Introduction It also very evident, the importance of

Introduction This introduction is mainly focused on how a patient adapts to live with type two diabetes in everyday life. What activities are taken and what measures can be taken in order to be able to control the disease. Further along the assignment we will also discuss the treatment, education and measures that can be taken. The patient is given a false name (Mrs Caruana). Necessary measures have been taken to protect the privacy and confidentiality of the patient. The patient is always a unique person and should be treated with respect and dignity irrispective of the age, gender or political views ( Maltese code of ethics for nurses and midwifes, 1997).  From this story we can also identify the importance of taking care of ourselves. It also very evident, the importance of the multidisciplinary team working together to be able to achieve the best results possible for the patient. A multidisciplinary team is a team that consists of nurses, psychologists, social workers, occupational therapists, counsellors, care workers and others. They all have different area of studies and they combine their skills together. They meet on a regular basis so as to see the progress of the patient (Mitchell G.K et al, 2008).  Pathopysiology  Diabetes mellitus is a persistent high blood glucose levels. They can be associated with either pancreas dysfunction, insulin deficiency or ineffective insulin secretion and action. It can also be inherited from another family member with history of diabetes mellitus (WHO, 2018). Insulin is a hormone made by the pancreas which allows the body to use glucose from carbohydrates in food that we eat for energy. Insulin helps keeps the sugar level from getting high blood glucose (hyperglycaemia) or low blood glucose (hypoglycaemia). (Hess – Fischl A, 2014). In Mrs Caruana’s case the blood sugar levels where always above 25.0mmol/I from when she was tested first for diabetes. Her relatives were very worried. Mrs Caruana would not be able to take care of herself alone since she was suffering from diabetes and dementia. She needed constant monitoring. The normal reading for a person without diabetes is 3.9 – 5.5mmol/I, while for someone with diabetes it will be 4.4 – 7.2mmol/I. There is also a long -term glucose test called the Haemoglobin or HbA1c. This is expressed as a percentage. For a non -diabetic patient it should be less than 5.7% while for a person with diabetes it is 7.0% or less (Spero D, 2016).  Types of diabetes There are three main types of diabetes: Type 1 diabetes It is an autoimmune disease that affects the regulation of the blood. The immune system of a person starts making antibodies that destroys the insulin- producing beta cells in the pancreas. Obviously than the pancreas fails to produce insulin. Without insulin, blood sugar will increase and would not be able to be delivered to the brain and muscles. People with type 1 diabetes can no longer produce insulin of their own so they start taking doses of insulin via injections as prescribed by the doctor. They must than watch the amount of insulin they inject with their diet. They have to make sure that the carbohydrates intake matches the insulin dose (Oberg E, 2016)  Type 2 diabetes Type 2 diabetes is the most common type of diabetes. Insulin resistance is no the common factor for this type of diabetes. One can have type 2 diabetes but will not be insulin resistance. One can have a form of type 2 diabetes where the body does not produce enough insulin. It develops in adults and most often in obese individuals which is characterised by hyperglycaemia. It will than result in the body being unable to compensate with increased production of insulin. In people with this type of diabetes, the body cells have become resistant to insulin (Capetta A, 2017). In our case Mrs Caruana had to administer insulin injections to regulate her readings since oral hypoglycaemic agents were not able to control it. Type 2 diabetes can be hereditary. If someone from the family had this condition before it means that one is at a greater risk. Genes also play an important role in diabetes type 2. Some may have a genetic mutation that may make the susceptible to type 2. Lack of exercise can also be a cause of diabetes type 2 since physical activity have many benefits and will greatly influence how the body uses insulin.Being obese makes it also more likely to develop it. One will become insulin resistance and that will lead to other health problems (Leontis M.L, 2017). Normally patients with this type of diabetes are not dependant on insulin but in cases where the blood glucose readings are unstable insulin injections may be administered.  Type 3 diabetes (Gestational diabetes)  This type of diabetes occurs when a pregnant woman who never had diabetes before, have high blood levels during pregnancy. According to the centres for control and disease prevention, 2014, gestational diabetes is as high as 9.2%. it seems that the placenta that supports the baby contains of a hormone that helps the baby develop. These hormones tend to block the mother’s insulin in her body. Insulin resistance makes it hard for the mother’s body to use insulin as she may need up to three times insulin. Without enough insulin glucose cannot leave the blood to be changed, so glucose ends up in the blood causing high levels (American Diabetes Association, 2016). As seen in Mrs Caruana’s case. She developed gestational diabetes during pregnancy and those who develop it during pregnancy are at higher risk of developing type 2 diabetes when they are older. Pregnant women who developed gestational diabetes during their first pregnancy are more prone to develop it during the second and third pregnancy also (Mann D, 2010).   According to Sullivan W (2014), that among all the medications available to treat medical conditions, prednisolone, similar steroids and thiazide diuretics have the most profound effect on metabolism. They tend to increase high blood sugar levels.