Chronic disease characteristics of Type 2 diabetes will affect the quality of life for that individual. The chronic disease characteristics are problems with sleep, depression, stress, distress about having the disease, how to cope with the illness, and lack of social support from family and society. If you have a chronic disease it will have these same effecting characteristics that Type 2 diabetes has. In addition, there is a psychological and social component that creates more hardship. Let’s look at the facts about type 2 diabetes.
30.3 million people (9.4%) in the US
84.1 million pre-diabetic (CDC 2015).
78 million people were considered obese
347 million people worldwide.
The seventh leading cause of death in 2015
Costs roughly $245 billion in the US
Average health care cost newly diagnosed diabetic over their lifetime is $85,200 53% of that cost will be used for treating complications
Type 2 diabetes is estimated to reach 642 million by the year 2040
Risk factors of obesity, smoking, and physical inactivity
Factors of stress include job loss, divorce, death of loved one, daily deadlines, traffic, family, and having to manage an illness. Individuals under stress may not follow the daily routine of self-care that entails eating healthy, exercising, and taking medication consistently. Individuals may drink alcohol to cope and may not check their blood sugar levels. Stress creates a biological change in the body by producing chemicals that place more sugar into the bloodstream. There is a significant amount of stress in managing blood sugar levels with several finger-prick checks a day, as well as dietary changes and an increase in physical activities. The burden of oral medication or insulin injections increases stress levels. The fear or perceived fear of developing future poor physical conditions
Patients are required to handle 95% of their own care which is a heavy burden. Coping is defined as thoughts and behaviors used to manage the emotional and logistical demands of situations that are judged as stressful. Diabetic females have a harder time coping with diet where diabetic men were more aware of diet changes.Stress and coping skills will affect self-care management. The heavy burden of self-care creates fear or perceived stress.
Distress is a reaction to a chronic health condition. Types of distress: emotional burden, regimen distress, interpersonal distress, and physician distress. Distress is the result of the emotional burden of self-management, fear of complications, and possible loss of function. Emotional distress is a response to the patients’ perception of health threats versus coping resources. Emotional distress is expressed as anger, frustration, denial, anxiety, and mostly depression. Furthermore, diabetes distress (DD) can create psychological pressure that produces sleeplessness, depression, and anxiety.
In people with diabetes, depression has found to be 10-15% higher. As a result, treating individuals with medications can affect blood sugar control. Depressive individuals display negative effects on adherence to medications, dietary measures, quality of life, and rate of mortality. Depressive symptoms and inflammation have been shown in recently diagnosed type 2 diabetics. Patients reporting more depression symptoms had more diabetes-related stress and negative appraisal of the illness. Biopsychosocial risk factors for depression with type 2 are occupation, marital status, social support, diabetes complications, and negative life events in the past 6 months. Furthermore, psychological conditions such as depression and anxiety have been connected to poor control or elevated blood sugars caused by a lack of self-care and poor coping skills.
There is a connection between sleep problems and inflammatory disease risk. Poor quality of sleep is related to the duration. Depression and sleep are linked together (Sleep Foundation). Sleep disturbances increase the hunger hormone and risk for obesity and type 2. Type 2 diabetics have sleep problems impacting blood sugar control. A too short and too long duration of sleep has a significant increase in the risk of type 2 (Diabetes Care). Diabetes and heart failure have similar sleep problems. Furthermore, poor sleep quality attributes to arterial thickening in type 2
Social support plays an important role in self-management. Positive social support results are Improvement in self-care, quality of life, and increased disease knowledge. Females received support through friends and family, however, males received support through their spouses. Females reported more stress from friends’ interaction. The family unit is a means of support for the diabetic’s lifestyle change and adherence. Be aware that negative beliefs toward family situations affected diabetic self-care. Supportive spouses, not controlling ones, had a better relationship in coping with this illness. Martial adjustment, family coping, and positive support resulted in good adherence behavior even with negative beliefs about medication. Furthermore, negative or conflicting support coupled with negative beliefs about medication lead to non-adherence
Quality of life (QoL) is the quality of interactions between physical, mental/cogitative, psychological, and social. Diabetic factors that modify the quality of life were age, sex, occupation, marital status, years with diabetes type 2, other conditions, and depression. Furthermore, perceived stress greatly affected QoL outcomes and researchers suggested that interventions include this psycho-social factor.
Non-adherence to self-care is a serious problem raising the cost of medical care. Therefore, good self-care behaviors are the most important undertaking for a diabetic. In other words, devotion and obedience are required in maintaining dietary changes, exercise, medication, and monitoring blood sugar levels. The stress of lifestyle change is taking responsibility for non-adherence that leads to comorbidity conditions and future complications. Similarly, know the stress-related factors that affect your situation. Take a minute to consider socio-economics, living conditions, health care systems, family adjustments, and partner’s support. Most importantly, learn coping mechanisms and obtain social support. Finally, challenge your belief about the use of medication.
The general advice is always diet, exercise, and proper sleep. In addition, the National Diabetes and Prevention Program (NDPP) developed a yearlong behavior change program to improve eating habits and lose weight. CDC, American Diabetes Assn, American Medical Assn, joined Ad Council public service funny videos on pre-diabetes (youtube) or go to pre-diabetes.org
In conclusion, I would like to see a comprehensive educational and intervention approach developed for the diabetic. For instance, a comprehensive course will include psychosocial factors along with attitudes and beliefs about having the disease. Finally, even if not a current diabetic, annual checkups with blood work for HbA1c and other markers should be done, .
Are you a man? Give yourself 1 point
Family history of diabetes? Give yourself 1 point
Do you have high blood pressure? Give yourself 1 point
Are you inactive? Give yourself 1 point
Are you over 40-50-60? Give yourself 1-2-3-points respectively
Are you overweight? Give yourself point: Somewhat 1, moderately 2, and very 3
Score 5 or more means you are in pre-diabetes status. Please have your HbA1c blood work done by your physician.
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To Your Health & Happiness,