Diabetes cause a myocardial infarction (heart attack). (M,Carey(2012),Asthma,Topic,14,http://vle.chesterfield.ac.uk/course/view.php?id=7473 ,

Diabetes type 2 is a more common than type 1 and
is increasing in society each day, with approximately 4 million people in the UK
who have been diagnosed, that is mainly involved in the endocrine system. When
diabetes occurs, the pancreas doesn’t produce insulin, or the insulin that is
present doesn’t work, insulin is a hormone that allows cells to open and allow
fat inside them to store. The service
user I will be reporting today has this disorder and she has it from her
lifestyle and diet choices, Mrs. A is 30 years old and has always had an
unhealthy diet and believes to have picked this up from her mother, who died at
the early age of 55 due to obesity but was never diagnosed with the disorder as
she didn’t see it as a problem. Mrs. A is worried that she will have an early death
like her mother if she doesn’t change her life style Mrs. A’s physical state
has deteriorated massively over the last 2 years she is now struggling to walk
for more than a few minutes and doesn’t exercise at all, If this continues she
will be unable to walk at all and muscles will rapidly deteriorate and become
unable to use and her state will become increasingly worse, if this disorder
isn’t rectified then the service user will be obese, now that Mrs .A  is aware of the consequences of carrying on
her lifestyle this way she decided to contact her local GP. Leaving diabetes
type two untreated can cause serious complications later on in life cause a
myocardial infarction (heart attack). (M,Carey(2012),Asthma,Topic,14,http://vle.chesterfield.ac.uk/course/view.php?id=7473
, Last accessed 19th Jan 2018)


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Lifestyle choices play a big part of
being diabetic, for example, if a person smokes cigarette their lungs won’t be
able to cope doing strenuous exercise meaning they won’t be able to burn off
fats that they are eating, smoking also increases your blood pressure and
increases the risk of heart attacks and strokes as well as other forms of
cancer Doing minimal or no exercise can be very dangerous too as the fast and
sugar isn’t being burnt for energy or used up it stays in the system and can
cause serious obesity over time. Mrs. A is currently a regular smoker but is
seeking help to stop, she feels although she can’t deal with the stress of her
mother’s death but fears she will gain even more weight if she stops. Having an
unhealthy diet high in saturated fats, one of the main reasons that adolescence
in this century are suffering with diabetes and obesity, eating foods that are
high in fats, sugar and saturated fats is likely to cause chronic obesity that
leads to increased insulin resistance that is very likely to develop into
diabetes over time. With more and more fast food chains opening each year this
problem is most likely to be on the rise. Also, the deficiency of vitamins in
the body can cause diabetes type 2. Having an unhealthy diet is the main reason
my service user now diabetic, from being in adolescence Mrs A has always eaten
food that has a high content of sugar and fats, and food from fast food chains. (E.Smith. (2005). type 2 diabetes and genetics. Available:
https://www.healthline.com/health/type-2-diabetes/genetics. Last accessed 20th
Jan 2018).

Signs and symptoms

observational signs and symptoms that Mrs. A experienced would be excessive
weight gain, wounds or cuts that take long to heal, nausea, or increased fluids
going In and out, these
symptoms might occur because some or all the glucose stays in the blood, which
means it isn’t being used as fuel for energy. The body tries to reduce blood
glucose levels by flushing the excess glucose out of the body in the urine.
Having glucose pass through the urine frequently makes it very likely to also
develop genital thrush. Other symptoms that are experienced by Mrs A include:

Increased hunger and thirst (especially after eating)

Dry mouth

Frequent urination or urine infections

Blurred vision

Diabetic coma (loss of consciousness)


and tingling in hands and feet


When Mrs A
first started to experience these symptoms, she started to become depressed and
felt although it was her fault, she lacks in motivation to get back on track
and overall didn’t cope with the diagnosis very well at all. After being
diagnosed with diabetes she rarely left her house and didn’t socialise with her
friends and family as often as she used to, this suggests Mrs A wasn’t
comfortable going out the house and may have felt she was being judged by other
making her self-image low. Mrs A also enjoyed going to a weekly literature
class but now feels uncomfortable joining in as she fears people will find out
about her disorder.

Diagnostic and
investigative procedures

When visiting
the GP, they are very likely to ask a series of personal questions, which don’t
have to be answered, but will determine the cause and the severity of the
disorder. These questions might include: ‘what is your daily calorie intake?’ ‘do
you smoke?’ ‘how much do you exercise during the week?’ Investigations for
diabetes include: blood glucose tests which determined how much glucose is in
the blood. If the reading appears to be 5.6 to 6.9 mmol/L this suggests you
have prediabetes and are at risk of developing diabetes. If it reads higher
than 7 mmol/L you are likely to be diagnosed with diabetes and maybe given a
machine to record your blood glucose over the course of a week or 2. Type 2 diabetes can be hereditary which mean
that if both parents have the disorder it doesn’t necessarily mean that you
will inherit it as well. The inherited traits of diabetes are associated with
the genes: TCF7L2, which effects the glucose production. ABCC8, which helps
regulate insulin. CAPN10, which helps move glucose into the pancreas and GCGR,
which is a glucagon hormone involved in glucose regulation.  (https://www.healthline.com/health/type-2-diabetes/genetics There
is testing available for some genes to see whether they have mutations;
although this is one of the least common ways of getting diabetes type 2.

There are
many ways in which you can be tested for diabetes type 2 including: random
blood glucose test, fasting plasma glucose test, HBA1c test or an oral glucose
test. (https://www.diabetes.co.uk/Diabetes-diagnosis.html) other investigations that might be carried out during the diagnosis would
be medical history checks, family history checks, and dietary and exercise questions, this is
important  because someone is a lot more
likely to develop diabetes if a member of family has had the disorder
previously. During Mrs A’s diagnosis she had to do many urine glucose tests and
a fasting plasma glucose test which includes of a sample of blood from the arm
after several hours of fasting, the sample is usually taken in the morning
before food, so it will be the most accurate, she did this over the course of a
week and recorded each reading as her GP insisted. After diagnosis Mrs.A was
given low dosages of metformin but after a month of taking it every day she
found herself feeling very unwell and sick a lot of the time, although it did
take her appetite away she was very unhappy with the side effects and generally
feeling depressed and anxious throughout the course. Mrs. A went back to the GP
and asked if there were alternative treatments, as she was very determined to
improve her lifestyle the GP referred her to a dietician who got the service
user on track and showed her appetising, healthy substitutes for her appalling
diet. Shortly after trying this new diet the service user was overwhelmed with
the results, she felt physically well like she hadn’t in a long time, she was
able to walk to the shop and enjoy walking as an activity, this made Mrs. A’s
confidence a lot higher than it was before as she wouldn’t go out or socialise
with any of her friends and only liked staying indoors, now she has been going
for regular walks and meeting with her friends for a few hours and feels incredible,
her anxiety about others isn’t as bad as it has been previously and she is excited
to meet them again. The service user’s self-image and overall health and
wellbeing has improved massively because of her new diet and she feels strong
willed to loose more weight and become a healthier person.

Treatment and
support available

After being
diagnosed with diabetes type 2 you will most likely be prescribed with tablet
form medication (depending on the severity) this could be either of the following:
sulfonylureas, meglitinides, thiazolidinediones and the most common, metformin
which you will have to take once to four times a day, depending on the
progression of the diabetes. This tablet will reduce the amount of glucose that
the liver is producing and releasing into the blood. Metformin also makes the
body respond to the insulin normally, however, if the tablets are taken to
often at high dosages and no other lifestyle factors change this could lead to
them being ineffective. insulin treatment is also another way of minimising the
risk of developing further diabetes, this includes of injecting insulin
directly to the blood stream, this treatment is often used when the glucose
lowering tablets no longer control the blood glucose levels as well. Quite
often after being diagnosed with prediabetes or diabetes type 2 people will
change their lifestyle choices and decide to eat healthier, lose weight and
exercise more frequently, doing this reverses the effects and symptoms of
diabetes type 2 and is one of very few physiological disorders where the
effects can be reduced and in some cases eliminated completely. (https://www.nhs.uk/conditions/type-2-diabetes/treatment/#making-lifestyle-changes)

There are a
few different types of help and support available for service users with
diabetes type 2; including an advocacy service, this person will take daily
recordings of what food they have eaten, what physical exercise they have done
and how they generally think they are feeling. An advocate will be present if
the service user is unable to make valuable life decisions for them self, for
example my service user is now unable to make healthy food choices always ate
fast food in the past. Mrs. A’s advocate now plans her meals weekly and always
considers her favourite food and drinks every time to ensure she follows It
each day. Her diet, that she’s been doing for the last 3 months, has been hard
for Mrs. A but she’s managed to stick to it and notice the difference in her
weight and finds considerably easier to get around. This has made her very
happy and now is motivated to carry on with this diet and eating even healthier
than she was before, Mrs. A’s new diet consists of:

Fresh fruit and juice

Fresh vegetables




investigation of both disorders’ is carried out very differently for example;




testing equipment is very important for people with diabetes as they can
use home testing kits to see whether they are safe to drive, many people
depend on these when dealing with diabetes daily.

people must do some sort of dieting of fasting before doing these tests and
some people might not be able to do so giving false readings.

investigations that are carried out for asthma include

tests can be done directly and be diagnosed within a couple of minutes. The
tests are easily done by the patients and don’t require any other
procedures throughout.

type of testing requires expensive equipment that may not be available to
some people across the world.










Introduction to
asthma and participant.

Asthma is a very
common respiratory disease which is most commonly diagnosed in children as
symptoms can become quite extreme, asthma is an inflammatory disorder which
affects the way the airways work. Just over 5.4 million people in the UK are
currently taking treatment for asthma, this includes 1 in every 12 adults and 1
in 11 children. The layer of bronchi is irritated by the inflammation. This
causes the muscle to tighten, narrowing the bronchi (small tubes which carry
air in and out of the lungs) and making it a lot more difficult to breathe,
causing wheezing and coughing. . (M,Carey (2012), Asthma,
Topic 14, http://vle.chesterfield.ac.uk/course/view.php?id=7473
, Last accessed 19th Jan 2018)  Mr E is a
patient who visits his GP frequently as he has become very worried and anxious
when he cannot breathe properly, and fears he is going to stop breathing when
having an asthma attack, these attacks also make Mr. E light headed and dizzy, now
edging towards later adulthood, this terrifies him as he expects to fall over
or have another severe condition. Mr E has just turned 60 and has really
enjoyed his life until being diagnosed at the age of 48, his physical state has
declined rapidly since his diagnosis. At around 55 he refused to exercise at
all as he cannot go to the gym and do the exercise of his choice, he was advised
not to do vigorous exercise at all but refused this at first and tried his
hardest to carry on with strenuous exercise, Mr. E did these daily exercises to
release stress but now finds it difficult to walk a few meters before he is
wheezing or needs an inhaler. Mr E has noticed himself becoming very stressed
at small things that don’t really matter but feels as though he cannot help it
and might decide to start smoking again which can make his physical state
rapidly worsen more than it already has.


There are
many factors that could contribute to getting this disorder, these include;
environmental factors- (your surroundings) having mould or damp inside the
house, animal faeces can cause lung and breathing problems, airborne substances
like dust mites, pollen or mould spores all these small particles will easily
stick inside the lungs and irritate them, constant exposure to these could lead
to further health problems such as; chronic obstructive pulmonary disease
(COPD) and even lung cancer.

choices can also play a big part in the development of asthma, for example,
smoking is a very common way of getting asthma and everyone diagnosed is advised
not to smoke and avoid smoke in general, your diet can also be a trigger for
asthma, being obese, lack of physical activity and stress can all be ways in
which asthma is caused. It’s also very likely that if one or both of your
biological parents had or still has asthma that you will inherit it as well,
most commonly from the mother as research says.





Signs and symptoms

The Signs
and symptoms to look out for in all young children and adults are, the
observational symptoms- coughing, wheezing and breathlessness. Other symptoms
that may be experienced by the patient-tightness in the chest (may get
progressively worse), wheezing or whistling sound when breathing and irritation
to the nose and chest. Furthermore, during asthma attacks the signs and
symptoms to look out for may include: being unable to speak, eat or sleep due
to breathlessness, confusion, drowsiness, fainting, blue fingers or lips,
breathing faster and the wheezing and tightness of the chest becomes severe and
constant. (https://www.nhs.uk/conditions/asthma/)

asthma can be long and continuous and there’s no evidence to suggest it will
ever go completely as all asthma can be different and influenced by different
traits, there is treatment that are available for all ages of people that seem
to keep the symptoms under control and free from asthma attacks so that this
disorder doesn’t affect your life too much, unless you have developed it at in
adolescence and have had it constantly until being older.

Investigative and
diagnostic procedures

Going through the
first stages of investigation include visiting your GP to identify what the
problem is symptoms are and maybe the severity of your condition. Diagnosing
asthma has more practical testing such as; trigger tests and lung functions
tests which can quickly tell what is irritating the lungs and what the cause is
or may have been, and how it could possibly be resolved, and the symptoms could
be reduced. The GP is most likely to do this by doing multiple breathing tests
and asking lifestyle and family history questions, for example, ‘has another
family member suffered with this before?’ or ‘are any of your family, including
yourself, smokers?’  ‘when do the
symptoms happened and how often?’ these types of questions may be able to
determine what the cause of the pulmonary function tests are measured with a
spirometry which can determine whether the lungs are working correctly and how
well you are able to breathe In and out. When visiting the GP for the first
time in many years Mr E was told his condition is very severe and ye needs to
stop he amount of exercise he does immediately as it could lead to serious
complications otherwise, including having his airways remodelled, this only
happened in seriously poor managed asthma cases when the lung tissue becomes
scarred, prescribed medicines do not work as well, and less air is able to move
through the airways.

Tests that
may be done to diagnose asthma might include: breathing tests-  a spirometry test can tell how well the lungs
and airways are working, this test involves the patient breathing out as fast
as possible, the machine records two measurements, the amount of air breathed
out and the amount of air that you are able to fit in your lungs, the reading
are then compared to normal measurement taken from someone of the same age. The
only disadvantage with this is the cost of the equipment, some low-income
places might not be able to afford this equipment. A peak flow test is a
simpler and cheaper was of testing for asthma, it tests how fast you can blow
air out of the lungs, the GP might give you a peak flow meter to record your
peak flow over a certain period. Any other test or more severe symptoms will be
referred to a specialist.

that come to service users that can use this equipment are; being able to use
it at no extra costs as its provided by the NHS this allows less fortunate
people to have the same health opportunities as wealthy and getting specialist
services that aren’t available to other around the world.

Mr E was
tested with a spirometry at his local doctors, he was diagnosed with asthma
immediately as was given a prescription for multiple inhalers to relive him
from the pain he was in. he quickly noticed a change in his breathing as he
used his inhalers quite regularly, when he returned to the GP he was convinced
he’d be able to do sports and exercise like he used to but suffered another
severe asthma attack recently.

The impact on the
body systems and service user.

Mr E first
got symptoms of asthma when he was in middle adult hood, but he didn’t
recognise them and didn’t think much of them as he never
thought his health would be a problem, at the age of 47 Mr E experienced his
first asthma attack whilst exercising and was very anxious and worried about
his health, he visited his local GP and he advised him not to do vigorous
exercise, this made Mr E upset as sports and exercise was his passion, he now
feels as though he’s uncappable of doing things he really enjoyed before such
as his daily morning he would walk, with his dog, to the shop to get a paper.
This upsets Mr E as he thinks his dog isn’t getting the right exercise and will
become unwell and leave him, the shop owners always looked forward to seeing
him as he always exchanged stories and was a very interesting loyal customer to
them, the shop owner offered to bring him a paper to his house every morning,
but he strongly refused as he feels as though he’s being a burden.

 As Mr. E moves towards later adulthood he
becomes increasingly terrified of having another asthma attack and experiencing
symptoms he felt before such as, rapid heartbeat, unable to speak due to
breathlessness, dizziness, confusion and exhaustion. Mr E said had never felt
truly exhausted until his asthma attack, and being a keen sportsman this was
devastating. Mr E has now started to feel worthless and although he has no
meaning in life, he has lost all his confidence in doing exercise and has
gained about 3 stone and lost his muscular figure since the diagnosis, this has
lowered his self-image dramatically and rarely leaves the house. Mr E was a
happy, caring and loving man by many friends and family, however he hasn’t seen
any of his team and feels as though they have that life he was never able to
achieve. Mr E was in the last stage of training to become a professional sports
coach but had to resign due to his diagnosis, he feels as though he didn’t
complete his dream and is almost like he’s given up with everything else because
of this. Mr E is now incapable of walking to the local shop and has his sister
visit every day to do shopping and general house work, Mr. E’s sister watched
her brother decline in mobility and feel more than sorry for him, Mr E wishes she
wouldn’t come as often as it might give him motivation to do things for himself
but at the moment feel so depressed and anxious about his weight and having
another asthma attack he rarely moves out of his bed which is seriously
damaging for his body, Mr E has only recently noticed that his physical, mental
and social state has deteriorated and knows he should do something about it,
but his lack of motivation is stopping him.