Question

Choose a health care concern from (diabetes, leukemia, CHF for example) chapters 1-15 and in your own words, discuss what concerns could be a problem for a patient with this health care issue and options available. Use the internet to research.

Answer 1

PATIENT WITH DIABETES

Diabetes mellitus (sometimes called "sugar diabetes") is a condition that occurs when the body can't use glucose (a type of sugar) normally. Glucose is the main source of energy for the body's cells. The levels of glucose in the blood are controlled by a hormone called insulin, which is made by the pancreas.

Complications of Diabetes

Here are more details on some common diabetes complications.

Neuropathy. Neuropathy is another term for nerve damage, and it occurs in more than 50 percent of people with diabetes. Neuropathy can have a variety of symptoms; these symptoms often occur in your feet or legs – and sometimes your hands and arms – when you have diabetes. The symptoms include tingling, increased sensitivity to touch, pain, numbness and weakness.

Kidney disease. Kidney disease is a common complication because high levels of glucose cause the kidneys to filter too much blood, making them work extra hard. Waste products can build up and make the kidneys stop working. The effects of severe kidney disease are often devastating.

Vision problems. A condition called diabetic retinopathy can affect your vision over time when you have uncontrolled blood sugar levels. The excess glucose causes damage to the vessels in your retina, which is part of the back of the eye. Symptoms include blurry vision and poorer daytime and nighttime vision. Left untreated, diabetic retinopathy causes vision loss.

Heart disease. Diabetes kills from the heart. The majority of patients will end up having some atherosclerosis-related events.  High blood glucose over time damages the heart – and those with diabetes are already more likely to have heart-related problems such as high blood pressure and high cholesterol.

Stroke. You're two to four times more likely to have a stroke when you have diabetes. This is because excess glucose in the body can lead to more fatty deposits or clots in the walls of the blood vessels. The clots can cause narrowing or blockages in your blood vessels, which could eventually stop the flow of oxygen to the brain and cause a stroke.

Low testosterone levels.  Testosterone is a reproductive hormone, and if the body is focusing on dealing with other issues, it's not focused on reproductive function. So, controlling diabetes and improving lifestyle will increase testosterone

Gastroparesis. Gastroparesis is a condition where your stomach slows or stops the movement of food to the small intestine. Symptoms include nausea, vomiting, stomach pain and feeling full after just a few bites. Diabetes is the most common cause of gastroparesis, according to the National Institute of Diabetes and Digestive and Kidney Diseases.

Sleep apnea. Sleep apnea is a common problem among patients with Type 2 diabetes; those who are overweight or obese are already more prone to sleep apnea. Treatment of sleep apnea can help control diabetes and daytime energy levels.

Diabetes care to avoid complications

Diabetes care is a lifelong responsibility. Consider some strategies to prevent diabetes complications.

1. Make a commitment to managing your diabetes

Members of your diabetes care team — doctor or primary care provider, diabetes nurse educator, and dietitian, for example — can help you learn the basics of diabetes care and offer support along the way. But it's up to you to manage your condition.

Learn all you can about diabetes. Make healthy eating and physical activity part of your daily routine. Maintain a healthy weight.

Monitor your blood sugar, and follow your doctor's instructions for managing your blood sugar level. Take your medications as directed by your doctor. Ask your diabetes treatment team for help when you need it.

2. Don't smoke

Smoking increases your risk of type 2 diabetes and the risk of various diabetes complications, including:

• Reduced blood flow in the legs and feet, which can lead to infections, ulcers and possible removal of a body part by surgery (amputation)
• Heart disease
• Stroke
• Eye disease, which can lead to blindness
• Nerve damage
• Kidney disease
• Premature death

Talk to your doctor about ways to help you stop smoking or using other types of tobacco.

3. Keep your blood pressure and cholesterol under control

Like diabetes, high blood pressure can damage your blood vessels. High cholesterol is a concern, too, since the damage is often worse and more rapid when you have diabetes. When these conditions team up, they can lead to a heart attack, stroke or other life-threatening conditions.

Eating a healthy, reduced-fat diet and exercising regularly can go a long way toward controlling high blood pressure and cholesterol. Your doctor may also recommend taking prescription medication, if necessary.

4. Schedule regular physicals and eye exams

Schedule two to four diabetes checkups a year, in addition to your yearly physical and routine eye exams.

During the physical, your doctor will ask about your nutrition and activity level and look for any diabetes-related complications — including signs of kidney damage, nerve damage and heart disease — as well as screen for other medical problems.

Your eye care specialist will check for signs of retinal damage, cataracts and glaucoma.

5. Keep your vaccines up to date

Diabetes makes it more likely you'll get certain illnesses. Routine vaccines can help prevent them. Ask your doctor about:

• Flu vaccine. A yearly flu vaccine can help you stay healthy during flu season as well as prevent serious complications from the flu.
• Pneumonia vaccine. Sometimes the pneumonia vaccine requires only one shot. If you have diabetes complications or you're age 65 or older, you may need a booster shot.
• Hepatitis B vaccine. The hepatitis B vaccine is recommended for adults with diabetes who haven't previously received the vaccine and are younger than 60. If you're age 60 or older and have never received the hepatitis B vaccine, talk to your doctor about whether it's right for you.
• Other vaccines. Stay up to date with your tetanus shot (usually given every 10 years). Your doctor may recommend other vaccines as well.

6. Take care of your teeth

Diabetes may leave you prone to gum infections. Brush your teeth at least twice a day with a fluoride toothpaste, floss your teeth once a day and schedule dental exams at least twice a year. Call your dentist if your gums bleed or look red or swollen.

7. Pay attention to your feet

High blood sugar can reduce blood flow and damage the nerves in your feet. Left untreated, cuts and blisters can lead to serious infections. Diabetes can lead to pain, tingling or loss of sensation in your feet.

To prevent foot problems:

• Wash your feet daily in lukewarm water. Avoid soaking your feet, as this can lead to dry skin.
• Dry your feet gently, especially between the toes.
• Moisturize your feet and ankles with lotion or petroleum jelly. Do not put oils or creams between your toes — the extra moisture can lead to infection.
• Check your feet daily for calluses, blisters, sores, redness or swelling.
• Consult your doctor if you have a sore or other foot problem that doesn't start to heal within a few days. If you have a foot ulcer — an open sore — see your doctor right away.
• Don't go barefoot, indoors or outdoors.

8. Consider a daily aspirin

If you have diabetes and other cardiovascular risk factors, such as smoking or high blood pressure, your doctor may recommend taking a low dose of aspirin every day to help reduce your risk of heart attack and stroke. If you don't have additional cardiovascular risk factors, the risk of bleeding from aspirin use likely outweighs any benefits of aspirin use. Ask your doctor whether daily aspirin therapy is appropriate for you, including which strength of aspirin would be best.

9. If you drink alcohol, do so responsibly

Alcohol can cause high or low blood sugar, depending on how much you drink and whether you eat at the same time. If you choose to drink, do so only in moderation, which means no more than one drink a day for women of all ages and men older than 65 and two drinks a day for men age 65 and younger.

Always drink with a meal or snack, and remember to include the calories from any alcohol you drink in your daily calorie count. Also, be aware that alcohol can lead to low blood sugar later, especially for people who use insulin.

10. Take stress seriously

If you're stressed, it's easy to neglect your usual diabetes care routine. To manage your stress, set limits. Prioritize your tasks. Learn relaxation techniques.

Get plenty of sleep. And above all, stay positive. Diabetes care is within your control. If you're willing to do your part, diabetes won't stand in the way of an active, healthy life.