Diabetes Mellitus (DM)

Question: Discuss about the Diabetes Mellitus (DM). Answer: Introduction Diabetes mellitus (DM) is a group of metabolic disorders characterized by the persistent higher blood glucose levels. Clinically, DM divided into two types, Type I and Type II. DM has multiple aetiologies and its major risk factors are genetic predisposition, obesity and sedentary lifestyles. Type I DM is mainly related to genetic factors that has transferred from parents to their off springs whereas obesity, old age and poor lifestyle are some factors contributes to the Type II DM. Common symptoms include increased thirst and hunger, constant feeling of tiredness and ulcers that do not heal. Diabetes mellitus may also lead to a lot of secondary complications like vascular diseases, heart diseases, strokes, diabetic retinopathy and nephropathy (Beulens, Grobbee, Nealb, 2010). Explanation of Amelias disability In the present case scenario, Amelia is suffering from Type II diabetes mellitus. She has diagnosed at the age of 65 years and in previous years she had gained significant weight possibly because of inactive social lifestyle. Her diabetes is poorly controlled and appears as a main cause of her present deteriorated condition. Currently, she is facing the complications of DM. She has developed the painful arterial ulcers which are healing at very slower rate due to uncontrolled diabetes. Because of heavyweight and painful ulcers, she finds difficulties in doing her day to day chores (Jude, Eleftheriadou, Tentolouris, 2010). Need for a learning program Diabetes Mellitus is non-curable chronic condition, but it can be managed by controlling the blood glucose levels. The complications of DM can also become harmless by educating the patients about the importance of controlling the glucose levels. Learning needs for the management of DM type II includes, regular monitoring of glucose levels, compliance with the diet chart, exercises, medications and management of co-morbidities. The main objective of the teaching plan is to educate the patients to undergo behavioural changes for improvement in overall health and limiting the complications (Lagger, Pataky, Golay, 2010). Learning Program for Diabetes Patients Providing diabetes knowledge is a lifelong process involving the four steps that make a cycle. These four steps are assessment, planning, implementation and evaluation and construct a hypothetical model of learning program (Figure 1) (Ozcan Erol). Figure 1: Hypothetical model of learning program The learning program stresses on the compliance with the prescribed medications and exercise programs. The teaching plan should be doctored as per the requirement of the patient and the stage of the disease. The learning program may include Microsoft PowerPoint presentations, reports, pamphlets and other reading materials in understandable language. The learning program for Amelia may include: Part 1: General overview of Diabetes, Complications associated with diabetes Part 2: Blood glucose monitoring and glucose charting Part 3: Medications and Insulin Part 4: Skin and Foot care, Exercise and diabetes Diet and diabetes (Haas et al., 2013). As presented in the case history, Amelia is Overweight and having arterial ulcers along with the uncontrolled diabetes. So, the learning program should focus on the dietary changes and exercise to lower down her weight. Dose titration of medication should be required to control the blood sugar levels. She must be educated for the importance of glucose monitoring and charting. Amelia should know about the skin care and care of her foot ulcers to protect from serious conditions which may lead to amputations. Teaching Methods and their importance Amelia is suffering from peripheral vascular disease. So apart from specialists for Diabetes, Amelia should need a person who takes care of vascular injuries. Other person must be an physical trainer or therapist who can teach her the behavioural changes required for the weight loss (Bakker, Apelqvist, Schaper, 2012). Vascular injuries related to the diabetic neuropathy are extremely painful and the extra care is required to protect the skin and extremities of the patient. Secondly, rising weight is the major hurdle in controlling the blood glucose levels of diabetic patients. So, the specific exercise regime is required for Amelia to control her weight (Kruse, LeMaster, Madsen, 2010). Visuals are always the effective means of communication with several advantages over printed study materials. We have chosen the PowerPoint presentations showing important points to manage the diabetes. Video clippings of discussion of patients and physicians showing the importance of glucose monitoring, exercise and skin care etc. is the second measure we can use to educate patients. In present case, we may arrange a bed-side video set up for Amelia during her scheduled clinic visits. We must tailor the videos and presentations as per the requirement of patient. Videos must not be lengthy or un-required stuff should be removed to uphold the interest of patients. The videos must have clear message that she should focus on her dietary changes, weight loss and care of her foot ulcers (Frosch, Uy, Ochoa, Mangione, 2011). Community programs are best sources of information for patient. Pamphlets and other study material showing benefits of diabetic education program can be the other resources for the information. The incidence and severity of DM can only be lowered by extending the knowledge to more and more patients and their caregivers. Various research has shown that imparting the required knowledge has positive correlation with the lower-extremity amputation rates, prescription costs, number of hospital visits etc. (Gagliardino et al., 2012). Conclusion The teaching program for the Diabetic patients and their care takers is designed into various sessions to include the complete overview of Diabetes and its harmful implications on their body. It also includes the medications and various precautions to prevent the development of secondary manifestations. The length and mode of knowledge sharing are fixed as per the needs of the audience. References Bakker, K, Apelqvist, Jan, Schaper, NC. (2012). Practical guidelines on the management and prevention of the diabetic foot 2011. Diabetes/metabolism research and reviews, 28(S1), 225-231. Beulens, Joline WJ, Grobbee, Diederick E, Nealb, Bruce. (2010). The global burden of diabetes and its complications: an emerging pandemic. 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