Running head: A MEDICAL AND THEORETICAL ASSESSMENT OF DIABETES

A Medical and Theoretical Assessment of Diabetes

Latoya Young

Methodist University

Nutrition for Health and Healing 3150

Professor Johnston

23 April 2017
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Abstract

Diabetes mellitus is an anguish on humanity. It affects a significant portion of the

population, can have severe complication such as loss of digits, and can even lead to death.

However, an effective method of managing the disease is found in nutrition. This paper examines

the diabetic patients use of self-help in managing their nutrition and diet and thus their disease.
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A Medical and Theoretical Assessment of Diabetes

Diabetes mellitus is several metabolic diseases resulting in an elevated blood sugar level

of long duration. While diabetes refers to a number of diseases, they all fall within one of three

broad categories, Type I diabetes, Type II diabetes, and Gestational Diabetes. Type I diabetes is

due to the pancreas failing to produce adequate insulin. This type was formerly known as insulin-

dependent or juvenile diabetes. Its exact cause remains unknown. Type II diabetes is due to

tissues failing to respond properly to insulin (Yokoyama, Barnard, Levin, & Watanabe, 2014). In

later states of this type of diabetes, there may also be inadequate insulin production. This form of

diabetes is non-insulin dependent, and its onset is generally in adulthood. The most common

cause is excessive body weight and a sedentary lifestyle. Finally, gestational diabetes occurs

when pregnant women with no previous history of diabetes develop elevated blood sugar levels

(Buchanan & Xiang, 2005). It can be seen then that diabetes mellitus represents a group of

metabolic diseases categorized according to their onset and pathophysiology of the disease

process.

Diabetes is a serious disease, because the consequential symptoms of hunger, thirst and

excessive urination can lead to acute complications that can result in a coma or death. In

addition, chronic complications include heart disease, stroke, kidney failure and eye damage that

can progress to blindness (Vos et al., 2012). Globally, nearly a half billion people have diabetes

of one form or another, with type II diabetes accounting for the vast bulk of those cases. Men and

women are equally afflicted. The problems with diabetes are compounded as reflected in the

estimate that in 2012, in the United States alone, diabetes cost $245 billion. That figure is

comprised of $176 billion in actual medical costs and $69 billion in lost productivity (American

Diabetes Association, 2013). Even more ominous is the fact that there are indications that the
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presence of diabetes, which afflicts 8.3% of the adult population, is growing. The evidence

reveals that there is a trend for its increasing future prevalence. When a person contracts the

disease, their likelihood of death doubles (American Diabetes Association, 2013).

Diabetes is a chronic disease for which there is no known cure, except in very specific

cases. Management efforts concentrate of maintaining blood sugar levels as close as possible to

normal levels without resulting in low blood sugar. In application, this is generally achieved with

the proper diet, exercise, weight control and the necessary medications (Yokoyama, Barnard,

Levin, & Watanabe, 2014).

One of the theories of nursing is Dorothea Orems self-care theory, also called the self-

care deficit theory (Black, 2014). Dorothea Orems theory is a holistic model and perspective

that provides a structure for critical thinking in the nursing process. The focus of Orems model

is the patients self-care capacity (Black, 2014). Thus, part of the management of diabetes

requires the patient to develop self-care by learning about diabetes and taking an active role in

the management process. People who manage their own blood sugar levels experience severe

complications less frequently and even experience fewer symptoms of the disease overall.

The actual dietary regimen is a matter of personal choices and availability. In 1992, the

American Diabetes Association advised that as much as seventy percent of all caloric intake

should be carbohydrate to help battle diabetes, while there are those researchers who claim this

figure should be less than forty percent. However, others extol the benefits of a high fiber

carbohydrate rich ( seventy-five percent) diet for such purposes (Burger et al. Post, Mainous,

King and Simpson, 2012). It is also known that vegetarians have a lower incidence of diabetes.

Thus, implementing vegetarian-based dietary interventions for managing diabetes has been

studied, and such research has revealed several factors that are potential explanations for why
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implementing a vegetarian diet for diabetic patients is beneficial (Ley, Hamdy, Mohan and Hu,

2014). Furthermore, several studies support these interventions, and future research stands to

delve deeper into this topic (Ley, Hamdy, Mohan and Hu, 2014). Despite this body of research,

controversy abounds and most medical professionals believe that more research is necessary to

resolve the issues of optimal nutritional requirements of managing diabetes.

As described in this paper, the theoretical framework for managing diabetes involves

behavioral change, which includes both what is eaten and the timing of those meals. Further

considerations include factors such as consuming a long-acting carbohydrate before bedtime to

forestalling common nocturnal occurrences such as hypoglycemia. Ironically, the morning

hyperglycemia that results from blood sugar reaching low levels at night often rebounds (Brijesh,

2015). Further management of diabetes entails having diabetic patients refrain from the

consumption of alcohol and drugs, or at least using them in moderation (Clark and Janevic,

2014). The reason for this is that these substances greatly impact sugar levels and can cause

harsh, and even deadly, outcomes if consumed in excess. There is an underlying theory to

enacting these lifestyle changes. This theory is built around conditioning with the understanding

that there is a positive reward received in exchange for the effort involved in making the change

(Clark and Janevic, 2014). Conforming to this theory, there are numerous interventions that can

change the person's nutritional profile (Thomson and Foster, 2014) in an effort to manage

diabetes.

Given the current state of research and understanding regarding diabetes, a diabetic

patient can manage the disease by following a set of guidelines regarding the persons diet.

Specifically, the patient will be educated, directed, and encouraged to make low fat, vegetarian

selections. Current research shows improved glycemic control and the reduction of
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cardiovascular risk factors in type II diabetics by following the appropriate diet (Lee, et al.,

2016); Yokoyama, Barnard, Levin & Watanabe, 2014). The proper diet can be maintained by

motivating the patient to accept and maintain the behavioral change regarding the patients diet.

That process will take some time for the patient to develop the proper habits such that they

become good routines. If the patient takes the condition seriously, and applies the suggested diet

proactively, the patient can greatly control their diabetes. In doing so, the patient can largely

eliminate many of the negative aspects of the disease. Ultimately, diabetic patients who utilize

nutrition as a tool for combatting diabetes are able to live full, healthy, and enjoyable lives. They

simply have to tweak their eating and drinking habits.

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