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Statistics
Insulin-dependent diabetes mellitus (IDDM), also termed as type 1 diabetes mellitus, is prevalent in the entire globe. In the United States, data have indicated ethnic and racial prevalence disparity. According to Centers for Disease Control and Prevention (CDC) (2014), 9.3 percent of Americans have diabetes. Those already diagnosed are 21 million individuals, while 27.8 percent (8.1 million persons) are undiagnosed. The National Health Interview Survey carried out in 2010-2012 showed that amongst Hispanics, 8.5 percent of Central and South Americans, 13.9 percent of Mexicans and 9.3 of Cubans had diabetes. Besides, 6 percent of Alaska Natives and 24.1 of American Indians also had this disease (CDC, 2014). In 2012, a projected 86 million US population aged twenty years and above had pre-diabetes. It included 38 percent of Hispanics, 39 percent of non-Hispanic blacks, and 35 percent of non-Hispanic whites (CDC, 2014). Approximately 208,000 (0.25 percent) persons aged less than 20 years have diabetes (CDC, 2014). Approximately 5-10 percent of individuals with this disease are diagnosed with IDDM.
Overview of the Disease
Description
IDDM is a type of diabetes mellitus that results from the destruction of autoimmune of the beta cells (Chiang et al., 2014). The cells located in the pancreas are responsible for producing insulin. The ensuing deficient in insulin results in amplified urine and blood glucose. IDDM is a chronic disease resulting in high mortality rate throughout the globe. The disease is not curable, but patients learn to manage it throughout their lifetime. Some of the classical symptoms of the disease include loss of weight, frequent urination, extreme thirst as well as hunger (Cooke & Plotnick, 2008).
Persons suffering from IDDM need significant amount of care as lack of it can be fatal. It means that treatment and management of the disease is critical. Insulin therapy is a key treatment, which entails administering insulin on a daily basis. Training on diabetes management is provided considering that it is quite challenging. If IDDM is not treated, it results both in acute and severe lasting complications. Long-term complications encompass kidney failure, eye damage, heart disease, foot ulcers, and stroke (Cooke & Plotnick, 2008). Acute complications include nonketotic hyperosmolar coma and diabetic ketoacidosis (Chiang et al., 2014).
In the US, IDDM is most prevalent in children. In the previous decades, substantial attention has focused on investigating the prevalence rate of the disease among children. IDDM registries have been developed with the aim of presenting comparable gathered data. Approximately 5 percent of all diabetes cases are IDDM (Chiang et al., 2014). Internationally, around 80, 000 children are projected to develop the disease annually. In the US, cases of the illness are high, and it is among the main causes of death. The development of new cases is high, which range from 8 to 17 for every 100,000 every year. Global measures have been put in place in order to control the disease. They include the implementation of programs and provision of resources, such as financial resources.
Long-Term Care
Controlling and managing diabetes entails balancing insulin, food, as well as exercise (Fleming et al., 2001). Health practitioners report that it is imperative to have education to help patients, as well as their families, comprehend the ways of caring for themselves and managing diabetes. Insulin is made in the laboratory using chemical processes. There are different types of insulin. Doctors prescribe the one best for a patient with regards to the disease level. A person with diagnosed diabetes requires several shots of insulin per day, which is given by injection. Nurses teach the patients and their families how to inject insulin into the body.
A person with diabetes needs foods that help the body grow, produce energy and keep blood sugar in balance. With the help of a dietitian, diabetic patients set up a meal plan based on their activity program, age, and gender. The dietitian or nurse educator teaches the patient how to include all food types in a meal so as to have a flexible meal plan.
Exercise maintains the body shape, builds muscles, and enhances the general health of a patient. Besides, it helps keep a person mentally alert and improves the heart muscle tone. Exercise increases the absorption and usage of insulin in the body, to help reduce the levels of blood sugar (Plotnikoff, Karunamuni, & Brunet, 2009). Therefore, patients with diabetes should include exercise in their daily plan.
Monitoring diabetes means keeping track of the disease to ensure it is under control. It will help a patient, and his family to know if the treatment plan is working as expected. Nurse educators teach their patients how to measure urine ketones and blood sugar. One way to check whether the blood sugar is under control is through blood testing. Once the blood sugars are tested they should be recorded in a logbook or a fax log sheet. Doctors ask the lab to measure a patient’s level of glucose for a three months period through a process called Hemoglobin A1-C or glycosylated hemoglobin done every four months.
Anatomy
The pancreas is responsible for manufacturing hormones that regulate blood glucose in the body. The pancreas has tiny cells known as islets of Langerhans. Most of the cells are beta cells which produce and store insulin (Chiang et al., 2014). Other cells present are the alpha cells which produce and store glucagon, a hormone that counters insulin effects.
After taking a meal, the carbohydrates found in the food are converted into glucose assimilated into the bloodstream. Beta cells will sense the heightening blood glucose levels and secretes insulin into the bloodstream (Chiang et al., 2014). In the blood, insulin helps glucose enter body cell where it is metabolized by the liver and muscles to produce energy. Liver muscles also convert glucose into glycogen, a reserve form of energy stored for future needs (Cooke & Plotnick, 2008). If the body is as active as it should be, the blood glucose levels return to normal after some time reducing insulin secretions. Alpha cells secrete glucagon into the blood and the stored glycogen is converted back into energy, producing glucose (Chiang et al., 2014).
Diagnostic Testing
Diagnosis of IDDM entails various tests. They include glycated hemoglobin (A1C), random blood sugar, and fasting blood sugar test (Cooke & Plotnick, 2008). A1C test involves quantifying the level of blood sugar that is in the hemoglobin. The examination exhibits the average amount of blood sugar for the preceding three months. If the level of blood sugar is high, the more of it will be attached in the hemoglobin. A 6.5% level or more evidences the presence of diabetes. The second test is random blood sugar, which entails checking the amount of blood sugar in the blood using a blood sample randomly. A level of 200mg/dL or more indicates the presence of diabetes (Fleming et al., 2001). In a fasting blood sugar test, a person is required to fast during the night after which a blood sample is taken and tested. A level of 126 mg/dL or more indicates diabetes. Blood tests are performed with the aim of differentiating between IDDM and type 2 diabetes. They check for the presence of antibodies such as ketones suggests IDDM.
Tertiary Health Promotion Strategies
The aim of the tertiary prevention programs is improving life quality for persons suffering from different diseases by regulating disabilities and complications, reducing the severity of the disease, and providing rehabilitation to restore self-sufficiency and functionality (Cooke & Plotnick, 2008). Tertiary prevention comprises of the actual treatment of illness. Qualified health care practitioners conduct tertiary health promotion strategies.. As earlier mentioned, people with diabetes lack adequate insulin; therefore, they must be injected with insulin several times during the day to receive the required amount. Around 5-10 percent of people with diabetes are diagnosed with juvenile diabetes.
Local, State, and National Resources
Most local governments rely on public health departments in assisting individuals requiring medical care. Local resources, which include charitable organizations, provide financial help for the expenses incurred during the treatment of people suffering from diabetes (Fleming et al., 2001). The costs may be direct or indirect. In 2007, the direct cost of diabetes was $ 174 billion, while the indirect was $ 116 billion (Centers for Disease Control and Prevention, 2014). On average, the medical expenses for an individual suffering from diabetes are over two times the costs of a person without diabetes.
For example, CDC offers technical and finance assistance to diabetes programs across 50 states including Puerto Rico, the District of Columbia, the U.S. Virgin Islands and 6 U.S. Associated Pacific Islands. The aim of the program includes the following;
· Stop the spread of diabetes amongst people with high susceptibility
· Sponsor adoption of diabetes care guidelines in health care facilities
· Help the state Medicaid programs to monitor the outcomes of quality care amongst individuals with diagnosed diabetes
· Educate the public and care providers on self-management and optimal diabetes care.
· Lessen health discrepancies through workable approaches
The National Diabetes Prevention Program aims at bringing evidence-based lifestyle interpolations for preventing juvenile diabetes to communities (Fleming et al., 2001). It is based on the prevention program research study for diabetes carried out by the National Institutes of Health (NIH), as well as other real-world studies (Fleming et al., 2001).