Unit 14 – Physiological Disorders and their Care – 14.1
P1 What is a physiological disorder, and what are signs and symptoms?
A physiological disorder is an illness that interferes with the body functions and has consequent
effects on the whole body. The two physiological disorders discussed in this report are Type 2 Diabetes and
Rheumatoid Arthritis. Both Type 2 Diabetes and Rheumatoid Arthritis are lifelong conditions, meaning that a
diagnosis can be impactful to the individual receiving it, as it will change the way they live for the rest of
their lives. One effective way of predicting how a patient’s life might be impacted following a diagnosis is to
consider Roper, Logan and Tierney’s 12 activities of daily living. These include eating, sleeping, working and
playing, and mobilising, and will be explored throughout this report. Since both these conditions most
commonly develop in adulthood, this report will discuss only its application to adults when referring to
lifestyle and likely impacts.
The first indication that a service user may have a physiological disorder is the presence of signs and
symptoms. A sign is an objective indication of a disorder noticed by a healthcare professional, such as weight
loss or gain, bleeding, or coughing. It is often something that can be measured and recorded by a GP or
other medical professional who is caring for the service user or investigating their suspected disorder. A
symptom is a feature complained about by the individual and is more subjective and may not be able to be
measured. These include anxiety, headache, and fatigue.
P1 M1 What is Type 2 Diabetes and what are the signs, symptoms, and causes of it?
Type 2 Diabetes is a condition where the body is unable to release glucose into the cells, causing
abnormally high blood sugar levels. It is a serious, lifelong condition that must be managed properly and has
impacts on the individual’s daily life. The main body system affected is the endocrine system, which is a
series of glands that produce and secrete hormones that the body uses for a wide range of functions. Other
body systems such as urinary and digestive are also affected. The main organ affected is the pancreas, which
is responsible for producing insulin, a hormone which allows glucose to enter the body cells. In a non-
diabetic body, the pancreas secretes appropriate amounts of insulin in accordance with the level of glucose
in the blood that needs to be absorbed by the cells, and this insulin does its job effectively. In a Type 2
Diabetic, this process does not occur as it should, due to a combination of insulin resistance and insensitivity,
and deficient insulin secretion. Insulin resistance and insensitivity is where the body is unable to respond to
normal levels of insulin, and deficient insulin secretion is where the pancreas is unable to secrete enough
insulin to compensate for the resistance. This results in glucose being unable to enter the cells and be used
for energy, meaning the level of glucose in the blood becomes too high, referred to as hyperglycaemia. The
condition can cause both short and long-term effects on the individual’s health.
Unlike Type 1, Type 2 Diabetes is usually caused by lifestyle factors, although family history certainly
does play a part, with those having a family history of the condition being 2-6 times more likely to develop it
themselves. Ethnicity is also a factor, as certain ethnic groups are at increased risk, including those of South
Asian, African-Caribbean, or Black African descent. Individuals are also at increased risk if they are over 40 if
they are white, and over 25 if they are from any of the higher-risk ethnic groups (Diabetes UK, n/a).
The way an individual cares for themselves has arguably the largest impact on the development of
Type 2 Diabetes, as an individual can present risk factors such as age and ethnicity without ever developing
the condition, so long as they take good care of themselves. Diet and weight are the biggest factors. Poor
diet can lead to obesity, which accounts for 80-85% of the overall risk for developing the condition, and
certain diets can increase risk. A low fibre, high glycaemic index diet increases risk of Type 2 Diabetes and
can also increase risk of becoming overweight or obese. High glycaemic index foods contain fast-release
carbohydrates which cause a rapid increase in blood glucose. When blood glucose spikes, the pancreas is
,required to produce more insulin to keep up, and over time this becomes decreasingly effective. It has been
found that carrying more body fat around the waist increases risk, as there is more fat surrounding the liver
and other organs. A diagnosis of Polycystic Ovary Syndrome also increases an individual’s risk, as it is
associated with insulin resistance (Diabetes UK, n/a).
Signs of Diabetes that a professional may notice, observe, or record when they meet the service user
are high blood glucose levels, weight loss, and recurring thrush. The blood glucose would likely be measured
following investigative procedures that lead the GP to suspect the patient has Type 2 Diabetes. Weight loss
can occur in Type 2 Diabetes patients because since their cells are unable to use the glucose consumed, the
body must instead produce energy by instead burning its fat and muscle stores. Patients may complain to
their GP of recurring thrush because diabetcs’ saliva, sweat and urine is high in sugar, which is a good
environment for candida to grow, thus increasing risk of overgrowth in the mouth and genitals.
The symptoms an individual may experience that would first indicate they have Type 2 Diabetes
include excessive thirst, feeling very tired, and experiencing occasional blurred vision. When the body is
struggling to release the glucose consumed into the cells to be used, the body cannot perform its normal
functions and every system is affected. Blurred vision occurs temporarily when the blood glucose becomes
too high, which causes the lens of the eye to swell and affects the ability to see. Excessive thirst occurs
because the kidneys cannot keep up with the level of blood glucose and it secretes into the urine, causing
dehydration. Dehydration affects the whole body and can cause headaches, dizziness, and in severe cases,
seizures. This can be uncomfortable for diabetics and confusing if they have not yet been diagnosed; they
may be drinking plenty but still feeling dehydrated, and not understand why. This will also affect the urinary
system, causing the individual to need to urinate more frequently, which can be inconvenient and
uncomfortable. Very high blood sugar can lead to hyperosmolar hyperglycaemic state (HHS) which develops
over a number of weeks due to dehydration and can be life-threatening. It can be avoided by drinking plenty
of fluids and monitoring blood glucose to ensure it does not remain high for too long (Diabetes UK, n/a).
Individuals can live with Type 2 Diabetes for up to ten years before being diagnosed. If they did not
have their blood tested during this time, noticed no symptoms, or dismissed their symptoms and did not
seek help, the condition could go unrecognised and long-term complications can occur due to the condition
going untreated. This is also the case if the individual manages their disorder poorly for a prolonged period
of time. These complications include retinopathy, neuropathy, and kidney disease, which can have serious
consequences.
Over time, high levels of blood glucose can cause build-up of fatty deposits in the blood vessels,
which reduces circulation and makes it harder to supply the nerves in the body, which causes nerve damage.
This can reduce the blood supply to the eyes, which then attempt to build new vessels, leading to damaged
vision and in severe cases, blindness. Similar problems can arise in the feet when the blood flow is reduced,
and nerve function is not working as it should. Wounds are more likely to go unnoticed and will not heal as
quickly, or at all. In extreme cases this can escalate to gangrene and may require amputation of toes, the
whole foot, or lower portion of the leg (Diabetes.co.uk, 2022). The same blood vessel damage can cause
kidney disease to develop over a long period of time. The kidneys’ role is to filter the blood, so when they
are damaged, waste products build up in the body and lead to a multitude of other health complications.
Diabetics who smoke, consume a lot of salt, are inactive, and overweight are at increased risk of developing
kidney disease (NIH, 2017).
D1 What impact does Type 2 Diabetes have on the health and wellbeing of service users?
One of the primary impacts Type 2 Diabetes will have on a service user’s way of living is eating and
drinking. As they have to be conscious of the carbohydrate and sugar content in what they consume, many
aspects of their life will be affected and the way they think about food is likely to change for the rest of their
, lives. The area of their life this is most likely to impact is socialising. Many social events such as birthday
celebrations are based around eating and drinking, meals out, alcohol, eating and drinking a higher volume,
and often higher-carb options, than usual. Someone with a Type 2 Diabetes diagnosis knows they have to be
careful how much sugar they consume in a short period of time as it is likely to send their blood glucose
levels too high and leave their body unable to cope. A diabetic using insulin will have to consider the sugar
content of the food they eat and dose their insulin appropriately. Since many alcoholic drinks are high in
sugar, this is also something the individual will have to be mindful of and they may not be able to participate
in this social activity in the way they would like to. This can very quickly become difficult when eating out at
a restaurant, as full nutritional information about the food on the menu is rarely available. This can mean
diabetics either have to miss out on some social occasions or run the risk of hyperglycaemia or a ‘hyper’,
when their blood glucose levels become too high. This is likely to make socialising troublesome and less
enjoyable for diabetics and could cause embarrassment, shame, or feeling left out. In some cases, it could
make them avoid these social events altogether and become somewhat withdrawn (Diabetes UK, 2019).
While those in receipt of a Type 2 Diabetes diagnosis are encouraged to increase their activity levels,
doing exercise can cause hypoglycaemia or ‘hypo’, where the blood sugar drops too low, the symptoms of
which include sweating, feeling tired, and dizziness. As some of these symptoms can also just be side effects
of exercising, it can be difficult for the individual to identify whether they are having a hypo or not. This can
cause frustration and they may have to repeatedly interrupt their exercise to check their blood sugar levels.
This can be an added inconvenience if the exercise is being done with a friend or family member. For
example, having to stop a friendly tennis game several times to check their blood sugar could feel awkward
and make the activity less enjoyable. This may also deter the individual from wanting to exercise in the first
place, even though they know it is good for their health.
If a Type 2 Diabetic’s case is on the more severe side, and their doctor feels it is the only appropriate
treatment, they may use an insulin pump to regulate their blood sugar levels. This pump is likely to be
attached to their clothing in some way, which can be a strange adjustment for someone who has never worn
one before and may be both physically and mentally uncomfortable at first. It could also make the individual
feel embarrassed, as they know others will see the pump and know they are diabetic. Some diabetics feel
ashamed and do not want others to know about their condition for fear of being misunderstood or judged
(Diabetes UK, 2019). On the other hand, pumps can bring great benefits to a diabetic’s life as they reduce
the need for repeated testing and injecting. They keep levels consistent without large spikes from injections
and they reduce the stress and hassle for the individual. This can allow them to spend more time and energy
on doing things they enjoy, minimising the impact on their personal lives.
Sleep is a vital part of staying mentally and physically healthy and it is important to have the right
amount of sleep, uninterrupted. This simple activity of daily living can be challenging for diabetics as their
sleep can be disrupted due to hypos. Poor quality of sleep can cause weakened immunity, decline in mental
health, reduction in sex drive, and poor concentration (NHS, 2021). This will have a knock-on effect on the
individual’s work life and could cause them to perform poorly at their job. This can go on to trigger low self-
esteem if the individual feels upset that they cannot perform as well as their peers or colleagues, or as well
as they once were able to. Employment can also be affected by a Diabetes diagnosis if the individual has to
attend appointments with their GP, Diabetes nurse, or dietitian. This could negatively affect work
performance, prompt poor feedback from employers, and reduced opportunities for career progression.
These appointments may also impact an individual’s ability to engage fully in their family and social lives.
However, with understanding and compassionate employers, and room for flexibility when booking check-
ups, the impacts this has on the individual’s work and personal life can be minimised.
The emotional impacts of living with Type 2 Diabetes can be somewhat extensive. Individuals may
experience anxiety about their health and what the future holds for them and the potential complications
that could arise from their condition. They may also find it difficult to relax as they feel they are constantly
worrying about their glucose levels. Since the primary method of controlling Type 2 Diabetes is through diet,
