Type 2 Diabetes: Causes, Complications, and Management

Type 2 Diabetes is a chronic condition that impairs the body's ability to produce or respond to insulin. It is caused by genes and lifestyle factors such as obesity and lack of physical exercise. The disease can lead to health complications like kidney diseases, heart attack, and stroke. Self-management and shared decision making are crucial in managing the condition. Evidence-based nursing practices can help improve patient care.

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In the last decade chronic conditions have become a burden in the healthcare field. Often they
are used to describe different state of human bodies like disabilities, physical impairment
syndromes etc. some examples of condition are cardiovascular diseases, cancers, respiratory
disease like asthma and diabetes. In UK over three million people have diabetes. While we have
two types of diabetes; type one and type two, type two diabetes is the most common and
predominant in every part of the world. The Public Health England and the National
Cardiovascular Intelligence Network produced the latest prevalence model of diabetes. On
average ninety percent of all diabetes cases are type two. Diabetes is becoming a health burden to
both the developing and developed countries. According to statics, in every four people one is
diabetic while 0.94 million are estimated to be unaware of their condition. If not carefully and
keenly dealt with early, the disease can cause some other health complications like kidney
diseases, heart attack and stroke. Most people around the globe have very little knowledge about
how deadly it is and how it can be prevented.
Diabetes is a disease that impairs the ability of the body to produce or respond to hormone
insulin. The health complication makes blood sugar levels go higher than the required. (Diabetes,
U.K., 2012). It interferes with how the body deals with the balancing of blood glucose. The
amount of glucose in the blood is regulated by the hormone insulin which is produced in the
pancreas. Insulin helps in converting the glucose in the food into usable energy. People who have
type two diabetes produce insulin, but the body cells cannot utilize it as required. The condition
is called insulin resistance. Initially, the pancreas manufactures a lot of insulin to get glucose
absorbed into the blood. As time goes on, sugar accumulates in the body since the body cannot
keep on producing extra insulin. (Kodiatte, et al 2012)

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Type two diabetes is caused by genes and life style factors such as obesity, and lack of physical
exercise. Diabetes may cause health complications like foot problem, erectile dysfunction,
kidney disease, gastro paresis and eye disease .its treatment deals with the changes in the diet and
body exercise. For the obese people, bariatric surgery is often used to improve the condition.
Those who use insulin are advised by the medical professionals to check their blood sugar levels
regularly (Ntuk, et al 2014)
In the statistical data released, approximately over 3.5 million people in England have diabetes.
The demographic is for those who are sixteen years and above both male and female. The
number represents about 9% of the adult population. Approximately 9.6 percent of men have
diabetes while it is only 7.6 percent of women who have diabetes. The black ethnic groups and
people from south Asia have higher chances of developing diabetes compared to the white and
mixed groups. The rate is 15.2 percent compared to 8.0 percent. (Palmer, 2016).
In the USA, a third of the population is at risk of developing diabetes. The one third represent
84million people. According to a recent report by the Center for Disease Control and Prevention
(CDC). Roughly thirty million American citizens represent 9.4% of the US population who are
treating diabetes. The report also suggested that 7.2 million diabetes cases were not yet
diagnosed. More than 90% of the people who have this condition do not know anything about
their status though the US government spends at least $245 billion each year (da Rocha et al
2016)
Anxiety is a common issue with the diabetic patient. It is the feeling of unrealistic and excessive
worry that tend to interfere with the physical and social operations of an individual. Anxiety is
associated with the feelings of panic, anger, nervousness, restlessness, rapid heartbeat, increased
and heavy sweating. People may get worried about short term and long-term complications

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associated with diabetes. Some of the few examples of these complications are the stroke, kidney
failure, heart attack and dementia (Smith, et al2013).
If not handled with the right resources and methods, anxiety is serious health matter and can
cause a lot of harm to an individual. The symptoms may include excessive perspiration, heart
palpitations shaking and sometimes even crying. When people are very anxious, they sometimes
fear to get out of the house. They may avoid meeting their friend or even strangers since they get
worried much about what people say about them. This affect the quality of their life and health
because they may fail to access the health care facilities at the needed time (Aksu et al 2012).
The preventive and treatment measures can be taken very seriously to help the patient improve
the quality of their lives. Anxiety can be treated through doing some things like getting involved
much in physical body exercise, maintaining a healthy balanced diet, reduce the caffeine intake,
avoiding alcohol and other recreational drugs and substances and getting enough rest, some
mindfulness like yoga, meditation self-hypnosis etc. A research was done at Stanford University
department of psychology and it used brain imaging technology to determine the impact of
mindfulness on anxiety. The study revealed that the people who completed the mindfulness
course had significantly reduced the symptoms and signs of anxiety (Maxwell, et al)
Stress is another psychosocial problem among the people who have diabetes. Stress is a state
where an individual experiences tension and emotional strain which occurs when one can no
longer cope with some pressures of life. The body tries to respond very fast to the situation by
releasing some hormones that give the cells access to the stored energy. It helps the body deal
with any impending danger. Both mental and physical stress have been proven to provoke
changes in the blood sugar levels. it is a widespread problem among the diabetic people. It

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affects the control and management of blood sugar levels directly and indirectly. (Hopkins, et al
2012)
Knowing that one is diabetic can lead to a lot of pressure and stress. It makes it even difficult to
control the blood glucose levels because the body produces so many hormones that interfere with
the blood sugar levels. For example, high levels of hormones like cortisol can lead to some
health problems like Cushing syndrome that is a known cause of diabetes. Continuous stress
caused by the thought of chronic health problem associated with diabetes brings difficulties in
regulating the blood sugar. Stress makes people feel low and can easily cause them to abandon
their health care duties such as physical exercise and regular check of the blood sugar levels. The
impact of stress on the blood sugar levels vary in different people. It can be treated naturally by
either taking a holiday, listening to music, carrying out some breathing exercise or regularly
getting involved in .physical exercise (Palizgir, et al 2013)
Decision making is a critical issue in the hospitals and other healthcare organizations. Shared
decision making is an approach that is centered on the patient and aims at improving the quality
of healthcare services offered. It acknowledges that people have different values which affect the
interpretation of issues. Informed consent of the patient is at the center of decision making
(Stiggelbout, et al 2012) They should be made to understand the advantages, disadvantages and
the possible risk factors involved in each option at their disposal Decision tools of the patient are
well designed and used give information about the possible options available as well as their
disadvantages and advantages. The tools are designed to create an environment where the patient
is free and comfortable to engage and participate in making the decisions on treatment. They are
used during consultations. Agoritsas, et al (2015) shared decision making also facilitate an
emphatic conversation between the healthcare providers and the patient. Some of the approaches

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used in decision making are making of choices, sharing of information and helping the parties
involved talk about how the can deal with diabetes (Elwyn, et al 2012). Although many studies
have been conducted about the shared decision both in Europe and US implementing it is a big
challenge to many health organizations. Nurses and other medical professionals should ensure
the practice of shared decision making through giving voice to the preferences, values and
choices of the patient, sharing information that is evidence based and creating an emphatic
conversation.
With the rising number of type two diabetes cases, success in preventing the complications
seems a little bit difficult. Only a small percentage of the patient receive the three-target
treatment. They include the lipids, blood pressure and glycemic control. Nurses should adopt a
more patient centered approach in order to improve on the treatment targets. Active participation
in the evidence-based decision making is important. Several factors have to be considered before
personalizing the treatments target such as blood pressure, smoking cessation weight loss and
lipids (Barry and Edgman 2012).
The clinicians should take into account the patient’s motivation, vascular complications and
morbidity, risk of hypoglycemia the duration of diabetes and age in setting the target of
controlling blood sugar levels. For the patient who have some issues with their weight, the nurses
should be careful of the possible side effects of gaining weight due to medication in order to
achieve a best medical care for the diabetes patients, their preferences for the treatment intensity
should be put into consideration. Shared decision making considers the preferences and priorities
of the patient as well as the clinical evidence. It is mostly used when there are two or more
treatment options (Joseph-Williams et al 2014)

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According to the European Association for the Study of Diabetes and the American Diabetes
Association personalized and patient centered care is the most essential thing when treating type
two diabetes. They emphasize on the need to use decision support tools. Recently the tools have
been used to achieve cardio metabolic goals and lifestyle modifications (Por, 2008).
Shared decision making in healthcare involves the patient and the clinicians. Several factors
determine its success in different organizations. A good decision regarding treatment of diabetes
is influenced by factors like support of the family, available resources, both national and
institutional policies, literacy etc. For example in some health organizations it is the patient who
decide their places of care, while others have policies to guide referrals for their clients. Different
studies have revealed that some barriers of the SDM are: overly assertive and over confident
physicians, lack of emotional connections between the patient and the clinicians as well as
lacking the perceived control over different situations (Légaré et al 2014)
According to Duffield et al (2009), people who actively participate in decision making have a
very a good sense of commitment to get better. Through participating in decision making the
patient receives confidence and competence of frequent self-management. Another study
revealed that diabetes patients remember the information they receive from the clinicians than
any other information. Participating SDM is very important since the patient is given room to
seek clarifications and questions to assist them in effective self-care. Diabetes patients who take
part in decision making easily receive assistance on how to deal with the weight and cholesterol.
The physicians explain the best diet for them as well as the recommended kind of physical
exercise.

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Self-management in diabetes is an evolutionary growth of awareness and knowledge through
learning to control the condition. In self-management, diabetic people spend very few hours
with the health professionals. They are trained how to manage their blood sugar levels by being
physically active, monitoring the blood glucose, healthy eating and complying with the
requirement of the medication. Self-management helps the patient to improve their lives and
reduces cases of hospital admissions. It is the most appropriate to help even reduce the number
deaths caused by this condition though many view it as undependable. It is very much
economical and the most practical form of treatment (Haas et al 2012).
A training should be offered by a registered pharmacist or a nurse. For example they can have
the X-PERT education programs conducted for diabetic patients. The program should take 15
split hours for six weeks. . The hand book given after the program is really important in helping
patient in self-care Patients must seek knowledge and be active in their care ( Nazar, and
Bojerenu,
2016). The self-care model is good but some of the patient do not follow the prescription of the
clinicians hence exposing them to so many risk factors. They ignore the regular checking of the
blood sugar while others don’t adhere to having the recommended diet. Self-management seems
a simple task, but is hindered by a number of factors like social support, financial resource of the
patient, age, culture, and literacy levels high cost of drugs degree of symptoms etc. Many
different studies have been conducted to identify the barriers self-care in diabetes. Factors such
as language and cultural differences, knowledge beliefs about diabetes, poor communication
were identified. Patient empowerment is really important if the self-care model will be affecting
in countering the effects of diabetes. The government should do proper education programs on

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self-management especially in the rural areas. The program will help reach many people hence
reducing the effects of diabetes at a very high rate (Funnel et al 2009).
Evidence based nursing practice is an effective method used to promote good decision making in
patient care and improve the approaches needed to eliminate good health care barriers. Type two
diabetes is steadily increasing among people of all ages across the world. The disease claims
thousands of lives every year despite the efforts made by different governments and other health
organizations to control the condition. The problem is becoming a world epidemic especially
with the increased number of people who are obese. However, all hope is not lost since it can be
controlled through many studies self-management is cost effective and good way of dealing with
it. Though many are already using this method of treatment, there is still a long way to go in
helping people understand why they should take it seriously (Mckenna et al 2018).
In conclusion type two diabetes is steadily increasing among people of all ages
across the world. The disease is claiming thousands of lives every year despite the efforts
by both the government and other health organizations to control the condition. The
problem is becoming a world epidemic especially with the increased number of people
who are obese. However, type two diabetes can be prevented and managed. The
preventive program should be developed to help people take control of their condition
through providing them with the tools and information they need to make the necessary
adjustments to their lifestyles. There are more healthcare initiatives that should aim at
enabling the people live a healthy life. Having to live with diabetes is really challenging
since its management and control calls for a frequent and continuous effort of the diabetic
patient. The diabetes patient should be provided with the needed resources, information
to support all other aspects in dealing with the condition. It is quite important to assess

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the individual’s ability to cope with and manage their condition effectively. Much should
be done to educate the public since the biggest percentage of the population knows very
little about diabetes.
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