Problem Identification
Diabetes mellitus is a disease that occurs when the body fails to regulate the level of glucose in blood. There are two types of diabetes mellitus, type I, and II, classified according to availability of insulin in the body. Type I diabetes occurs due to failure of pancreas to secrete enough insulin into the body causing glucose levels to increase, and mainly affects children and young adults. Type II diabetes occurs due to insensitivity of the body to insulin making blood glucose level to increase and the cells to experience physiological hunger. Type II diabetes mainly affects adults but due to changing lifestyles in the society and there are increasing incidences of such in young adults and adolescents. Diabetes mellitus is responsible “for the development of diabetic foot because high levels of glucose in blood damage nervous system and blood vessels leading to insensitivity and poor circulation of blood in the feet” (American Heart Association, 2010).
Importance of the Problem
Diabetes mellitus if not managed in time will cause many complications to patients and extend treatment burden to their families. According to Donald, “high blood glucose levels due to diabetes mellitus can damage the nerves, kidneys, eyes, blood vessels, immune system and cause foot problems” (2009, p.8). The many complications associated with diabetes are very grave and thus require immediate attention from health care system to give guidelines on how to manage rising cases of diabetes mellitus. Diabetic foot is a complication that arises due to damage of blood vessels and nerves around the feet by the high levels of glucose in the blood. Damage of blood vessels impair circulation of blood and subsequently affect the immune system causing slow healing of wounds. Damage of nerves makes the feet to become insensitive and lose physiological mechanism of sweats and oils leading to development of sores and cracks in the feet. Since damaged blood vessels impair circulation of blood, it is very difficult to administer antibiotics into target sites leaving the infection to develop into gangrene.
Diabetic foot arises due to diabetes mellitus and statistics reveal that people suffering from diabetes mellitus are 20 times more susceptible to diabetic foot relative to the general population. Such revelation affirms that diabetic foot is grave complication of diabetes mellitus that require urgent attention due to rising cases of diabetes mellitus in the population. “Out of the total number of all lower limb amputations, 40%-60% are carried out in persons with diabetes mellitus, and more than 85% of them are the consequence of a diabetic foot affected by deep infection and gangrene” (Poljicanin, Pavlic-Renar, Metelko & Coce, 2005, p.43). Since diabetes mellitus contributes about half of all cases that limb amputations, proper management of the condition is imperative in decreasing cases of diabetic foot that leads to limb amputation. Thus, diabetes mellitus and diabetic foot are health problems that have serious consequences such as increasing rates of disability, morbidity stress, and medical burden among the population.
In the United States, studies by National Hospital Discharge Survey show that in 1996, approximately 86, 000 of diabetic patients developed diabetic foot and underwent amputations of lower limbs. These findings made the National Institute of Health and the Health Care System declare that diabetes mellitus is increasingly becoming the leading cause of limb amputations. “People who have diabetes are vulnerable to nerve and vascular damage that can result in loss of protective sensation in the feet, poor circulation, and poor healing of foot ulcers …All these conditions contribute to high amputation rates” (Tobin & Kennedy, 2009, p. 6). Since diabetic foot is becoming a global issue, St. Vincent Declaration of 1989 aimed at reducing incidences of amputations across Europe by at least half in every five years. Therefore, to control and manage occurrence of diabetes mellitus and diabetic foot, it requires concerted efforts of the public and the health care system.
Project Objective
The major objective of the project is to reduce incidence rates of diabetes mellitus in the population with the view of preventing diabetic foot and other complications associated diabetes mellitus. The research hypothesizes that comprehensive education program can effectively reduce increasing incidences of diabetes mellitus and concomitantly reduce the incidences of diabetic foot by 10 % in the population. Tobin and Kennedy argue that, “…keeping blood glucose level as close to normal as possible significantly slows the onset and progression of diabetic nerve and vascular complications, which can lead to lower extremity amputations” (2009, p.5). Thus, an education program that will enhance awareness of diabetes and diabetic foot in terms of prevention, diagnosis, treatment, and management is critical in achieving research objective.
Solution and Description
Comprehensive education program is going to enhance awareness of diabetes mellitus and its associated complications such as diabetic foot. The enhanced awareness is will help the people to participate in prevention, diagnosis, treatment, and management of diabetes mellitus and diabetic foot. Donald advices that, “people with diabetes should learn how to examine their own feet, recognize the early signs and symptoms of diabetic foot problems, carry out routine foot care at home , and seek emergency treatment” (2009, p. 11). People can do all this activities if there is sufficient awareness of diabetes mellitus and diabetic foot.
Solution Description
Description of the Proposed Solution
To enhance awareness of diabetes mellitus and diabetic foot, comprehensive education of patients and the entire population regarding prevention, diagnosis, treatment, and management of these conditions is imperative. The comprehensive education programs target two groups of people in the population, the patients of diabetes mellitus and diabetic foot, and the general population. Patients of diabetes mellitus need education on how to treat and manage their diabetic condition and prevent occurrence of diabetic foot. Moreover, patients of diabetic foot require education on how to manage their condition and prevent it from aggravating their health conditions and subsequent amputation of their lower limbs. According to Ortegon, Redekop, and Nissen, “management of the diabetic foot according to guideline-based care improves survival, reduces diabetic foot complications, and is cost-effective and even cost saving compared with standard care” (2004, p.901). Hence, comprehensive education provides guidelines of managing diabetes mellitus and diabetic foot resulting into improved standard of health care.
Education of the public is very essential in preventing, diagnosis, treatment, and management of the diabetes mellitus and diabetic foot conditions. In the research, the public will receive educational materials that contain relevant information that will increase their awareness of the two conditions with the prime objective of encouraging the people become proactive in taking care of their health. Healthy lifestyles and regular medical examination is very important in preventing diabetes mellitus and subsequent development of diabetic foot. “Current clinical recommendations call for a comprehensive foot examination at least once a year for all people with diabetes to identify high risk foot conditions, while people with one or more high-risk foot conditions should be evaluated more frequently” (Rangnarson, & Apelquist, 2001, 2081). Sensitization of the population will enhance regular medical examinations and early diagnosis of diabetes mellitus and diabetic foot, hence prevention, treatment, and proper management of the conditions. The research expects that at the end of education program, people will be in a position to live healthy lifestyles by keeping their blood sugar within normal range, conduct regular foot check and care, and remain physically fit.
Consistency with Current Research
Since diabetes mellitus and diabetic foot cases are medical conditions that require management of health rather than treatment; therefore, comprehensive education programs put novel foundations that are critical in prevention and management of the conditions in population. According to Center for Disease Control and National Institute of Health, effective prevention and management of diabetes mellitus and diabetic foot need, “early diagnosis of diabetes mellitus, early detection of foot problems, early intervention to prevent further deterioration that may lead to amputation, and patient education for proper care of the feet and footwear” (Kandel, 2000, p.8). Therefore, patient education is one of the approaches that the health care system employs in prevention and management of diabetes mellitus and diabetic foot.
Feasibility of the Solution
Comprehensive education program is a feasible approach of preventing and managing diabetes mellitus and diabetic foot because increased awareness of the conditions in the population is going to enhance the efforts of health care system. According to World Health Organization, people can prevent and manage most diseases if they have enough information concerning causes, prevention, and treatment of varied diseases (Armstrong, Holtz-Neiderer, Wendel, Mohler, & Kimbriel, 2007, p.1044). Hence, comprehensive education of the patients and the public is a feasible approach of preventing and management of the diabetic conditions.
Consistency with the Resources and Culture
Conducting comprehensive education concerning diabetes and diabetic foot across all health institutions do not require much finances since health institutions already provide necessary framework of conducting the research. Therefore, healthcare professionals coupled with relevant information is important in research work of this disease. The research also has no ethical barriers since education of the people regarding diabetes and diabetic foot does not clash with any cultural belief in the society.
Conclusion
The incidences of diabetes mellitus are increasing alarmingly in the population due to change in lifestyles. Recent studies reveal that Type II diabetes is gaining prominence in adolescents and young adults causing complications such diabetic foot. Diabetic foot occurs when high level of glucose in blood damage blood vessels resulting into poor circulation of blood in the lower limbs. Moreover, high glucose levels in blood damage nerves causing lower limbs to lose sensitivity and develop sores. Collective complications of damaged blood vessels and nervous system results in diabetic foot in which if not properly managed will eventually lead to amputation of lower limbs. To prevent and manage these diabetic conditions, comprehensive education program enhances public awareness on how to improve their healthy lifestyles and foot care.
References
American Heart Association. (2010). Diabetes Mellitus. American Heart Organization. Web.
Armstrong, D. et al. (2007). Skin Temperature Monitoring Reduces the Risk for Diabetic Foot Ulceration in High-Risk Patients. The American Journal of Medicine, 120, 1042-1046.
Donald, T. (2009). Diabetic Foot Care. The Journal of E-Medicine and Health, 1-33
Kandel, S. (2000). Take Care of Your Feet for a Life Time. American Association of Diabetes, 1-13.
Ortegon, M., Redekop, W., & Nissen, L. (2004). Cost-Effectiveness of Prevention and Treatment of Diabetic Foot: A Markov analysis. Diabetes Care, 27(4), 901-907.
Poljicanin, T., Pavlic-Renar, I., Metelko, Z., & Coce, F. (2005). Draft Program of Prevention of Diabetic Foot Development and Lower Extremity Amputation in Persons with Diabetes Mellitus. Diabetologia Croatica, 34(2), 43-49.
Rangnarson, T., & Apelquist, J. (2001). Prevention of Diabetes-Related Foot Ulcers and Amputations: A Cost-Utility Analysis Based On Markov Model Simulations. Diabetologia Croatica, 44, 2077-2087.
Tobin, C., & Kennedy, C. (2009). A Health Care Provider’s Guide to Preventing Diabetes Foot Problems. National Institute of Health and the Centers for Disease Control and Prevention, 1-50.