Controlling the Risk Factors in Diabetic Patient in United Arab Emirates and Australia and Adherence to Insulin in Controlling the Long Term Complications a Cross Cultural Comparison

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TABLE OF CONTENTS

CHAPTER ONE: LITERATURE REVIEW1

1.1Introduction1

1.2Symptom of diabetes2

1.2.1Constant fatigue and sleepiness2

1.2.2Increase thirst3

1.2.3Skin diseases3

1.2.4Deterioration of vision3

1.2.5Weight gain4

1.3Types of diabetes4

1.3.1Type 1 diabetes4

1.3.1.1Symptoms of type 1 diabetes5

1.3.2Type 2 diabetes6

1.3.2.1Symptoms of type 2 diabetes7

1.3.3Gestational Diabetes7

1.3.4Diabetes secondary8

1.4Complications in diabetes8

1.4.1Degenerative complications9

1.4.2Dermatologic complications9

1.4.3Acute complications10

1.4.3.1Eye disorders10

1.4.3.2Neuropathy11

1.4.3.3Susceptibility to infection11

1.4.3.4Cardiovascular disease11

1.5Statistics complications caused by diabetes12

1.6Treatment of diabetes13

1.6.1Treatment of type 1 diabetes14

1.6.2Treatment of type 2 diabetes15

1.7Prevention of diabetes16

1.7.1Primary prevention16

1.7.2Secondary preventions17

1.8Strategies to reduce diabetes17

1.8.1Healthy weight18

1.8.2Balanced diet18

1.8.3Promote fibres18

1.9Insulin19

1.10Global diabetic statistics20

1.11Diabetes in UAE22

1.12Diabetic issues in UAE23

1.13Use of insulin by diabetic patients in UAE24

1.14Diabetes in Australia25

1.15Diabetic issues in Australia25

1.16Use of insulin by diabetic patients in Australia26

1.17Risk Factors27

1.17.1Lack of Exercise28

1.17.2Inappropriate Nutrition30

1.17.3Genetics31

1.18Comparison of Risk Factors in Australia and UAE32

1.18.1Australia32

1.18.2United Arab Emirates34

1.19Prevention35

1.19.1Primary and Secondary Prevention39

1.19.2Components of Primary Prevention Interventions for Diabetes39

1.20Lifestyle, Exercise and Diet44

1.21 Controlling long-term Diabetic Complications53

1.22. Effects of Complications59

1.23. Prevention of Diabetic Complications60

1.24. Approaches to Treatment64

1.24.1. The Conventional Approach64

1.24.2. Wellness Approach65

1.24.3. Integrative Lifestyle Therapy Approach66

1.24.4. Nutritional Therapy66

1.24.5. Initiation and Evaluation of Diet Therapy67

1.24.6. Vegetarian Diet for IDDM67

1.24.7. Exercise Prescription67

1.24.8. Benefits of Exercise68

1.25Insulin Therapy70

1.26 Adherence to Diabetic Treatment Regimens71

1.27Factors affecting adherence72

1.28 Methods for measuring adherence74

1.29Summary75

CHAPTER TWO: EXPERIMENTAL DESIGN82

2.1Introduction82

2.2Aim83

2.3Objectives83

2.4Overall research questions83

2.5Research Hypothesis84

2.6Conceptual Framework84

2.7Rationale90

2.8Methodology91

2.9Research Design91

2.10Research Approach93

2.11Data Collection Method97

2.12Research Instrument99

2.13Observational Method103

2.14Sampling Method103

2.15Participants and Sample size104

2.16Recruitment104

2.17Data Analysis105

2.18Transferability105

2.19Triangulation106

2.20Reliability and Validity107

2.21Ethical Considerations111

REFERENCES114

APPENDIX155

Questionnaire155

CHAPTER ONE: LITERATURE REVIEW

Introduction

Diabetes mellitus has been derived from ancient Greek word “Diabainein” which means pass or to flow through. Many studies have been conducted which have also argued that diabetes has been derived from a Latin word, which refers to the name of a group of metabolic diseases and which represents the excretion of sugar in urine (Engelgau, 2002, pp 1159)

Diabetes mellitus is a disease which is referred to as metabolic disease, characterized by an abnormal increase of sugar or glucose in the blood. Glucose is the main source of energy in the body but, when excessive, can have various health complications such as excessive sleep at an early stage, fatigue and physical problems, which further creates difficulty in performing the desired tasks (Smith, 1999, pp 198). The studies have proved that if diabetes is not treated properly, various kinds of complications can occur such as heart attack, stroke, kidney failure, vision problems and amputation of the foot lesions. Although there is no definitive cure for diabetes, there are various new and innovative treatments available which can be followed on a regular basis and can provide healthy and quality of life to the patient (Tessier, 2010, pp 45)

In short it can be stated that diabetes is referred to the group of metabolic diseases in which there is hyperglycemia, or high blood sugar. Diabetes mellitus is also referred to a group of endocrine disease which is a result of lack of hormone insulin in the human body. It also occurs due to hyperglycemia, which means that there is a persistent increase in the entire content of glucose in the blood. In short Diabetes mellitus has adverse impact carbohydrate, fat, protein, mineral and water and salt, contained ...