• Subject Name : Nursing

Health and Society

Contents

Introduction:

Anatomy and Physiology.

Pathophysiology.

Current and new treatments.

Social impact of condition/health problem on an individual discussed.

Public health initiatives.

Citation, Referencing and Integration of Source Materials.

Introduction to Type 2 Diabetes Mellitus Analysis

How common is type 2 diabetes?

Diabetes mellitus is a situation where the human body does not respond to the insulin secreted by the Langerhans cells. The cells in our body acquire resistance to the insulin produced and thus, do not utilise the insulin. This result in a condition called hyperglycaemia. This condition occurs when there is an excess of insulin amount in our body.

It is observed that the prevalence of Type 2 Diabetes is more noticeable than Type 1 Diabetes. Nowadays, children at a young age fall prey to this disease.

Who gets type 2 diabetes?

There is no defined age that is prone to diabetes mellitus type 2. Even children are diagnosed with this disease. Although, someone who is more than the age of 40 is much likely to get affected by diabetes mellitus type 2. Pondering about the physical characteristics of someone who is suffering from obesity and is overweight is more likely to get diabetes mellitus type 2 than the ones who are healthy and fit. People belonging to the African-American community, American-Indian or any such migrant community have more chances to acquire diabetes mellitus type 2.

Such communities have genetic type 2 diabetes which cannot be cancelled in the upcoming generations. Gestational diabetes can also lead to type 2 diabetes in the progeny.

What are the causes of type 2 diabetes?

1) diet: being overweight and obese is one of the prime causes of type 2 Diabetes.
2) lifestyle: stress and depression come with a busy lifestyle causing hypertension leading to type 2 diabetes. Smoking causes to increase blood-glucose uptake causing type 2 Diabetes.
3) exercise: lousy and obese person is more likely to develop type 2 diabetes than a person who is sincere at working out (Dendup, et al, 2018).

Can type 2 diabetes be cured?

Type 2 Diabetes is an Autoimmune disorder which is not curable. However, it is reversible. The disease can only be managed and prevented but not be cured completely. It is an ongoing disease which could be controlled if the diet is proper, medications are in time, and the physiological parameters are kept in control.

Can type 2 diabetes be managed?

There are a few ways in which the patients can manage their diabetic condition. The smokers must quit smoking, while the people with high blood pressure and cholesterol ought to control their blood pressure to normal and regulate their lipid levels under optimisation. Planning out the diet by incorporating healthy and nutritious food could keep the health conditions regulated. Fitness must be the key point and the problem of obesity must be channelled in the right direction to provide the best results (Ritu, 2017).

Anatomy and Physiology

Type 2 Diabetes is simply an example of negative feedback. Negative feedback is a cycle that reduces the actual functional output.

After having food, the glucose levels in the blood shoots than normal. This occurs due to the absorption of glucose from the diet.

This rise in the glucose levels results in the increased secretions of insulin from the beta cells of the pancreas.

The other organs like the liver, adipose cells and muscles (storehouse) are stimulated to absorb the glucose. This absorption makes the blood-glucose level fall.

This fall in the blood glucose levels is significant and once it reaches below the threshold, the body alarms against the condition.

This way, the functional output is reduced.

During Diabetes Mellitus Type 2, the secreted insulin is not utilised by the cells of the body because they fail to recognise them and ultimately get resistant to the insulin produced.

Pathophysiology

The major cause of Diabetes Mellitus type 2 is often some genetic changes or even environmental factors affecting cellular changes. Irregular and resistant insulin secretion is featured by some pathophysiological alterations in the human body of the diseased patient.

Prior to the onset of disease, the insulin secretion remains the same while the glucose response lowers. This signals the entrance of this auto-immune disorder. The fasting glucose level of an individual differs significantly from that of an individual who has had his meal. So, after the meal, the glucose level shoots causing postprandial hyperglycemia. It is commonly a multifactorial malady including different qualities that is more, ecological variables to shifting degrees. A certainty considered significant in pathogenesis is that Japanese show lower insulin secretory limit after sugar stacking, proposing littler potential for pancreatic Beta-cell work than Western individuals. It has likewise been brought up that Japanese people may have numerous diabetes-touchy qualities including frugal qualities. The quantity of diabetic patients is expanding quickly reflecting the adjustments in way of life. Weakened insulin release is ordinarily reformist, and its movement comprises glucose harmfulness and lipo-poisonousness (Weir et al., 2020). At the point when not treated, these are known to source a lessening in pancreatic beta-cell mass in being tests. The motion of the debilitation of pancreatic beta-cell effort enormously impacts the drawn-out switch of lifeblood glucose. Patients in early phases after illness start predominantly showing an increase in postprandial lifeblood glucose because of lengthened insulin opposition and weakened beginning stage emission, the flow of the weakening of pancreatic beta-cell work, therefore, roots a lasting rise of blood glucose. Insulin obstruction is a state wherein insulin in the body doesn't put adequate activity corresponding to its blood focus. The weakness of insulin activity in a substantial objective body part, for example, muscles and liver is a characteristic pathophysiological highpoint of type 2 diabetes. Insulin impediment creates and increases the preceding illness beginning (Jehan et al., 2018).

The investigation concerning the microscopic instrument for insulin action has explained how insulin antagonism is identified with genetic elements and biological variables (hyperglycaemia, free unsaturated fats, the incendiary system, and so forth). Realized hereditary components integrate not just insulin receptor and insulin receptor substrate (IRS)- 1 quality polymorphisms that justifiably impact insulin flags however additionally polymorphisms of prudent qualities, for instance, the beta-adrenergic receptor grade and the uncoupling protein (UCP) grade, linked with natural robustness and advance insulin opposition. Glucolipotoxicity and provocative mediators are similarly substantial as the instruments on behalf of weakened insulin discharge and insulin fading hindrance (Kautzky-Willer, 2016).

Current and New Treatments

The objective of diabetes treatment is to make sure about a personal satisfaction (QOL) and life expectancy equivalent to those of solid individuals, and an essential for accomplishing this objective is the counteraction of beginning furthermore, movement of vascular difficulties. The danger of macrovascular illness, for example, cardiovascular problems (atherosclerotic injuries) is expanded as of now in people with minor blood glucose levels, underscoring the necessity for early mediation. Viable treatment to control vascular confusions (Zaccardi et al, 2016). Information on the mediations to forestall the beginning of diabetes, control confusions, and progress guess have exhibited the accompanying realities:

(1) Way of life enhancement and hostile to diabetic medications (- glycosidase inhibitor, metformin, thiazolidine) to tend IGT smother the danger of creating type 2 diabetes,

 (2) SU medications, metformin, and insulin are compelling in regulating both microvascular sickness and macrovascular illness, besides prior intercession is fundamental to govern macrovascular disease, (Heerspink et al, 2016)

(3) far-reaching intercession including pulse and lipid the executives is amazingly powerful in controlling vascular difficulties and decreasing mortality rate,

(4) pioglitazone smothers the repeat of cardiac illnesses. Former furthermore, extra thorough (counting blood glucose, circulatory strain, and lipid) intercession is extra compelling in regulating vascular entanglements and refining visualization.

The therapy worldview for type 2 diabetes:

Initial commencement of mediation is likewise significantly meant for checking the movement of pathophysiological conditions. Early endeavours to eliminate the impact of glucose harmfulness however much as could reasonably be expected and to save pancreatic beta-cell work are basic essentials for the long haul the board of diabetes. The Microvascular malady is all the more firmly related with long haul blood glucose control.

Preferably, the treatment point ought to be to forestall the beginning of diabetes among people with IGT (essential anticipation). Notwithstanding proactive mediation for the way of life improvement, we need to quicken the discussion about whether to utilize pharmacological mediation.

The ongoing outcomes from the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study shows the likelihood that suddenly escalated treatment may every so often prompt poor prognosis. Alternatively, concentrated treatment has been accounted for to accomplish improved control of cardiovascular danger in patients with a minor history of illness. The treatment of patients with chronic ailment and an extended history of destitute blood glucose control, just as folks with cutting edge vascular harm, should focus on the steady development of blood glucose control as opposed to a quick reduction to HbA1c 6%.

Social Impact of Condition/health Problem on An Individual Discussed

Likewise, diabetes routine changes must be kept up by the individual patient inside the setting of accommodating or unhelpful friend and social weights, homegrown and financial obligations, and diverting life occasions. Self-care conduct change must be supported after some time to convert into improved blood glucose control and a decrease or easing back down of diabetes complexities movement (Feng et al, 2017).

Public Health Initiatives

As Type 2 diabetes moves toward a scourge level in our nation, its expansion is commonly credited to biologic qualities and conduct impacts. Several campaigns and awareness agendas are carried out to spread detailed account of diabetes and its underlying causes so that people take it seriously and improve their health. The Prediabetic Campaign in the US is one of the major awareness campaigns of the country. Biologic elements are identified with hereditary inclinations for the condition or therapy for other ailments and incorporate factors, for example, age, family ancestry, testosterone lack, and utilization of atypical antipsychotics or statins. Behavioural impacts incorporate factors, for example, physical dormancy and insufficient sleep. Although complex, the connection between Type 2 diabetes and weight is multifactorial and can additionally confuse counteraction and management. Type 2 diabetes is likewise connected with numerous other comorbid difficulties, for example, hypertension, cardiovascular illness, stroke, kidney failures, and visual impairment, further increasing medical services use and related expenditures. With almost 2 million new cases analyzed every year, Type 2 diabetes is an exorbitant general medical problem that provokes our ability to react at the patient level in an extensive and systemwide manner (Bertoglia et al., 2017).

Citation, Referencing and Integration of Source Materials

Bertoglia, M. P., Gormaz, J. G., Libuy, M., Sanhueza, D., Gajardo, A., Srur, Erazo, M. (2017). The population impact of obesity, sedentary lifestyle, and tobacco and alcohol consumption on the prevalence of type 2 diabetes: Analysis of a health population survey in Chile, 2010. PloS one12(5), e0178092.

Dendup, T., Feng, X., Clingan, S., & Astell-Burt, T. (2018). Environmental risk factors for developing type 2 diabetes mellitus: a systematic review. International journal of environmental research and public health15(1), 78.

Feng, X., & Astell-Burt, T. (2017). Impact of a type 2 diabetes diagnosis on mental health, quality of life, and social contacts: a longitudinal study. BMJ Open Diabetes Research and Care5(1)

Heerspink, H. J., Perkins, B. A., Fitchett, D. H., Husain, M., & Cherney, D. Z. (2016). Sodium glucose cotransporter 2 inhibitors in the treatment of diabetes mellitus: cardiovascular and kidney effects, potential mechanisms, and clinical applications. Circulation134(10), 752-772.

Hochberg, I., Feraru, G., Kozdoba, M., Mannor, S., Tennenholtz, M., & Yom-Tov, E. (2016). Encouraging physical activity in patients with diabetes through automatic personalized feedback via reinforcement learning improves glycemic control. Diabetes care39(4), e59-e60.

Jehan, S., Myers, A. K., Zizi, F., Pandi-Perumal, S. R., Jean-Louis, G., & McFarlane, S. I. (2018). Obesity, obstructive sleep apnea and type 2 diabetes mellitus: Epidemiology and pathophysiologic insights. Sleep medicine and disorders: international journal2(3), 52.

Kautzky-Willer, A., Harreiter, J., & Pacini, G. (2016). Sex and gender differences in risk, pathophysiology and complications of type 2 diabetes mellitus. Endocrine reviews37(3), 278-316.

Ritu B. (2017), Type 2 Diabetes, Mayo Clinic

Weir, G. C., Gaglia, J., & Bonner-Weir, S. (2020). Inadequate β-cell mass is essential for the pathogenesis of type 2 diabetes. The Lancet Diabetes & Endocrinology8(3), 249-256.

Zaccardi, F., Webb, D. R., Yates, T., & Davies, M. J. (2016). Pathophysiology of type 1 and type 2 diabetes mellitus: a 90-year perspective. Postgraduate medical journal92(1084), 63-69.

Zheng, Y., Ley, S. H., & Hu, F. B. (2018). Global aetiology and epidemiology of type 2 diabetes mellitus and its complications. Nature Reviews Endocrinology14(2), 88.

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