Comprehensive Analysis of Diabetes Mellitus: Factors and Care

This nursing assignment comprehensively examines diabetes mellitus, addressing multiple facets of the disease. It begins by identifying factors impacting self-esteem in individuals with diabetes, such as puberty, development, and weight issues, and suggests methods to improve self-esteem through confidence building and lifestyle management. The assignment then delves into care delivery issues, highlighting individual, cultural, and political barriers, including language barriers, lack of timely appointments, and medication supply issues. Environmental and social factors contributing to diabetes in the Australian population are discussed, along with specific challenges faced by Aboriginal and Torres Strait Islander people. The role of the National Diabetes Services Scheme (NDSS) in supporting patients is explored, followed by a discussion of diabetes care within the Australian context, the roles of general practitioners and endocrinologists, and the functions of the National Association of Diabetes Centres (NADC). Finally, the importance of family involvement and understanding in diabetes care is emphasized, along with a case study involving a patient with type 2 diabetes. The assignment provides a detailed overview of the disease, its management, and the various support systems available to patients.

Nursing assignment

1) Two factors that may affect the self esteem of a person with diabetes mellitus and there are
factors that affect their self esteem and management of diabetes mellitus.
There are lots of factor which is arises due to the diabetes which affect the life of an
person. As per the above the self esteem which make the diabetes in the graveyard is:
 Puberty and development: as in the developing age when the diabetes is identified the
confidence and life prospectus is down. In initially the major factor is create the way of
thinking is totally change by feeling himself as a patient.
 Weight issue: in the diabetes the major problem is faced by person is obesity where the
patient get overweighted due the effect of diabetes. And also due the the weight gain the
activeness of the body is reduced as compared to earlier. The proper management of the
diabetes in term of self esteem is to built confidence inside the mind. Don't be feel patient
while on any term, as per this formulate a thinking about that diabetes is a common
disease which is having a minor problem and hundred of one is facing this. Make a
timetable and follow a diet chart which is proper based on the diabetes management and
feel energetic all time. Sometime this management also create problem inside the body
while currently changing on the diet and life routine turns into a deep tough about a panic
form (Al Hayek and at. al., 2017).
2) The three main issues related to diabetes care delivery and diabetes related services based on
individual, cultural and political.
In the diabetes the client specific problem is identified which affect the quality of diabetic
care have must include delay in getting appointment, lack of proper utilisation of waiting are for
the main motto of health education, and the proper management is not understandable by the
physician or doctor due the lack of time, some word which is related to field of medical cant be
getting by the patient. So while providing information about the diabetes must be use easy and
appropriate language that helps the patient to understand. The cultural barrier which affect the
management of diabetes is language barrier with the diabetes nurses, improper provision of
continuous in the process of care, lack of clarification of disease related problem, delay in
finding the investigation of result which is may be patient of client himself, a long for the
ophthalmology appointment that make s significant path in prevention of diabetes (Chew and et.
al., 2016). And also in the diabetes the basic and major problem which is faced by patient is
inadequate supplies of prescribed medication to cover the time between appointment and

deficiency of refer to dietician. Sometime patient also gone through the different line of drugs
which is changed by the diabetic specialist which create some adverse and side effect on the
physiology of patient and medicine get resist in some cases (Crowshoe and et. al., 2018).
3) The environmental and social factors which is participating to diabetes mellitus in the
Australian common population
Diabetes is a heterogeneous syndrome where it is difficult to formulate a unified
pathogenesis. In many of countries, diabetes have create a bad impact even it is found in young.
Type-2 diabetes occur a decade earlier and type-1 occurs a time later which alter the medication
and patient in short duration. In the most of the cases the time of onset depend on the
environment factor which is started by the obesity, increase in age and diet indiscretion (Maier
and et. al., 2016). The survey team of Australian diabetes found, obesity and lifestyle estimated
the prevalence of type-2 diabetes in Australians aged 25 or more than above have 7.2% have
been faced this the male are 7.6% and female are 6.7%. this data represent the 850000 and more
are affected by this disease. The prevalence type -2 diabetes arisen with age like a person aged
70 year and or older at least ten time more likely to have thee chances of diabetes than someone
aged 30-40 years (Mozumder and et. al., 2019).
 25–34 years 0.1%
 35–44 years 2.4%
 45–54 years 6.0%
 55–64 years 16.0 %
 65–74 years 21.2 %
 75+ years 20.9%
 Total 7.6%
4) The factors include with higher rates of diabetes mellitus face by the Aboriginal and Torres
Strait Islander people in respect with diabetes.
The identification of type-2 diabetes in higher among aboriginal and Torres strait islander
people than the entire Australian population. The health care suggest that the prevalence may be
as high as 35% is some aboriginal society or communities, if compared with 5% in the common
population. In this context there is limited national records which properly measure the rate of
expansion of the disease among the aboriginal and Torres strait islander people. The most of the
survey which is held in aboriginal and Torres strait islander people have make their own self

report they have diabetes, but there is also major number of patient which is not diagnosed. The
overall observation include the type-1 and type-2 diabetes is reported around 98-99% of diabetes
in aboriginal and Torres strait islander people. As per the reports, national aboriginal and Torres
strait islander survey there are 3.9% of male and 5.0% female are suffering from diabetes in
1994. after the age of 45 years the rate is 17% to 25% (Neal and et. al., 2017).
5) Significance of the National Diabetes Services Scheme (NDSS) in supporting and delivering
services to diabetes patient for care to Australians.
The national diabetes service scheme (NDSS) which helps to people who is suffering to
diabetes by different management process and make life simple and convinced to live. Its also
provide reliable and affordable access to NDSS support service and product in a short duration of
time. Where the role of NDSS is to stand with diabetic patient and give him support as moral and
product basis to live life easily and accurately (Peña and et. al., 2020). The NDSS provide many
of product which is including and safety guideline for the diabetic patient are:
 Needle and syringe barrels.
 Blood glucose and insulin ampoule
 urine test sample and strips
 insulin pumps and ampoule for consumables
 continuity in glucose monitoring (CGM) product and also provide manual for use of
product (Petroni and et. al., 2017).
The NDSS also helps diabetic patient through their support service and product. They
always connect with the many of patient for the health premises and developing new
management to cure the diabetes.
6) Diabetes care in context of Australia
Diabetes care now a days become the one of the prior for the health system for the
Australia. Traditionally, the health system has been designed for providing the response of any
symptoms. Subsequently they are very poor in meet in needs of the chronic illness. Globally, the
diabetes services spectrum which are varies in the single healthcare provider which works in the
isolated community, they refers to the primacy care doctors and health nurses which are working
in health centres, clinics and district hospitals. The CCM which refers to chronic care model are
associated with the paradigm shift of healthcare delivery model, which focuses in the long term
problem to avoiding it. As like as the acute illness, diabetes includes the behavioural,

psychological, psychosocial, environmental also clinical factors. Which needs the team support
such as the Healthcare organisation, Community resources and policies, Decision support, self-
management etc. Healthcare organisation provides the structural foundation and the diabetes
service provider are able to support the health system and organisation. Community resources
and policies are helpful in proving the ancillary services for self management. Clinical
information system collects timely data about the patients individually. Delivery system design
are exploration of reconfiguring the care in community clinic, primary care and hospital settings
(Piatt, J.A. and Chiasson, L., 2016).
7) General practitioners in diabetes care
The General practitioners blood pressure, LDL cholesterol level in patients. They
performs foot examination and U-albumin in patients which are only in 30 -32%. They generally
provides some home remedies with the medication and ask their patients to follow all the steps
which are necessary for them and they need for their better treatment. They generally need to
modify their lifestyle. They are advised to take the proper diet which is recommended by their
physician. Patient need to follow the does and don't which are prescribed to them. The healthcare
need to monitor their patient that they are having properly their diet on time or not. They also
gives advised to the patient the proper information which related to their improvement in their
health. They advise the patients to not to smoke because it increases the risk of type 2 diabetes
and also increases the various complications such as heart disease, nerve damage, kidney disease,
stroke. They advice their patient for regular test of their health. They are advices to keeping the
vaccine up to date.
8) Role of endocrinologist in diabetes
Endocrinology is known for the field related with the hormone disease. They are the one who are
dealing with the endocrine system, and the specific hormone secretions. Endocrine system of
hum,an are consists of many glands which releases different hormone for controlling many
different functions. They advised you to see a specialist for confirmation of diagnosis of
diabetes. When your doctor is really a good specialist to believe in their treatment. They don't
have much experience in treatment of diabetes. They generally covers lot of diagnosis nad
treating conditions, they are good in the Bone metabolism such as osteoporosis, cholesterol,
reproductive glands such as testes in men, ovaries in women etc. They are good in the Thyroid,

Pancreas, Hypothalamus etc. They generally recommand their patient to get treatment with the
specialist.
9) Role of National Association of Diabetes Centres (NADC)
It was established in 1994. The main role of the NADC are described below.
 To conducting and managing the business of NADC on behalf of ADEA and ADS.
 To promote their membership.
 To need to manage and maintain the all the matters relating to NADC membership which
also includes the implementation and development criteria.\
 Their work is to develop the policy for governing the structure, operation and function of
the NADC,
 There role is to sustain their network by providing the peer support and info exchange
between the individual centres member.
 To provide the regular reports to the Board of ADEA and ADS on the activities.
 Appropriate performance indicators development, which is included as the periodic
assessment in progress of NADS and its stated goals.
 To developing and implementing the national programs which includes improvement to
scientific, collaborative clinic, educational research, continuing education, health
professional training and service provisions (Ye and et. al., 2018).
10) Identify the family or carer’s involvement of and understanding in a person’s diabetes
care.
Create trust, not dependency. Although you're there to personally and members join the beloved
one it's essential that they retain their freedom. While essential recommendations on meal
schedules, insulin consumption, and activity and so forth are available, they must still be
weighed against first experience that patinet gain every day from diabetes.
11) Why is it important to understand the family or carer’s understanding of and involvement
in the person’s diabetes care?

Diabetes self-management education (DSME) is indeed a vital aspect of treatment for all
individuals experiencing diabetes.2 For adults with type 2 diabetes, participating in self-
care practises with diabetes is linked with better glycemic regulation and can reduce
problems due to diabetes.2-5 Within their families and social setting, most of the epilepsy
management of patients actually occurs.
1. Part B – Case Study Questions:
1. James is diagnosed with type 2 diabetes. He started taking T. Metformin as prescribed by
the doctor. James stopped taking the medication as his blood glucose level was found
normal for a week. James had a busy week at work for the next three weeks and had
some stressful situations in his personal life. Three weeks later, James found that his BGL
has increased tremendously. Identify and describe two (2) possible factors that
contributed to the increased BGL which was found to be normal three weeks earlier.
 Much more food, including a bite of food that have more than regular glucose
 Being not energetic
 Not enough treatment for glucose or dental diabetes
 Health risks from many other drugs, such as prescription drug or hormones
 The body produces hormones to combat the disease, and these hormones increase the
blood glucose levels.
 Stress, that can generate hormones that increase level of glucose
2. Assume that you developed a care plan for providing nursing care and managing type 2
diabetes for a patient admitted in your ward. The dietician and diabetic nurse educator
rescheduled their timing for the ward visit. Now you are required to re-prioritise care
activities to accommodate the rescheduled visit of the dietician and diabetic nurse
educator. However, you have other priority tasks assigned in your day planner for other
patients. What would be the most appropriate action in this scenario?
Practicing customised, physician psychosocial treatment includes the background of the
individual with diabetes (PWD) as well as the beliefs and desires of the PWD to be taken into
consideration through contacts and relationships, difficulty detection, psychosocial testing,
diagnostic examination and intervention programmes.

3. Arnold was admitted in your ward a week ago with diabetic ketoacidosis. Arnold and his
wife are diabetic and both were not paying attention to their health. They did not
appropriately use the insulin pen when you asked them to demonstrate its use during the
initial days of communication with the client and family. They did not understand the
importance of consuming a diabetic diet.
Discuss five (5) possible areas Arnold and his wife must be aware of or trained in prior to
discharging the person from the hospital for self-management (ongoing management of diabetes)
at home.
 Reflecting established learning strategies.
 In a professional context, be produced by an educated group multidisciplinary.
 Be available to the widest range of individuals in an environment for groups.
 Encourage involved, customised learning to the degree that available to
respondents.
 Be educated and knowledgeable in the distribution of every principles including
substance of the particular curriculum which they have implemented they deliver
4. If a person with diabetes is unconscious due to suspected hypoglycaemia, which injection
could the trained nurses administer to address the emergency situation? Briefly describe
the action of this medicine.
There are calorie-free diets without meat or calories which are quickly turned into body sugar.
Try glucose pills or paste, coconut water, soft beverages, honey, even sugary sweets, normal, not
vegan.
5. A patient was brought to the emergency department with complaints of vomiting and
abdominal cramps. The patient had a dry mouth and high blood glucose level. You
performed a urine test using a test strip that was found positive for ketones. The BGL was
very high. What could be the possible diagnosis for this patient? Discuss nursing care and
management of this person.
Insulin seems to be the drug of choice for those with diabetes as well as for spikes in
blood glucose that are existence. It is possible to treat patients with diabetes with a
mixture of multiple injectable drugs. Insulin is also used by some persons with diabetes
mellitus.

6. As per the current care plan, Henry has type 2 diabetes and is on four hourly BGL
monitoring due to recent episodes of hypoglycemia. Here is his BGL chart (in mmol/dL)
for the last four days.
Consider the identified outcomes of BGL against evidence-based best practice in diabetes
nursing care. What does this pattern show? What changes could you suggest in Henry’s care
plan?
The greatest issue facing clinicians and diabetes care professionals at present is not so much a
matter of explaining a need for more care, but of assessing and maintaining its consistency and
efficacy. This has historically been discouraged either by consensus about where the much more
important indicators of the success of insulin health care are with certain scholars claiming that
the main impacts to be assessed are behavioral regulation and morbidity, whereas others argue
that improvements in behaviours and QOL are more distal consequences.

REFERENCES
Books and journals
Al Hayek and at. al., 2017. Fear of self-injecting and self-testing and the related risk factors in
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Chew and et. al., 2016. National Heart Foundation of Australia and Cardiac Society of Australia
and New Zealand: Australian clinical guidelines for the management of acute coronary
syndromes 2016. Medical Journal of Australia, 205(3), pp.128-133.
Crowshoe and et. al., 2018. Type 2 diabetes and Indigenous peoples. Canadian journal of
diabetes, 42, pp.S296-S306.
Maier and et. al., 2016. Task shifting from physicians to nurses in primary care in 39 countries: a
cross-country comparative study. European journal of public health, 26(6), pp.927-934.
Mozumder and et. al., 2019. Towards Privacy-preserving Authenticated Disease Risk Queries.
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Neal and et. al., 2017. Canagliflozin and cardiovascular and renal events in type 2 diabetes. New
England Journal of Medicine, 377(7), pp.644-657.
Peña and et. al., 2020. Screening, assessment and management of type 2 diabetes mellitus in
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Journal of Australia, 213(1), pp.30-43.
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patients: a retrospective study. Journal of Cardiovascular Medicine, 18(3), pp.152-158.
Piatt, J.A. and Chiasson, L., 2016. Impact of Motivational Interviewing on Readiness for Change
and Self-care Behaviours of an Assisted Living Resident with Type I Diabetes.
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Ye and et. al., 2018. An analysis of diabetes mobile applications features compared to
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