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Life can be unpredictable, particularly when it comes to one’s health. Some things we simply do not have any control over, such as genetics, family history, and age. Nevertheless, there are some things we do have control over. Living to your healthiest, best potential can add years to your life but also improve the quality of our lives. This project allowed me to interview an adult participant whom I will refer to as “KJ” and learn how to conduct a health assessment.
I am also able to identify teaching/learning needs from the health history of KJ. After collecting all the data, I was able to identify one modifiable risk that KJ is at risk for which is Type 2 Diabetes. Her father and paternal grandparents both have diabetes. I will explore different evidence-based teachings and create a teaching plan for KJ that promotes health with the aim of decreasing her chances of getting Type 2 Diabetes. Information technology-based interventions are increasingly being used to manage diabetes and other health diseases.
My teaching plan for KJ include helping her join a Center for Disease control approved lifestyle program that is specifically geared to help those at risk for developing Type 2 Diabetes.
Glucose (blood sugar) is processed differently in patients with the chronic disease Type 2 Diabetes. There are more than 30.3 million people in the United States living with Type 2 Diabetes (cdc.org.) Another troublesome estimate shows 84 million adults living in the United States are pre-diabetics and unaware of it. If these adults continue to go untreated the pre-diabetes can develop into diabetes within five years (cdc.
org.) The pancreas in an organ that produces the hormone insulin. Insulin works by allowing the body to use glucose from carbohydrates and using it for energy or saving it for impending use. Insulin is a hormone made by the pancreas that permits the body to use sugar (glucose) from carbohydrates in the food that you consume for energy or to store for future use. Insulin helps keeps your blood sugar level from getting too high (hyperglycemia) or too low (hypoglycemia). People with type 2 diabetes make insulin, but their cells don’t use it as well as they should. Doctors call this insulin resistance. At first, the pancreas makes more insulin to try to get glucose into the cells. But eventually it can’t keep up, and the sugar builds up in the blood instead (medlineplus.gov) Common symptoms of diabetes are frequent urination, feeling very thirsty, feeling very hungry – even though you are eating, extreme fatigue, blurry vision, cuts/bruises that are slow to heal, and tingling, pain, or numbness in the hands/feet (heart.org)
There are several ways to diagnose diabetes. The A1C test measures the average blood glucose for the past 2 to 3 months. The advantages of being diagnosed this way are that you don’t have to fast or drink anything. Diabetes is diagnosed at an A1C of greater than or equal to 6.5%. Another way to diagnose diabetes is through a Fasting Plasma Glucose (FPG) test. This test checks your fasting blood glucose levels. Fasting means after not having anything to eat or drink (except water) for at least 8 hours before the test. This test is usually done first thing in the morning, before breakfast. Diabetes is diagnosed at fasting blood glucose of greater than or equal to 126 mg/dl. There is also a Oral Glucose Tolerance Test (also called the OGTT). The OGTT is a two-hour test that checks your blood glucose levels before and 2 hours after you drink a special sweet drink. It tells the doctor how your body processes glucose. Diabetes is diagnosed at 2-hour blood glucose of greater than or equal to 200 mg/dl (diabetes.org.)
A diabetes-focused physical examination includes vital signs, funduscopic examination, limited vascular and neurologic examinations, and a foot assessment. Other organ systems should be examined as indicated by the patient’s clinical situation. Other possible physical findings are obesity, hypertension, eye hemorrhages, muscle atrophy and loss of deep tendon reflexes in ankles (Jarvis, 2016.)
I was able to identify KJ’s risk for the disease when I asked her about her family’s medical history. She told me that her father and her grandparents had Type 2 Diabetes. She stated that her “paternal grandfather became blind and lost his right leg, probably due to diabetes. His cause of death is unknown, and my father also had diabetes, hypertension, Parkinson’s Disease and Prostate Cancer. He however died from prostate cancer.” Given this information, there are two generations of diabetes, which places KJ at a high risk for Diabetes as well.
Studies has shown that people who are enrolled in lifestyle change program has a large reduction in their HbA1C levels versus those who toke an 800mg dose of Metformin daily over the course of two years. The participates totaled to 3,320 people who were selected because they were at risk of having diabetes. Half of the participants enrolled in a lifestyle change program which provided 3O minute individual sessions five days a week that emphasized the importance of a healthy lifestyle. These participants were encouraged to follow the Food Pyramid Diagram which consists of a low calorie, low fat diet. They were also motivated to partake in physical activity which could be a brisk walk for 150 minutes a week. The goal for this group was to lose 7% of their total body weight by adjusting their lifestyles. The second group only took the 800mg of Metformin daily for two years without diet and exercise. Participants assigned to the lifestyle intervention had much greater weight loss and a greater increase in leisure physical activity than did participants assigned to receive metformin (Pereira, 2016).
The program that I would advise KJ to join is the Collier Heights Recreation Center in Atlanta, Georgia. A trained lifestyle coach leads the program to help identify and make lifestyle changes that can ultimately prevent Type 2 Diabetes. This program also includes group support from others who share the same goals.
My short-term goal for KJ is have her take a pre-diabetes screening. One tool that I would use is a Pre-Diabetes Screening Test. This questionnaire will help KJ learn about her risk for prediabetes. The test consists of seven questions and is based off yes or no answers. If the score is 9 or above, then KJ is at risk of having Diabetes. During the interview, KJ stated she was a visual learner. Therefore, I would also have her watch a video called “A Change for Life”. In this video, people with prediabetes discuss how group lifestyle classes facilitated in maintaining healthy habits. Lastly, I would direct her to the Cdc.gov website which have an abundance of information regarding the benefits of using lifestyle change groups and reading testimonials for other participants. The long term-goal for KJ is to complete the year long lifestyle program, maintain a healthy weight through diet and exercise and most importantly continue to be Diabetes free.
A method I would use to evaluate if my intervention was effective is having KJ do some blood work that would include (HgA1c, FPG, and an oral glucose test.) I would also see is she lost any weight throughout the year. If my plan of having her enroll with a lifestyle coach at the Collier Heights Recreation Center in Atlanta, Georgia did not work I would see if perhaps an online version of the program would better fit her schedule and needs.
In the last 20 years, the number of adults diagnosed with diabetes has more than tripled as the US population has aged and become more overweight (cdc.gov.) Proper assessment of the KJ’s family history played a central role in identifying specific risk factors. Using evidence-based research, I came up with a teaching plan that involves a lifestyle change program. This lifestyle change program can help KJ lose weight through eating better and being more physically active. She will also learn how to reduce stress most importantly will help decrease her risk of developing type 2 diabetes. Life is not about how long you live, it is about how well you live life.
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