Type 2 Diabetes: A Comprehensive Overview of Management Strategies

This report provides a comprehensive overview of Type 2 Diabetes, beginning with an introduction to the case study of Jenny, a 58-year-old patient diagnosed with the condition. The report delves into the epidemiology of Type 2 Diabetes in Australia, detailing incidence, age of onset, prevalence, morbidity, and mortality rates. It then explains the pathophysiology of the disease, focusing on how altered blood glucose levels and insulin resistance contribute to the development of symptoms such as fatigue, blurred vision, and increased thirst. The report further discusses the management and nursing care strategies for individuals with Type 2 Diabetes, including medication (Metformin, insulin, and other drug classes), self-monitoring of blood glucose, lifestyle modifications (diet and exercise), and patient education. Finally, the report addresses the long-term complications that can arise from poorly controlled blood glucose levels, such as kidney diseases, cardiovascular problems, diabetic neuropathy, and retinopathy, emphasizing the importance of proactive management and care to mitigate these risks. This report provides valuable information for students and healthcare professionals alike.

Running head: TYPE 2 DIABETES
TYPE 2 DIABETES
Name of the Student:
Name of the University:
Author note:

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Introduction
This essay highlights a case study of Jenny, who was 58 years old, and was suffering
from fatigue, slight tickling in her feet and blurred vision. Jenny also experienced frequent
urge to urinate and was continuously feeling thirsty. On diagnosis, it was revealed that she
was suffering from type 2 diabetes mellitus. Hence, this essay will highlight the
epidemiology of diabetes type 2 comprising of occurrence, morbidity, mortality and
prevalence rate in Australia (DeFronzo et al., 2015). The pathophysiology of the condition
will also be highlighted in the essay focusing on the altered blood glucose level that leads to
the onset of condition. The nursing care strategy will be discussed with a long term
complication developed due to type 2 diabetes mellitus.
Epidemiology of Type 2 Diabetes
1. Incidence Rate
Diabetes is considered as the most challenging and epidemic health condition in
Australia’s health care system. Approximately 1 million population of Australia is suffering
from type 2 diabetes mellitus in the year 2014-15. More than 280 Australians suffer or
develop diabetes every single day, which states that 1 person develop diabetes in every 5
minutes (Aihw.gov.au, 2019). Approximately 1 million cases of hospitalization was reported
in the year 2015-16 due to diabetes resulting in 16,400 death of Australians in 2015, majority
of the death was because of type 2 diabetes mellitus. The rate of diabetic condition is high in
Australia and approximately 100,000 Australians had developed diabetes in 2015.
2. Age of onset
Diabetes type 2 is considered as an advanced condition where the patient’s body becomes
resilient to the standard amount of insulin or the body cannot produce adequate amount of
insulin. More than 90% of diabetic cases are due to type 2 diabetes mellitus, which generally

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develops in the adults who are more than 45 years of age but now the condition is also
affecting the younger children, adults and adolescence (Diabetesaustralia.com.au, 2019). The
threat of developing type 2 diabetes rises if the individual is more than 45 years of age and is
suffering from obesity or high blood pressure and also if a person has a past background
history of diabetes. The population of Aboriginal strait islander who are more than 35 years
of age are under risk of developing type 2 diabetes mellitus.
3. Prevalence Rate
The occurrence rate of type 2 diabetes is high in Australia as estimated from the survey
conducted by Australia Bureau of Statistics. Approximately 1.2 million population aged more
than 2 years are diagnosed with diabetes and the prevalence rate was almost doubled from the
year 1989-90 to 2004-05 (Health.gov.au, 2019). The prevalence rate had increased upto
4.4%-5.1% in the year 2014-15. The condition of type 2 diabetes is very prevalent in
Indigenous and Torres Strait Islander population of Australia affecting 12.8% of population
who are aged more than 15 years. In 2014-15, more than 85% of the population were
diagnosed with type 2 diabetes.
4. Morbidity Rate
In the year 2017-18, 1 in every 20 Australians were suffering from diabetes. From the
year 2001, rate of type 2 diabetes mellitus has been increasing with the rate of 3.3% and has
now reached a stability with the same morbidity rate in the year 2014-15. The risk of diabetes
is more common in males than compared to females, with 5.5% chances of developing
diabetes type 2 in males and 4.3% chances of developing diabetes type 2 in females
(Abs.gov.au, 2019). The risk of diabetes is increasing with age and affect people who are
aged 45 years and above.

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5. Mortality Rate
Diabetes in general is considered as a chronic condition, where type 2 diabetes is more
common and affect large population than type 1 diabetes. In 2016, more than 4,770
Australians died because of diabetes mellitus hence making this health condition as the
leading reason of death all over Australia (Abs.gov.au, 2019). The standard death rate in
Australia was 16.2 death per 1 million people, where the death rate is increasing every year.
The death rate is higher in males as compared to female. Before the year 2016, diabetes was
considered as one of the sixth major reason of demise in Australia.
Pathophysiology of Type 2 Diabetes
From the case study it was highlighted that Jenny was exhibiting the symptoms of
diabetes type 2 like blurred vision, ticking sensation in her feet, fatigue, urge to urinate and
frequent sense of feeling thirsty. The pathophysiology of each symptom is related to the
condition of developing diabetes type 2. Initially, it is crucial to recognize the
pathophysiology leading to type 2 diabetes by altering the normal blood glucose level in an
individual. Type 2 diabetes mellitus generally result due to the progression of insulin
resistance (Zaccardi et al., 2016). Insulin resistance is defined as the condition when human
body is incapable of responding or reacting to the insulin produced by the body that in turn
affects the normal blood glucose level and in turn increase the total level of blood sugar
resulting in type 2 diabetes. It can also develop due to abnormal dysfunction of pancreatic
beta cells. Approximately 80% of the population who have type 2 diabetes mellitus are
suffering from obesity that results in releasing high amount of unrestricted fatty acids, which
leads to the condition of insulin resistance in muscle cells and liver (Cersosimo et al., 2018).
This condition results in amplified gluconeogenesis within the liver, thereby inhibiting the
uptake of insulin-mediated glucose by the muscle cells, which results in increased level of
circulating glucose in the blood. With the increased production of free fatty acids more and

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more insulin is generated, which is further not maintained or controlled thereby disrupting the
pancreatic beta cells with reducing amount of insulin output. Hyperglycaemia develops and
the symptoms of type 2 diabetes is prevalent with almost 50% loss of pancreatic beta cell
function (Chatterjee, Khunti & Davies, 2017).
From the symptom it was evident that Jenny was suffering from the symptom of fatigue
and blurred vision. High level of blood glucose or sugar due to diabetes affects the capability
of an individual to see clearly as the high concentration of sugar causes the lens to swell
inside the eye of the patient that result in temporary blurred eyesight (Diabetes.co.uk, 2019).
This condition result in loss of eye sharpness in visualising anything and also increases the
incapability to see anything. This can affect either one eye or both the eyes of the patient.
Fatigue is considered as the most common symptom of type 2 diabetes. In case of type 2
diabetes mellitus, the blood sugar level is high because of either insufficient insulin or if the
insulin produced is not working effectively in the human body (Yabe et al., 2015). When
adequate insulin is not present the body it clearly states that sugar level in the blood is not
reaching the cells and hence the cells are not receiving enough insulin and energy to carry out
the daily activities of life and hence the patient tend to feel tired and fatigue because of
absence of enough energy to carry out the daily activities of life (ADL) (Diabetes.co.uk,
2019). In the condition of type 2 diabetes mellitus the body cannot covert enough glucose to
produce insulin and energy hence, excess sugar or glucose level accumulate in the blood. The
kidney lack the capability to store excess sugar and in turn excretes the excess sugar in the
form of urine by dragging fluids from the nearby tissues, where the body cannot produce
enough energy hence the organs and muscles will be short of adequate energy and the person
will develop the urge to drink more and more water. Hence this condition results in the
symptom of excessive thirst and frequent urge of urination (Antonioli et al., 2015).

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Management of type 2 diabetes Mellitus
In type 2 diabetes, the pancreas do not function effectively and the patient’s body is
developing insulin resistance and hence cannot convert glucose into energy. The
administration of type 2 diabetes is very important in order to maintain adequate level of
blood glucose in the body within the range of 4 to 6 mmol/L. The administration process of
type 2 diabetes mellitus includes modification of lifestyle comprising of regular exercise,
healthy diet and effectively managing and monitoring the blood sugar level. Medication
management is also very important in managing the level of type 2 diabetes. Few people can
preserve their blood glucose level by physical exercise and proper diet associated with
medication. The medication best effective in managing the blood glucose level are classified
as (Chaudhury et al., 2017):
 Metformin- It is the most common type of medication listed for the patient suffering
from type 2 diabetes as it reduces the development of glucose in the liver and thereby
improves the body’s sensitivity towards insulin thereby allowing the patient’s body to
consume insulin proficiently.
 Insulin- Insulin therapy is considered as the most effective therapy to treat the
condition of type 2 diabetes mellitus. Insulin lowers the level of glucose in the blood
thereby helping the patient to maintain adequate amount of glucose level (Tahrani,
Barnett & Bailey, 2016).
 Other medication- Other class of drugs are also useful for managing the condition of
type 2 diabetes such as sulfonylureas, thiazolidinediones, meglitinides, SGLT2
inhibitors, DPP-4 inhibitors and GLP-1 receptor agonists.
Self-monitoring of blood glucose (SMBG) is considered as the key element towards
managing type 2 diabetes mellitus. In self-monitoring or self-testing process the individual
develops the process of testing their glucose level in the blood using diabetes test strips that

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will help the patient to better understand their health condition and to track their HbA1c level
by continuously monitoring and improving their type 2 diabetes control (Powers et al., 2017).
This is the most widely accepted step of diabetes management, which allows the patient to
self-manage and evaluate the blood glucose level in the body. The overall management and
reducing the risk of type 2 diabetes require effective lifestyle modification to improve the
health condition. Lifestyle modification includes the following (Malin & Kashyap, 2016):
 Management of body weight- the chance of developing type 2 diabetes increases with
the risk of overweight or obesity. Hence it is very crucial to manage body weight by
exercising, doing yoga and getting involved in a variety of physical exercise
activities. Adequate and regular exercise id required to manage the body weight and
also to maintain the normal level of blood glucose.
 Eating healthy- It is very crucial to eat healthy as the eating habits can affect the
blood sugar level. A proper diet chart should be followed that is avoid of sugar
supplements and must include fruits, whole grains and vegetables. Intake of any meat
food and non-fat dairy food that are rich in fat and sugar is very important to avoid
any complication due to diabetes (Hutapea, 2016).
 Effective education- The patient suffering from type 2 diabetes must understand the
possible reason for developing diabetes and how to manage diabetes. Their
physicians should educate them to manage their stress level that will help them to
reduce blood sugar level and also educate them to quit smoking or any such activity
that will escalate the risk factor of type 2 diabetes and they must be aware of the
complication of not managing their condition effectively.
Due to untreated or undiagnosed diabetic condition various complication arises that may
be either long term or short term complication depending on the level of health complexity.
Various long term complication developed due to type 2 diabetes mellitus are kidney

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diseases, macro vascular problem, diabetic neuropathy and retinopathy. The long term effect
of diabetes result in impairment of the large blood vessels of legs, brain and kidney and also
damages the small blood vessels leading to the problems of nerves, kidneys, feet and eyes
(Betterhealth.vic.gov.au, 2019). Few other parts of the body is also affected due to type 2
diabetes that includes impairment of immune system, sexual organs, digestive system, skin,
gums and teeth.

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Conclusion
Hence it can be concluded that type 2 diabetes is one of the major chronic condition that
affects a large population of people in Australia and has a high incidence and mortality rate.
In this essay, the primary pathophysiology that result in type 2 diabetes mellitus is also
explained, which highlights the incapability of the patient to concert glucose into energy.
Various management techniques were also included in the essay that highlights medication
management, proper diet intake, regular exercise and effective education to help the patient
understand their health condition (Mayer-Davis et al., 2017). The essay concludes by
highlighting the long term health complication due to type 2 diabetes mellitus when the
condition is either left untreated or undiagnosed.

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