The importance of diet and exercise in preventing type 2 diabetes

Diabetes is reaching epidemic proportions globally with estimates of 374 million people worldwide (WHO 2014 ) and impacts on the people with the condition, their families and on health service resources. While type 1 diabetes is an autoimmune disease, the causes of type 2 diabetes are more multi-factorial. In the UK there are about 2.9 million with diabetes of whom approximately 90% will have type 2. It is also estimated that there are about 850,000 people in the UK who have type 2 diabetes but have not as yet been diagnosed ( NHS UK 2014). Coupled with this, there are people who have known risk factors for developing diabetes. This article aims to consider the role of diet in adults in preventing those who are at high risk of developing type 2 diabetes and to present the evidence and practical application for nurses

How do adults with cystic fibrosis cope following a diagnosis of diabetes?

The official published version of the article can be obtained from the link below.Aim. This paper is a report of a study examining the experience of adults with cystic fibrosis in adapting to the diagnosis of diabetes, a second chronic illness. Background. Diabetes is a common complication of cystic fibrosis; the onset signifies the development of a second chronic illness. Both cystic fibrosis and diabetes are complex conditions, which require daily treatment schedules as part of their management. However, it is unclear how people already living with cystic fibrosis respond to the diagnosis of diabetes. Method. A qualitative method was chosen to obtain an ‘insider’ experience of adjusting to a second chronic illness. Semi-structured interviews were conducted in 2004 with 22 adults with cystic fibrosis-related diabetes. The data were analysed using interpretative phenomenological analysis. Findings. Four recurring themes were identified: emotional response to diagnosis of diabetes, looking for an understanding, learning to live with diabetes, and limiting the impact of diagnosis. Having cystic fibrosis appeared helpful in limiting the impact of the diagnosis of diabetes. Juggling conflicting dietary demands of cystic fibrosis and diabetes coupled with the lack of practical professional advice available was seen as one of the biggest challenges in adapting to diabetes. Conclusion. Healthcare professionals need increased awareness of diabetes amongst adults with cystic fibrosis and provide adequate support and structured evidence-based education throughout the course of the illness, particularly in relation to diet. Nevertheless, patients’ familiarity with regular daily routines and problem-solving attitudes, already developed in the context of cystic fibrosis, may be drawn on to limit the impact of diabetes

Attitudes to food and lifestyle choices in women with well-controlled and poorly-controlled type 2 diabetes mellitus from different ethnic groups : a pilot study : a thesis presented in partial fulfilment of the requirements for the degree of Master of Science in Nutrition at Massey University

Type 2 diabetes has reached epidemic proportions in New Zealand, as it has globally. There has also been a dramatic rise in numbers from different ethnic groups attending the Auckland Diabetes Centre, with interpreters in approximately 60 different languages being employed. Research indicates that good glycaemic control in people with diabetes can dramatically reduce the risk of complications. However there are many barriers to achieving this. This thesis, by a dietician working at the Auckland Diabetes Centre, examines the research pertaining to the ethnic groups with the highest prevalence of type 2 diabetes, these being Maori, Pacific, Chinese and Indian, along with European groups. It investigates some of the socio-cultural and psychological issues which may be barriers to lifestyle and dietary modification for optimal diabetes control. A total of 232 women attending the Auckland Diabetes Centre took part in this study, aged from 24 to 78 years, the average being 56 years. Duration of diabetes ranged from one to 44 years, with an average of seven years. A questionnaire, designed to obtain their views on diabetes, how it affects their lifestyle, and their perceptions of food and health, was completed at their follow up visit. All had received dietary and lifestyle advice and questionnaire responses indicated a good dietary knowledge. It was evident from comments made that most felt the information given by the dietician was practical, focused on normal food; it was easy to understand and gave them confidence. Most agreed that not smoking, regular meals, daily physical activity, and taking medication (if prescribed) were very important. No statistical association was found between diabetes control and age, income, marital status, education, weight, blood pressure or lipid profile. However duration was significant, with more of those with poorly controlled diabetes likely to have diabetes longer; there was also evidence of an ethnic difference (p=0.02). This was to be expected given that diabetes is a progressive disease, but could indicate frustration and loss of motivation. Psychological issues were significant. The number of ethnic differences found in this study suggest that a more holistic approach and a wider knowledge of cultural and psychological issues is required in diabetes education. Health professionals need to be cognisant of the individual's health beliefs, cultural practices, and any psychological issues, to better assist people of different ethnic groups in management of their diabetes, in order that they may live full and normal lives and avoid complications. At present only 26 (8%) practising dieticians are from minority ethnic groups and not all of these are bilingual. There are only 192 (60%) dieticians employed by District Health Boards, for a population of four million people, 115,000 of whom have diagnosed diabetes. This pilot has identified more precisely the requirements for effective counselling

Applying persuasive design in a diabetes mellitus application

This paper describes persuasive design methods and compares this to an application currently under development for diabetes mellitus patients. Various elements of persuasion and a categorization of persuasion types are mentioned. Also discussed are principles of how successful persuasion should be designed, as well as the practical applications and ethics of persuasive design. This paper is not striving for completeness of theories on the topic, but uses the theories to compare it to an application intended for diabetes mellitus patients. The results of this comparison can be used for improvements of the application

An Advanced Conceptual Diagnostic Healthcare Framework for Diabetes and Cardiovascular Disorders

The data mining along with emerging computing techniques have astonishingly influenced the healthcare industry. Researchers have used different Data Mining and Internet of Things (IoT) for enrooting a programmed solution for diabetes and heart patients. However, still, more advanced and united solution is needed that can offer a therapeutic opinion to individual diabetic and cardio patients. Therefore, here, a smart data mining and IoT (SMDIoT) based advanced healthcare system for proficient diabetes and cardiovascular diseases have been proposed. The hybridization of data mining and IoT with other emerging computing techniques is supposed to give an effective and economical solution to diabetes and cardio patients. SMDIoT hybridized the ideas of data mining, Internet of Things, chatbots, contextual entity search (CES), bio-sensors, semantic analysis and granular computing (GC). The bio-sensors of the proposed system assist in getting the current and precise status of the concerned patients so that in case of an emergency, the needful medical assistance can be provided. The novelty lies in the hybrid framework and the adequate support of chatbots, granular computing, context entity search and semantic analysis. The practical implementation of this system is very challenging and costly. However, it appears to be more operative and economical solution for diabetes and cardio patients.Comment: 11 PAGE

Bypassing the selection rule in choosing controls for a case-control study

Objectives It has been argued that in case–control studies, controls should be drawn from the base population that gives rise to the cases. In designing a study of occupational injury and risks arising from long-term illness and prescribed medication, we lacked data on subjects' occupation, without which employed cases (typically in manual occupations) would be compared with controls from the general population, including the unemployed and a higher proportion of white-collar professions. Collecting the missing data on occupation would be costly. We estimated the potential for bias if the selection rule were ignored. Methods: We obtained published estimates of the frequencies of several exposures of interest (diabetes, mental health problems, asthma, coronary heart disease) in the general population, and of the relative risks of these diseases in unemployed versus employed individuals and in manual versus non-manual occupations. From these we computed the degree of over- or underestimation of exposure frequencies and exposure ORs if controls were selected from the general population. Results: The potential bias in the OR was estimated as likely to fall between an underestimation of 14% and an overestimation of 36.7% (95th centiles). In fewer than 6% of simulations did the error exceed 30%, and in none did it reach 50%. Conclusions: For the purposes of this study, in which we were interested only in substantial increases in risk, the potential for selection bias was judged acceptable. The rule that controls should come from the same base population as cases can justifiably be broken, at least in some circumstances. <br/

Education and training for people working with and caring for those with diabetes

The growing need for healthcare workers to be given education and training in diabetes care, along with the focus on improving self-management of the condition, prompted The Open University to launch 'Diabetes Care', a 20-week, first-level course, in 2005. The course was designed to meet the needs of lay people as well as those wishing to undertake a nationally accredited programme of study. It was immediately oversubscribed and continues to be extremely popular. The course model is being replicated in the design of two additional courses in preparation, 'Understanding Cardiovascular Diseases' and 'Managing Obesity'. – There is a substantial and growing demand for education and training in diabetes and its self-management, as evidenced by the ongoing popularity of the 'Diabetes Care' (SK120) course offered by The Open University – SK120 is a 20-week, entry-level course providing 15 CATS points that has been offered since September 2005 – It is based on a series of case studies presented via a DVD-ROM, a CD-ROM, a course book and online discussion forums – The model is being replicated in the preparation of two further courses focusing on cardiovascular diseases and the management of obesit

Young people's participation in the development of a self-care intervention--a multi-site formative research study.

The poor outcomes of young people with chronic health conditions indicate that current services and self-care programmes are not meeting the needs of young people. How young people self-manage their condition impacts on long-term health outcomes, but there is little published evidence that details the development of self-care programmes and their most effective components. This article reports on an innovative formative research study, the purpose of which was to develop a self-care intervention prototype. Participants were 87 young people, aged 12-17, and seven young adult facilitators, aged 18-25, with type 1 diabetes or asthma. Each contributed to talking groups exploring themes that young people wanted to be addressed within a self-care programme. Instead of being focused on 'illness', young people's main concerns were directed toward 'life as an adolescent', while at the same time building sustainable daily routines of self-care. Overall, this article illustrates the process of initiating and implementing a developmental approach focused on young people, while also demonstrating the tailored self-care intervention that the process developed. This approach can be used to involve young people in the design and development of other conditions that rely on self-care interventions