INTRODUCTION

Diabetes; Diabetes is a chronic, metabolic disease characterized by elevated blood glucose

levels (or blood sugar), leading to serious damage to the heart, blood vessels, eyes, kidneys, and
nerves. The most common type 2 diabetes is usually in adults, which occurs when the body
becomes resistant to insulin or doesn't make enough insulin. The most common types of diabetes
are; Type 1 diabetes, type 2 diabetes, Prediabetes, and gestational diabetes.
Type 1 diabetes is a chronic condition in which the pancreas produces little or no insulin. Type 2
diabetes is a condition that affects how the body processes blood sugar. With this type, the body
can either produce enough insulin, or it resists insulin. Prediabetes is a diabetic condition in
which blood sugar is high but not high enough to be type 2 diabetes. Gestational diabetes is a
form of high blood sugar affecting pregnant women.
Some of the symptoms of diabetes are; kidney failure, leg amputation, vision loss, and nerve
damage. Adults with diabetes also have a two- to three-fold increased risk of heart attacks and
strokes. In pregnancy, poorly controlled diabetes increases the risk of fetal death and other
complications.
To prevent diabetes, the following should be done;
 Avoid tobacco use – smoking increases the risk of diabetes and cardiovascular disease.
 Eat a healthy diet, avoiding sugar and saturated fats;
 Be physically active – doing at least 30 minutes of regular, moderate-intensity activity on
most days. More activity is required for weight control;
 Achieve and maintain healthy body weight;

Citations;
In 2014, 8.5% of adults aged 18 years and older had diabetes. In 2016 diabetes was the direct
cause of 1.6 million deaths, and in 2012, high blood glucose was the cause of another 2.2
million deaths.
Between 2000 and 2016, there was a 5% increase in premature mortality from diabetes/
 Patient diagnosis, symptoms, and acceptance of the diagnosis.
Diabetes can be diagnosed using different ways. For type1 and type 2 diabetes, you can try the
following methods;
 Glycated hemoglobin (A1C) test; measures the percentage of blood sugar attached to
hemoglobin, the oxygen-carrying protein in red blood cells. The higher your blood sugar
levels, the more hemoglobin you'll have with sugar attached. An A1C level of 6.5% or
higher on two separate tests indicates that you have diabetes. An A1C between 5.7 and
6.4 % indicates prediabetes. Below 5.7 is considered normal.
 Random blood sugar test; a blood sample will be taken at a random time. Regardless of
when you last ate, a blood sugar level of 200 milligrams per deciliter (mg/dL) — 11.1
millimoles per liter (mmol/L) — or higher suggests diabetes.
 Fasting blood sugar test; a blood sample will be taken after an overnight fast. A fasting
blood sugar level less than 100 mg/dL (5.6 mmol/L) is normal. A fasting blood sugar
level from 100 to 125 mg/dL (5.6 to 6.9 mmol/L) is considered prediabetes. If it's 126
mg/dL (7 mmol/L) or higher on two separate tests, you have diabetes.
 Oral glucose tolerance test; for this test, you fast overnight, and the fasting blood sugar
level is measured. Then you drink a sugary liquid, and blood sugar levels are tested
periodically for the next two hours.
For my patient, we used the random blood sugar test to test her. Before that process, we took
some medical data from the patient, and it's attached below this document.
My patient was diagnosed with type 2 diabetes. She was randomly tested for blood sugar levels,
and the test results came back positive as she had 230 milligrams of sugar per deciliter of blood.
From the results, my patient was frustrated at first and so downcast, but we finally came to an
agreement and conclusion, and she made peace with the diagnosis. As a doctor, I managed to
calm the patient down and understand her situation by using words of encouragement to give
hope. I told her to remember to laugh because life has not stopped, and there is a way to manage
diabetes and tools to help manage the disease in as much as there is no cure, i.e., Diabetes
Canada has a toolbox for the newly diagnosed. This site will help you understand diabetes and its
treatment, and it provides some supportive tips, including recipes and lifestyle hints.
Citations;
Symptoms of type 1 diabetes often appear suddenly and are often the reason for checking blood
sugar levels.
Symptoms of other types of diabetes and Prediabetes come on more gradually or may not be
evident.
 Home-based care and long-term management plan.
This refers to the actions or steps to manage diabetes and help them lead a better healthy longer
life. While there is currently no cure for diabetes, the disease can be effectively managed with
medications and a change in diet and exercise. An important part of treatment is maintaining a
healthy weight. Although there is no typical or strict "diabetes diet," it is recommended to eat
foods that are high in nutrition and low in calories - like fruits, whole grains, and vegetables -
instead of fatty, sugary foods.
Physical activity is also a must to manage weight, lower blood sugar levels and increase the
body's sensitivity to insulin. People with diabetes should aim for at least 30 minutes of aerobic
activity most days of the week. Medications and monitoring of blood sugar levels will be a part
of life for people with diabetes. Depending on the condition, blood sugar should be monitored
several times a day or several times a week. Besides, many people need insulin therapy
throughout the day or may need to take other oral or injected medications to manage the
condition. You can try the following home-based routine;
 Monitor the disease and what to do when levels aren't where they should be.
 Manage your medications - all of them, not just your insulin.
 See the impact of your behaviors on your diabetes.
 Exercise in your zone.
 Watch for signs that your diabetes might be having a negative impact on skin or nerve
feelings.
 Communicate effectively with your physician.
The long-term management plan for my diabetic patient was; controlling blood glucose, reducing
or maintaining healthy body weight, and preventing complications. I also advised her to visit a
diabetic educational center to get more details about diabetes and get the support she needs.
Clients are taught to perform self-monitoring at home, including blood sugar checks and
symptom monitoring. Long-term care staff knows that "normal" blood sugar levels may be
higher for seniors in order to avoid the risks associated with low blood sugar.
Registered Dietitians in long term care homes monitor resident progress towards their goals,
including checking blood glucose levels and providing individualized meal plans for residents
whose blood glucose levels are not stable or who require a special diet for complications of
diabetes, such as end-stage kidney disease, dialysis or other health issues. Dietitians, nurses, and
other health care professionals monitor and assess residents quarterly, or more frequently as
required and develop care plans that meet residents' individual medical and health needs.
Citations;
The goal for people with Type 2 diabetes is to control blood glucose, reducing or maintaining
healthy body weight, and prevent complications.
Many homes take a 'liberalized diet' approach with seniors, which allows residents with diabetes
to eat the same food as everyone else. This improves their lives, and research has shown that a
less restrictive diet provides more enjoyment of meals with fewer restrictions and better
nutritional intake for overall better health.
Aspects of social and family support.
Family and friends have a huge impact on the patient being diagnosed. Positive words and
actions result in the well-being of the patient. The opposite of this is also true, and negativity has
bad impacts on the patient. She may skip medication, avoid social interaction or even commit
suicide. Social support can benefit patients’ health by buffering stress, changing affective states,
increasing self-efficacy, and influencing change in negative health behaviors. (Rosland et al.
found that practical and emotional support received by both family and friends had a positive
influence on global measures of disease management in patients with diabetes “empirical studies
found that adherence was 27% higher when patients had practical support available to them.”)
Additionally, Pereira et al. indicate strong associations between positive family dimensions (e.g.,
cohesion and familial guidance) and better glycemic control among diabetic patients.
In as much as there is positive social and family support, there are negative influences from
friends and family. There is a lot of criticism and nagging that comes with family and friends,
i.e., a patient might want to go home and have home treatment while the family paying for the
hospital bills want the patient at the hospital because the doctors can take care of the patient
rather than the family. It causes wrangles amongst them. The patient's family agreed to carter for
the treatment of their relative, and they chose homecare-based treatment. They split the bill
whereby the family was to pay for 70% of the total bill.
Citations;
Social support from family provides patience with practical help and can buffer the stresses of
living with illness.
Regarding family, in which families are described as warm, accepting, and close, the odds of
adherence were three-times higher than with non-cohesive families.
Other studies have shown competing demands between patients and family members as barriers
to self-management.
Among adolescents, increases in responsibility for disease management have been linked to
higher parent-adolescent conflict levels and no adherence to treatment.
 CONCLUSION
In conclusion, all the points above assist in the long-term management and care and prevention
of complications and mortality. Family and social support are important aspects of adherence to
diabetes management. Numerous correlational studies have shown a positive and significant
relationship between social support and adherence to diabetes treatment. Future research should
identify the many types of social support interventions that promote adherence; in doing so,
diabetic patients are given the ability to seek social support that is most conducive and
appropriate for their lifestyle. Lastly, further empirical evidence is needed to address the
mechanisms by which social support works to directly influence health outcomes, health care
utilization, and behavior change.

References
World Health Organization article: https://www.who.int/health-topics/diabetes#tab=tab_1
World Health Organization article: https://www.who.int/news-room/fact-sheets/detail/diabetes
DiMatteo MR. Social support and patient adherence to medical treatment: a meta-analysis.
Health Psychol. 2004; 23:207–218. [PubMed] [Google Scholar]
NCBI; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3825688/#b10-dmso-6-421
Hospital News; https://hospitalnews.com/diabetes-in-long-term-care/
Interim Healthcare;
https://www.interimhealthcare.com/services/home-care/information/diabetes/
What to say to a newly diagnosed diabetic; https://buck.com/what-to-say-to-a-newly-diagnosed-
diabetic
Mayo Clinic; https://www.mayoclinic.org/diseases-conditions/diabetes/diagnosis-treatment/drc-
20371451#:~:text=A%20fasting%20blood%20sugar%20level,Oral%20glucose%20tolerance
%20test.