dm neuropathy in makati

7/29/2019 Dm Neuropathy in Makati

1/101

ACKNOWLEDGEMENTS

We would like to take this opportunity to give our greatest

gratitude to the people who have given us love and care ever since.

To our parents : Thank you for giving life for us, and for

supporting us morally, emotionally and financially, and we thank

you for being there for us no matter what, we love you with all my

heart;

To our relatives :Thank you for guiding us and being just like

a parent to us, we love you all;

To our friends: Thank you for sharing your life with us and for

giving us right attention and importance and thank you for being

there for us and for giving us suggestions in able for us to finish

this project

To our professor who have given me this task; Thank you for

giving us this project, and with this project we have proven that we

all have discipline and good intention to the group and have given


2/101

us the experience of researching and sharing comments and

suggestions for this project of ours;

And most especially to God ; thank you for guiding us and

giving us these wonderful people around us. Thank you God for

giving us the strength and knowledge in able for us to finish this

project.


3/101

CHAPTER 1

THE PROBLEM AND ITS BACKGROUND

INTRODUCTION

The research is entitled Lifestyle of Diabetes Mellitus Patient

who is high risk in developing DM neuropathy, would focus on the

lifestyle and practices of these patients that is diagnose with

diabetes mellitus. In order to further understand this condition, the

research has been brooded. And to be able to determine the status

of a person with diabetes mellitus, their lifestyle and practices has

been observed and thus, this research came up with using

questionnaire, to be able to hear out their views and understanding

about this disease and what are their lifestyle after diagnose with it.

This research paper would tackle about diabetes mellitus. It

will discuss the meaning of diabetes mellitus, its symptoms , how

one can avoid it and how can we cope up with it. The research

doesnt only tackle about diabetes mellitus but also the lifestyle on

how these patients cope up with this illness.


4/101

Diabetes Mellitus is a disorder of carbohydrate metabolism

characterized by the impaired ability of the body to produce or

respond to insulin and thereby maintain proper levels of sugar

(glucose) in the blood. In diabetes mellitus low insulin levels or

poor response to insulin prevent cells from absorbing glucose. As a

result, glucose builds up in the blood. When glucose-laden blood

passes through the kidneys, the organs that remove blood

impurities, the kidneys cannot absorb all of the excess glucose. This

excess glucose spills into the urine, accompanied by water and

electrolytesions required by cells to regulate the electric charge

and flow of water molecules across the cell membrane. This causes

frequent urination to get rid of the additional water drawn into the

urine; excessive thirst to trigger replacement of lost water; and

hunger to replace the glucose lost in urination. Additional symptoms

may include blurred vision, dramatic weight loss, irritability,

weakness and fatigue, and nausea and vomiting.

We all know that diabetes mellitus is an illness that are well-

known to us, at first hear of this word we always think of people

who take insulin because they are lack of it, and others think of

these people that they always avoid foods with sugar. From this


5/101

research paper, we can be knowledgeable about this illness and

how does these people diagnosed with this illness cope up with it.


6/101

STATEMENT OF THE PROBLEM

The researchers sought to assess the Lifestyle of Diabetes

Mellitus Patients who is high risk in developing DM neuropathy : an

analysis.

Specifically it tries to answer the following questions:

1. What is the profile of the respondents as to:

a. Age

b. Sex

c. Educational attainment

d. Position in the workplace

e. Monthly income

f. Family history of the disease

g. Duration of the illness

2. What are the lifestyle practices of diabetic neuropathy

patient with regards to the following aspects:

2.2 nutrition

2.3 physical ability

2.4 medical regimen

2.5 relationship with others


7/101

2.6 view about self

3. What problems are encountered by patients in terms of:

a. Family relationship

b. Self-care ability

c. Interpersonal relationship


8/101

HYPOTHESIS

Null Hypothesis:

There is no significant relationship between the extent

of perception on the lifestyle and practices on patients who are

diagnose with diabetes mellitus and who is high risk in developing

DM neuropathy with their knowledge and understanding in this kind

of disease.


9/101

SIGNIFICANCE OF THE STUDY

This study entitled the Lifestyle of Diabetes Mellitus Patients

who is high risk in developing DM neuropathy, therefore, the

following will benefit from this study:

Students. They will gain knowledge and understanding on

the history, meaning, and complications of diabetes mellitus.

Teachers. They would be guided accordingly on how to

teach their students about this disease.

Family. They would understand why it is important they

should know about diabetes mellitus and how they can teach their

children to understand this kind of disease.


10/101

SCOPE AND LIMITATION

This study deals mainly with the Diabetic neuropathy patients

of their age, sex, educational attainment, position in the workplace,

monthly income, family history of the disease, and duration of the

illness.


11/101

DEFINITION OF TERMS

Diabetes

medical disorder producing excessive urine: a medical disorder,

especially diabetes mellitus, that causes the body to produce an

excessive amount of urine

Diabetes mellitus

metabolic disorder affecting blood sugar levels: a disorder in which

there is no control of blood sugar, through inadequate insulin

production Type 1 or decreased sensitivity to insulin Type 2,

causing kidney, eye, and nerve damage.

Type 1 usually develops in childhood and requires lifelong injection

of insulin, while Type 2 typically develops in middle age and can

usually be controlled by diet and drugs.

Diabetic

1. having diabetes: having diabetes, especially diabetes mellitus

2. relating to diabetes: relating to or caused by diabetes, especially

diabetes mellitus

3. intended for somebody with diabetes: made without sugar and

therefore suitable for somebody who has diabetes mellitus


12/101

Insulin

hormone regulating glucose level in blood: a hormone produced in

the pancreas that regulates the level of glucose in the blood

Insulin resistance

failure of insulin to function normally: a condition associated with

non-insulin-dependent diabetes in which normal levels of insulin in

the blood do not produce the normal biological response

Illness

1. disease or sickness: a disease, sickness, or indisposition

2. bad health: a state of bad health

Health care

activities to maintain health: the provision of medical and related

services aimed at maintaining good health, especially through the

prevention and treatment of disease

Disease


13/101

1. medical condition: a condition in humans, plants, or animals

that results in pathological symptoms and is not the direct result of

physical injury

2. specific disorder: a disorder in humans, animals, or plants with

recognizable signs and often having a known cause

3. problem in society: a serious problem in society or with a group

of people

Glucose

1. sugar energy source: a six-carbon monosaccharide produced in

plants by photosynthesis and in animals by the metabolism of

carbohydrates.

The commonest form, dextrose, is used by all living organisms.

2. syrupy mixture: a syrup containing dextrose, maltose, dextrin,

and water that is obtained from starch. Use: food manufacture,

alcoholic fermentation.

Lifestyle

manner of living: the way of life characteristic of a particular

person, group, or culture


14/101

Symptoms

indication of illness felt by patient: an indication of a disease

or other disorder, especially one experienced by the patient, e.g.

pain, dizziness, or itching, as opposed to one observed by the

doctor sign

Deficiency

1. shortage: an inadequate supply of something necessary,

especially a nutrient

2. poor provision: a weakness in the provision or performance of

something

serious deficiencies in the provision of cleaning services

3. amount lacking: the amount by which something falls short of

being complete

Complications

1. difficult state: a difficult or confused state caused by many

interrelated factors

2. difficulty: something that makes something else more difficult or

complex

Far from being helpful, this is just a further complication.


15/101

3. introduction of difficulty: the act of making something complex

or difficult

4. plot device: an event or character whose introduction into a

story causes difficulty

5. medical problem: a disease or problem that arises in addition to

the initial condition or during a surgical operation


16/101

CHAPTER 2

REVIEW OF RELATED LITERATURE AND STUDIES

This chapter presents the review related literature and

review related studies utilized for the purpose of enhancing the

premise of the research.

Literature, including research studies related to the present

study were viewed in this chapter.

There is a large collection of literature and studies written

diabetes mellitus topics. Foreign studies as well as local studies are

reviewed and presented in this chapter.


17/101

FOREIGN LITERATURE

According to Smeltzer & Bare(2008), many people with

diabetes mellitus are unaware that they have diabetes. Their

lifestyles are the most important reasons of having the disease.

And because of this, people are unaware that their lifestyle

might contribute a lot. If ever it would be detected, compliance is

poor because it would be difficult for them to change their lifestyle.

If that will happen, is there still a chance for them to fully comply

on prevention regimen of diabetes mellitus?

Diabetes mellitus is a group of metabolic disease

characterized by increased levels of glucose in the blood

(hyperglycemia) resulting from defects in insulin secretion, insulin

action, or both . It is the number 6 leading causes of deaths in USA

according to 2001 data from the United States National Center for

Health Statistics. It is more prevalent in the elderly; as many as 50

% of people older than 65 years of age have some degree of

glucose intolerance. People 65 years and older account for almost

40 % of people with diabetes.


18/101

To understand why insulin is important, it helps to know more

about how the body uses food for energy. Your body is made up of

millions of cells. To make energy, these cells need food in a very

simple form. When you eat or drink, much of your food is broken

down into a simple sugar called glucose. Then, glucose is

transported through the bloodstream to the cells of your body

where it can be used to provide some of the energy your body

needs for daily activities.

The amount of glucose in your bloodstream is tightly

regulated by a hormone called insulin. Insulin is always being

released in small amounts by the pancreas. When the amount of

glucose in your blood rises to a certain level, your pancreas

releases more insulin to push more glucose into the cells. This

causes the glucose levels in your blood (blood glucose levels) to

drop.

To keep your blood glucose levels from getting too low

(hypoglycemia or low blood sugar), your body signals you to eat to

increase glucose levels and releases some glucose from the stores

kept in the liver.People with diabetes either don't make insulin or

their body's cells no longer are able to recognize insulin, leading to


19/101

high blood sugars. By definition, diabetes is having a blood glucose

level of 126 milligrams per deciliter (mg/dL) or more after an

overnight fast (not eating anything) (Nazario, 2003)

Risk factors. Although the causes of diabetes are unknown,

the following risk factors may increase your chance of developing

diabetes. In family history, if a parent or sibling in your family has

diabetes, your risk of developing diabetes increases. Another factor

is the race or ethnic background. The risk of diabetes is greater in

Hispanics, blacks, Native Americans, and Asians. Being overweight,

increase your risk of developing diabetes if you are 20% or more

over your optimal body weight.Hypertension,wherein high blood

pressure increases the risk of developing diabetes.

Abnormal cholesterol levels like HDL, or "good" cholesterol,

levels under 45 mg/dL for men and 55 mg/dL for women, and/or a

triglyceride level over 150 mg/dL increases also your risk. Age is

also a risk of developing diabetes increases progressively as you get

older. Use of certain drugs: Blood pressure medicines, such as

thiazides; Steroid medicines, such as prednisone or Decadron;

Hydantoin medicines, such as Dilantin; Medicines for transplant

recipients, such as cyclosporine, can increase the risk of diabetes.


20/101

Alcohol Use: Years of heavy alcohol intake increases your risk

of developing diabetes. Smoking, according to one study, 16 to 25

cigarettes a day increases your risk for type 2 diabetes to three

times that of a non-smoker. History of gestational

diabetes(developing diabetes during pregnancy) or of delivering a

baby over nine pounds can increase your risk.

Autoimmune disease can cause your body's defense system

(immune system) to attack healthy insulin-producing beta cells in

your pancreas increasing your risk of diabetes. Lastly, Some viruses

are thought to play a part in diabetes development. (Nazario, 2003)

Classification of Diabetes Mellitus. The major

classifications of diabetes are type 1 diabetes, type 2 diabetes,

gestational diabetes, and diabetes mellitus associated with other

conditions or syndromes.

Type 1 diabetes occurs because the insulin-producing cells of

the pancreas (called beta cells) are destroyed by the immune

system. People with type 1 diabetes produce no insulin. They must

use insulin injections to control their blood glucose.


21/101

The damage to the insulin-producing cells in type 1 diabetes

occurs over a variable period of time. However, the symptoms of

type 1 diabetes may occur over a period of days to weeks. Type 1

diabetes most commonly starts in people under the age of 20, but

may occur at any age.

In type 2 diabetes, unlike people with type 1 diabetes, people

with type 2 diabetes produce insulin. However, the insulin their

pancreas secretes is either not enough or the body is unable to

recognize the insulin and use it properly.When there isn't enough

insulin or the insulin is not used as it should be, glucose can't get

into the body's cells.

Type 2 diabetes is the most common form of diabetes

mellitus, affecting almost 16 million Americans. While over 91% of

these cases can be prevented, it remains for adults the leading

cause of related complications such as blindness, non-traumatic

amputations and chronic kidney failure requiring dialysis. Type 2

diabetes usually starts in people over age 40 that are overweight;

but can occur in people who are not overweight. Sometimes


22/101

referred to as "adult-onset diabetes," type 2 diabetes has started to

appear in children because of the rise in obesity in young people.

Gestational Diabetes on the other hand, is triggered by

pregnancy. The condition occurs in 4-7% of all pregnancies.

Hormone changes during pregnancy can affect insulin's ability to

work properly. Pregnant women who have an increased risk of

developing gestational diabetes are those who are over 25 years

old, are above their normal body weight before pregnancy, have a

family history of diabetes or are Hispanic, black, Native American,

or Asian.

Screening for gestational diabetes is important and is

performed during pregnancy. Left untreated, gestational diabetes

increases the risk of complications to both the mother and her

unborn child. Usually, blood glucose levels return to normal within

six weeks of childbirth. However, women who have had gestational

diabetes have an increased risk of developing type 2 diabetes later

in life (Nazario, 2003)

Symptoms of Diabetes Mellitus. The first symptoms of

diabetes are related to the direct effects of high blood sugar levels.


23/101

When the blood sugar level rises above 160 to 180 mg/dL, glucose

passes into the urine. When the level rises even higher, the kidneys

excrete additional water to dilute the large amounts of glucose lost.

Because the kidneys produce excessive urine, a person with

diabetes urinates large volumes frequently (polyuria). The

excessive urination creates abnormal thirst (polydipsia). Because

excessive calories are lost in the urine, the person loses weight. To

compensate, the person often feels excessively hungry

(polyphagia). Other symptoms include blurred vision, drowsiness,

nausea, and decreased endurance during exercise. In addition,

people whose diabetes is poorly controlled are more susceptible to

infections. Because of the severity of insulin deficiency, people with

type I diabetes almost always lose weight before undergoing

treatment. Most people with type II diabetes don't lose weight.

How is diabetes diagnosed?. The fasting blood glucose

(sugar) test is the preferred way to diagnose diabetes. It is easy to

perform and convenient. After the person has fasted overnight (at

least 8 hours), a single sample of blood is drawn and sent to the

laboratory for analysis. This can also be done accurately in a

doctor's office using a glucose meter. Normal fasting plasma

glucose levels are less than 100 milligrams per deciliter (mg/dl).

Fasting plasma glucose levels of more than 126 mg/dl on two or


24/101

more tests on different days indicate diabetes. A random blood

glucose test can also be used to diagnose diabetes. A blood glucose

level of 200 mg/dl or higher indicates diabetes.

When fasting blood glucose stays above 100mg/dl, but in

the range of 100-126mg/dl, this is known as impaired fasting

glucose (IFG). While patients with IFG do not have the diagnosis of

diabetes, this condition carries with it its own risks and concerns,

and is addressed elsewhere.

Though not routinely used anymore, the oral glucose

tolerance test is a gold standard for making the diagnosis of type 2

diabetes. It is still commonly used for diagnosing gestational

diabetes and in conditions of pre-diabetes. With an oral glucose

tolerance test, the person fasts overnight (at least eight but not

more than 16 hours). Then first, the fasting plasma glucose is

tested. After this test, the person receives 75 grams of glucose

(100 grams for pregnant women). There are several methods

employed by obstetricians to do this test, but the one described

here is standard. Usually, the glucose is in a sweet-tasting liquid

that the person drinks. Blood samples are taken at specific intervals

to measure the blood glucose.


25/101

For the test to give reliable results, the person must be in

good health (not have any other illnesses, not even a cold); the

person should be normally active (not lying down, for example, as

an inpatient in a hospital), and the person should not be taking

medicines that could affect the blood glucose. For three days before

the test, the person should have eaten a diet high in carbohydrates

(200-300 grams per day). The morning of the test, the person

should not smoke or drink coffee.

The classic oral glucose tolerance test measures blood glucose

levels five times over a period of three hours. Some physicians

simply get a baseline blood sample followed by a sample two hours

after drinking the glucose solution. In a person without diabetes,

the glucose levels rise and then fall quickly. In someone with

diabetes, glucose levels rise higher than normal and fail to come

back down as fast.

People with glucose levels between normal and diabetic have

impaired glucose tolerance (IGT). People with impaired glucose

tolerance do not have diabetes, but are at high risk for progressing

diabetes. Each year, 1%-5% of people whose test results show

impaired glucose tolerance actually eventually develop diabetes.

Weight loss and exercise may help people with impaired glucose


26/101

tolerance return their glucose levels to normal. In addition, some

physicians advocate the use of medications, such as metformin

(Glucophage), to help prevent/delay the onset of overt diabetes.

Recent studies have shown that impaired glucose tolerance

itself may be a risk factor for the development of heart disease. In

the medical community, most physicians are now understanding

that impaired glucose tolerance is nor simply a precursor of

diabetes, but is its own clinical disease entity that requires

treatment and monitoring.

Evaluating the results of the oral glucose tolerance test

. Glucose tolerance tests may lead to one of the following

diagnoses: Normal response, a person is said to have a normal

response when the 2-hour glucose level is less than 140 mg/dl, and

all values between 0 and 2 hours are less than 200 mg/dl. Impaired

glucose tolerance, a person is said to have impaired glucose

tolerance when the fasting plasma glucose is less than 126 mg/dl

and the 2-hour glucose level is between 140 and 199 mg/dl.

Diabetes, A person has diabetes when two diagnostic tests done on

different days show that the blood glucose level is high. Gestational

diabetes, A woman has gestational diabetes when she has any two

of the following: a 100g OGTT, a fasting plasma glucose of more


27/101

than 95 mg/dl, a 1-hour glucose level of more than 180 mg/dl, a 2-

hour glucose level of more than 155 mg/dl, or a 3-hour glucose

level of more than 140 mg/dl.


28/101

LOCAL LITERATURE

International and local diabetes experts believe that the

disease is emerging, especially among developing countries in Asia.

In the Philippines, the death rate from diabetes has risen by an

alarming 63 percent in 10 years time, from 4.3 per in 1984 to 7.1

per 100,000 population in 1993 (PHS). Local studies have shown

that there is under-reporting of deaths due to diabetes because

they are misclassified as deaths from cardiovascular or renal

disease. A 1995 nationwide prevalence survey on diabetes by the

DOH showed that four

out of 100 Filipinos are diabetics (4.1 percent prevalence). The

prevalence was higher in urban (6.8 percent) than in rural areas

(2.5 percent). The prevalence increases with age with a dramatic

rise observed in the 50 year old age group.

However, about 63 percent of those with the disease were

unaware that they had diabetes. The WHO estimates that diabetes

prevalence in Southeast Asia doubles every 5-10 years based on

the Singapore experience. With this assumption, prevalence of

diabetes in the country today could be in the range of 8-16 percent

and may approximate that of Singapore, an industrialized country

in Southeast Asia.


29/101

The mortality trend for DM is slowly increasing from 3.4

deaths per 100,000

population in 1980 to 14.1 deaths per 100,000 population in 2010.

Prevention and control of the different risk factors in the

development of this disease should be pushed and persons with a

family history of diabetes mellitus should undergo lifestyle

idification.(DOH,2000)

Monitoring blood sugar. If you've just received a

diagnosis of diabetes, monitoring your blood sugar may seem like

an overwhelming task. But once you learn to measure your blood

sugar and understand how important it is, you'll feel more

comfortable with the procedure and more in control of your disease.

Testing is crucial because it tells you whether you're keeping your

glucose levels in the range you and your doctor have agreed on.

The best range for you depends on your age and the type of

diabetes you have. For younger adults who don't have

complications of diabetes, a typical target range might be 80 to 120

mg/dL before meals, and below 180 mg/dL after eating. Older

adults who have complications from their disease may have a

fasting target goal of 100 to 140 mg/dL and below 200 mg/dL after


30/101

meals. That's because blood sugar that falls too low in older adults

can be more dangerous than in younger people.

How often you test your blood sugar depends on the type of

diabetes you have. If you take insulin, test your blood sugar at

least twice a day, and preferably three or four times a day. But if

you have type 2 diabetes and don't use insulin, you may need to

test your blood sugar levels only once a day or as little as twice a

week.

Keep in mind that the amount of sugar in your blood is

constantly changing. Self-monitoring helps you learn what makes

your blood sugar levels rise and fall, so you can make adjustments

in your treatment.

Medications. When diet, exercise and maintaining a healthy

weight aren't enough, you may need the help of medication.

Medications used to treat diabetes include insulin. Everyone with

type 1 diabetes and some people with type 2 diabetes must take

insulin every day to replace what their pancreas is unable to

produce. Unfortunately, insulin can't be taken in pill form because

enzymes in your stomach break it down so that it becomes

ineffective. For that reason, many people inject themselves with

insulin using a syringe or an insulin pen injector ? a device that


31/101

looks like a pen, except the cartridge is filled with insulin. Others

may use an insulin pump, which provides a continuous supply of

insulin, eliminating the need for daily shots.

An insulin pump is a pumping device about the size of a deck

of cards. You wear it outside your body. A small tube connects the

reservoir of insulin to a catheter that's inserted under the skin of

your abdomen. The pump dispenses the desired amount of insulin

into your body and can be adjusted to infuse more or less insulin

depending on meals, activity and glucose level. Insulin pumps

aren't for everyone. But for some people they provide improved

blood sugar control and a more flexible lifestyle.

The most widely used form of insulin is synthetic human

insulin, which is chemically identical to human insulin but

manufactured in a laboratory. Unfortunately, synthetic human

insulin isn't perfect. One of its chief failings is that it doesn't mimic

the way natural insulin is secreted. But newer types of insulin,

known as insulin analogs, more closely resemble the way natural

insulin acts in your body. Among these are lispro (Humalog), insulin

aspart (NovoLog) and glargine (Lantus).

Transplantation. In recent years, researchers have

focused increasing attention on transplantation for people with type


32/101

1 diabetes. Current procedures include: Pancreas

transplantation. Pancreas transplants have been performed since

the late 1960s. Most are done in conjunction with or after a kidney

transplant. Kidney failure is one of the most common complications

of diabetes, and receiving a new pancreas when you receive a new

kidney may actually improve kidney survival. Furthermore, after a

successful pancreas transplant, many people with diabetes no

longer need to use insulin. Unfortunately, pancreas transplants

aren't always successful. Your body may reject the new organ days

or even years after the transplant, which means you'll need to take

immunosuppressive drugs the rest of your life. These drugs are

costly and can have serious side effects, including a high risk of

infection and organ injury. Because the side effects can be more

dangerous to your health than your diabetes, you're usually not

considered a candidate for transplantation unless your diabetes

can't be controlled or you're experiencing serious complications. On

the other hand, pancreas transplantation may be an option if you

are age 45 or younger, have type 1 diabetes and need or have had

a kidney transplant, or if insulin doesn't control your blood sugar.

Islet cell transplantation. Your pancreas contains about 1

million islet cells, 75 percent to 80 percent of which produce insulin.

The beta cells that produce insulin reside in the islets. Although still


33/101

considered an experimental procedure, transplanting these cells

may offer a less invasive, less expensive and less risky option than

a pancreas transplant for people with diabetes. In islet cell

transplantation, doctors infuse fresh pancreas cells into the liver of

the person with diabetes. The cells spread throughout the liver and

soon begin to produce insulin. The liver, not the pancreas, is the

site of the transplant because it's easier to access the large portal

vein in your liver than it is to access a vein in your pancreas. What's

more, cells that grow in the liver secrete insulin much like cells in

the pancreas do.

Dietary Changes. Changing the type and amount of food

eaten can help people with diabetes to lose weight, improve blood

glucose control, and lower blood cholesterol levels and blood

pressure. A separate topic discusses these issues in detail.

Exercise Exercise is beneficial for all individuals, with or

without diabetes. Even persons with longstanding diabetes or

diabetic complications can benefit from exercise.

For diabetics, exercise promotes cardiovascular fitness and

weight loss, lowers high blood pressure, improves lipid profiles,

improves blood glucose control in some cases, and leads to an


34/101

overall sense of well-being. It may even help prevent type 2

diabetes in some people.

General exercise precautions. It is important to balance

enthusiasm and common sense when beginning an exercise

program. These precautions encourage patients to stay safe and

ensure that exercise is productive.

Wear well-fitting, protective footwear, Drink adequate liquids

before, during, and after exercise to prevent dehydration, which

can upset blood glucose levels.

Diabetics who use insulin should also: Measure blood

glucose before, during, and after exercise to determine their body's

typical response to exercise. If the pre-exercise blood glucose

reading is 250 mg/dL or higher, exercise should be postponed until

the level is under control. Consider a decrease in insulin dose by

about 30 percent during exercise. Choose an insulin injection site

away from exercising muscles (for example, avoid the legs if

running) Keeping rapidly absorbed carbohydrates on hand (glucose

tablets, hard candies, or juice). Eat a snack 15 to 30 minutes before

exercise, and again every 30 minutes during exercise.

Eat a source of slowly absorbed carbohydrates (dried fruit,

fruit jerky, granola bars, or trail mix) immediately after exercise.


35/101

This will counter a post-exercise drop in blood glucose levels.

(Microsoft Encarta Reference Library 2004)

Medication and Blood Glucose Monitoring. The day-

to-day management of blood glucose levels can be complicated.

Management may require a schedule of oral medications and/or

insulin, frequent blood glucose monitoring, and carefully planned

meals and snacks.

However, successful management of diabetes does not have

to take the enjoyment out of life. It can be difficult to establish a

routine that incorporates all aspects of diabetes care, though many

people find that the routine becomes second nature once

established. Written schedules may help patients to remember the

details of a routine until they are committed to memory. It is also

important to carefully manage situations that can complicate blood

glucose control, such as sick days and vacations.

People with diabetes may need to take several medications

throughout the day. Medications to lower high blood pressure, lower

cholesterol levels, and low-dose aspirin may be used to manage

and prevent complications. Each prescription should be taken

exactly as directed on a daily basis. If the medication schedule is


36/101

complex, a pill organizer or written outline may be helpful in

remembering to take specific medications at specific times.

Routine Medical Care. Making lifestyle changes is an

excellent step towards diabetes management. However, routine

medical care is important for people with diabetes; this may include

frequent medical appointments and screening tests. Your healthcare

team will periodically reevaluate the diabetes management plan,

and can work to detect health problems that do not cause

symptoms in the early stages.

Finally, it is important to listen to your body and seek care if

questions or problems arise. This may require calling and seeing a

clinician between scheduled appointments. Even persons who have

had diabetes for many years have difficulty some times, and

clinicians are skilled in helping to solve problems. (Imaginus 2001)

Factors of DIET. Diet is one of the most important

factors triggering diabetes mellitus, indeed diabetes mellitus is a

condition in which the blood sugar increases, and so, any diet that

contains carbohydrates (or more specifically sugar), in it, are

directly responsible for increasing the overall blood sugar level.

Diabetes mellitus is not easy to control, proper monitoring of

blood sugar level must be done at all times, so that it is not allowed


37/101

to go up, this is indeed one of the most frustrating aspect of the

disease. The following foods are directly responsible possible for the

development and aggravation of diabetes mellitus and they should

be strictly avoided:

All food containing sugar or jaggery, such as jam, jelly,

marmalade, chocolates, deserts, ice cream, candy, etc.

Honey in all forms

Cola, coke drinks, in all such artificially sweetened cold drinks

Milk, and milk products, including cheese, butter and

condensed milk

Fruits with high sugar content and their juices

Oily foods

Alcoholic beverages, include wines

Factors Related to lifestyle. Diabetes mellitus is a lifestyle

disease. It has been observe that this disease is more rampant in

the upper classes, since they tend to binge more on unhealthy

foods. For this reason diabetes mellitus is termed as a rich man

disease. Expostulating on this trend, it can be said that diabetes

mellitus is more urban disease than a rural disease. People who


38/101

migrate to advance countries stand a higher risk of contracting

diabetes mellitus.

It has been observe that people who lead sedentary lifestyle

are more vulnerable to non- insulin dependent diabetes or diabetes

type 2 such people have unexercised muscles and tissues, which

can affect the overall action of insulin and reduced its capacity in

the utilization of glucose.

STRESS is another very important cause of diabetes mellitus.

In some high risk people, STRESS can cause malfunctioning of the

pancreas, and hence secretion of insulin. Several reasons can bring

on stress and trauma. The following is the most common of the

stress causing factors:

Injury

Surgery

Infections

Pregnancy

Different kinds of mental tension and worries

Environmental and external factor. In many instances,

Diabetes mellitus can be originated from outside the body rather


39/101

than from within. The following are some of the more obvious of

this extrinsic factor:

People who take steroids and other drug that alter the

hormonal balance are very susceptible to diabetes mellitus, as the

amount of insulin can be reduced.

Some people can develop diabetes due to chemical contained

in certain vegetable such as beans.

Infections can also cause diabetes mellitus some

microorganisms can infect the pancreas and reduce its functioning.

The insulin dependent diabetes mellitus or diabetes mellitus type 1

is believed the cause, among other causes, due to the infection of

the coxsackie virus on the pancreas.

Hereditary Factors. Diabetes mellitus shows a very strong

hereditary connection. People who have the human leukocyte

antigen in their blood, which is obtained from the parents, they

have strong propensity towards developing diabetes mellitus type

1. Thought it is believed that diabetes mellitus type 1 is not

hereditary it seen like the disease is more common on people who

have a relative suffering from other of diabetes. Diabetes mellitus

type 2 is definitely hereditary, but it is compounded in future

generations due to other problems such as obesity, hypertension,


40/101

and High blood pressure. People can also get a defective

mechanism from their preceding generation to which the beta cells

of the islets of Langerhans can be impaired in their functions.

Factors Related to age. Though diabetes mellitus can occur

in any age, there are few points to be considered diabetes mellitus

type 2 mostly occurs in the adulthood. It can begin in youth, but its

repercussions on the overall health are found in later stage of life,

when the person riches middle age, on the hand, diabetes mellitus

type 2 was one called juvenile diabetes because it was found to be

prevalent in children and adolescent predominantly, however it

have been found out now that this type of diabetes too can occur

later stage of life.

In this manner, there are several factors that strongly

indicated to be responsible for diabetes mellitus. For this reason,

the prevention and control of the disease become exceeding

difficult. Proper knowledge is needed for the disease.

(Dr. Stephen Pascual 2002)

FOREIGN STUDIES


41/101

Dr.Sandeep Chaudhary, M.D., earned a double board

certification in both Internal Medicine and Pediatrics at Loma Linda

University Medical School and later earned his board certification in

Endocrinology at the University of California, San Diego. He is

currently the Medical Director of Wellspring Endocrinology at

Scripps Memorial Hospital in La Jolla, California.

According to Dr. Chaudhary Diabetes mellitus is a chronic

disease involving abnormalities in the body's ability to use sugar.

Diabetes is characterized by:

Elevated blood sugars for months to years.

Both hereditary and environmental factors leading to its

development and progression.

A relative or absolute deficiency of effective circulating

insulin. Insulin is a substance made by the pancreas which

lowers blood sugar in conjunction with meals. Diabetes is

characterized by either: (1) an inability of the pancreas to

produce insulin (type 1 or insulin-dependent diabetes

mellitus) or an inability of insulin to exert its normal

physiological actions (type 2 or non-insulin dependent

diabetes).
http://www.doctorsontm.com/sandeep-chaudhary-resumehttp://www.doctorsontm.com/sandeep-chaudhary-resume


42/101

Often recognized in patients and their families by excessive

urination, thirst, weight loss and/or a lack of energy. But

diabetes is often silent and may exist for many years without

the individual's noticing it.

Effects certain "target tissues," that is, tissues which are

vulnerable to the damaging effects of chronically high blood

sugar levels. These target tissues are the eye, the kidney, the

nerves and the large blood vessels, such as in the heart.

Dr. Sandeep Chaudhary: When you look at diabetes as a process

of manifesting disease in several stages, in the initial stages the

person develops insulin resistance. This means that your insulin is

not working as efficiently as it should, and consequently your blood

sugars start to rise.

As a secondary consequence, when the pancreas has been

overworked for decades, it starts secreting less and less insulin.

Now you need more insulin, but your pancreas cant make any

more; in fact, it slowly starts to die off because its been

overworked for years.

Research published in the Archives of Internal Medicine in

2006 shows that the practice of the Transcendental Meditation

technique can help during the initial stages, by lowering insulin


43/101

resistance. So even though its true that some damage has been

done to your pancreas over the years of developing diabetes, it

doesnt mean you cant still be helped.

Dr. Sandeep Chaudhary: If someone starts eating healthier

foodssuch as complex carbohydrates, healthier proteins and

cooked vegetables with high fiber contenthis pancreas will tend to

secrete less insulin because he is not stressing his pancreas as

much.

If, on the other hand, he eats junk food, his blood sugars will

go sky high; and because of that the pancreas will have to work

extra hard to secrete more insulin, to bring the sugar

Dr. Sandeep Chaudhary: Most people with Type 2 diabetes

have a family member who also has it. As a nation were getting

more and more obese, and because of that each subsequent

generation has more insulin resistance than the previous

generation. This is one reason why Type 2 diabetes is becoming

more prevalent in children.

Add to that our national habits of eating fast food, exercising

too little and living a stressful lifestyle, and you have a nation that


44/101

is becoming more and more obese and has a higher and higher

incidence of Type 2 diabetes.

This is where the Transcendental Meditation program can

really help, because if people can decrease stress, take time twice a

day to get in tune with their own nature, they might find

themselves thinking, Hey, Im not eating so much all the time, now

that Im not as anxious or stressed, or Lets go for a walk in

nature instead of sitting in front of the TV. Then you start fixing

many of these problems.

According to Dr. Chaudhary Symptoms for Type I dont really

show up until the destruction of the beta cells is almost complete.

The symptoms start to show when the insulin production is almost

done, and then they appear rather suddenly. Symptoms include

frequent urination, excessive thirst, especially for sweet drinks,

extreme hunger along with sudden weight loss, weakness, extreme

fatigue, visual changes especially blurred vision, and irritability.

Severe cases may have no symptoms, then be diagnosed by a

sudden onset of a diabetic coma caused by the extremely high

levels of blood sugar.

According to Dr. Chaudhary Type 2 diabetes is associated

with older age, obesity, family history of diabetes, history of


45/101

gestational diabetes, impaired glucose metabolism, physical

inactivity, and race/ethnicity. African Americans, Hispanic/Latino

Americans, American Indians, and some Asian Americans and

Native Hawaiians or Other Pacific Islanders are at particularly high

risk for type 2 diabetes. Type 2 diabetes is increasingly being

diagnosed in children and adolescents.

Type 2, previously defined as non-insulin-dependent diabetes

mellitus (NIDDM) is the most common form, affecting 90 percent to

95 percent of all people who develop diabetes.An insulin deficiency

or resistance characterizes type 2 diabetes. The symptoms of this

disorder develop gradually and are often overlooked. The Centers

for Disease Control and Prevention (CDC) estimates that nearly 30

percent of the people with type 2 diabetes are undiagnosed.


46/101

LOCAL STUDIES

ALEXANDRIA, Va., Nov. 23 /PRNewswire/ -- Diabetes, long

known to be a costly disease because of high medical expenses and

lost wages, can also take a big bite out of the local economy,

according to a study published in the December issue of Diabetes

Care. Numerous studies have analyzed the direct and indirect costs

of diabetes at the national level. This study, by researchers at

several universities in Texas, examined for the first time the

financial impact of diabetes upon local communities. The study

found that, for every $1 of lost income due to diabetes, another 36

cents is lost in reduced local spending."No matter how you look at

it, diabetes is a costly disease," said lead researcher Dr. H. Shelton

Brown, III, PhD, in the Division of Management Policy and

Community Health at the University of Texas School of Public

Health. "Those costs extend well beyond the price of medical care

and lost wages when people become incapacitated due to illness."

"Adults with diabetes who are not working spend less, hurting the

localeconomy," the study concluded. "In a small community with a

high prevalence of diabetes, the indirect costs of diabetes are quite

high and are not limited to adults with diabetes alone. Given these

results, policies to prevent diabetes should be especially supported


47/101

in communities with a high prevalence of diabetes precisely

because of its broad economic impact on the entire community."

The study looked at the financial impact of lost income due

to diabetes in four counties (Cameron, Hidalgo, Starr and Willacy)

in the Lower Rio Grande Valley of South Texas. In this region, the

largely Mexican-American community has a 25 percent prevalence

of type 2 diabetes. The study was paid for by a grant from the

National Institutes of Health entitled "Creation of a Hispanic Health

Research Center in the Lower Rio Grande." Previous studies have

shown that men and women with diabetes were roughly 7.5 percent

less likely to work than men and women without diabetes; that

women with diabetes earn $3,584.53 less than women without

diabetes; and that men with diabetes earn $1,584.66 less than men

without diabetes (Brown, Pagan and Bastida 2005 and Bastida and

Pagan 2002).

This study showed that, because people with diabetes

worked less, and earned less when they did work, than those who

did not have diabetes, they also spent less in the local economy.

Lower local spending can lead to layoffs and further reduced


48/101

spending by others in the community who do not have diabetes but

are impacted by its cost to the community at large.

Diabetes Care, published by the American Diabetes

Association, is the leading peer-reviewed journal of clinical research

into the nation's fifth leading cause of death by disease. Diabetes

also is a leading cause of heart disease and stroke, as well as the

leading cause of adult blindness, kidney failure and non-traumatic

amputations.


49/101

THEORETICAL FRAMEWORK

Rakel Edwin Robert said that Many people are unaware

that they have diabetes. In the late 20th century, for example, it

was estimated that more than 5 million of the 15.7 million American

cases were undiagnosed. The disease is usually discovered when

there are typical symptoms and a clearly high blood sugar level, as

defined by a daytime level greater than 200 milligrams per decilitre

or a fasting level greater than 140 milligrams per decilitre.

Occasionally a more detailed oral glucose tolerance test is required

for accurate diagnosis.

Before the isolation of insulin in the 1920s, most patients died

within a short time after onset. Untreated diabetes leads to

ketoacidosis, the accumulation of ketones (products of fat

breakdown) and acid in the blood. Continued buildup of the toxic

products of disordered carbohydrate and fat metabolism result in

nausea and vomiting, and eventually the patient goes into a

diabetic coma.

Treatment aimed at controlling diabetes is highly successful.

All patients are put on restrictive diets designed to help them reach

and maintain normal body weight and to limit their intake of sugars

and fats. Frequently they are encouraged to exercise regularly,


50/101

which enhances the movement of glucose into muscle cells and

blunts the rise in blood glucose that follows carbohydrate ingestion.

Diabetics who are unable to produce insulin in their bodies receive

regular injections of the hormone, often customized according to

their individual and variable requirements. In addition to

conventional beef-pork insulinwhich is the pancreatic extract of

pigs and cattlehuman insulin, based on recombinant

deoxyribonucleic acid (DNA) technology, became available for use

in the 1980s.

Research into other areas of insulin delivery include pancreas

transplantation and implantable mechanical insulin infusion

systems. Medications in the form of oral hypoglycemic (blood-

sugar-lowering) agents are also available.

The objective of all forms of treatment of diabetes is to keep

the level of blood sugar within normal limits and thus reduce the

complications, primarily cardiovascular, that account for most

diabetes-related deaths. Other serious complications include a

condition known as diabetic retinopathy (retinal changes that can

lead to blindness), kidney disease, and frequent infection.

According to Jean Weininger, Diabetes Mellitus is often

accompanied by hypertension, high blood triglyceride levels, and


51/101

obesityis an important risk factor for heart disease and also

warrants aggressive intervention. Furthermore, for people with

diabetes who have a heart attack, there is an unusually high death

rate, immediately or in the ensuing years. If blood glucose levels

are strictly controlled, vascular complications will be decreased.

At present no cure exists for diabetes, and scientists are

unsure of the exact cause, although researchers are investigating a

combination of genetic and environmental factors. So far

researchers have identified 20 genes involved in Type 1 diabetes,

and they are working to determine each genes role in causing the

disease. The inheritance patterns of Type 1 diabetes are

complicated, with many different genes influencing a persons risk.

For instance, a gene known as DR plays a role in Type 1 diabetes.

Two forms of this gene, called DR3 and DR4, are present in 95

percent of people with Type 1 diabetes. People who inherit DR3

alone develop diabetes at an older age and have antibodies that

destroy insulin-producing beta cells. Those who inherit DR4 tend to

develop diabetes earlier in life and have antibodies that destroy

insulin. A person with both DR3 and DR4 typically develops diabetes

at a very young age and has the highest level of insulin-destroying

antibodies.


52/101

William A. Redmond cited that researchers were surprised to

find that a variation of a gene called Caplain-10, which is not

involved in glucose metabolism, is associated with the development

of Type 2 diabetes. One form of this gene produces a small amount

of protein, and researchers are studying how this decrease in

protein increases a persons risk for diabetes. Other genetic studies

indicate that certain genes cause a variation of Type 2 diabetes

called maturity onset diabetes of the young (MODY), which

develops in people under the age of 25. Although scientists do not

yet understand how these genes cause MODY, the genes are known

to be active in the liver, intestine, kidney, and pancreas.

Other scientists hope to identify the environmental factors

that trigger Type 1 diabetes in people with a genetic predisposition

for the disease. If they can determine what causes the immune

system to attack the cells that produce insulin, they may discover

how to prevent the condition from developing. For instance, studies

suggest that certain viruses, such as coxsackie B, rubella, and

mumps, may trigger an immune reaction against beta cells or in

some cases directly infect and destroy these cells.

Researchers attribute most cases of Type 2 diabetes to

obesity. Studies show that the risk for developing Type 2 diabetes


53/101

increases by 4 percent for every pound of excess weight a person

carries. Researchers are investigating the exact role that extra

weight plays in preventing the proper utilization of insulin and why

some overweight people develop the disease while others do not.

Research also focuses on transplanting a healthy pancreas or

its insulin-producing beta cells into a person with Type 1 diabetes to

provide a natural source of insulin. Some patients who have

received pancreas transplants have experienced considerable

improvements in their health, but positive, long-term results with

beta-cell transplants have not yet occurred. In both types of

transplants recipients must take drugs that suppress their immune

systems so the body will not reject the new pancreas or cells. These

drugs can cause life-threatening side effects because the patients

body can no longer protect itself from other harmful substances. In

most people with diabetes, these drugs pose a greater risk to

health than living with diabetes. Scientists are also studying the

development of an artificial pancreas and ways to genetically

manipulate non-insulin-producing cells into making insulin.

New methods for accurately measuring blood glucose levels

may improve the quality of life for many individuals with diabetes.

New techniques include the use of laser beams and infrared


54/101

technology. For example, a tiny computer using infrared light can

be used to measure a persons blood sugar level. The computer

automatically delivers the reading to an insulin pump carried on the

diabetics body that injects the appropriate amount of insulin.

Other advances include new drugs that control blood sugar.

In April 2000 the United States Food and Drug Administration (FDA)

approved glargine, an insulin drug that needs to be injected only

once a day. Sold under the brand name Lantus, this drug can be

used by people with Type 1 diabetes, as well as by those with Type

2 diabetes who require insulin injections. And, as mentioned earlier,

in 2006 the FDA approved a form of insulin that can be inhaled.

Physicians have long known that some insulin-dependent diabetics

fail to take the drug as often as needed because of the discomfort

of injections. Doctors hoped the inhalant form of insulin would lead

to better patient compliance.

A number of drugs have been developed to help people with

Type 2 diabetes. Examples include acarbose, (sold under the brand

name Precose), which controls blood sugar by slowing the digestion

of carbohydrates; and metformin (sold under the brand name

Glucophage), which controls liver production of sugar, causes

weight loss, and reduces total cholesterol. Pioglitazone (brand


55/101

name, Actos) and rosiglitazone (brand name, Avandia) are drugs

that make the cells more sensitive to insulin.


56/101

CONCEPTUAL FRAMEWORK

INPUT PROCESS OUTPUT

FIGURE 1

Profile of the

respondents in terms of:

AgeSexEducational attainment

Position (work)

Monthly incomeFamily history in this

disease

Length of having the

illness

Lifestyle perceive in

terms of:

Nutrition

ExerciseTherapeutic regiment

Activities of daily living

Relationship with othersViews in life

Questionnaire

Descriptive survey

Statistical treatment

The lifestyle of diabetes

mellitus patients their

knowledge and practices

in coping on it is provenin this thesis.


57/101

PARADIGM OF THE STUDY

Figure 1 describes the conceptual framework of the study

wherein the input is consisting of the following: Age, Sex,

Educational attainment, Position (work), Monthly income, Family

history in this disease, and Length of having the illness, it also

includes the Lifestyle perceive of the patients in terms of: Nutrition,

Exercise, Therapeutic regiment, Activities of daily living,

Relationship with others and Views in life.

On the other side, the process being used is through

questionnaire, descriptive-survey and statistical treatment such as

percentage, mean and tallied. The output is the lifestyle of diabetes

mellitus patients their knowledge and practices in coping on it.

The researchers want to find out the lifestyle of diabetes mellitus

patients their knowledge and practices in coping on it. The table

shows how the researchers researched, surveyed and solved their

thesis statement.


58/101

CHAPTER 3

METHODS OF RESEARCH

This chapter presents the procedures used the

subject/respondents and how they were chosen the techniques in

the collection of the data and the statistics in the treatment of the

data.

RESEARCH DESIGN

The research used the survey method. Specifically, questions

were used as the techniques and questionnaires to be answered

were diabetes mellitus patients as an instrument. The survey

method goes beyond mere gathering and tabulation of data. It

involves the elements of interpretation of the meaning or

significance of what is being described. Thus, it is often combined

with comparison and contrast involving measurement,

classification, interpretation and evaluation. Through the use of

survey, the researchers were able to gather directly, first hand

information about the subject study. This kind of information is

more accurate, more valid and more reliable than any other

information.


59/101

The survey method is used as instrument, specifically in case

studies through giving of questionnaire to be read and answered by

the respondents. This is used when an extensively thorough and

comprehensive study of a particular individual, group, institution

involved over a period of time.

The researchers used structured type of questionnaire

wherein it involves questions pertinent to the study. The analysis

of the respondents helped the researcher to gather factual and

accurate data.

RESEARCH LOCALE

The respondents of the study are patients who are diagnosed

with diabetes mellitus who is high risk in developing DM

neuropathy. We choose them to be able to justify our findings

about their lifestyle and practices after finding out about their

health having a disease like this.

There would be 50 respondents who are diagnosed with

diabetes mellitus from different hospitals in Makati namely,

Makati Medical Center, Medical City and Ospital ng Makati.


60/101

DATA GATHERING

For the collection of data, the researchers used volunteer

sampling as part of their sample strategy. The researchers have

had one hundred students from the two selected schools volunteer.

The researchers conducted the study at separate dates,

because the survey cannot be done simultaneously in the two

schools. During the students vacant periods, the researchers asked

their permission to take part in this study as respondents.

ANALYSIS

All data gathered were presented a tabular form using a

simple statistical tool in analyzing the data. The frequency and

percentage were arrived at by applying the formula below:

P= f/n X 100

Where : P = resulting change

F = Frequency and

N = total number of respondents


61/101

WM= x/n

Where: WM = weighted mean

X = sum total of answers

Order each variable

N = total number of respondents


62/101

CHAPTER 4

PRESENTATION ANALYSIS AND INTERPRETATION OF DATA

This chapter reveals the presentation, analysis and

interpretation of the data gathered by the researchers from the

respondents regarding their lifestyle when they have been

diagnosed by diabetes mellitus.


63/101

TABLE 1

AGE OF THE RESPONDENTS

CATEGORIES RESPONDENTS %

20-25 10 20

26-30 12 24

31-35 18 36

36-above 10 20

TOTAL 50 100%

The table shows the distribution of the respondents according

to age group.

This table shows that there are more respondents who had

diabetes mellitus who aged 31-35.


64/101

DISTRIBUTION OF THE RESPONDENTS ACCORDING TO PIE

GRAPH


65/101

TABLE 2

SEX OF THE RESPONDENTS


MALE 35 70

FEMALE 15 30

TOTAL 50 100%

This table shows that there are more male respondents who

had diabetes mellitus with 35 in numbers and with 70% out of

100%.


GRAPH


66/101

TABLE 3

EDUCATIONAL ATTAINMENT


High school graduate 5 10College level 8 16

College graduate 29 58

Others/vocational 8 16

TOTAL 50 100%

This only shows that 58% out of 100% respondents are

college graduate and this means that they are knowledgeable about

their disease


67/101


GRAPH


68/101

TABLE 4

POSITION AT WORK


Staff/Crew 4 8Medical field 3 6

Technology field 2 4

Others/entrepreneur 41 82

TOTAL 50 100%

This only shows that 82% of the respondents is self-employed

or they are entrepreneur, they have hold their own time, and rather

can support themselves on maintaining their health after

discovering they had diabetes mellitus.


69/101


GRAPH


70/101

TABLE 5

MONTHLY INCOME


5,000-10,000 5 1011,000-20,000 14 28

21,000-30,000 29 58

30,000-above 2 4

TOTAL 50 100%

This means that these people, some of them are insulin

dependent, can ensure or rather support their expenses for their

diabetes mellitus maintenance.


71/101


GRAPH


72/101

TABLE 6

FAMILY HISTORY IN THIS DISEASE


Father 10 20Mother 12 24

Father side 18 36

Mother side 10 20

TOTAL 50 100%

The table shows the family history of the respondents

according to group. The respondents who had a father and

relatives from their mother side with diabetes mellitus is 20%, 24%

respondents claimed that their mother has diabetes mellitus, and

on the highest rank in the group is relatives with diabetes mellitus

on their fathers side.

This table means that all of the respondents acquired their

diabetes mellitus from familial tendency or it is in the genes.


73/101


GRAPH


74/101

TABLE 7

LENGTH OF HAVING THE DISEASE


0-5 years 5 106-10 years 14 28

11-15 years 29 58

16 years-above 2 4

TOTAL 50 100%

The table shows the patients length of the having the disease,

11-15 years is the highest, meaning that 58% of the respondents

already know their disease even before it is diagnosed.


75/101


GRAPH


76/101

TABLE 8

AWARENESS OF THE RESPONDENTS TO QUESTIONS

does your daily routine is affected when you are diagnosed

with the diabetes mellitus?

CATEGORIES FREQUENCY PERCENTAGE

YES 35 70

NO 9 18

MAYBE 6 12TOTAL 50 100%

70 percent answers that they agree that their daily routine is really

affected, most of them answers that their routines are decreased.


77/101


78/101

TABLE 9


does your diet or way of eating affected?


YES 35 70

NO 9 18

MAYBE 6 12

TOTAL 50 100%

70 percent said that their dies is really affected after they are

diagnosed with the disease.


79/101


GRAPH


80/101

TABLE 10


do you think that diabetes mellitus affects views in life?


YES 27 54

NO 8 16

MAYBE 15 30

TOTAL 50 100%

27 our of 50 respondents nodded with this question, meaning that

after they know that they have diabetes mellitus they have changed

their views in life, but still they remain energetic for the time being.


81/101


GRAPH


82/101

TABLE 11


are you informed about the causes of this disease?


YES 45 90

NO 0 0

MAYBE 5 10

TOTAL 50 100%

Accordingly, this only shows that most of the respondents are

informed with the cause of the disease.


83/101


GRAPH


84/101

TABLE 12


are you aware that you might have DM neuropathy?


YES 3 7

NO 26 52

MAYBE 21 41

TOTAL 50 100%

52 percent of the respondents that not aware that they might have

infections, 41 percent said that maybe they do know and only 7

percent relatively answers yes.

Meaning these respondents doesnt know that they might have

infection after having a diabetes mellitus


85/101


GRAPH


86/101

TABLE 13


do you think that not having this disease will decrease your

sexual drive?


YES 50 100%

NO 0 0

MAYBE 0 0TOTAL 50 100%

All of the 50 respondents agrees that they will loose their sex drive

because of this disease.


87/101


GRAPH


88/101

CHAPTER 5

SUMMARY, CONCLUSION & RECOMMENDATION

SUMMARY

Diabetes is detected by measuring the amount of glucose in

the blood after an individual has fasted (abstained from food) for

about eight hours. In some cases, physicians diagnose diabetes by

administering an oral glucose tolerance test, which measures

glucose levels before and after a specific amount of sugar has been

ingested.

Once diabetes is diagnosed, treatment consists of controlling

the amount of glucose in the blood and preventing complications.

Depending on the type of diabetes, this can be accomplished

through regular physical exercise, a carefully controlled diet, and

medication.

Individuals with Type 1 diabetes must receive insulin, often

two to four times a day, to provide the body with the hormone it

does not produce. Insulin cannot be taken orally, because it is

destroyed in the digestive system. Consequently, insulin-dependent

diabetics have historically injected the drug using a hypodermic

needle or a beeper-sized pump connected to a needle inserted

under the skin. In 2006, the United States Food and Drug


89/101

Administration approved a form of insulin that can be inhaled and

then is absorbed by blood in the lungs.

The amount of insulin needed varies from person to person

and may be influenced by factors such as a persons level of

physical activity, diet, and the presence of other health disorders.

Typically, individuals with Type 1 diabetes use a meter several

times a day to measure the level of glucose in a drop of their blood

obtained by pricking a fingertip. They can then adjust the dosage of

insulin, physical exercise, or food intake to maintain the blood sugar

at a normal level. People with Type 1 diabetes must carefully

control their diets by distributing meals and snacks throughout the

day so as not to overwhelm the ability of the insulin supply to help

cells absorb glucose. They also need to eat foods that contain

complex sugars, which break down slowly and cause a slower rise

in blood sugar levels.

Although most persons with Type 1 diabetes strive to lower

the amount of glucose in their blood, levels that are too low can

also cause health problems. For example, if a person with Type 1

diabetes takes too much insulin, it can produce low blood sugar

levels. This may result in hypoglycemia, a condition characterized

by shakiness, confusion, and anxiety. A person who develops


90/101

hypoglycemia can combat symptoms by ingesting glucose tablets or

by consuming foods with high sugar content, such as fruit juices or

hard candy.

In order to control insulin levels, people with Type 1 diabetes

must monitor their glucose levels several times a day. In 1983 a

group of 1,441 Type 1 diabetics aged 13 to 39 began participating

in the Diabetes Control and Complications Trial (DCCT), the largest

scientific study of diabetes treatment ever undertaken. The DCCT

studied the potential for reducing diabetes-related complications,

such as nerve or kidney disease or eye disorders, by having

patients closely monitor their blood sugar levels four to six times a

day, maintaining the levels as close to normal as possible. The

results of the study, reported in 1993, showed a 50 to 75 percent

reduction of diabetic complications in people who aggressively

monitored and controlled their glucose levels. Although the study

was performed on people with Type 1 diabetes, researchers believe

that close monitoring of blood sugar levels would also benefit

people with Type 2 diabetes.

For persons with Type 2 diabetes, treatment begins with diet

control, exercise, and weight reduction, although over time this

treatment may not be adequate. People with Type 2 diabetes


91/101

typically work with nutritionists to formulate a diet plan that

regulates blood sugar levels so that they do not rise too swiftly

after a meal. A recommended meal is usually low in fat (30 percent

or less of total calories), provides moderate protein (10 to 20

percent of total calories), and contains a variety of carbohydrates,

such as beans, vegetables, and grains. Regular exercise helps body

cells absorb glucoseeven ten minutes of exercise a day can be

effective. Diet control and exercise may also play a role in weight

reduction, which appears to partially reverse the bodys inability to

use insulin.

For some people with Type 2 diabetes, diet, exercise, and

weight reduction alone may work initially, but eventually this

regimen does not help control high blood sugar levels. In these

cases, oral medication may be prescribed. If oral medications are

ineffective, a person with Type 2 diabetes may need insulin doses

or a combination of oral medication and insulin. About 50 percent of

individuals with Type 2 diabetes require oral medications, 40

percent require insulin or a combination of insulin and oral

medications, and 10 percent use diet and exercise alone.

And thus, diabetes mellitus does not affect the daily activities

of the person diagnosed with it. Thus, they reduced these activities


92/101

and have several changes in dies especially the people who are

insulin dependent.


93/101

CONCLUSION

According to the information gathered the following are the

conclusions drawn:

At present no cure exists for diabetes, and scientists are

unsure of the exact cause, although researchers are

investigating a combination of genetic and environmental

factors;

A person with both DR3 and DR4 typically develops diabetes

at a very young age and has the highest level of insulin-

destroying antibodies.

New methods for accurately measuring blood glucose levels

may improve the quality of life for many individuals with

diabetes.

some insulin-dependent diabetics fail to take the drug as

often as needed because of the discomfort of injections.

If left untreated, diabetes mellitus may cause life-threatening

complications.


94/101

Blockages of large blood vessels in diabetics can lead to many

cardiovascular problems, including high blood pressure, heart

attack, and stroke.

RECOMMENDATION

After writing the conclusions the following are recommended

to read the research:

PERSON WHO ARE DIAGNOSED WITH DIABETES MELLITUS

PERSON WHO HAS RELATIVES WITH DIABETES MELLITUS

CLINICAL INSTRUCTOR

NURSING STUDENTS

This research would give them information about the disease

and how to cope up with it, and the changes it does to our lifestyle.


95/101

REFERENCES

1. Close, EJ, Wiles, PG, Lockton, JA, et al. The degree of day-to-

day variation in food intake in diabetic patients. Diabet Med 1993;

10:514.

2. Pan, XR, Li, GW, Hu, YH, et al. Effects of diet and exercise in

preventing NIDDM in people with impaired glucose tolerance. The

Da Qing IGT study. Diabetes Care 1997; 20:537.

3. American Diabetes Association. Nutritional Recommendations

and Principles for People with Diabetes Mellitus. Diabetes Care

1994; 17:519.

4. Torjesen, PA, Birkeland, KI, Anderssen, SA, et al. Lifestyle

changes may reverse development of the insulin resistance

syndrome. The Oslo diet and exercise study: A randomized trial.

Diabetes Care 1997; 20:26.
http://www.uptodate.com/patients/content/abstract.do?topicKey=~btiSIVAV2lvR5&refNum=1http://www.uptodate.com/patients/content/abstract.do?topicKey=~btiSIVAV2lvR5&refNum=1http://www.uptodate.com/patients/content/abstract.do?topicKey=~btiSIVAV2lvR5&refNum=1http://www.uptodate.com/patients/content/abstract.do?topicKey=~btiSIVAV2lvR5&refNum=2http://www.uptodate.com/patients/content/abstract.do?topicKey=~btiSIVAV2lvR5&refNum=2http://www.uptodate.com/patients/content/abstract.do?topicKey=~btiSIVAV2lvR5&refNum=2http://www.uptodate.com/patients/content/abstract.do?topicKey=~btiSIVAV2lvR5&refNum=3http://www.uptodate.com/patients/content/abstract.do?topicKey=~btiSIVAV2lvR5&refNum=3http://www.uptodate.com/patients/content/abstract.do?topicKey=~btiSIVAV2lvR5&refNum=3http://www.uptodate.com/patients/content/abstract.do?topicKey=~btiSIVAV2lvR5&refNum=4http://www.uptodate.com/patients/content/abstract.do?topicKey=~btiSIVAV2lvR5&refNum=4http://www.uptodate.com/patients/content/abstract.do?topicKey=~btiSIVAV2lvR5&refNum=4http://www.uptodate.com/patients/content/abstract.do?topicKey=~btiSIVAV2lvR5&refNum=4http://www.uptodate.com/patients/content/abstract.do?topicKey=~btiSIVAV2lvR5&refNum=1http://www.uptodate.com/patients/content/abstract.do?topicKey=~btiSIVAV2lvR5&refNum=1http://www.uptodate.com/patients/content/abstract.do?topicKey=~btiSIVAV2lvR5&refNum=1http://www.uptodate.com/patients/content/abstract.do?topicKey=~btiSIVAV2lvR5&refNum=2http://www.uptodate.com/patients/content/abstract.do?topicKey=~btiSIVAV2lvR5&refNum=2http://www.uptodate.com/patients/content/abstract.do?topicKey=~btiSIVAV2lvR5&refNum=2http://www.uptodate.com/patients/content/abstract.do?topicKey=~btiSIVAV2lvR5&refNum=3http://www.uptodate.com/patients/content/abstract.do?topicKey=~btiSIVAV2lvR5&refNum=3http://www.uptodate.com/patients/content/abstract.do?topicKey=~btiSIVAV2lvR5&refNum=3http://www.uptodate.com/patients/content/abstract.do?topicKey=~btiSIVAV2lvR5&refNum=4http://www.uptodate.com/patients/content/abstract.do?topicKey=~btiSIVAV2lvR5&refNum=4http://www.uptodate.com/patients/content/abstract.do?topicKey=~btiSIVAV2lvR5&refNum=4


96/101

DICTIONARY

5. Word power dictionary pp 499 vol iv 4998

6. The new lexicon websters dictionary ; 1995 vol II pp579

7. World book dictionary pp 487 year 1995

8. Readers digest word dictionary ; first edition 1998 pp 135

9. The new websters dictionary of the English language ;

international edition 1995 pp 104


97/101

QUESTIONNAIRE

INSTRUCTION: Please fill up the data by placing a check on the

space provided. (no erasure)

AGE OF THE RESPONDENTS

_____20-25

_____26-30

_____31-35

_____36-above

SEX OF THE RESPONDENTS

_____MALE

_____FEMALE


98/101

EDUCATIONAL ATTAINMENT

_____High school graduate

_____College level

_____College graduate

_____Others/vocational

POSITION AT WORK

_____Staff/Crew

_____Medical field

_____Technology field

_____Others/entrepreneur

MONTHLY INCOME

_____5,000-10,000

_____11,000-20,000

_____21,000-30,000

_____30,000-above


99/101

FAMILY HISTORY IN THIS DISEASE

_____Father

_____Mother

_____Father side

_____Mother side

LENGTH OF HAVING THE DISEASE

CATEGORIES

_____0-5 years

_____6-10 years

_____11-15 years

_____16 years-above

does your daily routine is affected when you are diagnosed with

the diabetes mellitus?

_____YES

_____NO

_____MAYBE


100/101

does your diet or way of eating affected?

_____YES

_____NO

_____MAYBE

do you think that diabetes mellitus affects views in life?

_____YES

_____NO

_____MAYBE

are you informed about the causes of this disease?

_____YES

_____NO

_____MAYBE


101/101

are you aware that you might have DM neuropathy?

_____YES

_____NO

_____MAYBE

do you think that not having this disease will decrease your sexual

drive?

_____YES

_____NO

_____MAYBE

dm neuropathy in makati

Documents