NMIH201: Comprehensive Report on Type 2 Diabetes, 2019

This report provides a comprehensive overview of Type 2 Diabetes, examining its epidemiology, including age of onset, incidence, and mortality rates, particularly within the Australian context. It delves into the pathophysiology of the disease, exploring its connection to presenting symptoms and ...Read More

Running Head: HEALTHCARE 1
Healthcare
Student’s Name
Professor’s name
Institution Affiliation
Date

HEALTHCARE 2
Introduction
For the past years Type 2 diabetes used to be well-thought-out as an illness of middle-
aged and aged individuals, however in the present years the occurrence of Type 2 diabetes
amongst teenagers has drastically increased significantly worldwide, determined mostly by
amassed obesity occurrence during early ages. A research conducted by the Japanese indicated
that type 2 diabetes grew drastically among young teenagers who are aged between 6–12 years
and doubled up amongst the youths for a period of 20 years (Atkinson, Eisenbarth, and Michels,
2014). In Australia, individuals detected with type 2 diabetes are between the ages of 11–
38 years were about 10% of the accounted recently recorded occasions in the year 2011.
Evaluate the Epidemiology of Type 2 Diabetes comprising of the age of onset, incidence,
occurrence, and illness and death ratios around Australia.
By help of a population-linked unit comprising of relatively 89% of all Australians
affected with type 2 diabetes in the middle of 1996 and 2012, it was indicated that a teenage age
at analysis of type 2 diabetes was linked with advanced all-source and CVD, IHD and instant
deaths, nevertheless less deaths caused by cancer, associated with analysis at an elder age. To
record these outcomes into a documented form, for two males who are the same age but are
distinguished by 10 years’ variations in diabetes suffered duration, the one diagnosed with the
earlier onset had a relatively 40% and 70% bigger chance of mortality from a few sources and
CVD, correspondingly, according to the male with the less time, at any age (Cuthbert, 2015).
Merely a partial sum of surveys has studied the consequence of age at analysis on the risk
of deaths. In researches where these studies have been carried out most have put in place age at
the analysis or diabetes period as a definite instead of an incessant variable. Present research

HEALTHCARE 3
from Denmark indicated that, at every specified age, teenage age at the examination of type 2
diabetes was linked with greater all-source death for the male gender; nevertheless the more risk
that leads to age at examination was considered to very weak amongst the females (Constantino,
Molyneaux, Limacher-Gisler, Al-Saeed, Luo, Wu and Wong, 2013). This duty only studied all-
source death and was health-linked, in variation to the results that indicated identical importance
as linked in both females and males.
The proof is amassing to claim that former onset of type 2 diabetes is linked to a
developed danger of problems and comorbidities which are associated with recent onset and that
the advancement and development of challenges which may be more hostile in those with former
onset. In Pima Indians, adolescence-onset type 2 diabetes is linked with an identical occurrence
of explicit nephropathy but then a significantly developed situation of the last-phase renal illness
linked with grownup-onset type 2 diabetes (Constantino, et al. 2013). Additionally, in this
regiment, retinopathy danger at 20 years’ diabetes period was greater for teenage-onset
compared with those for elder-onset type 2 diabetes regardless of the recent teenage age.
Therefore, centrally to death results, for micro-vascular results, the impact of age is weak
compared to the time of diabetes (Kleinman, Shah,Shah, Phatak and Viswanathan, 2017).
Discoveries from other surveys further indicate that individuals with early-onset diabetes
tend to be having the worst CVD details as compared to those examined at elder ages. Cross-
Sectional research carried out in a prime care scenery indicated that individuals with early-onset
type 2 diabetes in the United Kingdom were already recorded with a dangerous cardiovascular
profile similar to that of an elder grownup suffering from type 2 diabetes (Kleinman, et al. 2017).
Individuals who have early-onset type 2 diabetes are furthermost probable to have worse control

HEALTHCARE 4
of their glucose level, incurable hypertension, and hyperlipidemia (Czupryniak, Barkai,
Bolgarska, Bronisz, Broz, Cypryk and Martinka, 2014).
Evaluate the pathophysiology of Type 2 diabetes as it connects to the presenting symptoms.
Type 2 diabetes mellitus is a diverse illness with variable occurrence amongst various
cultural sets. In the United States, the residents who suffer from this illness are Local Americans,
especially those located in the desert Southwest, Hispanic-Americans, and Asian-Americans.
This disorder is categorized by outlying insulin confrontation, weakened production rate of
hepatic glucose regulation, and decreasing β-cell function, finally toβ -cell is destroyed and stops
functioning (Lee et al, 2014). Type 2 diabetes progresses when the body turns out to be resilient
to insulin or when the pancreas is incapable of producing adequate insulin. Precisely why this
takes place is unidentified, even though genetics and ecological aspects, like gaining weight and
indolent, are claimed to be the major causes.
The role of glucose
Glucose as a form of sugar is a major base of energy for the cells which build up muscles
and various nerves. Glucose originates from two main factors: food and a person’s liver. Sugar is
engrossed by the bloodstream, where it gets into cells through the assistance of insulin. The
liver’s function in the body is to stock and produce glucose. Whenever the amount of glucose is
less, like when one has not consumed in a long period, the liver breaks down stocked glycogen
until glucose is formed to ensure the amount of glucose is around a usual range (Lee, et al.
2014). In type 2 diabetes, this procedure doesn't function properly as instead of transporting the
sugar into one’s cells; the sugar accumulates up into a person’s bloodstream.

HEALTHCARE 5
Risk Causes
Causes that might expose a person to the dangers of type 2 diabetes consist of:
Overweight: an individual who is overweight is greatly exposed to the dangers encountered by
type 2 diabetes. Nevertheless, one is not necessarily supposed to be overweight to suffer from
type 2 diabetes.
Fat distribution: In case one store fat mostly in the lower part of the stomach, one is greatly
exposed to the danger of suffering from type 2 diabetes compared to the individuals who store fat
in other parts of the body, like in the hips and thighs (Reddy, MRilstone, Cooper and Oliver,
2016). A person’s degree of being exposed to type 2 diabetes increases if one is of the male
gender with abdomen limits of more than 40 inches or a female with an abdomen which is more
than 35 inches.
Inactivity: The more inactive one is the more rates of being exposed to the dangers of type 2
diabetes. Physical activity assists one to regulate and control their weight, the consumption rate
of glucose increases as one is active and increases the sensitivity of one’s cells to insulin.
Age: The danger of type 2 diabetes develops as one age, particularly after age 46. This is perhaps
why individuals prefer to exercise less, lose muscle mass and gain weight as they age (Reddy, et
al. 2016). On the other hand, type 2 diabetes is further amassing intensely amongst the young
individuals, teenagers and younger grownups.
Complications

HEALTHCARE 6
Type 2 diabetes is said to be easily ignored, particularly during the early phases when an
individual is feeling healthy than before. However, diabetes develops and destroys most
important and crucial parts of the body, as well as a person’s heart, blood vessels, muscles, eyes
and kidneys (Reddy, et al. 2016). By regulating your levels, blood sugar one is capable of
preventing such complications from taking place.
Heart and blood vessel illness: Diabetes intensely upsurges or exposes one to risks such as
heart attacks, stroke, increased blood pressure and contraction of blood vessels.
Nerve impairment: Surplus sugar can lead to prickly, emotionlessness, sweltering or agony that
regularly starts at the tip part of the toes or fingers and progressively extends to the upper parts of
the body. Finally, one possibly will lack all senses of sensitivity in the affected parts of the body.
Destruction of the muscles or nerves which are responsible for controlling ingestion can lead to
challenges with biliousness, queasiness, diarrhea or constipation (Thomas, Cooper and Zimmet,
2016).
Kidney mutilation: Diabetes can occasionally lead to the malfunctioning of the kidney or
permanent final-phase kidney illness, which may need dialysis or a kidney transfer.
Eye impairment: Diabetes upsurges the danger of severe eye illnesses, like cascades and
glaucoma, and may destroy the blood cells and vessels of the retina, possibly may lead to the loss
of eyesight (Thomas, et al. 2016).
Slow curing: Left damaged, wounds and swellings are said to cause severe contagions, which
even when treated tend to heal poorly.

HEALTHCARE 7
Discuss the Management and nursing attention of an individual with type 2 diabetes, as
well as medicine, the occurrence of self-analysis, along with diet, workouts, and training
Glycemic regulation is said to be important when one is managing diabetes. Potential
regular clinical tests like the Diabetes Control and Complications Trial (DCCT) and the United
Kingdom Prospective Diabetes Study (UKPDS) have indicated that progressed glycemic
regulation is linked to the continued reduced degrees of retinopathy, nephropathy, and
neuropathy (Ma and Chan, 2013). Epidemiological surveys sustain the possibility of
concentrated glycemic regulation in reducing CVD. A most important disadvantage to the
existing details or information is that they do not recognize the optimal level of regulating
specific patients, as there are people with variations in the dangers of hypoglycemia, gaining
weight, and various adversative results (Zheng, Ley, Hu, 2018). Additionally, with
multifunctioning interferences, it is uncertain how various mechanisms such as learning
interferences, glycemic objectives, day to day adjustments, and pharmacological causes lead to
reducing these problems.
PRECLUSION AND CONTROLLING DIABETES PROBLEMS
I. CVD: controlling of risk causes and examination for coronary artery illness
CVD is the main source of death for individuals who have diabetes. It is likewise the
main cause of disease and direct and indirect expenses of diabetes. Type 2 diabetes is a self-
governing risk source of macro-vascular illness, and it is commonly simultaneous disorders
which are further considered risk factors (Saffari, Ghanizadeh and Koenig, 2014).

HEALTHCARE 8
Surveys have indicated that the effectiveness of decreasing cardiovascular risk sources is
by avoiding or reducing CVD. Proof has briefed in the succeeding phases and look over
extensively in the ADA practical assessments on hypertension, dyslipidemia, migraine treatment,
and smoking cessation according to the agreement declaration involving CHD about individuals
with diabetes (Zheng, et al. 2018). Focus is supposed to concentrate on the reduction of
cardiovascular risk sources, when conceivable, and nurses are supposed to be aware of signs and
symptoms involving atherosclerosis.
A. Blood pressure control
Hypertension is referred to as common comorbidity involving diabetes, disturbing about
30–70% of individuals who are suffering from diabetes, according to time of life, plumpness,
and origin. Hypertension is further the main risk source designed for CVD and micro-vascular
problems like retinopathy and nephropathy. According to type 1 diabetes, hypertension is mostly
the outcome of fundamental nephropathy. Involving type 2 diabetes, hypertension is supposed to
exist in the group of the metabolic condition such as plumpness, hyperglycemia, dyslipidemia
which go along with great degrees of CVD (Zimmet, Magliano, Herman and Shaw, 2014).
Random medical tests have revealed the undeniable advantage of decreasing high blood
pressure to <135 mmHg systolic and <85 mmHg diastolic to an individual suffering from
diabetes. Epidemiologic studies indicate that blood pressures >130/85 mmHg are linked to larger
cardiovascular incident degrees and deaths of individuals who have diabetes (Zimmet, et al.
2014). Consequently, a goal set blood pressure aims at <135/85 mmHg is sensible when safely
attained.

HEALTHCARE 9
By using regimes decreasing of blood pressure according to antihypertensive
medications, together with ACE inhibitors, angiotensin receptor blockers (ARBs), β-blockers,
diuretics, and calcium network blockers, which is claimed to be efficient when decreasing
occurrence of cardiovascular disorders (Zimmet, et al. 2014). Numerous surveys claim that ACE
inhibitors tend to be greater to dihydropyridine calcium channel blockers (DCCBs) during the
reduction of cardiovascular disorders.
ACE stimulants have been used in improving cardiovascular results during high
cardiovascular peril patients with or without hypertension (Russell, King, Smillie, Kodji, Brain,
2014). For individuals suffering from a congestive heart disorder, ACE stimulants are linked
with greater results when associated with ARBs. ARBs they also recover cardiovascular results
in the subsection of individuals suffering from hypertension, diabetes, and final-body part wound
extended (Ludvigsson, Leffler, Bai, Biagi, Fasano, Green, Lundin, 2013).
Long-term probable problems of improper blood glucose level regulation
Micro-vascular Problems: Eye, Kidney, and Muscle Illness
Everyone has little blood vessels which are easily destroyed by constantly high blood
glucose over time. Destroyed blood vessels lack to distribute blood all over the body as they are
supposed to (Ruggiero, Riley, Hernandez, Quinn, Gerber, Castillo and Butler, 2014). Hence this
leads to other challenges, precisely with the eyes, kidneys, and muscles.
Eyes: Blood glucose drops out of the regular rate for an extensive period which mostly leads to
cascades and retinopathy in the eyes. The two disorders can lead to loss of eyesight (Zinman et
al, 2015). To prevent eye complications linked to diabetes, level your blood glucose around the

HEALTHCARE 10
rate and have regular eye check-ups which involve an opened eye test with an optician to
examine your health of the eye.
Conclusion
Diabetes signifies key and developing difficulties to the medical issue and the economic
status of our state. The dimensions involving recent and upcoming consequences involving
diabetes on people, relatives and societies obligate that the significant duty on its management
carried out so far is ominous. Recent interferences are required, and recognized intercessions are
made accessible to every person who may advantage from them. Acceptance of living a hale and
hearty lifestyle is important in preventing the occurrence of type 2 diabetes, however significant
development in this field will only take place around the basis of communal and government
assistance for and simplification of suitable day to day choices.

HEALTHCARE 11
References
Atkinson, M. A., Eisenbarth, G. S., & Michels, A. W. (2014). Type 1 diabetes. The Lancet,
383(9911), 69-82.
Constantino, M. I., Molyneaux, L., Limacher-Gisler, F., Al-Saeed, A., Luo, C., Wu, T., ... &
Wong, J. (2013). Long-term complications and mortality in young-onset diabetes: type 2
diabetes is more hazardous and lethal than type 1 diabetes. Diabetes care, 36(12), 3863-
3869.
Cuthbert, B. N. (2015). Research Domain Criteria: toward future psychiatric nosologies.
Dialogues in clinical neuroscience, 17(1), 89.
Czupryniak, L., Barkai, L., Bolgarska, S., Bronisz, A., Broz, J., Cypryk, K., ... & Martinka, E.
(2014). Self-monitoring of blood glucose in diabetes: from evidence to clinical reality in
Central and Eastern Europe—recommendations from the international Central-Eastern
European expert group. Diabetes technology & therapeutics, 16(7), 460-475.
Kleinman, N. J., Shah, A., Shah, S., Phatak, S., & Viswanathan, V. (2017). Improved medication
adherence and frequency of blood glucose self-testing using an m-Health platform versus
usual care in a multisite randomized clinical trial among people with type 2 diabetes in
India. Telemedicine and e-Health, 23(9), 733-740.
Lee, J. A., Nguyen, A. L., Berg, J., Amin, A., Bachman, M., Guo, Y., & Evangelista, L. (2014).
Attitudes and preferences on the use of mobile health technology and health games for
self-management: interviews with older adults on anticoagulation therapy. JMIR mHealth
and uHealth, 2(3), e32.

HEALTHCARE 12
Ludvigsson, J. F., Leffler, D. A., Bai, J. C., Biagi, F., Fasano, A., Green, P. H., ... & Lundin, K.
E. A. (2013). The Oslo definitions for coeliac disease and related terms. Gut, 62(1), 43-
52.
Ma, R. C., & Chan, J. C. (2013). Type 2 diabetes in East Asians: similarities and differences with
populations in Europe and the United States. Annals of the New York Academy of
Sciences, 1281(1), 64-91.
Reddy, M., Rilstone, S., Cooper, P., & Oliver, N. S. (2016). Type 1 diabetes in adults: supporting
self management. Bmj, 352, i998.
Ruggiero, L., Riley, B. B., Hernandez, R., Quinn, L. T., Gerber, B. S., Castillo, A., ... & Butler,
P. (2014). Medical assistant coaching to support diabetes self-care among low-income
racial/ethnic minority populations: randomized controlled trial. Western journal of
nursing research, 36(9), 1052-1073.
Russell, F. A., King, R., Smillie, S. J., Kodji, X., & Brain, S. D. (2014). Calcitonin gene-related
peptide: physiology and pathophysiology. Physiological reviews, 94(4), 1099-1142.
Saffari, M., Ghanizadeh, G., & Koenig, H. G. (2014). Health education via mobile text
messaging for glycemic control in adults with type 2 diabetes: a systematic review and
meta-analysis. Primary care diabetes, 8(4), 275-285.
Thomas, M. C., Cooper, M. E., & Zimmet, P. (2016). Changing epidemiology of type 2 diabetes
mellitus and associated chronic kidney disease. Nature Reviews Nephrology, 12(2), 73.
Zheng, Y., Ley, S. H., & Hu, F. B. (2018). Global aetiology and epidemiology of type 2 diabetes
mellitus and its complications. Nature Reviews Endocrinology, 14(2), 88.
Zimmet, P. Z., Magliano, D. J., Herman, W. H., & Shaw, J. E. (2014). Diabetes: a 21st century
challenge. The lancet Diabetes & endocrinology, 2(1), 56-64.

HEALTHCARE 13
Zinman, B., Wanner, C., Lachin, J. M., Fitchett, D., Bluhmki, E., Hantel, S., ... & Broedl, U. C.
(2015). Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes. New
England Journal of Medicine, 373(22), 2117-2128.