Nursing Assignment: Medical Case Analysis of Dave Turner

Question

Task

This nursing assignment is based on the given case scenario.

CASE STADY_ Dave Turner

Please WATCH: Diabetes Australia. (2019, July 6 ). Dave's type 2 diabete diagnosis- National diabetes week ( Video). You Tube. https://www.yoytube.com/ watch ?v=MBSbDtkvfko

Dave is 39 years old: He visited his local doctor after experiencing vision problems whilst driving. He has been unusually tried and urinating at night.

HIS HEALTH HISTORY IS: Gastro oesophageal reflux disease, Tibial Fracture (Right) aged 24 years - motorbike accident. FAMILY HISTORY : Dave's father was diagnosed with type 2 diabetes at the age of 50 years

Observation: Blood pressure 150/90 - Heart rate 105 beats per minute.. Body mass index 32- obese... Blurred vision with blue - yellow colour loss.. Random Venous Blood glucose level - 25.0 mmol/L

Diagnosis: Type 2 diabetes

Referrals: ophthalmologist, endocrinologist, diabetes educator, dietician, exercise physiologist

1. Discuss the differences between type 1 and type 2 diabetes. Relate to the risk factors, pathophysiology and treatment. support your answer with academic reference.
2. Discuss the non- pharmacological treatment of type 2 diabetes and relate to the pathophysiology of type 2 diabetes. Support your answer with academic references.
3. Discuss one (1) potential long term physical complication of type 2 diabetes and relate it to the pathophysiology of type 2 diabetes. Support your answer with academic references.
4. Discuss the relationship between type 2 diabetes and depression. Support your answer with academic references.

THE diabetes Australia and patient information sheets are example of consumer ( general public )resources and are not considered academic references. Official reports published by diabetes Australia for health professionals are academic references.

Answer

Differences between type 1 and type 2 diabetes risk factors, pathophysiology and treatment
It is evident herein nursing assignment that Type 1 diabetes is generally caused because of the presence of genetics. Type 1 diabetes causes various symptoms but the major factors that cause this type of diabetes to the patients it are yet to be determined. The symptoms however occur very prominently as compared to the other type of diabetes which is Type 2 Diabetes. The main difference between the two types of diabetes is that Type 1 Diabetes and Type 2 Diabetes occur because of different reasons. Type 2 Diabetes occurs mainly because of being overweight or ethnicity however Type 1 Diabetes occur because of genetic disorders. While in type 1 diabetes insulin is not produced, in type 2 diabetes response to insulin is insufficient. Risk factors for type 1 diabetes includes family history, geography, age and genetics while for type 2 diabetes it includes being prediabetic, having excess body weight, having a lot of belly fat, being physically inactive, and so on. In the present case of Dave, Type 2 Diabetes has been diagnosed. Dave has reflected symptoms of obesity with an index of 32 and Blood Pressure of 150/90 with a heart rate of 105 beats per minute. Dave has been repeatedly facing visual difficulties while driving and this is another symptom of Type 2 Diabetes. Therefore, it is evident from the present scenario that the risk factors are showing Type 2 Diabetes of the patient and thus must be treated accordingly.

Determining the risk factors, pathophysiology can ascertain appropriate treatment for diabetes of type 2.Type 2 Diabetes mellitus is mainly caused due to the peripheral resistance of insulin and glucose transport dysfunction (GLUT 4) and therefore such treatment helps in Type 2 Diabetes glucose production within the body. It helps the pancreas to secrete the required amount of glucose so that it helps in generating Type 2 Diabetes mellitus.

Cosansu et al. (2018) evaluated the different determining factors for Type 2 Diabetes among young adults. It was observed that Type 2 Diabetes mainly tends to hide within the body of the young adult and is not usually diagnosed. It may affect the health of the person and subside within the body without displaying any particular symptom. Carreras-Torreset al.,(2017)stated that Obesity is one of the major reasons for diabetes and thus it must be treated from an early period. Type 2 diabetes is diagnosed with a glycated haemoglobin test. Hence the major risk factors attributed to type 2 diabetes includes being overweight, inactivity or sedentary lifestyle, having a family history of type 2 diabetes, race or ethnicity, distribution of fat over the abdomen, blood lipid levels, age is another major factor, being prediabetic, also having areas of darkened skin near the neck and armpits can be seen as insulin resistance.

Treatment of such condition is undertaken mainly by drawing up management plans for the same by healthy eating, losing of weight, regular exercise, diabetes medication or insulin therapy and regulated monitoring of blood sugar levels. Thus intervention for Dave will include providing a nursing intervention plan such that his blood glucose levels can be monitored effectively.

Non-pharmacological treatment of type 2 diabetes and the pathophysiology of type 2 diabetes
Dave’s treatment for the management of type 2 diabetes must be based on the following measures;

a. Diet: People diagnosed with Type 2 diabetes though does not affect their pancreas directly and thus it still produces insulin in a smaller amount. That is why there is no need for insulin intake which is mandatory for Type 1 Diabetes patients (Postet al. 2012). Therefore, the diet for such patients may include normal eating foods and no insulin as glucose level has to be maintained properly, which can effectively manage the peripheral insulin resistance, and deal with the production of impaired regulation of hepatic glucose as well as declining of beta-cell functionality.

b. Exercise: People diagnosed with Type 2 diabetes has to maintain the level of their blood pressure as it is an important aspect of the patients. Moreover, in the present case of Dave, the patient has to practice regular exercise which includes cardio exercises to maintain the Blood Pressure level (Ozougwu et al. 2013). The BP of Dave is 150/90 which is very high for the patients. Physical has been reported to enhance abnormal glucose tolerance levels considerably that can cause insulin resistance when there are deficient circulating amounts of insulin.

c. Weight Management: Weight Management for such patients with Type 2 Diabetes is can create major significances. This is so because obesity impacts the level of diabetes. In the present case, Dave has been diagnosed with a 32-body index which is a major sign of obesity and therefore must be regulated accordingly (Ozougwuet al. 2013). With physical exercise, effective weight management can be undertaken to lead to effective controlling of type 2 diabetes leading to the underlying path physiology of decrease in insulin circulation.

Long term physical complication of type 2 diabetes and connection to the pathophysiology
One of the potential long term physical complications of Type 2 diabetes is obesity further leading to heart and blood vessel disease, nerve damage, kidney disease, skin conditions, eye damage, slow healing of infections, hearing impairment amongst many more. It has been observed by various researchers that Type 2 diabetes is caused because of obesity and that obesity affects the health of the person to a great extent. It was observed by Bellou et al., 2018 presence of high sugar levels in the blood can enhance the risk of heart disease, stroke, pressure as well as narrowing of blood eve vessels, and damaging nerves. Due to Dave having highblood pressure and bmi there is considerable significance pf the long-term complications arising, with the presence of peripheral insulin resistance, impairment of the regulation of hepatic glucose production also declining of beta-cell functionality leads to failure in beta cells eventually leading to a series of conditions.

Relationship between type 2 diabetes and depression
Type 2 diabetes and depression are intertwined. Different researches have been pursued to understand the close relationship between Type 2 diabetes and depression. It was observed by Bergmans et al.,2021 that Type 2 causes various symptoms of depression among the patients and symptoms are often identified much later but it impacts the mental health of the patient from the early phase of life. Due to current condition experienced by Dave, there can arise considerable risks of depression also arising from the need to manage such complications.Thus, mental health has to be under regular checks and if any sort of symptoms is found then it has to be treated early so that such things are not caused properly. Moreover, it was further observed by Lloyd et al., 2018 that depression is often caused to such patients and impacts their mental health to a great extent.

References
Bellou, V., Belbasis, L., Tzoulaki, I., & Evangelou, E. (2018). Risk factors for type 2 diabetes mellitus: an exposure-wide umbrella review of meta-analyses. PloS one, 13(3), e0194127. https://doi.org/10.1371/journal.pone.0194127

Bergmans, R. S., Rapp, A., Kelly, K. M., Weiss, D., & Mezuk, B. (2021). Understanding the relationship between type 2 diabetes and depression: lessons from genetically informative study designs. Diabetic Medicine, 38(2), e14399. https://doi.org/10.1111/dme.14399

Carreras-Torres, R., Johansson, M., Gaborieau, V., Haycock, P. C., Wade, K. H., Relton, C. L., ... & Brennan, P. (2017). The role of obesity, type 2 diabetes, and metabolic factors in pancreatic cancer: a Mendelian randomization study. JNCI: Journal of the National Cancer Institute, 109(9). https://doi.org/10.1093/jnci/djx012

Cosansu, G., Celik, S., Özcan, S., Olgun, N., Y?ld?r?m, N., & Demir, H. G. (2018). Determining type 2 diabetes risk factors for the adults: A community based study from Turkey. Primary care diabetes, 12(5), 409-415. https://doi.org/10.1016/j.pcd.2018.05.001

Lloyd, C. E., Nouwen, A., Sartorius, N., Ahmed, H. U., Alvarez, A., Bahendeka, S., ... & Xin, Y. (2018). Prevalence and correlates of depressive disorders in people with Type 2 diabetes: results from the International Prevalence and Treatment of Diabetes and Depression (INTERPRET?DD) study, a collaborative study carried out in 14 countries. Diabetic Medicine, 35(6), 760-769. https://doi.org/10.1111/dme.13611

Ozougwu, J. C., Obimba, K. C., Belonwu, C. D., & Unakalamba, C. B. (2013). The pathogenesis and pathophysiology of type 1 and type 2 diabetes mellitus. Journal of physiology and pathophysiology, 4(4), 46-57. DOI: 10.5897/JPAP2013.001

Post, R. E., Mainous, A. G., King, D. E., & Simpson, K. N. (2012). Dietary fiber for the treatment of type 2 diabetes mellitus: a meta-analysis. The Journal of the American Board of Family Medicine, 25(1), 16-23. https://doi.org/10.3122/jabfm.2012.01.110148