What is diabetes and how to prevent it. what are the tools i will use to help students cope with diabetes and do will i propose this to a legislator for intervention.

Diabetes type 2 is also known as non-insulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes.  It is a metabolic disorder that is characterized by high blood glucose in the context of insulin resistance and relative insulin deficiency.  Diabetes is often initially managed by increasing exercise and dietary modification and if the condition worsens, medication will be needed.  Signs and symptoms of the disease include polyuria (frequent urination), polydispsia (increased thirst), polyphagia (increased hunger), and fatigue and weight loss.


There is little tendency for type 2 diabetics towards ketoacidosis, Ketoacidosis results from a shortage of insulin and the body’s response is to burn fatty acids which produces acidic ketone bodies that causes complications.  However nonketonic hyperglycemia is a possible reaction.  Nonketonic hyperglycemia is when there are abnormally high serum glucose levels without ketoacidosis.  Long-term complications for Type 2 Diabetes include risk of heart attacks, strokes, amputations, kidney failure, and loss of hearing, eyesight, and cognitive ability. 


Diabetes management is very important.  A carefully managed diet, exercise, taking oral diabetic medication, using some form of insulin, and maintaining proper circulation in extremities.  Symptoms may be further complicated by external factors such as stress, illness, menses, injection site scarring and other physiological factors unique to individual patients.  A strong partnership between the patient and primary healthcare provider is an essential tool in the successful management of diabetes.  Through regular appointments, the primary health care physician and endocrinologist will be able to monitor the progression of the disease.


A college student with diabetes faces a difficult lifestyle.  These students not only have to juggle class schedules, living alone for the first time, part-time jobs, and dating, they have to monitor blood glucose levels, manage hypoglycemia, and take medications to control their diabetes.  These students can face a very stressful lifestyle as it is a constant struggle to monitor their health condition and control their diet and blood glucose levels.  It is important to be educated about the disease and to prepare a sufficient support system for students with this disease.  Diabetes management for college students begins before they even go to college.


Before a student goes off to college, they should meet with their primary care provider or endocrinologist.  They will need to outline and have a clear understanding of what relationship they will maintain whilst the student is away.  Also, copies of their medical records are very important.  The student  and their doctor should make contact with the college’s health facility and set up an appointment so they can identify the level of service they can provide for the student.


“Before leaving for college, students need to ensure that they have all of the supplies needed to manage their diabetes while at school. Although most remember to take their blood glucose meter, monitoring strips, alcohol wipes, insulin syringes (or pump), and insulin, many will forget items that they can easily find at home (e.g., sharps container) or may not have considered (e.g., urine ketone test strips). Other items to pack include ready sources of glucose (such as small cans of juice and glucose tablets), glucose gel, Medic Alert identification, a copy of important contact phone numbers, and their insurance card. In addition, it is a good idea to assemble a medicine kit for use during times of illness. Such a kit should include a thermometer, nonperishable bland foods and liquids (such as Jell-O, Saltines, broth-based soups, juice, and sugar-free beverages), ketone strips, approved over-the-counter medications (including sugar-free cough drops, etc.), and a copy of their sick-day plan. It is also advisable to have more supplies than anticipated since accidents (such as dropping insulin vials) are not uncommon. Students need to be reminded that their college dormitory will be quite different from their home environment; there may not always be a well-stocked refrigerator or a parent who can quickly go and get needed items.  (Preparing Students with Diabetes for Life at College.  American Diabetes Association.  Mellinger, David C. MD.  http://care.diabetesjournals.org/content/26/9/2675.full, retrieved 28 April, 2011.)”  The student’s regimen for insulin or oral medication is a critical element before going off to college.  College student’s lives are highly unpredictable and can have varying daily schedules.  Regular meal times are impossible and late-night eating binges more of a possibility.  Hence students on insulin must choose a plan which allows for great flexibility.  “The two regimens which best fit into the college lifestyle are 1) the use of a very long–acting insulin (such as ultralente or glargine) (5) combined with a rapid-onset, short-acting insulin (e.g., lispro) (6) and 2) the use of continuous insulin infusion via an insulin pump. Ideally the student should be on such a regimen for a few months before coming to college so that they are comfortable with adjustments that may need to be made under various circumstances. If a student has excellent glucose control (HbA1c <7%) on another, less flexible regimen, they may be unmotivated to change their insulin before coming to college. In this circumstance, a discussion about the options should still take place, and the student should be encouraged to consider switching if they discover that maintaining good glucose control on their regimen is difficult once they get to college.  (Preparing Students with Diabetes for Life at College.  American Diabetes Association.  Mellinger, David C. MD.  http://care.diabetesjournals.org/content/26/9/2675.full, retrieved 28 April, 2011.)” 


The student must also take note of their insurance.  Will their insurance cover the cost of their check-ups and medications while they are away at college or will they have to take an additional insurance?  Once in college it is recommended that the diabetic student informs their roommate(s) and their hall advisor.  These people should be briefed about diabetes and what to do in emergencies.


Food is important in managing diabetes so it is recommended that the student takes a trip to the cafeteria where they plan on eating most of their meals.  There should be access to nutritional information on the meals and the student should ensure that the food selection includes reasonable choices which are compatible to their meal plans.


Exercise is another important aspect in the management of diabetes.  The students should examine the options they have at the college.  Coaches should be informed of the student’s disease so they can treat them accordingly if the student experiences hyperglycemia whilst partaking in sports.


A very important topic which needs to be covered for students with diabetes is the ever-presence of alcohol beverages in a college student’s lives.  There are additional concerns associated with alcohol consumption for students with diabetes.  “Although alcohol can worsen or increase the risk of known diabetes complications (including neuropathy, retinopathy [15], gastrointestinal dysfunction, lipid abnormalities, and impotence), its most immediate impact is related to its effects on glucose metabolism (16). The most dangerous potential complication is that of alcohol-related hypoglycemia, both as a direct and indirect consequence of drinking (17). (Preparing Students with Diabetes for Life at College.  American Diabetes Association.  Mellinger, David C. MD.  http://care.diabetesjournals.org/content/26/9/2675.full, retrieved 28 April, 2011.)” 


Educating teens and young adults about the risk of developing Type2 diabetes and preventative measures they can take to ensure long, healthy lives.  Once they know their individual risk factors for developing Type 2 diabetes, they are more likely to make the lifestyle changes to help prevent and/or manage the disease.  The teen/young adult group is especially important because it is this time that lifelong habits are created. “The growing number of young adults being diagnosed with Type 2 diabetes combined with the severity of complications related to early onset diabetes demand that education about the disease, the risk factors, and preventative measures be made clear to all age groups, but especially to those most at risk. Intervention by those in the health profession is required in the form of patient education and care through the management of weight, blood pressure, and glucose levels, and the encouragement of healthy habits, including daily exercise. With the appropriate programs and education, health care providers can help young adults understand the disease and develop healthy habits that will enable them to prevent and/or manage Type 2 diabetes, along with other diseases. (A Rapidly Rising Number of Type2 Diabetes Diagnoses in young Adults Demands the Attention of Health Care Providers.  Collegiate Risk Management.  http://www.collegiaterisk.com/news_studenthealthnewsletter_51.html, retrieved 28 April, 2011.)”


 


 



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