Introduction
Type 2 Diabetes prevalence is on the rise among the middle age and the elderly in the US. As a long term disorder, the patients need to understand how to deal with the disease from its onset to ensure minimal interruptions occur to their life as a result. This requires an understanding of the common symptoms, medication and effect minimization to ensure a happy and long life. This learning project is therefore designed to create awareness on lifestyle risk factors of type 2 diabetes among the middle age and elderly in the US. It’s a project aiming at introducing the patients to their condition and guiding them at managing it effectively be ensuring they make healthy lifestyle related choices. To the rest of the society, the learning project will address the risk factors of lifestyle and provide an appropriate way forward that will combat the prevalence of type 2 diabetes.
Type 2 diabetes is associated with weight issues and cases of obesity. These two factors are as a result of poor dieting and lack of physical exercise. The patients are therefore likely to be obese and inactive hence the need for education on how to avoid worsening the situation by encouraging a shift of lifestyle choices towards ensuring normal weight and proper eating habits. Treatment of type 2 diabetes includes exercise and diet changes for a majority cases and this paper will create awareness of lifestyle related risks such as consumption of junk foods and inactive lifestyles dependant on technology. Other courses of treatment involve medication to lower blood sugar, insulin injections or pills. Insulin injections are a regular activity and patients do not need to visit the clinic for these shots or have a nurse check their blood sugar regularly. They will therefore be taught how to administer their insulin on their own and monitor their blood sugar comfortably at their own homes.
Identification of the learning need
In my clinic, I noticed that half of the patients seeking treatment are suffering from type 2 diabetes. During my blood checks routine as I did my hospital rounds, I realized that the prevalence is on the rise. With approximately 9.3% of Americans suffering from typre2 diabetes, there was a need to do something to minimize complications likely to result from the disease. The disease can be tamed through preventive measures which will be beneficial to the patients and the society at large.
The decision to promote awareness on type 2 diabetes was arrived at after an interview with my preceptor and the nurse at the clinic. This was mainly due to the fact that I pointed out on the need of educating diabetics in the importance of taking care of their conditions and ensuring that they fully understand the how, why and when of diabetes. As a medical condition, the alarming rate of readmissions after failing to administer insulin injections on time or reading their insulin levels correctly were rampant. The 44 bed unit in the clinic was occupied halfway by type 2 diabetes patients who with the proper education couldn’t need admission so often. The purpose of the training was therefore to ease congestion at my work place, reduce the workload and minimize unnecessary trips to the hospital for diabetes patients. In so doing, I ensure that all the patients can look after themselves at home with the help of family and friends without incurring unnecessary expenses that only increases the financial burden.
My education tool therefore seeks to control the risks associated with lifestyle choices diabetics are making every day and the society at large. This will mitigate the risk of type 2 diabetes associated with poor lifestyle choices. Due to the technological advancements and dietary changes, the prevalence of diabetes is on the rise. Junk foods are among the top lifestyle choices responsible for diabetes. In the current generation, pizzas, buggers, fizzy drinks and other fatty foods are among the most commonly consumed foods in the world. The society is therefore falling prey to the allure of the packed foods without realizing the damage they are causing. People have stopped eating healthy and abandoned exercise which is the main cause of obesity and eventually diabetes.
Assessing the scope of the learning need
The lifestyles choices we make everyday are leading to unhealthy living and increased cases of obesity. Consumption of sugary foods poorly processed coupled with the lack of exercise is the main cause of diabetes. The media frenzy and increased technological advancement has rendered people inactive. The cases of obesity are being increased by laziness as more people are turning into couch potatoes. The technological advancement has resulted in a lazy generation spending entire days curled in couches playing computer games and staring at the screens. The active generation is no more. People no longer understand the value of outdoor activities hence exercise has been neglected resulting in increased weight gain which only worsens the situation.
Purpose of the study
This is a learning project aimed at creating awareness of life style related risk factors of type 2 diabetes. The study will educate the community on the effects of bad dieting and the lack of exercise on diabetes. To the diabetics, the learning exercise will help them manage their conditions by teaching them how to administer their insulin, eat right and lead an active life. The learning process will extend to the whole community who will get a chance to understand type 2 diabetes; its causes and how to make life style choices that keep diabetes at bay. The teaching project will therefore teach the diabetic on how to manage their conditions outside their hospital which will be financially beneficial to them because it will reduce hospital trips and readmission. Management of diabetes will minimize the occurrences of health risks associated with diabetes such as hyper/hypoglycemic reactions, recurring wounds, and other complications.
Study objectives
This study aims to achieve the following objectives;
- Educate patients on how to manage their conditions effectively from home
- Reduce type 2 diabetes prevalence among the middle age and the elderly by creating the necessary awareness on the importance of dieting and exercises
- Teach diabetics how to administer their own insulin, check their blood sugar and identify the symptoms of hypo/hyperglycemic reaction.
Learning tool development and rationale
Diabetes is a long term disease that can be termed as non fatal. However, if unchecked, it results in further complications that have adverse effects on the health of the patients. Diabetes therefore makes the body week and susceptible to other infections. According to (International Diabetes Federation: a consensus on Type 2 diabetes prevention, 2011) approximately 80% of people with diabetes die of cardiovascular disease resulting from further complications. Type 2 diabetes increase the risk of coronary diseases two to four times higher than the rest of the population free from diabetes. With cases of diabetes, the effects of the coronary diseases are far more pronounced and the risk of death increases. Diabetes increases the risks of stroke and other conditions such as kidney failure, poor blood flow and blindness. This has resulted in premature mortality that has resulted in an average loss of 12–14 to diabetic patients.
According to the American Diabetes Association 2016, almost ten percent of all Americans had diabetes. Of the 30 million affected, those aged above 65 and above were 25 percent. The disease remains the 7th leading killer in the US with 70,000 death certificates listing diabetes as the cause of death and another 243, 000 listing diabetes as the underlying cause of death. Diabetes is therefore a killer disease which needs to be addressed via preventive and treatment tools.
Adult obesity is the main factor associated with type 2 diabetes (Gatineau Mary, 2014 ). According to the Public Health England survey, overweight individuals are the leading victims of type 2 diabetes. The affected majority are middle aged and the elderly in the society who stress it and fail to exercise. In most cases, they have weight issues, spend most their time inactive. Diabetes is encouraged by inactivity and poor dieting. People who have eating disorder, do not engage in any strenuous exercise and are too lazy to exercise are more likely to suffer from diabetes than the rest of the population. In cases of diabetics, those who are ready and willing to stick to dieting recommendations and regular training are less likely to develop further complications such heart failure or stroke.
AMA 2014 ‘Preventing Diabetes: Making a Difference by Linking the Clinic to the community’ offers guidelines aimed at preventing and managing Type 2 diabetes for the middle class and the elderly. Creating awareness of the lifestyle choices is emphasized because it is a starting point at controlling the disease. Lack of exercise combined with poor dieting are two underlying factors responsible for exercise weight gain associated with diabetes. Therefore achieving and maintaining a healthy body weight via dietary measures and exercise in individuals who already have diabetes is essential in controlling the complications. To reduce glucose levels dietary measures advice for the reduction of fatty foods and an increase in vegetable consumption to attain a moderate calorie intake. Overweight individuals should also ensure that they watch their weight and spent at least an hour of exercise every day. Physical activity raises the metabolism levels and reduces the chances of obesity.
The learning tool
The teaching tool was completed in three phases. At each stage, a single concept was tackled and once completed, the results were evaluated and if successful, the next phase was initiated. These three phases were necessary to ensure the success of the undertaking. In the first step, I introduced the type 2 diabetes patients to the program and made sure they were fully aware of what to expect. At this stage, the patients are asked to discuss the challenges they faced, which areas they could use a little bit of help and what they expected to achieve. It’s at this point that I explained the purpose of the learning tool and the expected outcome.
The second step was distribution of materials on recommended diets and the benefits of exercise. To many patients, the lack of information was top on the list of challenges they faced hence didn’t know which foods to eat and what to avoid. Therefore, I created flyers that were color coded and easy to use detailing the risky foods and the healthy foods to anyone trying to watch their weight and stop the escalation of diabetes. The flyers were handed out to the patients at the hospital and their families to help them ensure that the patients were on appropriate diets. The families are responsible for feeding the patients at home hence their involvement was necessary to ensure the success of the project. The support mechanism families’ support was also necessary in ensuring the process run smoothly and the patients participated fully. Family was therefore an integral part of this learning because they too were supposed to benefit from this process in the long run by learning to avoid the unhealthy processed sugary foodstuffs.
The second step emphasized the importance of exercise to the society. This was supposed to introduce a daily routine that worked effectively with the different patients. With most diabetics already facing weight issues, it would be impossible to start them on a rigorous exercise plan because that would be physically impossible. However, getting them on a diet that worked effectively would need to be followed by a gradual weight loss program that would accommodate different body size and intensify with time. The first step in weight watch involved reducing the number of hours spent idling. This required cutting the hours the patients spent watching television, playing computer games or just indoors by half. Therefore, each and every patient was required to adopt an outdoor activity that required some straining. This included walking, swimming, yoga classes or anything physical a patient was comfortable with. The patients were therefore supposed to engage in physical activities at least five times in a week to cut weight. The obese and overweight patients would get a handle on their situation by coupling exercise with dieting.
The final step involved teaching the patients on how to manage diabetes at home. At this stage, every patient was supposed to come into the clinic for a simple demonstration that I was supposed to go through step by step. Here the patients came in and I taught them how to administer their own insulin, check their blood sugar and identify the symptoms of hypo/hyperglycemic reaction before hand and take the necessary precautions. This included showing them how to use administer insulin, insulin storage conditions and the necessary steps if one was experiencing hypo/hyperglycemic reaction. At this step, using the hospital equipments I taught them how to use the syringe, select the spot to inject on the body and ensure that the process was done safely.
Project reception
After introduction to exercise, dieting and tutorials on insulin and blood sugar levels, the society was aware of lifestyle related risks of type 2 diabetes. After introducing people to the concept of exercise and dieting, it was evident that most people were unaware of what type of meals exposed them to the risk of diabetes. To most, the general assumption was that diabetes was an insulin related issue that could not be fixed by dieting or exercise. This is an indicator of how much effort and time has been spent on type 1 diabetes while ignoring the prevalence of type 2 diabetes in the society. Ignorance is bliss and at the expense of health, people continue to indulge in risky lifestyles because they do not know any better. The technology and culture change has created a generation at risk of type 2 diabetes and if something is not done soon, the problem will increase further.
Future development of the project
For further studies, I would like this study to focus on the alarming rate of obesity in America. Obesity is growing into a major concern for the whole American society despite class or social status. Cases of obesity hit 60 million adults or 30% of the adult population between 1980 and 2000 (Committee on Accelerating Progress in Obesity Prevention, 2012). The number of young adults overweight has tripled and resulted in cases of type 2 diabetes to the young people too. The main causes of obesity to the society include unhealthy ingredients in manufactured foods, schools failure to cover nutrition and physical education and the poor nutrition habits. The increased occurrence of obesity in the American society is mainly caused by the unhealthy lifestyle people are making. Influenced by the popular culture portrayed by the media and other sources of information, people are making wrong decisions on obesity and its causes every day which has resulted in diabetes and other health conditions that are plaguing the American society. The learning project shouldn’t therefore address only the middle aged and the elderly but the young generation too who are hard hit by obesity and affected by type 2 diabetes.
Reflection on the learning tool
The teaching concept was delivered successful in collaboration with my preceptor and the nursing staff at my unit who were instrumental in its conceptualization. The teaching process was meant to assist the patients and the rest of the community by informing them of the risks their lifestyles exposed them to. Most parts of the project were quite straight forward and easily implemented to suit a society characterized with different levels of understanding. To ensure maximum effect, sections requiring critical thinking were included to nudge the society towards the truth they were missing. Comparing the levels of type 2 diabetes between the US and the third world countries was one of the few illustrations that pointed towards lifestyle choices and prevalence in the society.
Conclusion
Technology and other lifestyle related changes have resulted in a reduction in physical activity leading to a spike in type 2 diabetes. The majority of populations in the developing countries are at risk of contracting diabetes. The increasing inactivity coupled with the shift from healthy dietary routine has become a catalyst for weight gain, obesity and eventually diabetes. Hence, type 2 Diabetes is more pronounced in developing and industrialized countries than in rural areas where people retain traditional lifestyles. Incidences of type 2 Diabetes are pronounced in regions aligning towards major changes including diet consumed as people abandon indigenous foods for western diets.
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