Diabetes: Understanding Disease, Pathophysiology, and Nursing Process

This report provides a comprehensive overview of diabetes, a metabolic disease characterized by high blood sugar levels. It details the different types of diabetes, including type 1, type 2, and gestational diabetes, and explains the underlying pathophysiology, focusing on the role of insulin and glucose metabolism. The report also explores the psychosocial factors associated with diabetes, such as emotional distress and eating disorders, and discusses the genetic and genomic aspects of the disease. Furthermore, it outlines the nursing process involved in diabetes management, including diagnosis, lifestyle modifications, and medication. The report emphasizes the importance of early diagnosis and patient education for effective disease management, referencing key studies and guidelines from organizations like the American Diabetes Association.

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Disease or disorder
This paper aims to discuss the key factors associated with diabetes. According to the
doctors diabetes is mainly referred to the consequence of diabetes mellitus (DeFronzo et al.,
2015). The condition is described as the combination of various metabolic diseases that lead
to high blood sugar (glucose). The consequences of diabetes may occur due to inadequate
production of insulin or due to the poor response of cells to insulin, or in some cases both.
Common sufferings such as frequent urination, increasing hunger and thirst are associated
with diabetes (Tattersall, 2017). The disease can be classified into three major types such as
type 1 diabetes, type 2 diabetes and gestational diabetes (American Diabetes Association,
2014). Type 1 diabetes mainly occurs when the pancreas fails to produce adequate amount of
insulin and the prevalence has been found to be 10% (Zimmet et al., 2016). 90% of diabetes
cases are associated with type 2 diabetes which causes due to the inability of cells to response
to the insulin or insulin resistance and gestational diabetes affects the women during the
period of pregnancy (Goldstein & Müller-Wieland, 2016). Further the disease has become
global concern as it may lead to severe cardiovascular risk (Tattersall, 2017).
Detailed Pathophysiology
The main consequence of diabetes is the high blood sugar or glucose. Glucose is
mainly obtained by the absorption of food, glycogen breakdown and storage in liver and
glucose production through non-carbohydrate elements by gluconeogenesis. In this regards
insulin play an important role in order to maintain the glucose balance in the body. It could
inhibit the gluconeogenesis or glycogen breakdown and stimulate glucose transport and its
storage as glycogen (DeFronzo et al., 2015). Insulin plays the instrumental role in the glucose
uptake by muscle, adipose tissue and liver from blood in order to produce energy. Thus, poor

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absorption or storage of glucose occurs due to lack of insulin or insulin resistance which lead
to various metabolic issues such as poor protein synthesis, high blood glucose and other
disarrangements in metabolism. Hence, insulin deficiency or insulin sensitivity of the
receptors is considered as the main reason of diabetes (Tattersall, 2017). Additionally, high
blood glucose affects the reabsorption by kidney thus increases urination along with the
excretion of glucose. It results in loss of blood volume and dehydration that increases thirst
(Goldstein & Müller-Wieland, 2016).
Behavioural or Psychosocial Related Issues
Beside the above discussed physical issues there are some psychosocial factors that
are associated with diabetes. For example, emotional distress or depression has been found to
be related with diabetes and risk of diabetes increases by 37 to 60% due to depression
(Zimmet et al., 2016). However, the related psychosocial factors are not limited to diabetes,
in addition, anxiety, panic disorder and post traumatic stress have been found to be associated
with diabetes (Hackett & Steptoe, 2016). Whereas, such poor mental health is considered as
risk factor of diabetes, similarly, diabetes may cause mental disorder known as diabetes
distress due to the stress of diabetes management (Feinkohl et al., 2015). In most of the cases,
patient with diabetes have been found to develop eating disorder as well (Hackett & Steptoe,
2016). Furthermore, high blood sugar has significant effect on the mood of the patient that
leads to rapid changes in mood. Such condition affects the lifestyle and social participation of
the patient in an effective manner (Feinkohl et al., 2015).
Genetics or Genomics
Brunetti, Chiefari & Foti, (2014) have indicated that diabetes can be hereditary.
However, diabetes in the parents does not guaranteed that the child will develop diabetes, but

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increases the risk of diabetes. It is difficult to identify the genes that are responsible for the
genetic transmission of diabetes (Tattersall, 2017). Study conducted by Brunetti, Chiefari &
Foti, (2014) has informed that there are certain variants that increases the risk of diabetes
such as HLA-DQA1, HLA-DQB1, and HLA-DRB1 genes. Such genes belong to the human
leukocyte antigen that helps to differentiate between body proteins and foreign proteins. The
variations known as haplotypes such as HLA-DQA1, HLA-DQB1, and HLA-DRB1 increase
inappropriate response to beta cells and damages this insulin producing cells. Thus,
individual with these variants are more susceptible to diabetes, especially type 1 diabetes
(Tattersall, R. B. (2017).
Related nursing process
In order to provide adequate treatment it is important to diagnose the disease at early
stage. The available diagnosis process includes demonstration of fasting plasma, plasma
glucose and glycated haemoglobin (American Diabetes Association, 2014). Diabetes is a
chronic condition and complete cure process is not available, however, with effective nursing
intervention the disease could be managed. For example, effective diet, adequate physical
activities, weight loss lifestyle modification such as quit smoking and alcohol intake and anti-
diabetic medication could help to maintain normal blood sugar level (Inzucchi et al., 2015).
In this regards it is important to educate he patient about self-management to increase their
active participation in treatment (Coppola et al., 2016). Such interventions could help to
manage diabetes in an effective manner.

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References
American Diabetes Association. (2014). Diagnosis and classification of diabetes
mellitus. Diabetes care, 37(Supplement 1), S81-S90. Retrieved from
https://doi.org/10.2337/dc14-S081
Brunetti, A., Chiefari, E., & Foti, D. (2014). Recent advances in the molecular genetics of
type 2 diabetes mellitus. World journal of diabetes, 5(2), 128. Retrieved from
https://dx.doi.org/10.4239%2Fwjd.v5.i2.128
Coppola, A., Sasso, L., Bagnasco, A., Giustina, A., & Gazzaruso, C. (2016). The role of
patient education in the prevention and management of type 2 diabetes: an
overview. Endocrine, 53(1), 18-27. doi:10.1007/s12020-015-0775-7
DeFronzo, R. A., Ferrannini, E., Alberti, K. G. M. M., Zimmet, P., & Alberti, G. (Eds.).
(2015). International Textbook of Diabetes Mellitus, 2 Volume Set (Vol. 1). John
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cognitive decline: potential vascular, metabolic, and psychosocial risk
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https://doi.org/10.1186/s13195-015-0130-5

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Goldstein, B. J., & Müller-Wieland, D. (Eds.). (2016). Type 2 diabetes: principles and
practice. CRC Press. 2nd edition. 13-452. Retrieved from
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