Implications of a Type 1 diabetes-Long Term condition on a patient’s life journey and wellbeingIntroductionType 1 diabetes constitute of 5-15% of 285 million adults with diabetes. The disease is increasing at 3% annually, particularly in white Europeans, including northern Europe (Hovorka et al 2011). It accounts for almost 57000 death every year among under 75years, the most intensive users of high cost services (DoH, 2008). As one of the diseases associated with long term conditions, type 1 diabetes is a global concern. Approximately 17.5 million people have a long term condition (Margereson and Trenoweth, 2010).
In Britain, six out of ten adults have a long-term condition that can’t be cured thus making their care and management even more complex (Chronic disease management, 2004). This aim of this paper is to present a detailed discussion on the implications of a Type 1 diabetes long term condition on a patient’s life journey and wellbeing with a use of a case study of patient suffering from the disease. Background to LTC-Type 1 diabetesPeople with Type 1 diabetes are generally are not obese and may present initially with diabetic ketoacidosis (DKA).
The distinguishing characteristic of a patient with type 1 diabetes is that if his or her insulin is withdrawn, ketosis and eventually ketoacidosis develop. Therefore, these patients are dependent on exogenous insulin which calls for a multidisciplinary approach by physician, nurse, and dietitian. At the new-onset of type 1 diabetes, permanent insulin therapy has to be started. There is also need for a long-term medical attention both to limit the development of its devastating complications and to manage them when they do occur. Type 1 diabetes is one of an autoimmune disease that results when the body’s system for fighting infection—the immune system—turns against a part of the body.
In this case, immune system attacks and destroys the insulin-producing beta cells in the pancreas (Devendra, 2004). It is related to premature beta-cell failure or pancreatic beta-cell destruction where the patients completely lack insulin secretion leading to increased blood and urine glucose or severe metabolic lability and eventually ketoacidosis. According to McAnulty, Robertshaw and Hall, patients with type 1 diabetes are generally vulnerable or prone to lipolysis, proteolysis and ketogenesis.
These processes are repressed by minimum levels of insulin secretion (McAnulty, Robertshaw and Hall, 2000). Associated symptoms include polyuria (frequent urination), polydipsia (increased thirst), polyphagia (increased hunger), and weight loss. Several authors have also reported a close association between anxiety with Blood Glucose Monitoring and Glycemic Control (O’Kane, Bunting and Copeland, 2008; Herzer and Hood, 2009). Case Study: implications of a Type 1 diabetes-Long Term condition on a patient’s life journey and wellbeingThe following case study describes the diagnostic dilemma presented by an aged man with type 1 diabetes and a history of severe hypoglycemia complicated by other medical, psychiatric, social, and functional problems but has also indicated a unique protection over some ailments.
Diabetes, of course, may cause an increase in cognitive decline over the course of time because of vascular risk factors (Logroscino, Kang and Grodstein, 2004) in patients with type 1 diabetes; cognitive dysfunction is characterized by a slowing of mental speed and a diminished mental flexibility, whereas learning and memory are spared. The extent of the cognitive dysfunctions varies from mild to moderate, however even mild forms of cognitive dysfunction may hinder considerably daily activities because they can be likely to result to trouble in more challenging situations (Augustina et al 2005).
Depression is also associated with patient suffering from diabetes particularly with old people. In part, this could be as a result of memory impairment, changes caused by the illness or treatment of diabetes, or due to the psychosocial demands related to diabetes and/or its treatment. In addition, it could also be linked to changes in physical activity and diet that may increase risk for diabetes, and depression may also produce physiological changes that increase risk for diabetes (Husain et al, 2004).