Abnormal Blood Glucose and Type 2 Diabetes Mellitus Screening
The risks associated with diabetes usually increase with age, and this makes the condition more common in older adults. About 25% of adults who are over the age of 60 have diabetes. When diagnosed with diabetes, it means that blood sugar levels are too high, and body cells require glucose for energy. Typically, the hormone insulin is released when food is taken, and this helps glucose obtained from food get into the cells. Less insulin in the body causes glucose to build up in the blood and not to reach cells. As a result, there are complications like damage to the kidney, mobility problem, or heart disease (Amutha & Mohan, 2016). The paper will address abnormal blood glucose and type 2 diabetes Mellitus screening for a community group of adults between the age of 40 to 70 years
The Rationale
I choose this screening because adults at the age of 40 to 70 years with the overweight problem are at considerable risk of heart problems. According to the US preventive services task force, this screening is ranked grade B and is recommended for screening abnormal blood glucose due to the risk of cardiovascular. The grading rank is based on effectiveness, and people with abnormal blood glucose should be referred to interventions like behavioral counseling to promote physical wellness and healthy diets. Patients with diabetes history, diagnosed with gestational diabetes, or belong to a particular racial group, have high risks for the problem. Therefore, this screening would be appropriate, and its process can be better if taken earlier when a client presents with one or more of the mentioned characteristics.
The need to screen diabetes in an overweight adult population between the age of 40-70 years is that risk factors that come along with the condition are modifiable. Many individuals in this population group end up undiagnosed. The seriousness of diabetes health problems and the immediate effects or associated long-term complications necessitate the need to carry out a screening process. From O’Brien et al. (2018) studies, information is revealed early intervention would help prevent hypertension, dyslipidemia, or cardiovascular (CVD) problems.
CVD is a leading cause of death in states like America, and this can be preventable if detected early enough. By modifying the risk factors associated with cardiovascular, which include abnormal blood glucose levels, then the death rate can be managed. Diabetes mellitus type takes time to develop and progresses from abnormal blood sugar levels. Research shows that abnormal metabolism of blood sugar is a risk factor for CVD, and the progression leads to a threshold whereby diabetes must be diagnosed. When the condition of pre-diabetes is early detected through the screening approach, some measures can be recommended (O’Brien et al., 2018). For example, adults who have smoking habits could be advised to quit smoking once pre-diabetes gest determined.
Benefit of Screening
Early identification of diabetes and pre-diabetes is essential as it would help patients to start monitoring or managing the condition at an early stage. In that way, it becomes easy to prevent further complications like a heart-related problems that can lower the quality of life. In recent times, the diabetes conditions are as well observable even in children. Unlike in adults, to identify type 2 diabetes in children can be challenging as they may not show indicative symptoms (“U.S. Preventive Services Task Force,” 2014b). Diagnosis in young people means they may carry the disease for an extended period compared to developing as adults. The longer the duration of the illnesses, the more rates of severe complications, including blindness, amputations, or real failures. Hence, these adverse conditions necessitate the need for screening.
Harmful Effects of Screening
Studies have revealed that measuring blood glucose can induce anxiety as a short-term complication. However, the harm resulting from lifestyle interventions for diabetes is less significant, almost to zero. Harm resulting from drug therapies vary from small to moderate effects based on the type of drugs prescribed. Systematic, targeted screening can help identify patients with conditions that have disabling symptoms. Following this discovery, the treatment intervention employed could lead to the rapid improvement of health-related quality of life. In that way, the person’s perception of ill-being could be interpreted as attributed to unrecognized illness. The experience itself of discovering a chronic disease could lead to a decline in quality of life, otherwise known as labeling.
Risk Factors
Risk factors for abnormal blood glucose and Type 2 diabetes mellitus screening include obesity, abdominal fat, being physically unable to engage in activities, and smoking. Abdominal blood glucose is lined with heart-related risk factors such as hypertension. According to US preventive screening criteria for diabetes, the goal of conducting screening is to promote early identification and intensive treatment to avoid associated adverse health outcomes (O’Brien et al., 2018). Risk factors associated with diabetes and pre-diabetes in adulthood include developing obesity complications, lack of regular exercise, a patient population being over 45 years old, or family history. Other key factors include being previously diagnosed with gestational diabetes or the presence of damaged immune system cells (“U.S. Preventive Services Task Force,” 2014). Gestational diabetes is a diabetic condition that comes up during pregnancy as a result of hormonal changes.
Treatments and Interventions for Diabetes in Adults
Once diabetes in adulthood has been identified through the screening process, several treatments can be employed to help patients manage the condition. Behavioral intervention, which can be combined with counseling on the right diet, is an effective approach to this condition. Physical activity is recommended with multiple contacts over a particular period. For diabetes type-2 patients, insulin can be used or tablets, although watching diet and healthy habits like exercises can help. Insulin is prescribed for type 1 diabetes and some patients with type 2 to control blood glucose levels (Wherrett et al., 2018). Metformin is the most common type of medication prescribed to patients with type 2 diabetes. Drugs stimulate the pancreas to produce more insulin and help lose weight. For overweight and obese patients who appear to be insulin resistant modest weight loss is recommendable (Viner, White & Christie, 2017). Lifestyle change intervention can be a primary approach to weight loss.
Accuracy of Screenings for Diabetes in Adulthood
Abnormal blood glucose and type 2 diabetes mellitus screening are accurately done by measuring hemoglobin A or fasting of plasma glucose with oral tolerance. Screening is confirmed with repeated tests at different intervals. According to studies, screening approaches- use of glycated hemoglobin A1c, oral glucose tolerance test, or fasting plasma glucose have been used for a while (Viner, White & Christie, 2017). Fasting glucose screening methods, for example, is known to be specific and not very accurate. HbA1c test is also not a specific nor sensitive approach. Studies have confirmed the accuracy of diagnostic screening tests for pre-diabetes by comparing it with the risk of progression of the disease. For example, in the oral tolerance test standard, a meta-analysis was carried to assess the risks of progression to type 2 diabetes. The research found that a screening approach would be effective if a test identifies people at high risks of diabetes- sensitivity, and exclude those at low risks- specificity. HbA1c was found to have a mean sensitivity of about 0.5 and specificity of 0.8 in identifying pre-diabetes.
Effectiveness of Treatments
Although no single treatment approach like drugs has for diabetes can be regarded as super effective in fighting the conditions, adherence to prescriptions is the key to health management. The response of medications varies according to patients’ needs and factors like the overall nature of a person’s health, level of blood sugars, and duration of the conditions. However, proper adherence to medications and interventional approaches like healthy lifestyles, which include proper diet and exercises, have proved effective in managing diabetic conditions.
Reasons for recommending the screening
One significant benefit for abnormal blood glucose and type 2 diabetes Mellitus screening is the behavioral counseling intervention, which would help clients monitor their health. For patients who have increased risk of cardiovascular diseases, the screening will help lower the risks, reduce blood pressure, lipid levels, and manage obesity (“U.S. Preventive Services Task Force,” 2014). Another reason is related to cost benefits. Typically, managing diabetes condition can be expensive, and not all persons are well off in terms of resources. A screening program will save adults for life-term cost burden. Also, from an economic perspective, I recommend screening to facilitate economic progress through productivity once diabetes conditions are managed early.
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