Diabetes Prevention and Manifestations PDF

11/20/23, 5:25 PM Realizeit for Student Prevention The Diabetes Prevention Program Research Group (2002) reported that type 2 diabetes can be prevented with appropriate changes in lifestyle. Participants at high risk for type 2 diabetes (BMI greater than 24 kg/m2, fasting and postprandial plasma g...

11/20/23, 5:25 PM Realizeit for Student Prevention The Diabetes Prevention Program Research Group (2002) reported that type 2 diabetes can be prevented with appropriate changes in lifestyle. Participants at high risk for type 2 diabetes (BMI greater than 24 kg/m2, fasting and postprandial plasma glucose levels elevated but not to levels diagnostic of diabetes) received standard lifestyle recommendations plus metformin, an oral antidiabetic agent; standard lifestyle recommendations plus placebo; or an intensive program of lifestyle modifications. The 16-lesson curriculum of the intensive program of lifestyle modifications focused on weight reduction of greater than 7% of initial body weight and physical activity of moderate intensity. It also included behavior modification strategies designed to help patients achieve the goals of weight reduction and participation in exercise. Compared to the placebo group, the lifestyle intervention group had a 58% lower incidence of diabetes and the metformin group had a 31% lower incidence of diabetes. These findings were found in both genders and all racial and ethnic groups. This research demonstrates that type 2 diabetes can be prevented or delayed in persons at high risk for the disease (Diabetes Prevention Program Research Group, 2002). The Diabetes Prevention Program Outcomes Study followed participants for 15 years and demonstrated that those who enrolled in the program continued to develop type 2 diabetes at a lower rate compared to controls (Diabetes Prevention Program Research Group, 2015). Researchers have also reported in a study of more than 7000 participants followed for 8 years that those who took glucosamine, a supplement that decreases osteoarthritis and joint pain, had a lower risk of developing type 2 diabetes compared to those not taking the supplement (Ma, Li, Zhou, et al., 2020). Clinical Manifestations Clinical manifestations depend on the patient’s level of hyperglycemia. Classic clinical manifestations of diabetes include the “three Ps”: polyuria, polydipsia, and polyphagia. Polyuria (increased urination) and polydipsia (increased thirst) occur as a result of the excess loss of fluid associated with osmotic diuresis. Patients also experience polyphagia (increased appetite) that results from the catabolic state induced by insulin deficiency and the breakdown of proteins and fats (Norris, 2019). Other symptoms include fatigue and weakness, sudden vision changes, tingling or numbness in hands or feet, dry skin, skin lesions or wounds that are slow to heal, and recurrent infections. The onset of type 1 diabetes may also be associated with sudden weight loss or nausea, vomiting, or abdominal pains, if DKA has developed. https://herzing.realizeithome.com/RealizeitApp/Student.aspx?Token=0Dn26kXyU%2f6F5gOCz4%2f2IX2deLl%2f4FdfKSHmHSZ7peJYyAcbNSqCsVXJC0jIBoVz… 1/5 11/20/23, 5:25 PM Realizeit for Student Assessment and Diagnostic Findings An abnormally high blood glucose level is the basic criterion for the diagnosis of diabetes. Fasting plasma glucose (FPG) (blood glucose determination obtained in the laboratory after fasting for at least 8 hours), random plasma glucose, and glucose level 2 hours after receiving glucose (2-hour postprandial load) may be used (Fischbach & Fischbach, 2018). See Chart 46-2 for the ADA’s diagnostic criteria for diabetes (ADA, 2020). In addition to the assessment and diagnostic evaluation performed to diagnose diabetes, ongoing specialized assessment of patients with known diabetes and evaluation for complications in patients with newly diagnosed diabetes are important components of care. Gerontologic Considerations Diabetes is particularly prevalent in older adults. In fact, type 2 diabetes is the seventh leading cause of death and affects approximately 20% of older adults (Eliopoulos, 2018). There is a high prevalence among African Americans and those who are 65 to 74 years of age (Eliopoulos, 2018). Early detection is important but may be challenging because symptoms may be absent or nonspecific. A glucose tolerance test is more effective in diagnosis than urine testing for glucose in https://herzing.realizeithome.com/RealizeitApp/Student.aspx?Token=0Dn26kXyU%2f6F5gOCz4%2f2IX2deLl%2f4FdfKSHmHSZ7peJYyAcbNSqCsVXJC0jIBoVz… 2/5 11/20/23, 5:25 PM Realizeit for Student older patients due to the higher renal threshold for glucose (Eliopoulos, 2018). https://herzing.realizeithome.com/RealizeitApp/Student.aspx?Token=0Dn26kXyU%2f6F5gOCz4%2f2IX2deLl%2f4FdfKSHmHSZ7peJYyAcbNSqCsVXJC0jIBoVz… 3/5 11/20/23, 5:25 PM Realizeit for Student https://herzing.realizeithome.com/RealizeitApp/Student.aspx?Token=0Dn26kXyU%2f6F5gOCz4%2f2IX2deLl%2f4FdfKSHmHSZ7peJYyAcbNSqCsVXJC0jIBoVz… 4/5 11/20/23, 5:25 PM Realizeit for Student https://herzing.realizeithome.com/RealizeitApp/Student.aspx?Token=0Dn26kXyU%2f6F5gOCz4%2f2IX2deLl%2f4FdfKSHmHSZ7peJYyAcbNSqCsVXJC0jIBoVz… 5/5