Diabetes type 1 is commonly occurring diabetes in which the body is enable to produce enough insulin to help in controlling the blood glucose levels. It is usually insulin dependent diabetes as additional insulin amount is needed to help the body sustain the normal levels. Managing blood glucose levels is very crucial in order to prevent any associated complications. The following case study evaluation will be helpful in identifying the key challenges faced by the individuals suffering from the same and as to how they can be helped with, in order to manage their condition through a holistic approach.
Diabetes is a major chronic illness that can also facilitate in manifesting other health related issues as well. The patient in the case study is suffering from diabetes type 1 and is also obese. The presence of obesity in the individuals suffering from type 1 diabetes can increase the risk of insulin resistance. This is liable to cause hypoglycemia as well as increased cardiovascular risks in the person. The increased weight of the patient along with irregular working hours is also liable to bring about complication associated with diabetes. The patient in the case study is also having poorly managed working hours. It is possible that she is having poor eating habits as well, as she is unable to give sufficient time for dietary regulation. Poor dietary regulations can be observed as increased salt or sugar intake, intake of fast food and so on. This can lead to cardiovascular complications, dyslipidemia and hypertension and so on in the patient (Corbin, 2018).
These conditions can also be observed as comorbidities in individual, ultimately increasing the prevailing stress in managing the disease condition. Poor dietary control is also directly associated with poor metabolic regulation in the body, leading to abrupt blood glucose levels. Therefore, the patient obese status of BMI is directly related to development of type 1 diabetes in the patient (Verma, 2017). Due to the additional stress of the disease burden the patient is also observed to be having symptoms of depression. This deterioration in mental health status can have a detrimental effect on the physical well-being of the individual (Sickel, 2019). This depressive mood of the patient is also liable to cause impact on the individual in terms of managing work life balance. The stress can further lead to decrease in the physical capacity of the patient by multiple folds, thus, increasing the risk and complications of obesity as well as diabetes.
Following team members can be helpful in assisting the individual in managing her condition:
Dietician- The dietician can be helpful in providing a diet that can be both as per Abbey’s food choices as well as in sync with her working schedule. The patient can also be encouraged to keep a track of the calorie intake during the day to encourage her for having good eating habit. Diet can play a major role in helping the patient reduce her weight as well as keep a close vigil on her salt and sugar intake (Harris, 2018).
Guidance counsellor- The counsellor can provide the information to the patient about the alternate treatment methods for her condition. They can also help the patient in resolving her concerns and misconceptions regarding the diseased condition.
Psychologist- They can help the patient to manage her depression. The patient can be helped with the means of group therapy sessions. By interacting the patients suffering from the same condition, the patient will be able to relate well with her own issues and thus, will be helpful in providing the patient with a sense of re-assurance (Hilliard, 2016).
General practioner- They can help the patient with the medical management part. They can also provide the patient with education sessions as to how to administer her insulin on regular basis. The patient can also be encouraged for self-monitoring of the blood glucose levels and can be helped with managing the same. The general practioner can work in collaboration with the specialists that can assist the patient in managing her complications as well. In few cases the patients might develop kidney related issues and the general practioner in such case scenarios can refer the patient to nephrologist, endocrinologist and so on. They can also assist the patient in managing other diabetes related complications such as diabetic neuropathy, diabetic retinopathy, and diabetic nephropathy and so on (Wilkie, 2017).
Physical therapist- The role of physical therapist can be seen in encouraging the patient for including physical activity in her daily routine. The patient can be motivated to start with low intensity exercises having a duration of at least 30 minutes daily. The patient can also be encouraged for swimming, which can be helpful in managing her weight as well (Mottalib, 2017).
The role of nurse in managing any chronic condition supersedes the role of other healthcare professionals. The nurse can be observed to be working in collaboration with the members of multidisciplinary team, in order to provide the patient with the holistic care support as needed by them. The nurse in the given scenario can work in close sync with the patient to help in identifying and preventing early complications. The nurse can also play the role of the educator, by providing the patient with the proper guidance on management of her condition. The nurses in the given scenario can work in collaboration with the dietician in order to help with the weight control (Alotaibi, 2018).
Educative pamphlets can also be provided to the patient with required information of valid resources that can be helpful for her in smooth facilitation of management of her condition. The nurse can also keep a regular follow-up with the general physician as well as the psychologist, in order to keep a close monitoring on the patient mental as well as physical health status. The patient can also be taught self-care, by imparting education to her regarding the adverse signs and symptoms. The patient can be encouraged to observe these signs and report back with any concerns in timely manner. The nurses can also help in medication adherence with the help if setting alarm on insulin pump, so that the patient does not miss any of her dose (Smallwood, 2017).
Nurses can also aid the patient by keeping close monitoring of vitals as well as taking regular feed backs through telephonic conversations or other feasible means of communication. The regular follow-ups can also be done by the means of regular home-visits and helping the patient is medication refilling as well as reconciliation. The nurse can also help the patient in a role of facilitator, by working in collaborative approach with the community based services that can be helpful in providing urgent care and management in times of distress.
Diabetes is a chronic illness that can be give rise to many health related issues. These can be observed in the form of various complications. The role of collaborative approach of multidisciplinary team is of vital importance in helping the patient not only managing their condition, but also from the point of view of providing the patient with a composite care model of treatment. The nurses can be observed as the front line managers, working in close coordination with the patient as well as various healthcare professional in assisting in smooth facilitation of best possible healthcare solution to the patient. Thus, helping in obtaining improved healthcare outcomes from the patient and improving their quality of life.
Alotaibi, A., Gholizadeh, L., Al‐Ganmi, A. H. A., & Perry, L. (2018). Factors influencing nurses’ knowledge acquisition of diabetes care and its management: A qualitative study. Journal of Clinical Nursing, 27(23-24), 4340-4352.
Corbin, K. D., Driscoll, K. A., Pratley, R. E., Smith, S. R., Maahs, D. M., Mayer-Davis, E. J., & Advancing Care for Type 1 Diabetes and Obesity Network (ACT1ON). (2018). Obesity in type 1 diabetes: pathophysiology, clinical impact, and mechanisms. Endocrine Reviews, 39(5), 629-663.
Harris, S. M., Joyce, H., Miller, A., Connor, C., Amiel, S. A., & Mulnier, H. (2018). The attitude of healthcare professionals plays an important role in the uptake of diabetes self‐management education: analysis of the Barriers to Uptake of Type 1 Diabetes Education (BUD 1E) study survey. Diabetic Medicine, 35(9), 1189-1196.
Hilliard, M. E., Powell, P. W., & Anderson, B. J. (2016). Evidence-based behavioral interventions to promote diabetes management in children, adolescents, and families. American Psychologist, 71(7), 590.
Mottalib, A., Kasetty, M., Mar, J. Y., Elseaidy, T., Ashrafzadeh, S., & Hamdy, O. (2017). Weight management in patients with type 1 diabetes and obesity. Current Diabetes Reports, 17(10), 92.
Sickel, A. E., Seacat, J. D., & Nabors, N. A. (2019). Mental health stigma: Impact on mental health treatment attitudes and physical health. Journal of Health Psychology, 24(5), 586-599.
Smallwood, C., Lamarche, D., & Chevrier, A. (2017). Examining factors that impact inpatient management of diabetes and the role of insulin pen devices. Canadian Journal of Diabetes, 41(1), 102-107.
Verma, S., & Hussain, M. E. (2017). Obesity and diabetes: an update. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 11(1), 73-79.
Wilkie, L., Mitchell, F., Robertson, K., & Kirk, A. (2017). Motivations for physical activity in youth with type 1 diabetes participating in the ActivPals project: a qualitative study. Practical Diabetes, 34(5), 151-155.
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