DIABETES MELLITUS
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Introduction
Diabetes mellitus is a metabolic disease that causes high blood sugar. Diabetes is considered a chronic illness in that when one has the disease, the body either doesn’t make enough insulin or cannot use the insulin it makes effectively. The general symptoms of diabetes include weight loss, extreme fatigue, blurry vision, sores that hardly heal, frequent urination, increased thirst, hunger, etc. It is crucial to understand that there are symptoms that affect women and those that affect men. Symptoms in men with diabetes are erectile dysfunction, decreased sex drive, and poor muscle strength. For women include yeast infections, urinary tract infections, and dry, itchy skin. Therefore, untreated high blood sugar from diabetes may damage organs in the body such as the kidneys and tissues throughout the body. It is crucial to understand that even though diabetes can lead to serious medical complications, there are ways to manage the condition with medications and lifestyle changes. Healthy eating is a central part of managing the disease. Additionally, insulin can also help manage diabetes since it replaces the hormone the body is not able to produce.
Impact of Stigma on Health Outcomes
There have been a lot of people with diabetes mellitus that face stigmatization in society. Many diabetes patients claim that people say that they brought the disease to themselves. In contrast to other diseases, the public is less accepting and encouraging people living with diabetes. Since diabetes is believed to be associated with obesity, these patients are presented as overweight, lazy, and guilty of bringing the disease upon themselves. Even though being overweight is a risk factor for diabetes, there are other factors such as family history, socioeconomic factors, and environmental factors that cause the disease (Patra et al., 2021). Therefore, such misconceptions and misplaced judgments may bring these patients down and this may result in some negative effects.
Some of the impacts of stigma on the health outcomes for the vulnerable population with diabetes include: First, stigma can lead to worse health outcomes. It is essential to understand that diabetes patients have reported feelings of fear, blame, guilt, low self-esteem, and anxiety due to stigmatization. Such negative emotions mainly result in depression and higher levels of stress. When diabetes patient experiences this kind of stress, they increase their chances of developing health complications like macrovascular problems, sexual dysfunction, and retinopathy.
Secondly, stigmatization among these vulnerable populations may contribute to having poor self-care and diabetes management. Since people with diabetes are always made to feel entirely responsible for managing their health by ensuring their glucose level is normal, when they feel stigmatized, they may stop taking care of themselves as expected. Therefore, it is quite evident that harsh judgments made to people with this chronic disease can prompt efforts to conceal basic diabetes management. An example is patients with diabetes who have reported avoiding injecting themselves with insulin, eating unhealthy meals, manipulating glucose diaries and data to avoid being judged by healthcare professionals, among others.
Thirdly, stigma may also prevent patients from seeking the necessary care especially when healthcare professionals stigmatize them. According to the study, many patients who are mentally ill anticipated stigma from their healthcare professionals, and this contributed to them not seeking care since their patient-provider relationship was compromised. An example is individuals who were blamed for bringing diabetes to themselves reported to reduce their frequency of eye health checks and AIC testing. These are just but a few negative impacts of stigmatization faced by individuals with diabetes. There could be others not mentioned here that are equally important.
Barriers Faced
Stigmatization is one barrier that diabetes patients face, there are other barriers they come across that affect them negatively. One barrier is a lack of knowledge about diabetes self-management practices. Self-management of diabetes individuals entails controlling their glucose levels, adhering to healthy lifestyle practices, and ensuring they adhere to their medication. Quite a number of people diagnosed with diabetes lack the knowledge of diabetes self-management practices. This means that they are not aware of what kind of diet they should eat and what they should do to ensure their glucose levels remains normal. This makes many of these patients diagnosed with the disease follow the wrong ways to manage their disease. However, a way to avoid this barrier is by ensuring when a patient is diagnosed with diabetes, they should be taught ways they should manage their illness by healthcare practitioners (Reddy et al., 2021). This can be done through counseling and the practitioner demonstrating how insulin should be injected into the body. Healthcare practitioners can also develop a timetable to show what kinds of foods diabetes patients should eat and drink.
The second barrier is financial constraints. Diabetes does not affect individuals equally not in terms of its severity but in terms of financial stress, it places on patients. There are many individuals living with diabetes that are unable to cope with the disease due to financial constraints. It is evident that many diagnosed with diabetes are low and middle-class families. This makes them less likely to afford cost-related medication, good housing, and foods required to ensure they manage the chronic illness. Difficulties in maintaining this costly lifestyle in order to manage diabetes have affected patients globally. A way to prevent financial constraints among diabetes patients is by seeking help from medicine-assistance programs and acquiring government health insurance. Also, hospitals should be able to provide free insulin bags and injections for people with diabetes as it is costly to buy them.
The third barrier is insufficient counseling. Many are times people living with diabetes suffer from stigmatization which later causes them to be depressed since they do not receive appropriate counseling that will help them overcome the stigma. Also, with less counseling, these individuals may experience eating disorders and anxiety. Therefore, after a patient has been diagnosed, it is crucial for healthcare practitioners to guide and counsel them on how they should avoid feeling stigmatized, self-care management, and social activities they should undertake to help manage the chronic disease. Frequent counseling is essential as it helps to keep the patient on track.
The fourth barrier is a lack of support from family members and friends. This is a major problem for diabetes patients and it may result in stress which later derails treatment. According to a study, those who do not acquire any strong social support report cases of health complications and poor eating habits causing high health risks. Therefore, social support is essential in that it helps them to manage their disease and in turn reduces the risk of diabetes-related hospitalization or even death, fewer psychological issues, and speedy recoveries (Thompson et al., 2015).
Impact on Family Members
Family members mainly take part in caring for and supporting their loved ones with diabetes. This may cause physical and emotional stress for the entire family including stress, exhaustion, and irritability. However, many changes take place for the family as well as individuals caring for people with chronic illnesses. Some major adjustments that family caregivers make when a loved one is diagnosed with diabetes mellitus include: First is how to manage financial resources. Financial resources have had a major impact on family members since they have to put some finances aside for medical treatment and healthy and nutritious foodstuff for the diabetic family member. Also, money is needed for frequent checkups and doctor’s appointments. This can be quite challenging and overwhelming for the family.
Second is the disruption of leisure activities and social exclusion. With a family member that is diagnosed with diabetes, then a lot of time is needed to care for the patient. This makes it difficult for the family caregiver to have time for themselves hence no leisure time or lack of engagement in social activities (Schiel et al., 2018). Social exclusion is often a part of having a chronic illness patient since family members will want to keep their loved ones close to ensure they are well cared for.
The third is increased role strains. It is crucial to understand that having chronically ill patients in the family means that more roles and responsibilities are required of them. Family members are often required to ensure their loved ones eat a healthy balanced diet, their glucose level is normal, and that they are mentally healthy. This mainly causes some levels of anxiety regarding the well-being of their loved ones. In addition, exhaustion is also caused since the family members are doing their level best to ensure the patient is doing well.
Things that can be done to assist family caregivers to provide care for their loved ones with diabetes include Emotional and mental support. It is vital to note that most family members often experience anxiety, depression, exhaustion, and stress as they care for their sick loved ones. All they need is mental and emotional support as they go through a lot of caring for their loved ones. This will help prevent them from being stressed or depressed.
Policy Support
A major national policy that supports persons living with diabetes mellitus is having private and public insurance coverage. The government has been able to provide insurance coverage for diabetes patients. This has helped individuals with diabetes both rich and poor to have access to medical facilities and medicine such as insulin that will assist in improving their health outcomes. The main goal of this policy is to provide care to patients with both high, medium, and low incomes and ensure better health outcomes.
Conclusion and Recommendations
Strategies that will help improve health outcomes for people living with diabetes mellitus include: One is closing gaps in preventive care. Diabetes is a chronic disease that primarily gives rise to other health complications such as cardiovascular disease, eye and hearing impairment, neuropathy, among others. Diabetes patients should be able to address these problems even before they arise to avoid further complications and costly when treating. This can be done by eating healthy, having blood pressure and cholesterol-lowering medication, etc. Therefore, closing this care gap is a vital step as it creates an effective care program for diabetes individuals.
The second strategy is having healthy lifestyle choices. People living with diabetes require some lifestyle changes that will keep them in good health. Living active lifestyles by doing physical exercises and eating a healthy nutritious diet is essential as it regulates blood sugar levels (Whittemore and Roy, 2002). It is essential to understand that lifestyle changes can also be extended to substance-related habits such as no cigarette smoking and alcohol consumption. Adhering to all these choices will help in the management of weight.
The third strategy is adhering to medication. For people living with diabetes, adhering to medication is a critical aspect in managing their condition and living a healthier life. Medical adherence is mainly linked to positive clinical outcomes. Therefore, when one does not adhere to their medication, there are increased chances of morbidity and mortality, with a great risk of cardiovascular issues.
References
Patra, S., Patro, B. K., Padhy, S. K., & Mantri, J. (2021). Prevalence of diabetes distress and its relationship with self-management in patients with type 2 diabetes mellitus. Industrial Psychiatry Journal, 30(2), 234.
Reddy, P. A., Saravanan, K., & Madhukar, A. (2021). A Study on Assessment of Attitude and its Impact on Practice in Patients with Diabetes Mellitus. Journal of Young Pharmacists, 13(4), 396.
Schiel, R., Bambauer, R., & Steveling, A. (2018). Technology in Diabetes Treatment: update and future. Artificial organs, 42(11), 1017-1027.
Thompson, V. L. S., Johnson-Jennings, M., Baumann, A. A., & Proctor, E. (2015). Peer-Reviewed: Use of Culturally Focused Theoretical Frameworks for Adapting Diabetes Prevention Programs: A Qualitative Review. Preventing chronic disease, 12.
Whittemore, R., & Roy, S. C. (2002). Adapting to diabetes mellitus: a theory synthesis. Nursing Science Quarterly, 15(4), 311-317.
