Glycemic Control and Excess Mortality

Question: Discuss about the Glycemic Control and Excess Mortality. Answer: Introduction: The type 1 diabetes is linked to chronic kidney disease (Inzucchi et al. 2015). Though the mechanism is unknown, the high blood glucose levels damages the glomeruli. There is decreased glomerular filtration rate or albuminuria resulting in chronic kidney disease due to prevailing high blood glucose levels in the body of the patient. In the given case study, Mrs Mallacoota is suffering from type 1 diabetes linked to chronic kidney disease. The diabetes or high blood glucose levels in the body have injured the small blood vessels in the body. Due to this, the kidney is not able to clean the blood efficiently and as a result, more water and salt is retained in the body that resulted in ankle swelling and tiredness in the patient. It has also caused puffy eyes in the patient due to excess fluid and sodium retention. It gets accumulated during sleeping due to gravity and appears puffy after getting up from sleep. Relationship between type 1 diabetes and chronic kidney disease According to Burrow and Ride (2016) there is burden of kidney disease among the Aboriginal population than the non-indigenous population. They are susceptible to diabetes and high blood pressure linked to chronic kidney disease. People above the age of 60, having a high blood pressure or type 1 diabetes are prone to chronic kidney disease due to high blood glucose levels (). The type 1 diabetes harms the kidney functioning. The tiny blood vessels in the filtering units of kidney become narrow and highly clogged due to high blood sugar levels in the body. Therefore, the kidneys get damaged due to decrease in the efficiency of the glomerular filtration rate and there is deposition of salt and water leading to puffiness in eyes and ankles in the patient. Evidence has proved that lifestyle programs that are short term help to keep the high blood sugar levels and high blood pressure in control (Atkinson et al. 2014). The low sodium, potassium and phosphorus in diet, physical exercise, diabetes meal plan, limiting of protein, physical exercise and proper sleep would help Mrs. Mallacoota to keep blood glucose levels under control (Smith et al. 2014). Moreover, she is stressed thinking about her future and that she requires new pair of kidneys. The progressive relaxation therapy would help to manage stress in her and prevent the heart co-morbidities in her (Lind et al. 2014). References Atkinson, M.A., Eisenbarth, G.S. and Michels, A.W., 2014. Type 1 diabetes.The Lancet,383(9911), pp.69-82. Burrow, S. and Ride, K., 2016. Review of diabetes among Aboriginal and Torres Strait Islander people. Mt Lawley (AUST): Edith Cowan University Australian Indigenous Health InfoNet. Inzucchi, S.E., Bergenstal, R.M., Buse, J.B., Diamant, M., Ferrannini, E., Nauck, M., Peters, A.L., Tsapas, A., Wender, R. and Matthews, D.R., 2015. Management of hyperglycemia in type 2 diabetes, 2015: a patient-centered approach: update to a position statement of the American Diabetes Association and the European Association for the Study of Diabetes.Diabetes care,38(1), pp.140-149. Lind, M., Svensson, A.M., Kosiborod, M., Gudbjrnsdottir, S., Pivodic, A., Wedel, H., Dahlqvist, S., Clements, M. and Rosengren, A., 2014. Glycemic control and excess mortality in type 1 diabetes.New England Journal of Medicine,371(21), pp.1972-1982. Smith, L.B., Kugler, B.B., Lewin, A.B., Duke, D.C., Storch, E.A. and Geffken, G.R., 2014. Executive functioning, parenting stress, and family factors as predictors of diabetes management in pediatric patients with type 1 diabetes using intensive regimens.Children's Health Care,43(3), pp.234-252.