Long-term conditions consist of chronic illnesses that cannot be cured, although they can be managed through medication (Carrier 2015). In the United Kingdom (UK), long-term conditions undermine the health status of at least 15 million people. Hence, the need to improve the quality of healthcare provided to the population is inevitable. The leading long-term conditions in the UK include diabetes, arthritis, asthma, persistent obtrusive pulmonary syndrome, and hypertension. The prevalence of long-term illnesses is usually higher among older people compared to younger ones. In this respect, the prevalence of chronic illnesses among individuals above 60 years old is at an alarming 58% compared to the mere 14% among individuals below 40 years old (Wilson & Mayor 2006). Further, older people in the lower social classes are more vulnerable to long-term illnesses compared to their rich counterparts since the prevalence currently stands at 6-% and 30% respectively.
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The National Health Service (NHS) England has put in place measures to facilitate the management of long-term care in the country, especially in older people. Currently, NHS focuses on the instillation of relevant skills that assist people who are suffering from long-term illnesses to manage their health (Newbould et al. 2012). Further, the health body considers the personal needs of individuals affected by long-term diseases in developing care plans (Costello 2009). Diabetes is one of the most worrying long-term conditions in the UK. England has recorded at least a million cases of people diagnosed with diabetes (González et al. 2009). Similar to the case in other countries, the risk of developing diabetes in the UK increases with age. In this respect, the need to enhance the efficiency of treating diabetic patients in the UK is crucial for improving the well-being of the population affected by the long-term condition (McVeigh 2009). Important to note, diabetes is one of the long-term conditions that have put the older population in the UK under the end of life care. As such, this paper provides a critical exploration of the care and treatment of a person with diabetes.
Diabetes: A Long-term Condition
The diabetes condition occurs due to the inability of the body to generate or respond to insulin hormones, thus leading to the abnormal breakdown of carbohydrates, as well as heightened levels of glucose in the blood and urine. The failure to treat high glucose levels can result in the development of complications that threaten the health status of an individual considerably. Type 1 and Type 2 diabetes constitute the two main sorts of long-term conditions. About 90% of individuals diagnosed with diabetes have the Type 2 condition, while the Type 1 sort is reported by the remaining 10% (Cowie et al. 2009). Nonetheless, the two categories of diabetes are critical. Thus, they require proper treatment and management.
The pancreas generates the insulin hormone that is crucial for the effective functioning of an individual’s system. The breakdown of food containing carbohydrates to extract glucose requires insulin to move it to the cells. The cells require glucose to generate energy for a person. Therefore, to keep the body energised unceasingly, the efficient functionality of insulin is significant for maintaining the well-being of a person (Wilson & Mayor 2006).
Several symptoms suggest the development of diabetes on an individual. Early detection of the symptoms of diabetes is crucial for timely medical interventions that can foster the effectiveness of managing the long-term condition. The common symptoms of diabetes include frequent urination, especially at night, increased hunger and thirst, unusual fatigue, effortless weight loss, skin infections, and nausea. Additionally, other symptoms of diabetes include blurred vision and slow healing of wounds (Posnett & Franks 2008).
Diabetes as a long-term illness has a considerable effect on the psychological, physical, and material well-being of an individual besides their family. Adversely, diabetes can lead to the development of other health conditions, including stroke, cardiovascular disease, kidney failure, blindness, and amputation (González et al. 2009). Therefore, the essence of mitigating the prevalence of the long-term condition in countries such as England is important for improving the wellness of the population, a move that can also help to cut healthcare costs.
Notably, proper preventive mechanisms have the potential of hindering the development of Type 2 diabetes while at the same time delaying its onset. Further, the efficient management of the diabetes condition increases an individual’s life expectancy. The need to engage in the proactive, preventive, and patient-centred management of diabetes also reduces the chances of developing related complications. Important to note, self-management is one of the fundamentals of managing the long-term condition effectively (Carrier 2015).
The Prevention of Diabetes
Between the two sorts of diabetes, Type 2 diabetes is on an alarming increase in the UK. Currently, 85% of the people diagnosed with diabetes have the Type 2 condition. Type 1 diabetes claims 15% of the diagnosed population (Newbould et al. 2012). In this concern, the NHS has put in place measures that seek to prevent the prevalence of the two types of diabetes. Additionally, the NHS also focuses on the reduction of inequalities that influence the risk of developing diabetes. The health agency also monitors the effectiveness of various strategies aimed at reducing the prevalence of the life-long condition.
Undoubtedly, it is not possible to modify some of the diabetes risk factors, including family background, advancing age, and ethnic origin. For this reason, the NHS concentrates its preventive efforts on the modifiable risk factors, for instance, obesity and being overweight, physical inactivity, and abnormal body fat distribution (Wilson & Mayor 2006). In this case, the NHS, through its various programmes, has raised awareness regarding the necessary measures to take to prevent and reduce the cases of people developing diabetes. By so doing, the agency underscores the essence of self-management to reduce the chances of developing Type 2 diabetes.
One of the key interventions towards the prevention and reduction of the diabetes condition entails curbing and minimising the prevalence of obesity and overweight cases, as well as central obesity (Newbould et al. 2012; Margerson & Trenoweth 2010). The preventive measures usually prioritise vulnerable populations that have a great chance of developing diabetes. In the UK, the population vulnerable to the prevailing long-term illness includes minority ethnic communities. Through this preventive approach, the NHS encourages the general population to not only embrace healthy dietary habits but also engage in physical activity regularly (Allender et al. 2007). In this regard, strategies such as empowering groups that are vulnerable to diabetes while influencing them to change their lifestyles form some of the crucial preventive mechanisms that can help to reduce the incidence of diabetes.
To foster the effectiveness of the preventive measures, healthcare professionals need to acquire continuous education regarding diabetes, a serious long-term condition. In particular, the NHS supports programmes that seek to educate primary care practitioners. Continuous education usually focuses on risk factors for the two types of diabetes. Education and training also address the relevance of modifying diabetes risk factors as a way of preventing the occurrence of the condition in the UK (González et al. 2009). Moreover, the education offered to primary care experts needs to enlighten them on the working interventions that prevent, treat, and manage overweight and obese people besides the need to increase physical activity (Allender et al. 2007).
The Identification of Individuals with Diabetes
The NHS emphasises the importance of early identification of people with diabetes. In considerable instances, people usually do not know they have diabetes until the adverse health implications start to emerge. In this light, early detection of the long-term illness can curb the onset of related complications. For instance, early identification of Type 1 diabetes reduces the deaths caused by diabetic ketoacidosis (DKA) among children. Therefore, for the sake of fostering early identification of diabetes, the NHS has put in place measures, including raising awareness regarding the symptoms and signs of the long-term condition, regular testing and follow-up of high-risk populations, and opportunistic screening (Wilson & Mayor 2006).
The NHS executes programmes aimed at improving awareness about the signs and symptoms associated with diabetes. The initiatives normally seek to raise the awareness of both the general public and healthcare experts since they are the main stakeholders in managing the diabetes menace in societies such as the UK. Hence, the NHS facilitates the early identification of individuals who have diabetes to foster timely health care services and interventions (Posnett & Franks 2008).
Further, the NHS encourages healthcare institutions in the UK to offer regular testing and follow-up of people predisposed to a high risk of developing diabetes (Posnett & Franks 2008). For this reason, as a management intervention, health organisations should participate in testing and following up of the vulnerable individuals, including the older persons and minority ethnic groups. Additionally, opportunistic screening of individuals exposed to several diabetes risk factors is also integral in facilitating the identification of formerly undiagnosed diabetes. Importantly, the early identification of ineffective glucose regulation is one of the proactive approaches encouraged by the NHS to manage the life-long condition.
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Moreover, initiatives that are geared towards increasing the identification of diabetes in the general population prompt the NHS and partner agencies to engage in plans at the local level (Wilson & Mayor 2006). The local plans integrate a collaborative approach that requires stakeholders to play active roles that enhance the identification of diabetes as a strategy for mitigating the menace of long-term conditions in the UK. The key stakeholders that facilitate the identification of diabetes include NHS staff, primary and community health care staff, hospital staff, cardiology specialists and renal teams, and residential and nursing home staff. Other stakeholders include podiatrists, dentists, optometrists, and pharmacists. The collaboration of the high-risk population as an important stakeholder is equally crucial for reducing the cases of diabetes.
Clinical Care and Management of Diabetic Adults
The provision of clinical services to individuals with diabetes primarily pursues the maximisation of their quality of life entirely (Coulter, Roberts & Dixon 2013). The NHS also advocates for the delivery of quality care services to minimise the risk of triggering the long-term complications associated with diabetes (Carrier 2015). In this case, the NHS requires the health institutions in the UK to provide high-standard care in the entire lifetime of children and adults diagnosed with diabetes (Edge, James & Shine 2008).
Several clinical interventions facilitate the care and management of the diabetes condition among adults (Gately, Rogers & Sanders 2007). Healthcare facilities administer treatments that seek to enhance the control of blood sugar. The clinical intervention is crucial among people diagnosed with either Type 1 or Type 2 diabetes since it curtails the onset of microvascular complications related to the long-term condition (Wilson & Mayor 2006). Improvement of blood sugar regulation also reduces the chances of a diabetic patient to develop cardiovascular disease.
Further, healthcare professionals could apply drugs or treatments that seek to regulate the heightened blood pressure of an individual diagnosed with diabetes, as well as co-existing hypertension (Cowie et al. 2009). The caring approach is essential for lessening the risk of developing related health issues, including microvascular complications and cardiac disease. The administration of medical intervention geared towards controlling the blood pressure of an individual affected directly by diabetes aims at curbing the emergence of other chronic complications that could worsen the health of the patient.
The treatment of adults diagnosed with diabetes also requires the health care provider to pursue the patient to consider ceasing smoking since the habit heightens their chances of acquiring a cardiovascular illness or microvascular complications (Carrier 2015). Notably, the NHS encourages the general population to take part in managing the long-term conditions that undermine the improvement of their health status. Thus, influencing the affected population to change its lifestyle habits to improve the status of health is one of the key strategies towards fostering the efficiency of managing long-term conditions.
Moreover, as a management strategy, health care professionals encourage people with diabetes having high cholesterol levels to engage in practices that cut the cholesterol level in their body (Sutherland & Hayter 2009). The treatment approach aims at preventing the emergence of other long-term conditions, especially cardiovascular disease. Nonetheless, there is a need to enhance the quality of diabetes care in the UK since the current state shows an increase in its prevalence among different sections of the population. In this respect, constant recall and review of adults with diabetes is the right step towards improving the quality of care and management of the long-term condition.
Clinical Care and Management of Diabetic Children
On the other hand, the NHS has put in place measures that ensure the provision of high-standard care and management of children with diabetes in the UK. Importantly, the clinical services administered to kids take into consideration the special needs of the children patient group (Wilson & Mayor 2006). Amid the low prevalence of diabetes among children, the administration of clinical interventions to children facilitates the ability of the patients to effectively manage the issue from a young age through adulthood (Edge, James & Shine 2008). Therefore, the NHS underlines that the transition from paediatric diabetes care and management to adult diabetes services needs to be smooth, thus fostering continued treatment to boost the life expectancy of the individual (Marmot & Wilkinson 2006).
The NHS collaborates with the education sector in facilitating the clinical care and management of children with diabetes in the UK. For this reason, the Department of Health (DH) in the UK encourages education staff to acquire training about the identification of new-onset diabetes among children attending school (Crossland & Dobrzanska 2007). The early recognition of diabetes among children plays a considerable role in preventing the advancement of the condition to diabetic ketoacidosis. Notably, diabetic ketoacidosis is a serious complication of the long-term condition that can lead to death. Therefore, for the sake of prolonging the life expectancy of children experiencing the diabetic condition, education staff and healthcare professionals need to engage in efforts that facilitate the identification of the long-term condition at an early stage before advancing to a level that is difficult to manage (Sutherland & Hayter 2009).
Further, efforts such as the clinical care and management of children with diabetes have seen the NHS collaborate with small intervention groups (Crossland & Dobrzanska 2007). Notably, small intervention groups, including the young people with or without their parents who can advocate for strategies that detect the long-term condition at an early stage, have seen considerable support from the NHS. Such initiatives seek to address practical issues that revolve around the management of diabetes among children. Such forums provide opportunities for guiding and supporting the clinical care approaches, thereby enhancing the acquisition of knowledge regarding the essence of efficient blood sugar control, self-care, and management of the condition (Gately, Rogers & Sanders 2007).
Clinicians usually provide care that is geared towards facilitating the effective regulation of blood sugar to boost the physical growth and development of young people with diabetes (Sutherland & Hayter 2009). Importantly, medical interventions focus on reducing the development of long-term and acute complications related to diabetes. Besides, the NHS oversees the planned transfer of the care and management interventions from the paediatric to adult services. The smooth transition is integral in promoting the efficiency of self-care, as well as enhancing the realisation of desirable outcomes among people affected by the long-term condition.
Notably, the entire healthcare organisations in the UK engage in the assessment of diabetic children and young people. Further, healthcare providers seek the continuous care and management of children, as well as young people with the prevailing long-term condition (Russell et al. 2009). The facilities also put efforts that are geared towards identifying and following up young people and children who are not attending clinical care and management sessions. Moreover, the NHS facilitates the provision of suitable support to young people with diabetes in boarding facilities and care homes among other residential settings.
Improving the Care and Management of People with Diabetes in the UK
Through the NHS, the UK has shown a commitment to improving the delivery of services to people with diabetes (Posnett & Franks 2008). Notably, the health agency focuses on improving the various care and management aspects, including prevention, structured education, care process recommendations, observation of treatment standards, and empowerment. The NHS seeks to cut the rising prevalence of diabetes in the UK. As such, Public Health England implements the preventive strategies recommended by the NHS by carrying out campaigns that seek to bolster prevention and awareness of chronic illnesses, including diabetes (Khunti et al. 2007). In this respect, the NHS Diabetes Prevention Programme and the NHS Health Check constitute the major initiatives implemented to facilitate the prevention of the long-term condition in the UK.
Agencies such as the National Institute for Health and Care Excellence (NICE) emphasise the need for improving patient education in the UK to raise awareness on the proper ways of managing the condition (Russell et al. 2009). Undoubtedly, structured education plays an integral role in minimising the chances of developing complications related to diabetes. The education programmes are important towards improving the care and management of the long-term illness by bolstering knowledge, facilitating the control of blood glucose, underlining the essence of dietary and weight management, psychological health maintenance, and promoting physical activity (Dyson et al. 2011).
The Committee of Public Accounts has also endorsed health care providers in the UK to administer to at least 80% of diabetic patients with the nine recommended care processes to improve the care and management of the long-term illness by March 2018 (Khunti et al. 2007). The recommended processes incorporate a quality improvement approach to diabetes services by reinforcing the aspects of screening, identification, treatment, and follow-up. The recommendations are in line with the treatment standards developed by the NICE. The improvements have also seen more patients admitted in hospitals receive foot examination, reduction of medical errors, and the effective control of blood sugar levels.
Diabetes is one of the long-term conditions that affect a considerable population in the UK. To improve the care and management of people with diabetes, the NHS, among other relevant agencies, offers support programmes to healthcare professionals and other stakeholders who are affected by the health issue. Nonetheless, efforts that are geared towards the prevention, identification, and treatment of people with diabetes required reinforcement to realise a proactive and high-quality approach to attain greater success in combating the prevalence of the public health issue in the UK.
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