDC, 2014). In general, diabetes has already become as a major epidemic in the
world.
Signs and Symptoms of Diabetes
There are numerous characteristics associated with diabetes. For diabetes type 1, notable
signs are polyuria, polydipsia or abnormally increased thirst, and polyphagia or abnormal
excessive hunger or increased appetite (Silbert-Flagg, Sloand & Millonig, 2011). These
symptoms are the also called the Three P's, and they are the main signs of diabetes type 1. Other
signs are bedwetting in children who never had a history of wetting their beds at night, blurred
vision, irritability, weight loss, mood swings and fatigue.
Type 2 diabetes has almost similar signs and symptoms to the diabetes type 1. The only
difference is that in type 2, these symptoms appear slowly making them almost unnoticeable
(Salvo, 2009). Nonetheless, even though diabetes type 2 is the most prevalent, there are

CHRONIC CONDITIONS PREVENTION AND MANAGEMENT 7
sometimes when it shows no symptoms at all. This characteristic complicates the situations
making it hard to diagnose. In (Pratley, 2013), the study explains that type 2 diabetes take years
to diagnose due to those periods that it shows no symptoms. However, the study clarifies that the
asymptomatic nature of type 2 diabetes leaves practitioners with only one option which is to treat
it through opportunistic testing. Last is gestational diabetes. For this kind of diabetes, the patient
has to undertake prenatal screenings as the only diagnostic procedure (Lavery, Friedman, Keyes,
Wright & Ananth, 2016). However, in (Farrar, 2016) since this condition attacks pregnant
women, these people develop hyperglycemia caused by placental hormone secretion caused due
to insulin resistance.
Screening and Diagnosis
There are various methods of screening patients for diabetes. One of these methods is
Glycosylated hemoglobin. This test is commonly known as hemoglobin A1c or HbA1c
(Florkowski, 2013). Regarding diabetes screening and diagnosis, this one is the most
recommended test to all the practitioners. According to (Higgins, 2012), this test checks for the
persisting levels of blood sugar in patients that have diabetes and it evaluates the patient’s
chances of complexities.
HbA1c test uses the concept of testing the blood glucose which is readily taken up by red
blood cells and then reacts with hemoglobin. According to (Makris & Spanou, 2011) when sugar
couples with hemoglobin, they react to form glycated hemoglobin. With this, the term
Hemoglobin A1c (HbA1c) refers to one of the glycated hemoglobin clinical tests analysis in the
diagnosis and management of diabetes through a quantitative analysis called HbA1c or A1c test.
The HbA1c analysis provides an index level of glucose integrated over extended periods of time
(2–3 months). From this test, the levels of HbA1c obtained in a single specimen presents

CHRONIC CONDITIONS PREVENTION AND MANAGEMENT 8
diagnostic data among diabetic patients (Makris & Spanou,2011). This test shows the level of
both past and current glycemic control which practitioners use to estimate the chances of future
complications (Florkowski, 2013).
The second screening method is the oral glucose tolerance test (OGTT). This one
establishes the abnormal level of glucose fasting (Hage, Lundman, Rydén, & Mellbin, 2013). In
healthy people, it's the function of the pancreatic juice to keep a check on the glucose level to
keep it within a stable concentration. In this connection, if the insulin action fails, either through
lack of secretion or a malfunction, that will lead to a raised level of glucose in the bloodstream.
Therefore, such an individual would require a diagnosis aimed at keeping the insulin functioning.
The use of the OGTT is to define borderline levels in fasting plasma glucose. However, HbA1c
is preferred over OGTT due to its simplicity, accuracy, and no need to fasting.
Action Plan Against Diabetes
It is of paramount that nurses and other medical practitioners to develop an action plan
for diabetes. In particular, nurse practitioners should create plans for actions. For this, they may
consider taking a primary, secondary, or a tertiary care involvement. When it comes to primary
actions, the provider can make a plan like educating the society on primary prevention (Green,
Brancati & Albright, 2012). These are methods aimed at preventing the disease entirely. To
accomplish this, providers can conduct forums to teach people how to avoid unsafe behaviors
that can facilitate the development of diabetes. Some of the precautions are like advocating for
balanced diet, minimizing stress and exercises.
Secondary prevention methods are those procedures that aim at discovering the disease at
its early stages. This plan of action would be almost similar to that of primary prevention, but
this one will focus on enlightening the society on the ways the methods they can use to discover

CHRONIC CONDITIONS PREVENTION AND MANAGEMENT 9
the disease before its signs and symptoms are apparent (Philis-Tsimikas & Gallo, 2014).
Notably, the goal is to stop the disease from progressing to severe complications. Therefore, the
primary focus of secondary prevention methods would be to work with the patient in monitoring
the blood sugar, the diet, and the exercise plan. In addition to all that, the provider would also
help the patient with the medical procedures.
Tertiary prevention comes where there are simple signs or even notable deterioration. In
this, tertiary plans will be aiming at stopping further deterioration. On top of that, patient
engagement will be a necessity in addition to coming up with a care plan. Where a care plan
already existed, the provider may consider changing it (Turner & Hurley, 2015). Also, nutritional
guidance to the patient would be essential in this state plus exercise program. In this regard,
setting up or suggesting a care group is another approach that the provider can take to help the
patient adhere to the lifestyle changes. During this phase, there is certainty of medications. On
this account, the medication could be either the beginning or a modification of the previous one
basing the decision on the lab results and the symptoms.
When thinking of a plan of care, it is necessary to include the patient in the case together
with the decision-making process. By involving the patients, it will make them feel more
appreciated and included in their plan, and it also helps them to comply with the decision (Turner
& Hurley, 2015). The consumer’s outcome is tremendously beneficial when the practitioner
includes the consumers in the decision-making session rather than leaving them out.
Community training is another method that Nurse professionals may employ.
Conducting training aimed at creating awareness to the society will not only improve the
community's health, but it would also simplify the work of the practitioners. Learned society can
take part in assisting the nurses in the disease management and control. Also, it minimizes the

CHRONIC CONDITIONS PREVENTION AND MANAGEMENT 10
costs of medication as and management since even the society can contribute to the education
and prevention programs. In this case, it will substantially reduce the enormous cost of diabetes
(Philis-Tsimikas & Gallo, 2014).
Conclusion
As a nursing practitioner, it's one's role to make sure that consumers get their quality
assistance while struggling to overcome diabetes complications. It is also a nurse position to
educate the consumers as well as the general public to enlighten them on the current status and
risk associated with diabetes. For those consumers with contingency factors for diabetes, it is
also advisable that such people should take screening procedures as a way of detecting and
preventing diabetes from advancing. It is worth noting that the highest number of population can
prevent diabetes by engaging in exercises plans, and the same exercise procedures also work for
those who need to prevent diabetes development. Also, it is good to empower the patients so that
they can assist in the management of their diabetes conditions. Nurses can also enable the
general public in conduction educational forums on diabetes.

CHRONIC CONDITIONS PREVENTION AND MANAGEMENT 11
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