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Effect of Non-Adherence to Management and Co-Commodities and Type of Personality on the Outcome of Type 2 Diabetes Mellitus

Introduction

Background

Diabetes is one of the most pervasive diseases and nowadays is very common among the people. It causes a variety of problems such as anxiety and depression and health issues to the individuals. Diabetes could be categorized into two categories, type 1 and type 2. Both these types of diabetes are dangerous and could put adverse impact on the health if proper precautions have not been taken, and meticulously medication as advised by the doctors is not followed. Due to the metabolic disorder, the symptoms of diabetes 2 Mellitus could be realized. The type 2 Mellitus is responsible for causing various other diseases like blood pressure, cholesterol, and coagulation. It is not a positive condition for the health and body. Obesity is one of the reasons that causes type 2 Mellitus diabetes, and its ratio tends to increase in near future (Brady, Tilden and White, 1996). It is predicted that in the next 20 years, the level of patients who are suffering from diabetes will be increased by 65 percent. It is a huge amount and demands some serious steps to be taken.

The present situation demands huge consideration from the government and other health service providers. Proper actions must be taken so that the negative impacts of diabetes could be reduced effectively. Although proper medication is available for the same, but there is a requirement of bringing appropriate changes in the lifestyle so that diabetes could be prevented. Further, the adherence to the proper medication can also show its impact on minimizing the risks of macrovascular or microvascular complications. With the rise in age, the risk factors also increase and may result in depression. In such situations, depression is required to be handled properly (Fisher, 2005). It could help in controlling the negative implications of diabetes on health.

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The state of depression and anxiety actually disturbs the metabolic functions and effects the medication as well. In the case of type 2 diabetes Mellitus, the problem is worst as the depression causes the fluctuation of blood pressure which is not good for health. Therefore, the state of depression must be avoided. The type 2 diabetes Mellitus is also divided into two types. First one is common among the youngsters and arises due to the poor lifestyle, and most importantly, due to the genetic factors. The old age people are the second type who has more health complications due to the type 2 diabetes Mellitus (Johnson and Stoskopf, 2010). Here in this report, the effect of non-adherence to the medication on the type 2 diabetes will be investigated. Moreover, the impact of anxiety disorder will also be studied with respect to Mellitus. These two factors are also combined with each other as non-adherence to medication is essential for ensuring the proper metabolism functionality. In the current scenario, the whole lot of consideration has been given to the type 2 diabetes Mellitus while analyzing the impact on above mentioned variables.

Literature Review

Introduction

The relevance of literature is huge on shedding proper light on the topic as it allows digging deep down into various available resources. Further, several past studies will be investigated properly so that the right kind of information could be provided. It could strengthen the basis of the study and could increase the intellect.

Diabetes Type 2 Mellitus

Diabetes type 2 Mellitus is a metabolic disorder that can cause serious troubles for the health. Lack of insulin, high blood sugar, and insulin resistance are some of the major characteristics of type diabetes mellitus. The major symptoms of the same are frequent thirst, weight loss, the increment in hunger, frequent urination and so on. The serious complications or the long term effect of diabetes are heart diseases, stroke, and kidney failure. There is a requirement of taking the proper medication else the health aspects could become more complicated (Leslie And Robbins, 1995).

There are various medications or various kinds of treatments available for type 2 diabetes Mellitus. The insulin injections are mostly preferred on the regular basis. Tablets for controlling diabetes and blood or sugar levels could also be useful. The bariatric surgery could also be preferred by the people. Other than these medications, the most suitable and useful techniques are regular exercising, early morning walk, and proper diet plans. These are some of the most useful tactics to prevent the type 2 diabetes mellitus. Among these activities, diet has great expediency in controlling the negative aspects of type 2 diabetes mellitus (Barnett, 2006). The diet must include the proper nourishing food, and the intake of vitamin D is also recommended.

Definition of Non-Adherence

The definition of non-adherence refers to a situation when a person neglects the prescribed diet, exercise, medication, and insulin which are recommended by the service provider. The non-adherence is one of the causes of the type 2 diabetes. There are so many reasons that cause the non-adherence, the major is the carelessness of the patients towards their health, not taking the disease and its implications very seriously, skipping exercise due to the busy lifestyle and so on. In various studies, the rate of non-adherence has been revealed. It is clear that the people who actually start their medication for the very first time they do not give much attention to the disease. Their neglecting behaviour causes serious health issues as they take it very casually. On the contrary, the old age people who have some bad experiences generally seem to be so adhered towards the medication (Leatherman and Sutherland, 2005). Thus, it is clear that the mindset plays an important role in showing dedication and commitment.

Reasons for the Non-Adherence

As mentioned above, carelessness is the major cause which leads towards the non-adherence attitude towards the medication. Further, age is another factor that also leads towards the non-adherence. Many people have the perception that at their age it is not necessary to take medicines. They just skip the medication and continue to live the normal life. Additionally, the lack of information is also needed to be considered while discussing the non-adherence (Lloyd, Braithwaite and Southon, 1999). The patients generally remain unaware of the problems and other health issues that could be raised due to non-adherence. Sometimes the complexities involve in taking the dosages or the frequency of dosage could also make people casual. They forget to take the medicines or become undisciplined towards their diet. The patients do not give much attention towards their health, and this may result in a major fundamental problem. Additionally, the cost factor also needed to be included while discussing for the non-adherence attitude. Due to the high-cost, people give up on the medication and continue to suffer or compromise with their health (Lloyd, Braithwaite and Southon, 1999). Therefore, these are some of the major elements that could be treated as major reasons behind the non-adherences.

Ways to Deal with Non-Adherenc

Various ways could be helpful with respect to dealing with the non-adherence attitude of patients. Firstly, the patients must get proper counselling from the health and service care provider. It could guide the patients to follow the medication properly. The camps could be arranged on the regular basis where the expediency of diet and regular exercise could be explained (Ludhra, 2014). Through educational campaigns also, the people could be educated or informed about the negative implications of non-adherent attitude. In educational campaigns, the initiatives could be taken to spread awareness among the patients. The self-awareness is the ultimate solution to deal with type 2 diabetes. Other than these efforts, the interventions of government and NHS could also be appreciable. The government interventions can speed up the campaigns, and NHS can provide value to the educational programs. To minimize the cost, the government can contribute immensely. The health care service providers need to ensure bringing such mechanism where the medicines and injections could be provided at low cost. The medicines and its dosage must be simple so that it could become possible for the patients to memorize the dosage quantity and its appropriate timing (Narang, 2010). Therefore, these are some of the most useful steps that could be taken to deal with the non-adherent attitude of patients.

Effect of Non-Adherent Attitude on Type 2 Diabetes Mellitus

In the section above, the reasons for non-adherent attitude have been discussed along with the explanation of ways to deal with it articulately. Now it is essential to understand the negative effects of non-adherence management on the outcome of type 2 diabetes Mellitus. It is clear that insulin helps in absorbing the glucose (absorb by cells) and further it results in stimulating the energy. However, in the case of diabetes Mellitus, the body functions in such a way that it loses its ability to produce insulin and use it properly. Thus, it affects the energy gaining efficiency or the capacity of the body. It put a negative impact on most of the parts of the body. The glucose level could not remain proper, and it just affects the functioning of cells. This whole process is known as insulin resistance (Leatherman and Sutherland, 2005). In the long term, the major drawback that could be faced is related to the nerve and kidney damage.

These are the serious implications of non-adherent attitude on the outcome of type 2 diabetes. As mentioned above, the type 2 diabetes causes extra sugar in the blood, so improper medication definitely causes some health issues. Majorly, the eye problems like blindness and glaucoma could be experienced. Skin problems are common along with the gum disease. The tingling in legs could become routine and, later on, it could be termed as a peripheral arterial disease. It is to acknowledge that these diseases are very dangerous as it affects the productivity as well as weaker down the metabolism functioning of the body (Allott and Robb, 1998). The scars could not be healed immediately, and the process becomes slower which further results in infection.

Further, the lack of insulin is responsible for the diabetes ketoacidosis where the body is not able to burn fat. At the later stages, where the non-adherence management is not proper then the body could lose its capacity to gain nutrients from food. The cells do not get any kind of nutrition’s. The cells could be damaged completely, and supply of oxygen could be stopped. Therefore, these are some of the major negative effects of non-adherent attitude to the patients of type 2 diabetes Mellitus. It is very much nefarious for the patients as the chances of losing life increases, and premature death could occur (Brady, Tilden and White, 1996).

Effect of Depression or Anxiety on Type 2 Diabetes Mellitus

Other than the physical and environmental factors, certain psychological factors are also equally responsible for putting the ill impact on the health of patients who are suffering from type 2 diabetes. Out of various psychological problems, the state of depression needs to be considering on the priority basis. It is clear that the depression is the worst mental state where an individual is not attached to any aspect of life. Hence, in such situation element of self-care is absent. The patients are not compliant with the treatment and the medication. It has been noticed that the depressed patients are unaware of their diet, exercise, medication, and regular glucose monitoring. Such kind of non-compliance makes the situation worst for the patients and creates troubles for the health care service providers (Allott and Robb, 1998).

The lifestyle of depressed patients is also not so appreciable which lead towards the birth to various diseases within the body. The problems like increment in cortisol and catecholamine levels could be experienced which further results in the insulin resistance. It is to acknowledge that the mindset of the depressed patient is abnormal which diminishes their awareness towards the self-care. The dietary plans never gain the priority, and stress weakens the body. It results because of ignoring exercise and improper walking routines. These are some of the essential activities which must never be neglected while taking the medication of diabetes. The stressed and depressed patients forget their responsibilities towards themselves and health issues. There are various studies which indicate that depressed patients have the low-level ofHbA1c (Flanagan, 2008). Hence, the psychological state of an individual is required to be perfect to respond well to the medication.

It is to acknowledge that the depressed patients suffer from the acute mental pain and different thought process which is not good for their health. Thus, the combination of depression with the diabetes is dangerous. It prevents the patients to take the right decisions, and it results various other diseases like obesity, addiction, etc. At the same juncture, it is essential to mention that sometimes the medication of depression also affects the diabetic patient adversely (Giordano, 2010). Moreover, the depressed patients also suffer from a variety of personality disorders which also lead towards the eating disorders. Further, the depression stimulates the level of stress and anxiety as well. It leads towards the fluctuated blood pressure and imbalance glucose level within the body. It again put its negative impact on diabetes and chances of strokes increases. Overall, it is easily understandable that both physical and psychological aspects must be handled properly to deal with the type 2 diabetes Mellitus. Thus, these are the certain possible negative impact of depression or anxiety over the outcome of type 2 diabetes mellitus (Koelen, 2004).

Focus and Purpose of the Study

Broadly, the major focus has been given to the medical field and to narrow it down the type 2 diabetes have been studied. Further, the focus will be given to the medication as well. Hence, in current study both physical and psychological aspects will be covered. The relationship between the depression and type 2 diabetes indicates the same. The purpose of the study is to raise awareness among the people towards the type 2 diabetes Mellitus and their lifestyle. Here, the non-adherence includes the negligence of an individual about the medicines, thought process, stress, diet, exercise and so on. Another purpose of the study is to gather adequate information about the type 2 diabetes mellitus.

Aim, Objectives, and Research Questions for the Study

Aim

The major aim of the study is to analyze the effect of non-adherence to medication and depression and anxiety on the type 2 diabetes mellitus.

Objectives

  • To understand the symptoms and causes of type 2 diabetes mellitus
  • To analyse the reasons behind very poor outcome of type 2 diabetes Mellitus
  • To identify the reasons behind the non-adherent attitude of patients
  • To understand the relevance of non-adherence to medication on the treatment of type 2 diabetes Mellitus
  • To identify the impact of depression on the type 2 diabetic patient’s health
  • To recommend various ways to control the negative implications of type 2 diabetes Mellitus

Research Question

  • What are the causes and symptoms of type 2 diabetes mellitus?
  • What are the reasons behind very poor outcome of type 2 diabetes Mellitus
  • Why are patients non-adherent towards their medication?
  • What is the effect of non-adherence to medication on the treatment of type 2 diabetes mellitus?
  • What is the impact of depression on the health of type 2 diabetic patient?
  • How the negative consequences of type 2 diabetes could be controlled?
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Rationale for the Study

The major reason for the study is to investigate the impact of type 2 diabetes on the health of an individual. This reason is justified as it could help further in establishing the relationship of treatment results and medication. The negative aspects of non-adherence to medication could be easily understandable. Another reason is to analyze the impact of depression or the anxiety on the type 2 diabetic patient. The impact of the depressed state of mind could be analyzed with respect to diabetic patients. Therefore, these are major reasons behind the selection of current topic.

Research Methodology

This study is based on proper facts and figures and to strengthen the outcomes of the report the major priority will be given to select the most appropriate research methodologies. The major consideration will be given to the philosophical viewpoint. In the current report, the positivism research philosophy will be selected so that the universal impact of non-adherence to medication and depression could be investigated. The selected approach in the current report is the deductive approach where the whole observation will become the basis of conclusion (Hoy, 2009). The philosophical viewpoint and selected approach are suitable as per the aim and objectives of the study.

Further, the nature of the study will be qualitative which depicts that the study will be lengthy and is based on subjective information. The research design will be exploratory so that the subject matter could be explored in proper and articulated manner. Further, the techniques for the data collection will both secondary and primary sources of data collection. The primary sources of data collection will be questionnaire as various questions will be asked to doctors so that the impact of medication could be investigated properly (Merriam, 2009). The questionnaire will include the questions related to diabetes as well as depression. The sample size will be of 10 doctors which involve both who provide a solution for the psychological problems and the doctors who provide consultation for diabetes.

Along with this, the secondary data will be collected from the various articles and previous studies. The books will be referred to the same. To analyze the data, the thematic analysis will be applied so that the desired outcomes could be gained. The ethical aspects that will be taken into special consideration are that the details of doctors will remain confidential, and it will never be shared under any circumstances. The plagiarism will be avoided as it increases the credibility of the report. Hence, these research trajectories will be followed in current report (Muijis, 2010).

Significance of the Study

The major significance of the study is that with the help of current report the causes of diabetes could be identified. The lifestyle could be improved accordingly. Further, the reasons behind the type 2 diabetes Mellitus could also be identifiable easily. Moreover, the patients could understand the expediency of medication and adherence to their consultation. The awareness level among the patients could be improved significantly. The list of significance also includes that individuals could try to avoid the state of depression as the negative implications will be investigated properly. Hence, these are major significant aspects of the current report.

Tentative Structure of the Report

Chapter 1:Introduction: It is a section that huge role in laying down the foundation for the whole study. It discusses the reasons for conducting this study. The benefits that could be availed along with the aims and objectives of the study also included under this section. Thus, this section must be taken into special consideration.

Chapter 2:Literature Review: Here in a current report this chapter focuses on investigating the various studies that could be helpful with respect to selected subject matter. The previous studies and various articles will be reviewed so that gap could be identified.

Chapter 3: Non-Adherence, Co-Commodities, Medication, and type 2 diabetes mellitus: It is a chapter which is completely based on assessing the impact of non-adherence on medication and state of depression on the type 2 diabetes mellitus. It could provide a detailed understanding of the topic.

Chapter 4:Research Methodology: In this chapter the researcher aimed at applying the methodological practices which are helpful for supporting the report. It deals with the data collection, philosophical views, sampling, and nature of the study.

Chapter 5:Data Analysis: Here the researcher analyzes the data and information with the help of various tools and techniques. The role of nature of the study is immense in selecting the appropriate data analysis technique.

Chapter 6: Findings and Results: On the basis of above-analyzed data or information the researcher proposes the findings or results of the study in this section. It is a major section as the whole study depends on the success of this section.

Chapter 7: Conclusion and Recommendations: At last it is last section that could be helpful to understand the whole study in summarized way. The conclusion is based on the objectives and findings as the researcher tries to establish a relationship between them. The recommendation is based on the problems that will be identified in the report.

References

  • Allott, M. and Robb, M. 1998. Understanding Health and Social Care: An Introductory Reader. SAGE.
  • Barnett. A. 2006. Diabetes: Best Practice & Research Compendium. Elsevier Health Sciences.
  • Brady,W. Tilden, J. and White, G. 1996. Diabetes. Health Research Books.
  • Fisher, A. 2005. Health and Social Care. Heinemann.
  • Flanagan, T. 2008. Health Promotion: A Therapist's Concise Guide to Advertising. Troubador Publishing Ltd.
  • Giordano, S. 2010. Exercise and Eating Disorders: An Ethical and Legal Analysis. Routledge.
  • Hoy, K. W. 2009. Quantitative Research in Education: A Primer. SAGE.
  • Johnson, J. and Stoskopf, C. 2010. Comparative Health Systems: Global Perspectives. Jones & Bartlett Learning.
  • Koelen, M. 2004. Health Education and Health Promotion. Wageningen Academic Pub.
  • Leatherman, S. and Sutherland, K. 2005. The Quest for Quality in the NHS: A Chartbook on Quality of Care in the UK. Radcliffe Publishing.
  • Leslie, R. And Robbins, D. 1995. Diabetes: Clinical Science in Practice. Cambridge University Press.
  • Lloyd, P. Braithwaite, J. and Southon, G. 1999. Empowerment and the performance of health services. Journal of Management in Medicine. 13(2). pp.83–94.
  • Ludhra, S. 2014. Common Sense Guide to International Health and Safety. Routledge.
  • Merriam, B. S. 2009. Qualitative Research: A Guide to Design and Implementation. 3rd ed. John Wiley & Sons.
  • Muijis, D. 2010. Doing Quantitative Research in Education with SPSS. SAGE.
  • Narang, R. 2010. Measuring perceived quality of health care services in India. International Journal of Health Care Quality Assurance. 23(2). pp.171–186.

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