Patient Mrs. Gulcin Ozdemir Primary

¶ … Patient

Mrs. Gulcin Ozdemir

Primary care

Primary care for a patient with type II diabetes requires the treatment of the immediate physical symptoms of the illness, limiting the risks for the exacerbation of the illness in the future, and addressing the psychological and lifestyle issues contributing to the disorder. "In the UK the delivery of primary care is via GP services," (Primary care, a Dictionary of Nursing, 2011). General Practitioners must prescribe a self-care regime that a patient can use to manage diabetes on a daily basis. "If a patient sees a provider for a 10- or 15-minute office visit four times a year, that's equivalent to an hour of interaction annually. But the patient lives with diabetes 8,760 hours a year. Providers diagnose, prescribe and adjust medications, and monitor for complications, but it's the patient who manages the disease every day" (Peeples & Seley 2007). It is extremely troubling that Mrs. Ozdemir believes that the 'tablets' she has been prescribed will cure her.

The GP must make Mrs. Ozdemir cognizant of the nature of diabetes: it can be controlled with modifications in her diet and medication, but the medication controls her blood sugar, it does not cure her. Weight loss, exercise, and careful dietary management and blood sugar control is required to treat diabetes. Unless Mrs. Ozdemir understands the nature of how the disease progresses, she will be unable engage in appropriate self-monitoring. She also faces additional challenges, given the linguistic and cultural barriers she faces. "Fewer than one-third of people with diabetes reported that they were able to manage their disease themselves" (Peeples & Seley 2007).

Secondary

Diabetes treatment specialists have been extremely useful in controlling the progression of the illness. Secondary or specialized care can help the patient create a diet modification program that limits carbohydrates and calories. "Diabetes education has evolved to include systematic description, assessment, and measurement of outcomes related to the following self-care behaviors: healthful eating, being active, monitoring, medication taking, problem solving, reducing risks, and healthful coping" (Peeples & Seley 2007). It should be noted that Mrs. Ozdemir's problems are not entirely physical in nature. Her loneliness and isolation in a country in which she has limited command over English have caused her to pour her energies into cooking traditional, heavy meals for her family and using overeating as a coping mechanism.

Seeing a counselor who speaks her language and can aid her in talking about her cultural adjustment issues seems essential. Without psychological support, it is unlikely that Mrs. Ozdemir will feel sufficiently motivated to change her lifestyle. Ideally, diabetes education at the secondary level should also be culturally sensitive, and provide dietary and exercise-related suggestions. Proposed menus can reflect Mrs. Ozdemir's culture, such as Mediterranean dishes that emphasize vegetables and beans, rather than sugary sauces and meats. Also, walking rather than taking public transportation is a potential source of exercise. Ozdemir should receive regular lipid screening, and, if warranted, eye exams and cholesterol screening.

Tertiary