Chronic Illness & Long Term Care : Diabetes Mellitus

Chronic diseases, also called non-communicable diseases, cannot be passed from person to person, they last long and progress slowly (WHO, “non-communicable diseases”). Chronic diseases can also be defined as:

A disease that persists for a long time. A chronic disease is one lasting three months or more, by the definition of the U.S. National Center for Health Statistics. Chronic diseases generally cannot be prevented by vaccines or cured by medication, nor do they just disappear (, “the definition of chronic diseases”). According to World Health Organization (WHO), chronic diseases can be grouped into four main types: cardiovascular diseases (like heart attacks and stroke), cancers, chronic respiratory diseases (chronic obstructive pulmonary disease and asthma), and diabetes.

Chronic diseases cannot be cured. They can only be managed. Chronic diseases are a strain on the patient and their families both physically and psychologically. Moreover, chronic diseases and conditions are among the most common, expensive and preventable of all health issues (CDC: chronic disease overview). It is considered to cause disability among patients. People faced with these diseases have to contend with it their whole lives. It takes a massive toll on their social, recreational and occupational lives, making it a bread-winner of a family suffering from any of these diseases would send the family into economic crisis. Patients with chronic conditions often have to adjust their lifestyle, employment, and aspirations; most grieve about it before adjusting (Kelly & Turner 124).

Of all the chronic diseases listed either by WHO or the CDC, the most common is diabetes mellitus, which is a disease characterized by increased level of glucose (sugar) in the blood, widely known as hyperglycemia. There are different types of diabetes mellitus, but the main classifications are type 1 and type 2 diabetes. About 10% of people have type 1 diabetes in which the beta cells do not produce insulin due to autoimmune destruction. As a result, such people need insulin injections to control their blood glucose level. They present with a myriad of clinical symptoms such as increased urination, increased hunger, rapid weight loss. If this non-communicable disease is not controlled correctly, it can lead to more severe consequences like limb loss, loss of eyesight, coma or even death. Since this disease is more associated with children and young adults, living a ‘normal’ life is far away from them. They have to adapt to specific diets, take routine tests. This health condition can lead to confidence loss and social isolation. People with chronic diseases often face depressions. Moreover, “Physical symptoms such as disturbed sleep, impaired appetite, and lack of energy may already exist as a result of the disease” (Kelly & Turner 125).

Management of these chronic diseases has not been an easy task for both clinicians and the patients because it requires long-term continuous care. According to Wagner “Evidence-based care for many chronic illnesses requires increasingly complicated drug regimens, ongoing support of self-management, and close monitoring” (Wagner 945). He further stated that many of these patients provide difficulty to health-care providers as well as the practitioners due to various reasons like socioeconomic status, comorbid conditions, disabilities, and others (Wagner 945). Long-term care according to McCall “refers to a continuum of medical and social services designed to support the needs of people living with chronic health problems that affect their ability to perform everyday activities” (3). This differs completely from acute care, while acute care is aimed at trying to return the patient to his or her previous functioning level. Long-Term care is targeted at preventing the deterioration of the patient’s condition. About 99 million estimated Americans live with a chronic illness. Surveys have shown that these people have not been rendered effective therapy and no “optimal disease control” (Rothman & Wagner 256). Furthermore, they report that due to the substandard care rendered to these patients, care should be shifted to a specialist. However, looking into this, how many specialists would be able to take care of about 99 million people. I do not believe this is an effective method for managing a patient with chronic illness. Looking though Rothman and Wagner’ article, I have concluded that “the future of primary care in the United States may depend on its ability to successfully redesign care systems that can meet the needs of a growing population of chronically ill patients” (Rothman & Wagner 256). It is not feasible that this would likely happen now in the proposed future.

Østbye and colleagues carried out a research to discover if time was the reason patients with chronic diseases are not receiving the required treatment. They discovered that “chronic illnesses require more time than primary care physicians have available for patient care overall” (Østbye et al. 210). Having accepted that it is impossible to know the amount of time a doctor should spend managing a chronic disease due to its variability, they concluded that alternative methods, as well as nationally accepted guidelines, were required to meet the standard of health care delivery to patients with these chronic illnesses.

Rantz, Marek & Zwygart-Stauffacher (51) stated that consumers of health care want services and care available to them at all times when they need them. Moreover, “they want long-term care that addresses six areas of concern: community-based services, continuity, coordination, caring, convenience, and cost” (Rantz, Marek & Zwygart-Stauffacher 51). Co-operation between health care providers and consumers is believed to bring a solution to all of these concerns.

Works Cited

Center for Disease Control and Prevention: Chronic Diseases: The Leading Causes of Death and Disability in the United States, last reviewed June 2017. Retrieved from

McCall, Nelda. “Long-term care: Definition, demand, cost, and financing.” Who will pay for long-term care (2001): 3-31.

Rantz, Marilyn J., Karen Dorman Marek, and Mary Zwygart-Stauffacher. “The Future of Long‐Term Care for the Chronically Ill.” Nursing Administration Quarterly 25.1 (2000): 51-58.

Rothman, Arlyss Anderson, and Edward H. Wagner. “Chronic illness management: what is the role of primary care?.” Annals of Internal Medicine 138.3 (2003): 256-261.

The World Health Organization; Noncommunicable Diseases(Jul 2014). Retrieved from

The Medical definition of chronic disease; reviewed May 2016: retrieved from

Turner, Jane, and Brian Kelly. “Emotional Dimensions of Chronic Disease.” Western Journal of Medicine 172.2 (2000): 124–128. Print.

Wagner, Edward H. “Meeting the Needs of Chronically Ill People : Socioeconomic Factors, Disabilities, and Comorbid Conditions Are Obstacles.” BMJ : British Medical Journal 323.7319 (2001): 945–946. Print.

Østbye, Truls et al. “Is There Time for Management of Patients With Chronic Diseases in Primary Care?” Annals of Family Medicine 3.3 (2005): 209–214. PMC. Web. 6 Mar. 2018.

The terms offer and acceptance. (2016, May 17). Retrieved from

[Accessed: October 27, 2021]

"The terms offer and acceptance.", 17 May 2016.

[Accessed: October 27, 2021] (2016) The terms offer and acceptance [Online].
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[Accessed: October 27, 2021]

"The terms offer and acceptance.", 17 May 2016

[Accessed: October 27, 2021]

"The terms offer and acceptance.", 17 May 2016

[Accessed: October 27, 2021]

"The terms offer and acceptance.", 17 May 2016

[Accessed: October 27, 2021]

"The terms offer and acceptance.", 17 May 2016

[Accessed: October 27, 2021]
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