Running head: RUN AWAY DIABETES 1

Run Away Diabetes

Siera R Stokes

Westminster Nursing College

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Attending the Senior Centers is quite a different experience from all other

clinicals. Some residents are bubbly, outgoing and happy while others are grumpy,

impatient and unhappy, and sadly with others there is such a thick language barrier that I

was barely able to converse with them. However, one thing that majority of them all have

in common is that they have a chronic disease. The craziest part of it is, most of the

chronic diseases these patients have are preventable! I chose to focus on Diabetes

Mellitus Type II due to the fact that type II is completely preventable and there are many

ways to manage it. I was blown away seeing how many people are diagnosed with DM,

and choose to not manage it or even try to. Also, I’m intrigued by how many non-

pharmacological alternatives there are to diabetes and how your body can heal from all

the damage patients do to their bodies.

In order to explain this chronic disease to my patients I would simply state,

Diabetes Mellitus is deemed as ‘insulin resistance.’ Insulin is produced by your pancreas

to even out the level of sugar in your blood, which is more important than it may sound.

With DM Type II your pancreas produces enough insulin, but the cells don’t react as they

should and this causes your blood sugar to be higher than your body would like it to. The

good news though, is that you have the control to possibly change your lifestyle and help

give your pancreas and cells a break to control your diabetes. Or if you were to meet with

your physician, they could prescribe you medications that can help your body be less

resistant to insulin and assist with your blood sugar levels. I also had clients ask me how

they would know if they had diabetes and while they couldn’t completely self diagnose, I

informed them that a few of the major signs and symptoms are: excessive thirst, frequent
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urination, fatigue, increased hunger, and high blood sugar. This was taught to me

throughout my years of schooling in multiple classes.

Through research I found many complications accompanying DM, however I

narrowed it down to the most common complications. The American Diabetes

Association deemed skin, eye, kidney, and neuropathy problems as serious side effects.

The article “Skin Complications” (2013) went into detail explaining:

Some of these problems are skin conditions anyone can have, but people with

diabetes get more easily. These include bacterial infections, fungal infections, and

itching. Other skin problems happen mostly or only to people with diabetes.

These include diabetic dermopathy, necrobiosis lipoidica diabeticorum, diabetic

blisters, and eruptive xanthomatosis.

It was also taught that there are multiple eye conditions that diabetes may contact and

stated facts such as, “People with diabetes are 40% more likely to suffer from glaucoma

than people without diabetes. The longer someone has had diabetes, the more

common glaucoma is. Risk also increases with age” ("Eye Complications," 2013). This is

even more specific to our clients not only due to Diabetes, but also due to their age, and

they should be made aware of how serious this can be. In the same article, “Eye

Complications” (2013), it specified that cataracts can be a serious problem and, “People

with diabetes are 60% more likely to develop this eye condition. People with diabetes

also tend to get cataracts at a younger age and have them progress faster. With cataracts,

the eye's clear lens clouds, blocking light.” The ADA made it apparent that there are

multiple complications that are threatening to patients, and the list doesn’t end there.

They continued on in the article “Neuropathy” (2013) stating:

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Nerve damage from diabetes is called diabetic neuropathy. About half of all

people with diabetes have some form of nerve damage. It is more common in

those who have had the disease for a number of years and can lead to many kinds

of problems.

Adding onto what the ADA taught, the neuropathy that is especially harmful for diabetics

would be peripheral neuropathy in their feet which can lead to amputation of their

toes/feet if they lose sensation and have a wound on their lower extremities that they

don’t treat properly. One of the last complications taught by the American Diabetic

Association in their research titled “Kidney Disease” (2013) is renal problems which also

has residual problems but is explained as:

High levels of blood sugar make the kidneys filter too much blood. All this extra

work is hard on the filters. After many years, they start to leak and useful protein

is lost in the urine. Having small amounts of protein in the urine is

called microalbuminuria.

It is concerning to know how many complications there are that accompany DM, which

can be controlled and prevented yet there are many patients who don’t have the means,

desire, or opportunity to control their diabetes.

As mentioned previously, Diabetes Mellitus Type II can be prevented and

managed with multiple non-pharmacological techniques. There are a variety of different

solutions such as: increase activity level, eat healthier, drink more water, and create

healthy habits. To specify, with one’s activity level they can try to make a goal of how

long to work out each day, go on daily walks, try water aerobics, walk to find someone in

their house instead of yelling their name for convenience, and many more simple
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activities. For their diet, patients can use less salt, eat foods with lower fat and cholesterol

levels, eat more fruits and veggies, snack on healthy items during the day, limit sugar

intake, don’t eat fried foods often, and try to choose foods with less preservatives.

Drinking more water is simple, and try to drink less sugary drinks and carbonated drinks.

As for healthy habits, patients can take the stairs instead of an elevator if their body

permits, stand up and walk during TV commericials, or put smaller portions of food on

their plates while eating slower. They can also avoid eating dinner in front of a television

in order to listen to their body’s hunger cues or stretch daily. The list goes on of ways to

prevent or manage diabetes, and I feel as though patients are not educated enough to

know about these, but education would be extremely beneficial.

In the senior centers, I had a few clients with abnormal results and I had to

explain to them what this meant. I explained that their blood sugar was too high and this

can be harmful to their body if it isn’t maintained.Some patients responded with

questions inquiring about the complications and I was happy to answer them as well as

possible. If patients had a physician I told them to take the card I had given them with

their blood sugar on it and set up an appointment with their doctor to have it looked at,

and if they didn’t have a doctor I gave them the resource page and showed them where

they could go to find a doctor who could help them. To my surprise, only one client

seemed concerned and wanted to comply with the instructions I had given them. The

others didn’t seem to care about the news I had just told them and acted as though it

wasn’t a problem. No one was upset by the news though, which was a relief. For

patients with normal results I simply told them to keep doing what they’re doing and try

to stay active and eat appropriately. In the end, it is the patient’s responsibility to take
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care of their body and this was reiterated to me while reading (Hinkle & Cheever,

2014, p. 51) and explained:

Taking responsibility for oneself is the key to successful health promotion. The

concept of self-responsibility is based on the understanding that the individual

controls his or her life. Each person alone must make the choices that determine

the health of his or her lifestyle. As more people recognize that lifestyle and

behavior significantly affect health, they may assume responsibility for avoiding

high-risk behaviors such as smoking, alcohol and drug abuse, overeating, driving

while intoxicated, risky sexual practices, and other unhealthy habits.

While not all of those behaviors apply directly to diabetes, the overall concept does and is

applicable to all clients.

Overall, the senior centers opened my eyes to the fact of how many people are

dealing with a chronic disease. It was an educational experience to see the difference

between those managing their diabetes and those who don’t. I realized this is an endemic

for our country and education at a younger age may be a huge factor in preventing

diabetes for populations growing older.

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References

Eye complications. (2013, November 1). Retrieved November 6, 2016, from

http://www.diabetes.org/living-with-diabetes/complications/eye-

complications/#sthash.Ea6YaDnP.dpuf

Hinkle, J. L., & Cheever, K. H. (2014). Brunner & Suddarth's textbook of medical-

surgical nursing. Philadelphia: Wolters Kluwer Health/Lippincott Williams &

Wilkins. http://coursepoint.vitalsource.com

Kidney disease (nephropathy). (2013, December 10). Retrieved November 13, 2016,

from http://www.diabetes.org/living-with-diabetes/complications/kidney-disease-

nephropathy.html#sthash.IUgBtPRE.dpuf

Neuropathy (nerve damage). (2013, December 5). Retrieved November 13, 2016, from

http://www.diabetes.org/living-with-

diabetes/complications/neuropathy/#sthash.MMonJtHJ.dpuf

Skin complications. (2014, March 31). Retrieved November 4, 2016, from

http://www.diabetes.org/living-with-diabetes/complications/skin-

complications.html#sthash.iAIzmaQq.dpuf