Alin.docx

ENGLISH ASSIGNMENT JOURNAL

Created By : Amalina Nur Fadhilah P1337420217061 Ii B

POLITEKNIK KESEHATAN KEMENTRIAN KESEHATAN SEMARANG PRODI DIII KEPERAWATAN PURWOKERTO 2018

A Metasynthesis of the Self-Management of Type 2 Diabetes Timothy Gomersall,1 Anna Madill,1 and Lucinda K. M. Summers Type 2 diabetes is a metabolic disorder characterized by chronically elevated blood glucose levels and a high risk of cardiovascular disease and other complications affect-ing the eyes, kidneys, and nervous system (Strine et al., 2005). The maintenance of normal blood glucose levels depends on the release and functioning of insulin from the pancreas. For people with type 2 diabetes, the cells targeted by insulin develop resistance to its effects, which results in greater amounts of glucose in circulation. The development of insulin resistance has been linked to a number of lifestyle factors including smoking, sedentari-ness, and high dietary fat intake. Hence, the progression of type 2 diabetes can, in principle, be brought under control if such factors are moderated by patients themselves. Diabetes is a growing challenge for health care systems worldwide. Recent estimates predicted that more than 300 million people will have the condition by the year 2025, increasing from an estimated 150 million in 2000 (King, Aubert, & Herman, 1998; Zimmet, Alberti, & Shaw, 2001). The rapid increase of diabetes has coincided with changes in environment and lifestyle associated with advanced industrialization and globalization , including more sedentary jobs, aging populations, and increased availability of sugary drinks and foods with high fat and salt content (Kolb & Mandrup-Poulsen, 2010; Zimmet et al.). Hence, it has been predicted that the greatest increases in type 2 diabetes are likely to occur in developing countries as they become industrialized and are subjected to the influences of globalization (Wild, Roglic, Green, Sicree, & King, 2004; Zimmet, 2003). For instance, King et al. predicted a rise in diabetes cases between 1995 and 2025 of 42% in the developed world (Europe, North America, Australia, New Zealand, and Japan), and 170% in the rest of the world.

Stroke in Patients With Diabetes The Copenhagen Stroke Study Henrik Stig J0rgensen, MD; Hirofumi Nakayama, MD; Hans Otto Raaschou, MD; Tom Skyh0j Olsen, MD, PhD

Although diabetes is a strong risk factor for stroke, it is still unsettled whether stroke is different in patients with and without diabetes. This is true for stroke type, stroke severity, the prognosis, and the relation between admission glucose levels and stroke severity/mortality. This community-based study included 1135 acute stroke patients (233 [20%] had diabetes). All patients were evaluated until the end of rehabilitation by weekly assessment of neurological deficits (Scandinavian Stroke Scale) and functional disabilities (Barthel Index). A computed tomographic scan was performed in 83%. Results The diabetic stroke patient was 3.2 years younger than the nondiabetic stroke patient (P<.001) and had hypertension more frequently (48% versus 30%, P<.0001). Intracerebral hemorrhages were six times less frequent in diabetic patients (P=.OO2). Initial stroke severity, lesion size, and site were comparable between the two groups. However, mortality was higher in diabetic patients (24% versus 17%, P=.O3), and diabetes independently increased the relative death risk by 1.8 (95% confidence interval [CI], 1.04 to 3.19). Outcome was comparable in surviving patients with and without diabetes, but patients with diabetes recovered more slowly. Mortality increased with increasing glucose levels on admission in nondiabetic patients independent of stroke severity (odds ratio,1.2 per 1 mmol/L; CI, 1.01 to 1.42; P=.O4). This was not the case in diabetic patients. Diabetes influences stroke in several aspects: in age, in subtype, in speed of recovery, and in mortality. Increased glucose levels on admission independently increase mortality from stroke in nondiabetic but not in diabetic patients. The effect of reducing high admission glucose levels in nondiabetic stroke patients should be examined in future trials. (Stroke. 1994;25:1977-1984.)