Community Health Nursing: Caring For Children with Type 2 Diabetes Mellitus
#45384147, #21048146
University of British Columbia
Nursing 321 Section 001
November 7, 2016
Wendy Andrews
Community Health Nursing: Caring For Children with Type 2 Diabetes Mellitus
Type 2 Diabetes Mellitus (T2DM) is one of the fastest growing chronic diseases affecting children ages 6 to 11 worldwide (Montgomery, Johnson & Ewell, 2015). This recent development is occurring at an alarming rate, with numbers expected to quadruple by the year 2050 (Montgomery, et al., 2015). Without timely intervention from the healthcare system, this condition could have a devastating effect on the health outcomes of children across North America. Many studies have identified some common factors that put youth at major risk for developing T2DM, with childhood obesity, physical inactivity, low socioeconomic status, and lack of knowledge and access to healthy food choices among the leading causes (Dean & Sellers, 2015; Montgomery et al., 2015). There are many opportunities for Community Health Nurses (CHNs) to play a role in health promotion within this population. This paper will address the social factors contributing to adolescent T2DM, the current role of CHNs in addressing this condition, and ways to ensure these children have adequate access to health care.
History and Background
Prior to 1985, very few cases of T2DM were reported in children, with
Type 2 Diabetes in children and adolescents is an emerging epidemic within the last 20
Type 1 diabetes, is an incurable but treatable disease which can occur at any age but is mostly found in children due to the high levels of glucose in the blood (Eckman 2011). Juvenile diabetes affects about 1 in every 400-600 children and more than 13,000 are diagnosed yearly (Couch 2008). Type 1 Diabetes means your blood glucose, or blood sugar, is too high. With Type 1 diabetes, your pancreas does not make insulin. Insulin is a hormone, which helps glucose gets into your cells to provide energy. Without insulin, too much glucose stays in your blood. Over time, high blood glucose can lead to serious problems with your heart, eyes, kidneys, nerves, gums and teeth (American Diabetes Association). Previous research has suggested proper
Childhood obesity is a serious medical condition that is affecting children and adolescents. It occurs when a child is well above the normal weight for his or her age and height and can result in serious medical conditions. The prevalence of childhood obesity has increased significantly over the past ten years. Childhood diabetes has been on the rise since the early 90’s and continues to rise. In the article, “Don’t Blame the Eater” David Zinczenko, shows that “ Before 1994… only about 5 percent of childhood cases were obesity-related, or Type 2, diabetes. Today...Type 2 diabetes accounts for at least 30 percent of new childhood cases of diabetes in this country” (463). Type 2
Health has become a very popular topic in today’s society; how to lose weight, healthy body mass index, proper foods to eat to give your body nutrition, certain exercises to help lose weight here or gain muscle there, lower prices for a gym memberships, it seems to be a topic we are hearing about all the time now. However, there seems to lack of conversation about the health of the younger generation. Obesity among children is a growing problem in today’s society (Ogden, Carroll, Lawman, Fryar, Kruszon-Moran, Kit 2015).
Type 2 diabetes is a very serious disease with many life threatening consequences, but if it is manage properly through preventative measures, diabetics can live a normal life.
Obesity in America is literally a growing problem, affecting every age group. Children are the most venerable group because they have no control over where they have dinner or how often they have fast food. Parents and guardians make decisions about food and are responsible for the health of children. Childhood obesity has more than doubled in the last twenty years. This is concerning because Type Two diabetes is a horrible, crippling disease that is affecting children and teens dramatically whereas the disease was primarily seen in adults. Children are said to have a shorter life span than their parents for the first time ever. In the United States sixty-six percent of adults are overweight and one in
“The physical and emotional health of an entire generation and the economic health and security of our nation is at stake” a quote made by the First Lady, Michelle Obama, as she launches her comprehensive initiative to change the way children think about nutrition and physical fitness (“Learn the Facts,” 2010). Three decades ago, children lived active lives that kept them healthier. They walked to and from school, ate home cooked, reasonable portion meals with vegetables and played outdoors most of the time. Today, children ride the bus instead of walk, eat more fast food and snacks throughout the day because parents are busier, and watch more television or play video games rather than be active outside with peers (“Learn the Facts,” 2010). Young children are becoming overweight and obese along with being diagnosed with type 2 diabetes more frequently. They are making poor dietary choices, inadequate physical activity, and spending too much screen time all contributing to the obesity crisis. One of the effective solutions to reversing the trend of childhood obesity is to provide safe, affordable and accessible after-school health and physical fitness educational programs for all school ages across the nation.
However, this can be hard to promote if a community such as Germantown experiences such health disparities that puts them at risk for chronic illnesses such as diabetes, hypertension, and obesity, all of which could be preventable. Therefore, as nurses we can intervene and plan ways to improve the health of Germantown in the most realistic way possible. The nursing intervention to help try and eliminate the health disparity of knowledge deficit related to nutritious foods primarily focuses on education, as it is a primary means of impacting change. Our intervention would be implemented through an educational program at multiple community locations such as school or churches. The program would consist of weekly meetings discussing the characteristics of a healthy diet, how to read food labels correctly, picking the right food choices based on the options available in the community, and informing the participants about the impacts nutrition has on health such as obesity, heart disease, and diabetes. Each session would encompass pre-briefing followed by demonstration of healthy food recipes and then a debriefing to reiterate the importance of that session. Through education, we hope to impact more people of Germantown to use the public transportation to shop at the local farmer's market or supermarkets and have a positive change in their health. Therefore, there shall be a decreased incidence in obesity, hypertension, and diabetes and increase in the community’s knowledge about obtaining nutritional
The obesity epidemic is at an all-time high as evidenced by the fact that there are more overweight and obese people than those of healthy weight in the U.S. today. Many political, medical and surgical interventions have proven to be largely unsuccessful. There has only been marginal success with government led nutritional initiatives such as First Lady Michelle Obama’s Let’s Move campaign. The key to ending this obesity epidemic lies within health promotion. Nurses possess the essential skills and training developed from nursing practice to use health promotion and preventative health care to target at risk clients and communities before obesity develops. Through teaching, especially children what foods they should eat and the right portion size we can save the next generation from an obesity epidemic.
This is a diabetes case study of Mr. Charles D., a 45-year old male who is experiencing classic symptoms of hyperglycaemia. Recently divorced and living alone in a new home, Charles has complained of recent weight loss, excessive thirst, and frequent urination. He is a busy CEO for a major technological company. This case study for Charles will educate him as to what are the causes of diabetes: explain the presenting signs and symptoms emphasize the psycho-social impact to his amended life, and instruct him in the economic impact that he and millions share.
C.S. is a morbidly obese 32-year-old female admitted to the hospital on 8/26/05 with an admitting diagnosis of poly-drug overdose. According to the patient, the last thing she remembers is going to bed and then waking up in the hospital 2 days later without any recollection of what had happened. She has a history of suicide twice in the past, but denies suicidal ideations this time. C.S. also has a history of Diabetes type II that is normally controlled with oral medications. She states that she checks her blood glucose at home and it has been in the 200mg/dl range for the past month. Current blood glucose is 256mg/dl. C.S. is to be discharged tomorrow with a new prescription for insulin.
In today’s world, parents have an abundance of worries when it comes to their children. Drugs, bad grades, and pre marital sex are just some things that may plague a parent with sleepless nights. But even on the worst of those nights of worry, most parents can’t imagine that their child could face an illness. Not just a runny nose or seasonal flu, but an illness that would affect their child throughout his or her entire life. Diabetes is a disease without a cure, and one that more, and more children have to live with.
What was once thought to be found only among adults has become one of the most common chronic diseases among children in the United States. Ordinarily, when diabetes strikes during childhood it is assumed to be type 1. The SEARCH for Diabetes in Youth Study began in 2000 and has provided the most comprehensive estimates of the prevalence and incidence of type 2 diabetes among youth less than 20 years of age in the US (Centers for Disease Control and Prevention, 2014). The Centers for Disease Control (CDC) reports that annually, an estimated 18,436 youth are diagnosed with type 1 diabetes, and 5,089 youth are diagnosed with type 2 among youth. In the last two decades, type 2 diabetes, has been reported among U.S. children and adolescents with increasing frequency. Disease researchers at the Centers for Disease Control and Prevention made the prediction that one in three children born in the United States in 2000 will likely develop type 2 diabetes sometime in their lifetime unless they get more exercise and improve their diets, particularly for Latino children (CDC, 2014). Without changes in diet and exercise, their odds of developing diabetes as they grow older was about 50-50.
Diabetes is a major problem in our society today. Many people have heard about the disease; however, they do not know too much about its complications. Diabetes is a chronic, progressive and lifelong condition that affects the body’s ability to use the energy found in food (WebMD, 2016). Many new cases are confirmed every year and unfortunately, many go undiagnosed for years. Diabetes is a serious disease and need to be taking seriously. The disease can lead to many other health problems such as blindness, nerve damage and kidney diseases. The more the community understand and made aware of the seriousness of the disease, the better it can be control and or prevented.
Children in the United States are currently considered to be facing an obesity epidemic. Overweight and obese children are diagnosed with a number of health issues such as Type 2 diabetes, Hypertension, Cholesterol and Lipid abnormalities, Hyperinsulinemia and obstructive Sleep Apnea. In her book, Underage and Overweight, Frances M. Berg, a licensed nutritionist and adjunct professor at the University of North Dakota School of Medicine stated that during the 1990s, cases of diagnostic diabetes for all ages rose 33% nationwide. She also explains by 2004 diabetes was the seventh leading cause of death in the United States and is the main contributor to health problems like heart disease, stroke, blindness, high blood pressure, kidney disease and amputation which occurs with increased frequency in overweight children and adolescents. Although many fast food restaurant businesses argue