Self-Management Education Programmes for Type 2 Diabetes

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TABLE OF CONTENTS

CHAPTER TWO: LITERATURE REVIEW1

Introduction1

Overview of Diabetes1

Management of Type 2 Diabetes4

Medication Management5

Self-Management6

Diabetes Self-Management Behaviours and Glycemic Control6

REFERENCES7

CHAPTER TWO: LITERATURE REVIEW

Introduction

Individuals with diabetes are at a greater risk for morbidity and mortality than individuals without diabetes (Moyer 2008, 21). Individuals with diabetes have higher rates of mortality due to the fact that there are many medical complications associated with the disease.

In 2002, the estimated cost of diabetes to the United States economy was $132 billion annually (Moyer 2008, 22). These annual economic costs have risen 30% since 1997 (Moyer 2008, 22). Diabetes is a chronic illness that, if not effectively managed, can lead to serious complications and economic costs. The self-management of diabetes often requires a person to reliably engage in a complex set of self-management behaviours.

Overview of Diabetes

Diabetes is a chronic disease characterized by high levels of blood glucose, resulting from problems with insulin resistance or insufficient levels of insulin (Wu, Liang, Wang, Chen and Jian 2010, 2657). Glucose stimulates the release of insulin from the beta cells of the islets of Langerhans in the pancreas. Insulin binds to receptors in the body's cells and aids in the uptake of glucose (Wu, Liang, Wang, Chen and Jian 2010, 2657). So, insulin acts to decrease levels of blood glucose. When a person consumes a meal or a snack, blood glucose levels tend to rise.

In response to the rise in blood glucose, insulin levels rise as well. The highest levels of insulin are secreted when blood glucose levels reach 300mg/dl, and insulin secretion is stopped when blood glucose levels reach 50 mg/dl (Wu, Liang, Wang, Chen and Jian 2010, 2657). In a person without diabetes, the body's insulin is adequate to control levels of blood glucose. In a person with diabetes, the pancreas' ability to produce insulin is disrupted, so there is a deficiency in levels of insulin in the body.

There are three main forms of diabetes mellitus. Their current classification into Type 1, Type 2 and gestational diabetes is fairly recent, with a focus on aetiology of the disease rather than its treatment.Type 1 Diabetes is an autoimmune disease, generally characterised by beta-cell destruction in the pancreas (about 90% of Type 1 cases), which leads to absolute deficiency in insulin secretion. Onset is usually rapid and diagnosis generally occurs between childhood and young adulthood <30). There are a number of subtypes and it is noteworthy that one form of Type 1 diabetes occurs in adults >40.

Type 2 Diabetes is the most common form and is classified as a heterogeneous syndrome due to the interaction of environmental factors (especially obesity, sedentary lifestyle and physical inactivity) and genetic factors. The combination leads to beta-cell failure and different combinations of insulin resistance. Onset is slower and people with Type 2 diabetes are often asymptomatic. People diagnosed are generally in middle or late adulthood (>40), with a peak onset between 60 and 70. Recent years have seen an increase in the diagnosis of children ...