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这项护理学assignment作业将首先分析什么是全球非传染性疾病，然后选择一种特定的非传染性疾病（NCD）。此外，任务还将讨论这种非传染性疾病（1型糖尿病）是什么以及为什么选择它。接下来，它将对1型糖尿病做一个关键的分析，关于如何管理这种疾病和照顾病人。综上所述，总结所有信息，找出要点。
This assignment will analyse what global non-communicable diseases are at first and then select a specific non-communicable disease (NCD). Also the assignment will discuss about what this NCD (type 1 diabetes) is and why it was chosen. Next, it will do a critical analysis of type 1 diabetes, about how to managethis disease and take care of a patient. In conclusion, it will summarize all information to work out key points.
世界卫生组织（2015年，第38页）显示，非传染性疾病（NCD），也称为慢性病，不会在人与人之间传播。这些疾病持续时间长，进展缓慢。报告还指出，有四种主要的非传染性疾病：心血管疾病，如心脏病和中风、癌症、慢性呼吸道疾病（如慢性阻塞性肺病和哮喘）和糖尿病。邓宁（2014年）和美国糖尿病协会（2016年）都表示，1型糖尿病是一种疾病，通常在儿童和年轻成人中被诊断出来，以前被称为青少年糖尿病。根据美国糖尿病协会（2016年），“1型糖尿病是该组织的一个关键焦点，我们超过三分之一的研究对象是糖尿病。tfolio致力于与1型糖尿病相关的项目。然而，Dunning（2014）认为1型糖尿病是一种胰岛素缺乏症。此外，他还指出，“1型糖尿病可能是由于自身免疫或特发性过程”。因此，根据Watkins等人（2004年）和美国糖尿病协会（2016年），选择1型糖尿病进行分析的原因是血管疾病风险增加是正常的。
World Health Organization (2015, P38) shows that ‘non-communicable diseases (NCDs), also known as chronic diseases, are not passed from person to person. They are of long duration and generally slow progression.’ It also states that there are The four main types of no communicable diseases: cardiovascular disease, such as heart disease and stroke), cancer, chronic respiratory diseases (such as chronic obstructive pulmonary disease and asthma), and diabetes. Dunning (2014) and American Diabetes Association (2016) both state type 1 diabetes is a disease, which isUsually in children and young adults diagnosed, and previously known as juvenile diabetes.According to American Diabetes Association (2016), ‘type 1 diabetes is a critical focus of the organization, and more than one-third of our research portfolio is dedicated to projects relevant to type 1 diabetes’. However, Dunning (2014) argued that type 1 diabetes is a disease of insulin deficiency. Moreover, he also states ‘type 1 diabetes can be due to an autoimmune or idiopathic process’. Therefore, according to Watkins et al (2004) and American Diabetes Association (2016), the reason why type 1 diabetes were chosen to analysis is that it is normal in the increased risk of vascular disease.
Health promotion/Support self-care健康促进/支持自理
美国糖尿病协会（2016年）和Watkins等人（2004年）和Colton（2003年）都表示，饮食调整在糖尿病治疗中发挥了重要作用。作者指出，患者的饮食建议应基于他们目前的饮食习惯。应该考虑一些因素：年龄、职业、财务状况、高血压、血糖和其他一些医疗状况。因此，如果人们想降低患1型糖尿病的风险，最重要的是他们应该优先选择均衡饮食。美国糖尿病协会（2016）显示，1型糖尿病患者的身体不产生胰岛素。它还指出，1型糖尿病可以将食物所吃的糖或淀粉分解成一种简单的糖，称为血糖，用于能量。因此，美国糖尿病协会（2016年）和Watkins等人（2004年）都指出，健康饮食是减少因疾病风险增加而患1型糖尿病可能性的重要途径。此外，美国糖尿病协会（2016年）也表明，定期的身体活动对患者的健康和健康具有重要意义，这表明，如果患者想了解身体的典型血糖，它会对运动作出反应，帮助他们避免血糖过低或过高。
American Diabetes Association (2016) and Watkins et al (2004) and Colton (2003) all state that diet modification has played a significant role in the treatment of diabetes. The author states patient’s dietary recommendations should be based on their current eating habits. There are some factors should be taken consideration: age, occupation, financial status, hypertension, blood glucose and some other medical conditions. Therefore, if people want to reduce the risk of type 1 diabetes, the vital thing is that they should follow a balance diet as a priority. American Diabetes Association (2016) shows the patient’s body does not produce insulin in type 1 diabetes. It also states the type 1 diabetes can breaks down the sugars or starches which foods eat into a simple sugar called blood glucose, which it uses for energy. Therefore, American Diabetes Association (2016) and Watkins et al (2004) both state the healthy diet is an important approach to reduce people who have the possibility of type 1 diabetes because of the increased risk of diseases. Also American Diabetes Association (2016) shows a regular physical activity is significant for patient’s health and wellness, which states that if patient want to know the body’s typical blood glucose, and it will response to exercise which can help them keep their blood glucose from going too low or too high.
Watkins et al (2004) and American Diabetes Association (2016) both state patients should know eating and drinking simple sugars (such as fresh fruit juice, sodas, cakes or other foods) that can produce a rapid rise in blood glucose concentrations to cause type 1 diabetes. Also they argued that patient should recognize the risk of this disease to avoid hypoglycemia and control fat metabolism in their regular meal to help them keep a balanced diet.
According to American Diabetes Association (2016), if the blood glucose is too low, People will experience in or exercise after blood sugar drops, so you have to control your blood sugar, ready to treat hypoglycemia (low blood sugar). Therefore, in order to study how different types of activities affect hypoglycemia, people should check their blood sugar before, during and after an exercise session, which argued that there are some ways to deal with it, like put a trial and error system into place which meansPeople need to lower their insulin dose or movement before eating some additional carbohydrates make blood sugar in a safe range, because some exercise appears to cause a decline in blood sugar quickly, but not for some other tools(Calderón-Larrañaga,2015). So if the data can keep in a safe range, it means that people can have a healthy body in their daily life. In addition, people can have a pre-exercise snack if blood glucose levels are trending down before a result worked out. Besides, if people eat a carbohydrate food or drink (like juice or glucose tabs) during their life that will quickly increase your blood glucose.
Moreover, American Diabetes Association (2016) also states ‘If blood glucose level is less than 100 mg/dl before you start your activity, try having a small carbohydrate snack (about 15 grams) to your blood glucose and reduce your risk for hypoglycemia’, which is vital for them to ensure their body’s circulating insulin levels during the exercise time or exercising for more than 30 minutes. Therefore, it can regard as a best way to remain blood glucose.
However, American Diabetes Association (2016) also argued that if blood glucose is too high, people may under pressure to cause it high during or after exercise, particularly in a high-intensity exercise. So relax them before exercise can avoid high blood glucose. Also, it suggests that people can check blood or urine for ketones if the blood glucose is high before starting exercise. Then if the results do not have ketones in the blood or urine, it means they can have a good exercise.
Disease management/ Case management
According to Calderón-Larrañagaet.,al (2015), the treatment of type 1 diabetes include: taking insulin, carbohydrate counting, frequent blood glucose monitoring, eating a healthy diet, exercise regularly and maintain a healthy weight, this country's people with type 1 diabetes need insulin treatment. Moreover, there are several Types of insulin: Rapid-acting insulin, Rapid-acting insulin, Long-acting insulin, Intermediate options. However, option still has some different ways on this insulin, such as injections. Therefore, if want to choose injection, nurses can clean the skin at first, then use a needle and syringe or an insulin pen to inject insulin under patient’s skin to treatment them. Also, the treatment shows that in order to improve blood sugar levels, it can take daily infections like Apidra, Humolog or Novolog. In addition, another way is using an insulin pump to work out the current blood glucose during their eating time. Besides, artificial pancreas is an emerging treatment way to prevent low blood sugar levels occurred. However, it also states some information about other medications, such as pramintide (Symlin), some high blood pressure medications,Aspirin, cholesterol-lowering drugs, blood sugar monitoring, healthy eating and monitoring carbohydrates and physical activity. However, whatever nurses choose to use, they may need to check and record the blood glucose level at least four times a day. In addition, people also should keep a healthy weight, avoid have an obesity even caused type 1 diabetes.
The American Diabetes Association (2016) suggests that people can check blood glucose levels before meals and snacks, before bed, before exercising or driving by themselves. glucose also shows it is the best way to ensure the blood sugar level remains within the safe range to reduce the risk of type 1 diabetes. When treating diabetes, there might be many factors affect the results of blood sugar level response to food, activity, illness, medications, stress, hormonal changes and alcohol.#p#分页标题#e#
According to Calderón-Larrañagaet.,al (2015), healthy eating habits arebased on nutritious foods such as fruits, vegetables and whole grains. Therefore, people can set an eating plan to keep health even though they do not have types 1 diabetes However, people should eat fewer animal products or some carbohydrates foods to keep their nutrition in daily life. Furthermore, another way is doing some activities such running, walking, swimming and biking regularly. Thus, having a flexibility and strength training exercises is an essential way to keep a balanced diet. Before people doing exercise, they should check their blood sugar level at first because exercise will affect the results. Then after exercise, they can gather different information to compare with previous results. Also, it should take some specific circumstances into different considerations, especially in driving and working. When people droved, hypoglycemia may occur at any time. Therefore, it is a good idea to check blood sugar before driving or traffic jam. Moreover, if people who have low blood sugar, they should pay attention as possible as they can. As for working, type 1 diabetes can produce some challenges in the people’s workplace. Besides, hypoglycemia also might pose a serious risk to patient and those around them. Thus, if they can find a job near the hospital or clinic it is a good idea for them. If a person has a low blood sugar, he should prepare some sugars, biscuits or some juice drinking at any time. By doing this, he may improve his work efficiency during working time. When he has a rest, he should check the level of his blood sugar, if the data is too low, he should eat some foods which contains simple sugars. If the patient is an older person, his disease management goals may different with the goal which they set in younger. Because his body may be worse than before, he will increase the time of exercise and reduce the strength at the same time.
In addition, about investigational treatment, it contains pancreas transplant,islet cell transplantation andstem cell transplant. If people can use successful pancreas transplant, they do not need insulin. However, it argued that pancreas transplant cannot always be successful. So it still should be improved. With regard to islet cell transplantation, it still used for immune-suppressing medications, but it cannot be available for patient to become more widespread. It shows that researchers want to find out an approach to protect islets from the immune system. As so far as to stem cell transplant, before it was used to diagnose with type 1 diabetes, it can be treated with stem cells from their own blood.
Calderón-Larrañagaet.,al (2015) state there also has some problems in treatment, like low blood sugar (hypoglycemia), require immediate care. So if a person who has low blood glucose level, he should ask doctor to learn the symptoms of low blood sugar, and test blood sugar if he thinks his blood sugar levels are dropping (Mayo Clinic, 2016) . When he in leisure time, he can do a blood sugar level test to make sure the data is low. Early signs and symptoms of low blood sugar include: sweating, shaking, hunger, vertigo or dizziness, fast or irregular heartbeat, fatigue, headache, blurred vision and irritability. Later, however, the signs and symptoms of low blood sugar include drowsiness, confusion, behavior changes, sometimes dramatically, lack of coordination and convulsions. Because patient know early and later sign and symptoms of low blood sugar, wherever they are, if they have symptoms of hypoglycemia, they should eat some foods which contains sugars at first and then test as soon as possible. In addition, too low blood sugar will cause them to lose consciousness. If this occurs, they may need an emergency injection of glucagon right away and then they should ask people for help to go to a hospital. As for high blood sugar (hyperglycemia), which means blood sugar is higher than target range, there also are many factors: frequent urination, increased thirst, Blurred vision, fatigue, irritability, hunger and difficulty concentrating. Therefore, if a person who has hyperglycemia, he should check blood sugar at first. And he can use some medicine or adjust his meal or exercise plan to control blood sugar. As a consequence, the high blood sugar can be managed for the patients to control, such as regular exercise and eating habits.
American Diabetes Association (2016) states patient should get emotional support from their family, friends, carers and community, which plays a key role in diabetes care, the reason is that the patients could be supporting from them from the emotional care and care giving . When they forget the exercise plan outside, their family or friends can remind them of specific thing. When they forget injection or taking insulin in the hospital, carers can help them. In addition, testing blood glucose multiple times each day and dealing with the various highs and lows (both physical and emotional) of life with diabetes can base on some device to check blood sugar level. However, Colton (2003) states the benefits of control type 1 diabetes is that ‘the risk of developing microvascular complications is substantially reduced’. He goes on to shows that there are many risk factors such as obesity, smoking. However, Colton (2003) states a possible future treatment for diabetes is islet-cell transplantation but still may not use worldwide.
Discussion
To analysis type 1 diabetes principle management can based on: blood glucose control by keep a balance diet and insulin management, exercise. In order to reduce the risk of type 1 diabetes,the most important thing is to keep a healthy lifestyle. First, people can set up a health plan some activities, such as sports. About the nutrition knowledge, this is one of the most important part of the diabetes problems. Understand how different foods affect blood glucose and flexible learning development and nutrition meal plan will be an important part of daily life. When patient have type 1 diabetes, they should eat fewer fruits, juice drink, and do not eat many sugar or cakes. Principle management could be supported by the regular exercise, eating habit, and emotional control over the high blood pressures. Emotional improvement could also be categories of the heart rate in the contribution of the sugar rates. The positive emotion could have the blood rate, no heavy exciting and pressure on the mood. Sometimes, the parents, surroundings and colleagues could all give the positive energy on the patient, so that giving warm and care which are important for the patients in the caring.
Moreover, Type 1 diseases can divide into low blood sugar (hypoglycemia) or high blood sugar (hyperglycemia). So there are some different ways to treatment hypoglycemia and hyperglycemia. If a person has low blood sugar, he might choose change his diet or do some exercise rather than taking some medication or insulin. However, if patient have high blood sugar, they choose taking insulin more than change their habits. As for treatment of type 1diabetes, it will diagnose by glucose meter. There are some ways in treatment like taking insulin, Carbohydrate counting, frequent blood sugar monitoring, eating healthy foods, exercising regularly and maintaining a healthy weight. It states people who has type 1 diabetes needs to take insulin therapy. Then it has some other ways to treatment type 1 diabetes in medication such as investigational treatment, which contains pancreas transplant,islet cell transplantation andstem cell transplant. However, this device still should be improved due to the fact that pancreas transplant cannot always be successful. As for islet cell transplantation, it still used for immune-suppressing medications, but it cannot be available for patient to become more widespread. Besides, through multiple daily injections with insulin pens or syringes or an insulin pump, it can monitor blood glucose levels. Therefore, it can regard as a best way to remain blood glucose at the safe range.
As for exercise, it is also a key thing of proper diabetes care. Along with all other benefits you will receive a being active, type 1 diabetes will be in the same way to respond and more stable blood sugar levels. Furthermore, when people do exercise, they should exercise at least for 30 minutes. In addition, it also should check blood sugar level before exercise and after exercise. Then it can do a compare to discover that exercise will affect the blood sugar level, also different time will work out different blood sugar level. As a consequence, physical exercise could enhance the performance with the improvement of the blood sugar level. In addition, the heavy body exercise could have the negative impact on the blood pressure level, the reason is that the heavy consequence to the heart in the heavy exercise. In the beginning of the treatment, the slow and soft exercise could give reflection on the body. With the increase of the exercise could also contribution with body improvement.
Conclusion
In conclusion, this assignment mainly talked about the management of type 1 diabetes, which includes low blood sugar and high blood sugar. Moreover, having a healthy eating diet is the best way to deal with the slight diabetes. Also, doing exercise more than 30 minutes can affect the level of blood sugar. Also keep a healthy weight can reduce the risk of type 1 disease, which means patient just can eat fewer sugars, cakes and some other foods which contain simple sugar. In addition, another approach is taking some medication or insulin more than four times each day to remain blood sugar at safe range. There are some ways in treatment like frequent blood sugar monitoring and taking insulin, especially islet cell transplantation, which still used for immune-suppressing medications, but it can not be available for patient to become more widespread. Besides, through multiple daily injections with insulin pens or syringes or an insulin pump, it can monitor blood glucose levels. Last but not least, with the rapidly development of technology, islet-cell transplantation may become the highest possibility of future treatment for diabetes around the world.In addition, emotional treating is greater than the physical medicine for them, that means management principles are quite important for them. #p#分页标题#e#
Reference
American Diabetes Association (2016)Type 1 Research Highlights[online]
Calderón-Larrañaga, A, Abad-Díez, J, Gimeno-Feliu, L, Marta-Moreno, J, González-Rubio, F, Clerencia-Sierra, M, Poblador-Plou, B, Poncel-Falcó, A, &Prados-Torres, (2015), 'Global health care use by patients with type-2 diabetes: Does the type of comorbidity matter?', European Journal Of Internal Medicine, 26, 3, pp. 203-210, Academic Search Premier.
Dunning, T. (2014) Care of People with diabetes.Oxford: John Wiley and Son, Ltd.
Lynne, L. & Parker (2004) Diabetes for Nurses. USA: Whurr Publishers Ltd.
Watkins, P. and Amiel, S. and Howell, S. and Turmer, E. (2004) Diabetes and its Management. Australia: Blackwell Publishing Ltd.
World Health Organization (2015)Non-communicable diseases [online]
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