Genetics of Type 2 Diabetes

Introduction

Genetic history is frequently decisive for developing of certain diseases and conditions. Evaluation of genetic history provides an opportunity to reveal the risks because a person who has hypertension or diabetes in the family history is more likely to develop these diseases than individuals whose relatives were healthy. The person interviewed for evaluation of family genetic history is at a high risk of developing type 2 diabetes because there are cases of this disease both from maternal and paternal side. Still, diabetes is a preventable disease in case the risk factors are mitigated. The patient involved in the assessment should pay attention to his diet as a modifiable risk factor associated with type 2 diabetes. Thus, the purpose of this paper is to review the preventable disease under consideration, plan an evidence-based intervention aimed at its prevention, implement it, and provide the implementation of teaching plan with its further evaluation.

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Preventable Disease Overview

Type 2 diabetes is a highly prevalent chronic disease. Currently, over 30 million Americans live with diabetes and almost three times more have prediabetes (Centers for Disease Control and Prevention, 2018). The major symptoms associated with type 2 diabetes that should not be ignored include increased thirst, increased hunger, the feeling of dry mouth, frequent urination, weight loss of unexplained character, fatigue, blurred vision, and headaches (“Symptoms of type 2 diabetes,” 2017). Since most of these symptoms appear due to high blood sugar, type 2 diabetes can be proved after a blood test. The test is measuring blood glucose level. The normal value is 4.0 to 5.9 mmol/L before meals. For individuals with type 2 diabetes the normal levels range from 4 to 7 mmol/L before and should be under 8.5 mmol/L after meal. For diagnosing, a patient with 7.0 mmol/l or more is considered to have diabetes. As for physical assessment, a physician can identify a recent weigh gain, velvety dark skin changes of the neck, numbness of the feet and hands, and erectile dysfunction (“Symptoms of type 2 diabetes,” 2017).

The individual questioned for family genetic history evaluation is likely to develop diabetes due to the following reasons. First of all, his younger brother already has diabetes. Secondly, some relatives on the maternal side reported to have diabetes. Both cases increase the risk of type 2 diabetes because this disease has a strong hereditary component (Ali, 2015). Finally, he is African American, and thus is at a higher risk of developing diabetes.

Evidence Based Intervention

Despite its chronic character, type 2 diabetes is a preventable disease. Investigations prove that evidence based interventions have a potential for reducing the risk of its development. For example, in case of the patient under analysis, dietary and lifestyle interventions are expected to be effective. Dietary and lifestyle interventions have a proved efficiency because they stimulate weight reduction and decrease in blood glucose levels (Dunkley et al., 2014). Moreover, the study by Dunkley et al. (2014) revealed the connection between adherence to guidelines and weight loss, which allows supposing that strict adherence, will provide better results and thus be more effective for disease prevention.

For this case, evidence-based intervention will involve a smartphone application to control meals and weight. Also, the application will remind about the necessity of a regular blood test. In case diabetes is diagnosed, the application allows tracing blood glucose levels in dynamic. For this intervention, short-term goals are to reveal prediabetes and stimulate lifestyle change. A long-term goal is to prevent the development of type 2 diabetes and improve overall health of the patient.

Implementation: Teaching Plan

Patient teaching is necessary to make sure that the patient is aware of his risks and can manage the application. Thus, the teaching plan comprises the following steps:

  • Introduction into the problem: explaining the role of genetics and the related risks
  • Teaching about diabetes and its complications: inform the patient about symptoms, diagnosing possibilities, treatment alternatives, and possible negative outcomes
  • Teaching how to use the application and its opportunities for preventing diabetes
  • Presenting a brief course on healthy eating with practical classes.

The resources provided for the patient will include printed handouts, recommendations on a diet, websites with useful information, and contacts of a local diabetes center to address in case of taking blood tests.

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Evaluation

Evaluation of the suggested intervention will include two steps. The first one will be taken before the program implementation and consist of BMI measurement and blood glucose level test. The second step will be taken after three months of intervention implementation and include the same measurements. In case of the intervention effectiveness, the patient’s BMI will decrease and blood glucose level will be lower and closer to normal limits. In case the plan proves to be not successful, it is necessary to assess if the patient followed all the recommendations.

Summary

Since some diseases are hereditary and have a genetic nature, they can be prevented in case a person is aware of the existing genetic risks. In case the risks are known, there is an opportunity to implement diverse interventions to reduce the existing risks. By the presented intervention, the patient is expected to change his eating habits to healthier ones and lose weight, which will minimize the risk of developing diabetes. Consequently, an individually-developed intervention has a potential to reduce the risks of genetic diseases..

References

Ali, O. (2013). Genetics of type 2 diabetes. World Journal of Diabetes, 4(4), 114. Web.

Centers for Disease Control and Prevention. (2018). About prediabetes and type 2 diabetes. Web.

Dunkley, A., Bodicoat, D., Greaves, C., Russell, C., Yates, T., Davies, M., & Khunti, K. (2014). Diabetes prevention in the real world: Effectiveness of pragmatic lifestyle interventions for the prevention of type 2 diabetes and of the impact of adherence to guideline recommendations. Diabetes Care, 37(4), 922-933. Web.

Symptoms of type 2 diabetes. (2017). Web.

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