Nutrition and Type 2 Diabetes
Currently, there are about 34 million Americans with type 2 diabetes which represents 5.9% of the population. Out of that, only about 66% are diagnosed and actively treated. The number of diabetic patients continues to surge and the potential of people developing diabetes is high with the prevalence of IGT increasing at a high rate as well. There are 22 million people estimated to have IGT in America today. This disorder has 3 basic defects which include resistance of insulin, defect in insulin secretion. This is non-autoimmune mediated, and the increase in blood sugar (Francois et al., 2017).
The causes of these metabolic defects and type2 diabetes are still not known. what is well known is that in most cases type 2 diabetes is generic and is common in some ethnic groups such as American Indians, Hispanics, and African Americans. However, experts are still researching whether patients’ genes can cause the disorder but the experts still believe that the disease is a type of multi genetic defect. Obesity, age, and lifestyle are the main contributors of insulin resistance. Other acquired factors that may contribute to the defects in secretion of insulin include elevated free fatty acid levels and glucotoxicity (Tabesh et al., 2018). The purpose of this paper is to explore type 2 diabetes and the role nutrition in treatment and managing diabetes.
Role of Nutrition
Diabetes can be managed by managing a diet or by medical intervention. Lifestyle and strategic goals are the primary areas of focus for nutrition principles and nutrition. The objective of nutrition therapy is to support and facilitate individual lifestyle and changes that in behaviour enhance control of glycaemia (Gilbert, 2018). Along with the benefits of reducing the chances of developing diabetes food and following a healthy meal plan and physical activity can help maintain and control the blood sugar at a safe and healthy level (Francois et al., 2017).
Etymology and Progression
Etymology
Diabetes affects millions of lives around the world for years. Diabetes is suspected to have been discovered in Egyptian manuscripts in about 1550 B.C. Studies show that ancient Indians were aware of the disease in all its two types, and called it honey urine. The term “diabetes” is a Greek term that means “to go through.” It was named so by Apollonius because of its main symptoms; passing excessive urine. The Greek, Indian, Chinese, Egyptian, and Arab doctors were aware of the situation but were unaware of its treatment. The first step of discovering its treatment and cause was taken in the early 1900s. In 1926, Edward Albert discovered diabetes patients pancreas could not produce sufficient insulin. Scientists used dogs as guide pigs to reverse the effects of diabetes and they were finally successful in improving the condition of people with diabetes. In 1936, Harold Himsworth distinguished diabetes into two main groups. insulin sensitive and insulin insensitive. Insulin sensitive is today called type 1 diabetes and insulin insensitive is type 2 diabetes (Chatterjee et al., 2017).
In the past, Type 2 diabetes was called adult-onset. Some experts referred to it as non-insulin-dependent diabetes. The diabetes develops from stages showing small symptoms of insulin resistance and proceed to mild postprandial hyperglycemia and finally reaches frank diabetes which needs invention by a pharmacologist. Medical practitioners must understand the etymology of the disease to guide them in designing a proper medical intervention that differentiates between all steps of the condition. This is because the optimal medication regimen used together with dietary changes and exercise requires the primary care providers to modify the care provision for each patient as the disease progresses (Chatterjee et al., 2017).
Impaired Glucose Tolerance or pre-diabetes is a term that was coined in 1979 to replace the terms borderline, chemical, and asymptomatic diabetes mellitus. This is a stage of mild postprandial hyperglycemia which is the vital maker of patients risk of developing type 2 diabetes. Patients at this stage require timely education and more aggressive interventions to help prevent them from progressing to type 2 diabetes. Some of the interventions required at this stage include diet, exercise, and/or medication.
Progression
Type 2 diabetes is a condition that may progress to cause stroke, myocardial infarction, microvascular events, and even death. This type of develops slowly over time. Spotting the symptoms of Type 2 diabetes is challenging because they appear gradually. Some of the symptoms of diabetes may be leg pain and dry mouth. It is a common trend for people with diabetes to stay with condition not knowing that they have the condition. There are situations in which diabetes type 2 may be under diagnosed. Conditions may sometimes only be identified during a routine medical check-up (Chatterjee et al., 2017). The progressive decline in b-cell insulin secretion in the first phase happens acutely after a rise in glycemia. This is the most vital defect of the functional cell that precedes the progress of the condition. The next step in the progression is the progression to medication. Younger patients and those with high weight gain are more likely to have high rates of diabetes progression and should focus on aggressive diabetes management (Tabesh et al., 2018).
Treatment and Recommended diets
The primary symptoms of diabetes type 2 during the early stages include; fatigue, dry mouth, constant urination, blurry vision, and itchy skin. In cases of prolonged blood sugar levels the following are some of the symptoms that may include yeast infections, foot pain, feeling numb in extremities, soreness, and dark patches on the patients skin. If an individual has two of the above symptoms, they should see a doctor (Evert et al., 2019).
A patient can effectively manage type 2 diabetes. A doctor can direct the patient on how to check blood sugar levels. The most important objective is to keep blood glucose at a specific level. The following tips are recommended for type 2 diabetes patients. Lifestyle changes are alone cannot be sufficient in lowering blood glucose levels and keep type 2 diabetes under control. Some of the medications for treating type 2 diabetes include, sulfonylureas, metformin, meglitinides, sodium-glucose cotransporter-2 (SGLT2) inhibitors, dipeptidyl peptidase-4 inhibitors, glucagon-like peptide-1(GLP-10 receptor agonist, and thiazolidinediones (Evert et al., 2019).
Metformin is effective in lowering a patients blood glucose and enhance the patients response to insulin. This treatment is often preferred for this diabetes. Sulfonylureas is an oral treatment to assist the patients body produce insulin at high levels. Meglitinides acts faster, takes a short duration by stimulating the pancreas to produce high amounts of insulin. Thiazolidinediones increases the bodys sensitivity to insulin. Dipeptidyl peptidase-4 inhibitors assist in blood sugar reduction. Glucagon-like peptide-1(GLP-10 receptor agonists reduces the rate of digestion to enhance the levels of sugar. Sodium-glucose cotransporter-2 (SGLT2) inhibitors help in the prevention of kidney from reabsorbing glucose into the blood and removing out inform of urine. Besides, there are FDA OKs which is a new pill for treating diabetes 2, which the Drug Administration has approved in the United States (Li, Fan, & Chen, 2018). It is critical to note that the medications listed above may have side effects and therefore one should only take prescribed medications (Evert et al., 2019).
Diet also forms an important of diabetes treatment. Diet help in keeping the heart of the patient’s health and levels of blood glucose within a healthy and safe range. The good thing about this is that it can be kept simple and pleasant. Furthermore, the diet followed by a diabetic patient is similar to everyones except for a few adjustments. One should eat meals and snacks on schedule, take care not to react in a extreme rates, and read food labels keenly. The following are foods recommended include High-quality protein such as beans, unsweetened yogurt, eggs, low-fat dairy, and beans. One should also take Vegetables and fruit especially those fresh and more colorful. Healthy fats from fish oils, nuts, avocados, or flax seeds, olive oil is also recommended. One should avoid shellfish, processed food, sugary drinks, baked foods, foods heavy in fats, organ meat, pasta, and high-fat dairy products (Gilbert, 2018).
Nursing Assessment and Intervention
Diagnosis of type 2 diabetes is readily identified when the patient starts to presents symptoms such as weight loss, polyuria, and polydipsia. Type 2 diabetes patients have often have been having the condition for between four to seven years when they are diagnosed. A physical examination may not reveal the symptoms during the early stages. End-organ damage can ultimately be observed. Some other things that may be observed during physical assessment include. High-blood pressures, obesity, dry feet, muscle atrophy, claw toes, and ulcers (Tabesh et al., 2018).
Another factor that is more prevent in type 2 diabetes patients is BMI. BMI is a popular factor that indicate obesity which widely known to cause type 2 diabetes. BMI is a risk element mainly for cardiovascular morbidity. Most studies show that BMI leads to the high prevalence of type 2 diabetes. Despite this, contradictory studies show that BMI has little effect or association with obesity hence also has little association with diabetes. Since diabetes affects several parts of the body, the doctor is also supposed to perform a physical examination that includes; mouth, foot, nervous system, and skin examination. Patients should be wary of several symptoms. Some of the include, yellowish, reddish, or brown patches on the skin; darker skin areas; hard thickening skin; blisters; skin infections; open wounds and sores; shin spots; small reddish-yellow bumps; and extremely dry, itchy skin (Tabesh et al., 2018).
There are several interventions that nurses can take to enhance the outcomes of type 2 diabetes. The interventions should be offered at individual levels by the health providers, health system, and the patient themselves. This type of interventions includes both self-management and other interventions. Self-management include, exercise, diet, self-monitoring, medication. Other interventions may include; other interventions include; Educating on how to monitor home glucose. Reviewing aspects in glucose variability; Encouraging clients to read labels; Checking the insulin viability; and discussing how medications work in antidiabetic clients (Tabesh et al., 2018).
Client education and adherence
The client education will include the following;
Measures to enhance adherence to therapy for this condition also include the reduction of the complexity of the disease by giving fixed dose and fewer medication needs, using more safer medication, enhancing the creativities for education, and enhancing the communication practices of healthcare providers (Li et al, 2018). Adherence behaviors in type 2 diabetes patients are divided into five classes:
References
Chatterjee, S., Khunti, K., & Davies, M. J. (2017). Type 2 diabetes.The Lancet,389(10085), 2239-2251.
Evert, A. B., Dennison, M., Gardner, C. D., Garvey, W. T., Lau, K. H. K., MacLeod, J., … & Yancy, W. S. (2019). Nutrition therapy for adults with diabetes or prediabetes: a consensus report.Diabetes Care,42(5), 731-754.
Francois, M. E., Durrer, C., Pistawka, K. J., Halperin, F. A., Chang, C., & Little, J. P. (2017). Combined interval training and post-exercise nutrition in type 2 diabetes: a randomized control trial. Frontiers in physiology, 8, 528.
Li, B., Fan, J., & Chen, N. (2018). A novel regulator of type II diabetes: MicroRNA-143. Trends in Endocrinology & Metabolism, 29(6), 380-388.
Ph.D. Rd, S. E., & Gilbert, J. A. (2018). Williams Essentials of Nutrition and Diet Therapy (12th ed.). Mosby.
Tabesh, M., Magliano, D. J., Koye, D. N., & Shaw, J. E. (2018). The effect of nurse prescribers on glycaemic control in type 2 diabetes: a systematic review and meta-analysis.International journal of nursing studies,78, 37-43.
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