Type-2 Diabetes mellitus (T2DM) is a common disease worldwide. According to the American Diabetes association (ADA), 1808 million people in the United States have been diagnosed with diabetes, and another 7 million are thought to have the disease but have not been diagnosed. (Hilaire, Woods, 2013). This disease has impacted everyone in some way. It is a controllable disease; however many individuals choose not to control it or are uneducated on how to control it. Many people with type 2 diabetes (T2DM) also have hypertension, high cholesterol, obesity, lack of physical activity, poorly controlled blood sugars, and smoking. “Current evidence supports the concept that ...view middle of the document...
People with diabetes also tend to develop some form of cardiovascular disease at an earlier age than those without diabetes. Some studies suggest that people who are middle-aged and have T2DM are at a higher risk of having a myocardial infarction at a younger age. The societal impact of this issue is that more and more people are developing Diabetes and diabetes with cardiovascular disease. Findings have shown that a substantial amount of people with diabetes have not been diagnosed or are not being treated for the disease. One of the most effective management of T2DM is treatment of associated risk factors (Gakidou, Mallinger, 2010).
Monetary Impact of the Issue
The monetary impact of T2DM is very high. “The indirect and direct costs of diabetes are increasing. In 2007, the total costs for diabetes was approximately $174 billion dollars” (Hilaire, Woods, 2013). Not only are the medical visits expensive, there is the cost of the medications to control diabetes. With diabetes alone there is the cost of the glucose meters and supplies plus the insulin to control hyperglycemia. If there are any cardiovascular risks there may be the cost of anti-hypertension medications, anti-coagulants, and/or cholesterol medications. Without insurance and even with; the cost of the medications can be more than the patient can afford. If the patient cannot afford the medications they will be unable to control their diabetes which can lead to further complications. With the new prescription plans most pharmacies have less expensive forms of medications that a patient can request to help them be able to comply with their medication regimen that their doctor places them on.
Evidence Based Nursing Care
Evidence Based Guidelines
“To reduce cardiovascular disease risk factors, patients with T2DM are advised to eliminate trans fats and to limit saturated fat to <7% of total caloric intake. A moderate weight loss (5% of body weight) has been found to improve insulin action, decreasing fasting blood glucose (FBG) concentrations, and reduce the need for diabetes medication” (Rredmer,2013). There have been many studies done to find ways to reduce the risks involved with diabetes and cardiovascular disease. From all of the evidence so far diet and exercise are the best option to help improve patient outcomes. “There is convincing evidence from epidemiological and pathophysiological studies that hyperglycemia has a detrimental effect on cardiovascular risk profile in its own right. It is well known that among patients with T2DM, those with higher levels of blood glucose and HbA1c are at greater risk for CVD” (Mannucci, Dicembrini, 2013).
Barriers of Implementation
The barriers of implementation could be that the patient will not or cannot follow the treatment plans needed. Medication adherence can affect the implementation of treatment whether it is the cost of the medication or not taking the medication. Medication and dietary adherence is the best way to control diabetes and...