Diabetes Mellitus Case Study: A Comprehensive Analysis

Desklib provides solved assignments and past papers to help students succeed.

Introduction
Diabetes is a chronic disease characterised by high blood sugar levels and its prevalence is
continuously rising worldwide (WHO, 2019). In Australia, itself, almost 1.2 million people,
that accounts for nearly 5% of the total population of the country has been diagnosed with
diabetes in the year 2015 (Diabetes Australia, 2015). In the given case study, a single mother
of four children, Sarah has been diagnosed with type 2 Diabetes Mellitus, two months ago.
She is a busy working 50 yrs old female, who eats high sugar foods, processed takeaways and
also leads a sedentary lifestyle. To manage her rising blood sugar level, she is being advised
to modify her lifestyle, but she is finding it difficult to adopt that routine. Therefore, HCP
must talk to Sarah to convince her to change her lifestyle to have better health outcomes.
Difference between type 1 and type 2 diabetes
Diabetes Mellitus(DM) is broadly of two types, Type 1 diabetes and type 2 diabetes. Type 1
diabetes is an autoimmune condition in which body's own immunity cells start working
against the beta cells of the pancreas, which are mainly responsible to produce insulin in
human body (Department of Health, 2016). Insulin is the main hormone that converts blood
glucose to energy and in lack of insulin, glucose remains unconverted and it's level increases
in blood. Type 1 diabetes is also called juvenile onset since most people develop it at an early
age. However, it can occur at any age. Further, it can only be treated through insulin and
affected people to become highly insulin dependent. On the contrary, type 2 diabetes, is much
more common than type 1 and is caused due to hereditary causes and lifestyle factors
(Diabetes Australia, 2015). It accounts for almost 85% of all cases of diabetes and is closely
associated with an unhealthy diet and sedentary lifestyle as seen in Sarah's case. Here, the

high blood sugar level (BGL)is caused due to failed action of insulin receptors or due to
actual deficiency of insulin production. It usually occurs in adults above 45 yrs and is treated
through oral medications and change of lifestyle. Active lifestyle, reducing weight and low
sugar healthy balanced diet is found to be really effective in managing BGL in type 2 DM
(Department of Health, 2016).
Pathophysiology and major complications of type 2 Diabetes
The pathophysiology of diabetes mellitus includes two major causes of impaired insulin
secretion and increased insulin secretion. Kahn, Cooper, & Del Prato, (2014) have found that
when genetic predisposition combines with certain environmental factors of obesity, stress,
poor diet and lack of exercise routine, a progressive condition develops in which insulin
secretion is reduced and glucose responsiveness is lowered. Gradually, this condition
progresses to cause a decrease in pancreatic beta cells and thus, insulin production becomes
deficient (Kahn et al, 2014). Another mechanism of type 2 is insulin resistance in which
action of insulin is insufficient especially in major target organs like muscles and liver. Thus,
insulin fails to convert blood glucose to energy leading to high BGL (Ding et al. 2015).
Unmanaged diabetes cases have a high blood sugar level that eventually leads to major small
blood vessels and large blood vessels complications. The microvascular complication of
diabetes involves eye complications even blindness, nephropathy leading to renal failure and
neuropathy causing diabetic foot and other infections (WHO, 2019). Moreover,
macrovascular complications of diabetes are heart diseases like strokes, hypertension and
heart attacks. Sarah is having uncontrolled diabetes, to prevent all these complications, she
needs to be educated and motivated ((Ding et al. 2015).
.

Importance of conflict resolution for Healthcare professionals
Conflict resolution is one of the very important communication skills that should be
possessed by health care professionals (Tabak &Koprak, 2007). This is because conflicts are
quite common in the healthcare profession and can occur between patient and care providers
or even among colleagues. Lahana et al (2019) suggested that whenever there is more than
one person, miscommunications can happen and opinions may vary leading to conflicts. So,
effective conflict resolution is one of the key communication skills required in healthcare
practice. Hepp et al (2015) contributed by suggesting that effective conflict resolution greatly
helps in improving the quality of care delivered and also leads to enhanced patient
satisfaction and treatment adherence. On the other hand, Lahana et al (2019) found that
unmanaged conflicts can cause tension and produces poor health outcomes, thus, it becomes
essential to resolve conflicts.
Conflicts must not be looked as an issue rather must be taken positively and as an opportunity
to improve. If a healthcare professional has communication skills of accommodating,
avoiding, compromising, forcing or collaborating, he can very well manage conflicts (Almost
et al., 2016). Almost et al., (2016) also stated that at times, patients may unconsciously pose
difficult attitude by being arrogant, unrealistic or demanding. Such challenging situations
must be faced by wisdom and HCPs must try to understand the patient's viewpoint. Further,
Hepp et al. (2015) suggested that by changing one’s attitude towards difficult patients and
making efforts to change own viewpoint, professionals can manage the conflict as well as the
patient. By learning to deal with conflicts, HCPs can increase patient satisfaction and
ultimately improve their practice productivity (Hospital Access Management, 2018). On the
contrary, Brandenburg, (2017) suggested that if HCPs escalate the conflict by playing the

blame game and turning out, conflicts can be escalated and eventually it would harm the
patient. Therefore, to foster trust and ensure the health and safety of the patient, professionals
need to understand patient's issues and support them by listening, acknowledging, asking and
taking responsibility (Brandenburg, 2017).
Strategies to resolve conflict with Sarah
The two strategies to resolve conflict with Sarah are active listening and verbal
communication skills of avoiding negative language. The first strategy of active listening is
the most essential step in resolving conflict with Sarah. The HCP need to understand her state
of mind and her perspective and for this, it is important to engage well in the communication
session (Jahromi, Tabatabaee, Abdar &Rajabi, 2016). Sarah must feel that she is being heard
and this can be done by adopting the SURETY approach. By sitting at an angle to Sarah with
uncross legs and arms and maintaining optimum eye contact, the HCP should actively listen
to her and consider her viewpoint (Stickley, 2011).
The second strategy is to have positive verbal communication with Sarah. Brandenburg
(2017) suggested that HCPs must avoid negative phrases and sentences while communicating
with the patient and must replace such phrases with more positive phases. For example, HCPs
should not say that ‘You failed to.. or you neglected’ rather sentences as ‘we can suggest you
to..’ or ‘one option open to you is..’ Such positive phrases act as major barrier breakers in
managing conflicts and help in gaining a patient's trust (Jahromi et al. 2016).

Conclusion:
In conclusion, this case study highlighted the rising cases of diabetes, explained the
difference between two major types of diabetes and depicted the complications. The skill of
handling conflicts with people in healthcare has been emphasised which help in developing
trust with patients, improve patient satisfaction and leads to treatment adhesion. By adopting
effective conflict resolution skills such as active listening and positive verbal communication,
HCPs can greatly help and encourage people having a difficult time with diabetes mellitus

References:
Almost, J., Wolff, A. C., Stewart‐Pyne, A., McCormick, L. G., Strachan, D., & D'souza, C.
(2016). Managing and mitigating conflict in healthcare teams: an integrative review. Journal
of advanced nursing, 72(7), 1490-1505.
Brandenburg, S. J. (2017). Nurse Perceived Barriers to Effective Nurse-Client
Communication.
Department of Health. (2016). Retrieved from
http://www.health.gov.au/internet/main/publishing.nsf/Content/chronic-diabetes#com
Diabetes Australia. (2015). Retrieved from https://www.diabetesaustralia.com.au/type-2-
diabetes
Ding, D., Chong, S., Jalaludin, B., Comino, E., & Bauman, A. E. (2015). Risk factors of
incident type 2-diabetes mellitus over a 3-year follow-up: Results from a large Australian
sample. Diabetes research and clinical practice, 108(2), 306-315.
Hepp, S. L., Suter, E., Jackson, K., Deutschlander, S., Makwarimba, E., Jennings, J., &
Birmingham, L. (2015). Using an interprofessional competency framework to examine
collaborative practice. Journal of Interprofessional Care, 29(2), 131–137.
https://doi.org/10.3109/13561820.2014.955910
Jahromi, V.K., Tabatabaee, S.S., Abdar, Z.E., &Rajabi, M. (2016). Active listening: The key
of successful communication in hospital managers. Electronic Physician, 8(3), 2123–
2128. doi:10.19082/2123

Kahn, S. E., Cooper, M. E., & Del Prato, S. (2014). Pathophysiology and treatment of type 2
diabetes: perspectives on the past, present, and future. Lancet, 383 North American
Edition(9922), 1068–1083. https://doi.org/10.1016/S0140-6736(13)62154-6
Lahana, E., Tsaras, K., Kalaitzidou, A., Galanis, P., Kaitelidou, D., & Sarafis, P. (2019).
Conflicts management in public sector nursing. International Journal of Healthcare
Management, 12(1), 33-39.
Patient Access Needs Conflict Resolution Skill Set. (2018). Hospital Access
Management, 37(6), 63–64. Retrieved from https://search.ebscohost.com/login.aspx?
direct=true&AuthType=ip,sso&db=c8h&AN=131266517&site=ehost-live&scope=site
Stickley, T. (2011). From SOLER to SURETY for effective non-verbal communication.
Nurse Education in Practice, 11(6), 395–398. doi:10.1016/j.nepr.2011.03.021
Tabak, N., &Koprak, O. (2007). Relationship between how nurses resolve their conflicts with
doctors, their stress and job satisfaction. Journal of Nursing Management, 15(3),
321–331. doi:10.1111/j.1365-2834.2007.00665.x
World Health Organisation. (2019). Retrieved from
https://www.who.int/diabetes/action_online/basics/en/index3.html