Helping persons with diabetes
Knowing someone cares can make a big difference. For the diabetic patient/client, the whole family, close friends, colleagues, and church associates can encourage compliance with diet and medications prescribed by the physician, as well as promote adopting a healthy lifestyle and a using step-by- step approach to make the necessary changes.
Moreover, Powers et al. (2015) documented that “helping persons diagnosed with diabetes to understand the specifics related to the disease state, apply knowledge, skills, and behavioural, problem-solving, and coping strategies need a delicate balance of multiple factors (e.g. the patient’s ability to manage his/her blood sugar levels, cope with diabetes complications, other health conditions, take prescribed medications, make wise food choices, physical limitations, emotional needs, and perform activities for daily living which include bathing, dressing, meal preparation, grocery shopping, etc.). You should take into consideration the individual and the context in which he/she lives and/or operates such as clinical status, cultural heritage, values, occupation, family, and social and community environment.” This of course indicates the need to provide “Diabetes self-management education and support;” several studies conducted show that using this approach may probably show a decrease in the onset and/or advancement of diabetes complications (Diabetes Control and Complications Trial Research Group, 1993 & Stratton et al. 2000), which aided in improving quality of life (Deakin et al. 2005, Cooke et al. 2013, Cochran and Conn, 2008, Trento et al. 2004, Toobert et al. 2003) and lifestyle behaviours e.g. choosing healthy balanced meals and snacks, participating regularly in physical activity (Toobert et al.
2011), enhances self-efficacy and empowerment (Tang et al. 2012), increases coping skills, and thereby minimising decreasing diabetes- related stress and depression (Thorpe et al. 2013, Fisher et al.
2013, Siminerio et al. 2014, Hermanns et al. 2 015, de Groot et al.
2012. In today’s article, the main focus is on the diabetic meal assisting persons with diabetes.
A brief overview According to the World Health Organisation, diabetes is a chronic disease which occurs when “the pancreas does not produce enough insulin or the body is unable to effectively use the insulin produced.” Uncontrolled blood sugar levels over a period of time contribute to complications. Examples of the type of diabetes: (a) Type 1 diabetes (formerly referred to as insulin-dependent diabetes or juvenile-onset diabetes) characterised by “deficient insulin production and requires the administration of insulin.” (b) Type 2 diabetes (formerly referred to as non-insulin dependent diabetes or adult-onset diabetes) may probably account for more than 90 percent of all diagnosed cases with diabetes, unhealthy lifestyle practices (unhealthy diet, excess body weight and physical inactivity) contribute to the illness; in most cases, it result from a combination of insulin resistance and β-cell failure. (c) Gestational diabetes can described as glucose intolerance with the onset first recognition that occurs during pregnancy (Mahan and Escott- Stump, 2008).
Globally, there is an increase in the number of persons diagnosed with diabetes from 108 million in 1980 to 422 million in 2014; similarly, there has also been an increase in the percentage for individuals 18 years old with diabetes from 4.7 percent in 1980 to 8.5 percent in 2014. Also, among middle income and low income countries, the prevalence of diabetes has increased. Failure to manage blood sugar (blood glucose) levels negatively impacts health and may contribute to the economic burden in territories; diabetes mellitus is the major cause of kidney failure, blindness, heart attacks, stroke and amputation of the lower limb. During 2012, the mortality distribution for diabetes – estimated 1.5 million deaths, and the other 2.2 million deaths resulted due to high blood glucose levels (World Health Organisation, Geneva, 2016).
Presently in Trinidad and Tobago, diabetes mellitus contributes to approximately 13.6 percent of the deaths, along with heart disease and cancer accounting for 25.75 percent and 13.75 percent, respectively (Ministry of Health).
Overall, chronic diseases impact the quality of life – affecting productivity, contributing to absenteeism at school and in the workplace, and premature mortality which accounts for at least half of all deaths of persons under 70 years; also in the Caribbean region approximately 50 percent of disability-adjusted life years is lost. The contributing factors are high blood pressure, high blood sugar, and high cholesterol levels.
(Healthy Caribbean Coalition).
Recommendations In helping persons with diabetes nutrition care management is essential, and it should be individualised.
The registered dietitian can provide the nutrition assessment and counseling, educating patients and their family members using a practical approach – to include making wise food choices, discuss the importance of complying with the prescribed diet and medication regimen, planning balanced meals, carbohydrate counting, and including between meal snacks.
Healthcare professionals should also discuss the importance of managing blood pressure and lipid levels, weight reduction (if the client is overweight or obese), and incorporating regular physical activity to improve health. The aim is to aid the patient in adopting a healthy lifestyle. You should note that prior to engaging in physical activity, first seek advice from your medical doctor (Diabetes Care, 2015).
The medical nutrition therapy goals include: (a) improve/maintain blood sugar levels within acceptable target range; (b) to improve/maintain lipid levels (total cholesterol, LDL-cholesterol, HDL-cholesterol, and triglycerides) within acceptable parameters; (c) weight management; (d) blood pressure management, to acceptable levels; (e) prevent and treat associated complications of diabetes, modifying diet and using lifestyle approaches for the prevention and treatment of obesity, hypertension, and heart disease; (f) improve overall health by making healthy food choices and participating in physical activity; and (g) address individual needs and preferences taking into consideration age, school/work schedule, cultural heritage, religious affiliation, money available to purchase food, food availability and accessibility, the number of persons living in the household, presence of hypoglycemia unawareness.
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"Helping persons with diabetes"