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INTRODUCTION:

Diabetes mellitus is a condition in which the pancreas no longer produces enough insulin or cells stop
responding to the insulin that is produced, so that glucose in the blood cannot be absorbed into the cells
of the body. Symptoms include frequent urination, lethargy, excessive thirst, and hunger. The treatment
includes changes in diet, oral medications, and in some cases, daily injections of insulin. The most
common form of diabetes is Type II, It is sometimes called age-onset or adult-onset diabetes, and this
form of diabetes occurs most often in people who are overweight and who do not exercise. Type II is
considered a milder form of diabetes because of its slow onset (sometimes developing over the course
of several years) and because it usually can be controlled with diet and oral medication. The
consequences of uncontrolled and untreated Type II diabetes, however, are the just as serious as those
for Type I. This form is also called noninsulin-dependent diabetes, a term that is somewhat misleading.
Many people with Type II diabetes can control the condition with diet and oral medications, however,
insulin injections are sometimes necessary if treatment with diet and oral medication is not working.
The causes of diabetes mellitus are unclear, however, there seem to be both hereditary (genetic factors
passed on in families) and environmental factors involved. Research has shown that some people who
develop diabetes have common genetic markers. In Type I diabetes, the immune system, the body
s defense system against infection, is believed to be triggered by a virus or another microorganism that
destroys cells in the pancreas that produce insulin. In Type II diabetes, age, obesity, and family history of
diabetes play a role. In Type II diabetes, the pancreas may produce enough insulin, however, cells have
become resistant to the insulin produced and it may not work as effectively. Symptoms of Type II
diabetes can begin so gradually that a person may not know that he or she has it. Early signs are
lethargy, extreme thirst, and frequent urination. Other symptoms may include sudden weight loss, slow
wound healing urinary tract infections, gum disease, or blurred vision. It is not unusual for Type II
diabetes to be detected while a patient is seeing a doctor about another health concern that is actually
being caused by the yet undiagnosed diabetes. Individuals who are at high risk of developing Type II
diabetes mellitus include people who:

are obese (more than 20% above their ideal body weight)
have a relative with diabetes mellitus

belong to a high-risk ethnic population (African-American, Native American, Hispanic, or Native


Hawaiian)

have high blood pressure (140/90 mmHg or above)

have a high density lipoprotein cholesterol level less than or equal to 35 mg/dL and/or a
triglyceride level greater than or equal to 250 mg/dL

have had impaired glucose tolerance or impaired fasting glucose on previous testing

People with diabetes require at least two to three times the health-care resources compared to people
who do not have diabetes, and diabetes care may account for up to 15% of national health care budgets.
In addition, the risk of tuberculosis is three times higher among people with diabetes. The apparent
prevalence of hyperglycemia depends on the diagnostic criteria used in epidemiological surveys. The

global prevalence of diabetes in 2008 was estimated to be 10% in adults aged 25+ years. The prevalence
of diabetes was highest in the Eastern Mediterranean Region and the Region of the Americas (11% for
both sexes) and lowest in the WHO European and Western Pacific Regions (9% for both sexes).The
magnitude of diabetes and other abnormalities of glucose tolerance are considerably higher than the
above estimates if the categories of impaired fasting and impaired glucose tolerance are also
included.The estimated prevalence of diabetes was relatively consistent across the income groupings of
countries. Low-income countries showed the lowest prevalence (8% for both sexes) , and the upper
middle-income countries showed the highest (10% for both sexes).

Diabetes mellitus is a common chronic disease requiring lifelong behavioral and lifestyle changes. It is
best managed with a team approach to empower the client to successfully manage the disease. As part
of the team, we as nurses plan, organize, and coordinate care among the various health disciplines
involved; provide care and education and promote the clients health and well being. Diabetes is a
major public health worldwide. Its complications cause many devastating health problems.
As nursing students, we are challenged to choose this case because of the fact that it is hard to manage,
difficult to handle and requires a large amount of money for purchasing of medications and equipments
(insulin, glucometer, reagent strips, scheduled visits to the clinic etc.). And at the same time, we are
curious on how this disease affects the patients life and well-being and what would be the possible
predisposing and precipitating factors before an individual acquires it based on their health history.