The Role of Exercise and Nutrition in Type II Diabetes, Research Paper Example

Introduction

In this research the health condition type 2 diabetes mellitus was selected for analysis as the health condition of significance. The presentation consist of two parts; a nursing process section followed by a nursing research whereby two articles pertaining to type 2 diabetes and the relevant diagnosis will be reviewed.

Section 1: Nursing Diagnosis

Description of the health condition

Type 2 diabetes mellitus is a metabolic disorder affecting the human pancreas. The disorder is characterized by high blood random sugar levels above 200mg and fasting over 110mg. Other symptoms associated with the dysfunction are frequent urination exceptional hunger and thrust along with unexplained weight loss. Type 2 diabetes Mellitus if the most common three classified diabetes conditions. They are diabetes insipidus, diabetes mellitus type 1 and diabetes mellitus type 2. Type 2 diabetes mellitus, significantly, manifests as insulin resistance whereby the body does not produce enough insulin to metabolize all its sugars and carbohydrate intake (Sarwar, Gao, &Seshasai, 2010).

As such, the pathophysiology of type 2 diabetes mellitus reflects a situation of poor carbohydrate and sugar absorption within the body cells and tissues. The islet of Langerhans is responsible for producing insulin. In the early stages this insulin intolerance could be reversed by many therapeutic interventions. They include medication, diet and exercise. Type 2 diabetes is often diagnosed later in life from age 35 – 40 and upward. With diet and exercise many cases are reversed, but not cured because there is no cure for diabetes mellitus (Sarwar et. al, 2010)

Precisely, the body gets glucose from three sources. They are intestinal absorption of food known as glycogen synthesis; the liver, which stores a form of glucose and the generation of glucose from carbohydrate substrates ingested into the body. Insulin is responsible for balancing glucose levels within the human body. By reducing the glycogen synthesis. This hormone is also capable of transporting glucose in fat cells and muscle. Hence the wasting of body fast experienced by persons with diabetes type two and other forms of the disorder. When glucose levels are consistently high in the blood it is reabsorbed by the kidney and circulates in the urine(Sarwar et. al, 2010)

It is important to devise methods in controlling the onset of this disease, since diet is a contributory factor along with a sedentary life style. Obesity has been the leading predisposing factor for type 2 diabetes. More importantly, the complications of uncontrolled type 2 diabetes mellitus are severe. They include retinal damage, which can ultimately lead to blindness; cardio vascular disorders such as hypertension and heart disease, kidney failure, cognitive dysfunction and peripheral neuropathy all long term effects. In the short termhyperglycemia and diabetic ketoacidosis are frequent compilations ((Sarwar et. al, 2010).

Statistics as of 2013 on diabetes internationally showed where approximately 382 million people were affected by the disorder. Type 2 diabetes accounted for 90% of all cases diagnosed. This figure represents 8.3% of the adult population witha equal distribution between men and women. Further, in 2012 complications of diabetes was the recorded as the 8^th leading cause of death accounting for 1.5 million people globally.These deaths are most frequent in among low and middle income families/countries. Interestingly type 2 diabetes is most prevalent among developed nations. Developing and underdeveloped nations, which show significant increases in type 2 diabetes mellitus cases also indicate a predisposition to urbanization which is considered environmental. Research is still being conducted into assumptions that diet and insufficient exercise are the leading causes of type 2 diabetes mellitus (Mathers &Loncar, 2006).

Three part medical diagnosis

Clinical condition, or health problem.

A three part nursing/medical diagnosis follows the format of problem, etiology and symptoms

Problem – The problem here is related to consistently high blood sugar levels above the normal l

Etiology– The etiology part of this diagnosis describes reasons for the problem. This reads insufficient insulin to synthesize sugars and carbohydrates taken into the body; obesity and inadequate nutrition.

Symptoms – This according NANDA is defining characteristics of the problem by NANDA. Unexplained weight loss for the past three months; frequency in urination, hunger, thirst, fatigue and blurred vision.

One short/long term client goal

At the end of six months this client ought to have blood sugar levels at 150 mgs or lower.

Identification of three nursing interventions to facilitate achievement of goal/s

Three nursing interventions, which are necessary immediately is instituting patient education on diabetes care. The rationale for this intervention relates to the fact that many people diagnosed with type 2 diabetes never understand how the disease occurs. Only if they knew that by taking the necessary precaution the situation might have been different. Now that he/she is diagnosed education on how to control blood sugar and delay complications is very important diagnosed.The education intervention would take the form of three hourly interactive sessions with a close relative and another health care worker. Both patient and relative would be asked to voice their knowledge about the disease. Clarification would be made as misunderstands are identified. Patients and relative would agree to meeting the goal of lower blood sugar levels to 150 and below on a daily basis. At the end of each session on form recording how much was learnt from the interaction will be filled out by the patient and relative. This responses will be rated as an evaluation of whether the patient and relative understand the requirement for meeting this goal.

The next intervention pertains to assisting the patient to eat a diet that would enable the blood sugar levels to be stabilized. She would be offered a diet sheet showing the foods that could to be minimized and ones which can be lavishly tolerated. For two-weeks she would record on a diet sheet what she eat for breakfast, morning snack, lunch afternoon snack and dinner. Foods would be compared to determine if they coincide with the proposed menus. This is a method of evaluating if the patient followed instructions correctly.

The third intervention is assisting the patient to test and record glucose level readings correctly. Many diabetics do not take their blood sugar readings correctly. Those who are on sliding scale insulin this is disastrous when testing is inaccurate. As such, at three interactive sessions with a close relative. The patient would be offered a glucose meter which is simple to understand the reading of the blood sugar. Simultaneously she would be asked to bring the machine she uses and home. At the interactive session the patient would be asked to demonstrate how she takes her blood sugar. Observations will be made in order to discern discrepancies, which will be clarified. Once this aspect is completed a demonstration by the nurse facilitator using the meter offered to the client at this session will be undertaken. Any concerns will be addressed and the client will then take her own blood sugar using the new meter. Observations will be made an an evaluation of whether she can now correctly test and record her blood glucose level using the device.

Section 2:  Nursing Research

Summary of 2 research article

John Hopkins University (2013).Evaluating the Effects of a Diet and Exercise Program in People with Type 2 Diabetes or Prediabetes. The national Institute of Health.(The SHAPE3 Study).

This study was designed to compare the effects of ‘a weight loss diet versus a weight loss diet plus an exercise program on body composition and cardiovascular factors that are early predictors of future cardiovascular disease in overweight and obese people with type 2 diabetes and Prediabetes’ ( John Hopkins University, 2013. p. 1). Researchers utilized an interventional study applying a randomized Endpoint Classification: Efficacy Study detailing a parallel assignment masking with the primary purpose of prevention. This study began in 2009 and ended in 2011. A total of 77 subjects were enrolled in the program. The inclusion criteria were overweight people with type 2diabetes mellitus. Methods of execution involved active comparator diet; active comparator weight loss diet plus exercise;behavioral weight loss diet and behavioral weight loss diet plus exercise as the control intervention. Subjects had to be 30 -65 years old to be eligible for the study. Researchers hypothesized in their conclusion that by limiting the amount of calorieconsumed dailyand increasing physical activity are b very important features in important factors improving blood glucose control( John Hopkins University, 2013).

However, they further contend that there has been insufficient research regardingdiet and exercise as it pertains to abdominal obesity, blood vessel structure,fitness, heart disease and its factors.  As such they attempted to investigate the impact of diet and exercise on reducing these factors and controlling blood sugar levels ultimately( John Hopkins University, 2013).

Polikandrioti1, M., &Dokoutsidou, H. (2009).The role of exercise and nutrition in type II Diabetes mellitus management.Health science Journal, 3(4); 216 -220.

The purpose of this study was reviewing the role of exercise and nutrition in type II diabetes mellitus. The authors applied abibliography research through a literature review analysis implicating exercise and nutrition in type II diabetes mellitus Management. The authors were able to retrieve a number of primary studies related the effectiveness of diet and exercise in reversing diabetes symptoms. They concluded that enough valid evidence was found from the studies reviewed to advance the use of diet and exercise in controlling type2 diabetes

Discussion on how nurses can apply interventions/findings to practice

Both the primary research source and supporting article support diet and exercise. In my opinion as a nurse these interventions can be practiced at both the primary care level  as well as secondary interventions when clients seldom adhere to education. Primary care is preventive. Therefore life style regulation regarding what clients eat and how mobile they are on a daily routine determines the outcome of diabetes. These studies support the evidence that people who do not following a regular exercise program and eat food sparse in fruits and vegetables tend to manifest complications earlier than those who are compliant with diet and exercise.

Discussion of how 2nd supporting article could be applied to nursing practice.

Findings of the literature bibliography o studies are profound. The author used key wordsphysical activity- type II diabetes mellitus-nutrition- management in retrieving studies for the review. The authors revealed that there are 146 million people living with diabetes worldwide. However, from my personal research a larger number of 382 million was tendered. It was significant that an incidence rate was offered and it is hopeful that this number is authentic. There is a great difference between 146 million and 382million. Essentially, I have learnt from this article to conduct my own research if authenticity and validity issues in a conclusions and findings are to be erased. Also this was not a primary research offering evidence. The information gathered here was secondary. Hence, these are the irregularities evidence based practitioners need to scrutinize before applying evidenced to practice. The source should always be challenged and validated

Conclusion

The foregoing article descried a typical case type 2 diabetes mellitus and three pertinent nursing diagnose were tendered regarding problem, etiology and symptoms. One patientgoal relating achievement of normal blood sugar levels after six months was set. Interventions pertaining to how this goal would be accomplished were outlined.The rationale as well as evaluation process was discussed.Finally two research studies were used as evidence supportive of interventions and applications to present nursing practice were offered.

References

Mathers, C.,&Loncar, D. (2006). Projections of global mortality and burden of disease from 2002 to 2030″PLoS Med. 3 (11): e442.

John Hopkins University (2013). Evaluating the Effects of a Diet and Exercise Program in People with Type 2 Diabetes or Prediabetes. The national Institute of Health. (The SHAPE3 Study).

Polikandrioti1, M., &Dokoutsidou, H. (2009). The role of exercise and nutrition in type II Diabetes mellitus management. Health science Journal, 3(4); 216 -220.

Sarwar, N. Gao, P., &Seshasai, S. (2010). Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: A collaborative meta-analysis of 102 prospective studies.The Lancet 375 (9733): 2215–22.