Healthcare priorities: peripheral neuropathy and hypertension in people with type 1 diabetes

Healthcare Priorities: Peripheral Neuropathy And Hypertension

This interview is with Rachel Robin (pseudonym). She is a 59 year old female who came to Australia from India in 2007. When she moved to Australia with her family in 2007, she was diagnosed with non-insulin diabetes. Because she had a full-time job and she was raising two children, she couldn’t control her diabetes. In 2013, he was diagnosed with type 1 diabetes and started insulin therapy. Her medical history included peripheral neuropathy, hyperlipidemia, hypertension, iron deficiency, vitamin D deficiency, GORD, mild microalbuminuria, and moderate nonproliferative retinopathy (case-related). increase. This article discusses Rachel’s two health priorities: her peripheral neuropathy and high blood pressure. Both priorities are described using the RLT paradigm.

A health behavioral model was used to manage Rachel’s illness. In type 1 diabetes, the pancreas produces little or no insulin. The body perceives insulin as foreign and begins to destroy it. This is an autoimmune reaction (DiMeglio, Evans-Molina & Oram, 2018). Diabetes fatigue is much more than just fatigue and can lead to undue hopelessness. Hypertension, also known as hypertension, is one of the leading causes of cardiovascular disease worldwide. People with high blood pressure often fail to adhere to treatment while taking medication. In many cases, there is no unified model for evaluating such aspects (

The Health Belief Model (HBM) is a cognitive and intrapersonal health behavioral model. This health model was first developed in the 1950s and updated in the 1980s (Green, Murphy & Gryboski, 2020). This concept is based on the premise that a patient’s tendency to modify his or her medical practice is determined primarily by health-related beliefs. According to this paradigm, a particular individual’s views about their health and health problems play a role in determining their health-related activities (Green, Murphy, & Gryboski, 2020). HBM is a “value expectation” model. It aims to describe and assess health-related behaviors, focusing on the mindset and thought processes of people and communities. The model consists of six domains: Perceived Vulnerabilities, Perceived Severities, Perceived Benefits, Perceived Barriers, Directions for Action, and Correctors. Widely regarded as one of the most powerful models in the history of health promotion professionals, it is widely used to predict health-related behaviors in many populations with or at risk of peripheral neuropathy and hypertension. (Luquis & Kensinger), 2019).

The first priority is treatment of peripheral neuropathy. Rachel was diagnosed with type 2 diabetes and started insulin therapy. Her medical history includes peripheral neuropathy, as noted in her interview. Peripheral neuropathy is nerve damage caused by diabetes and persistent hyperglycemia. Peripheral neuropathy has many reasons, including high blood sugar that prevents access of vital nutrients to other body organs, such as the feet and legs. In addition, it causes numbness, sensory disturbance, and discomfort in feet, legs, and hands (Agarwal, 2018).

The RLT paradigm has been extensively developed to address the psychological, biological, and social needs of patients and to provide comprehensive treatment strategies (Williams, 2017). The RLT paradigm consisted of 12 daily tasks: maintaining a healthy atmosphere, effective communication skills, breathing, eating, drinking, toileting, bathing and dressing, thermoregulation, exercise, work and play, expressing sexual orientation, and sleeping and dying. It consists of For Rachel, she works at her PCA almost five days a week. She was too busy working and raising children to eat healthy. She has to do all her own work. After a long day at work, Rachel gets tired and falls asleep, so she has little time to exercise (Holland & Jenkins, 2019).

Therapeutic use of the RLT paradigm

Unconsciousness due to hypoglycemia can occur if this condition is not controlled. Rachel may not be aware of the signs of hypoglycemia. Loss of sensation is the reason people with diabetic neuropathy have their legs amputated. They don’t notice small cuts or lesions, but if left untreated, they can cause infections in the legs and eventually lead to gangrene. Low blood pressure can occur suddenly. It can also cause digestive problems and sexual dysfunction (Bodman & Varacallo, 2021).

A nurse needs to teach Rachel her ABCs so she can take steps to prevent the condition she is suffering from. She must be convinced that serious complications can occur if her condition is not controlled (Abedzadeh Zavareh & Sayehmiri). A1C blood test stand. A1C is a blood test that calculates Rachel’s average blood sugar over the past few months. B indicates blood pressure. Rachel has diabetes, so she needs to understand that regulating her blood pressure is just as important as controlling her blood sugar. Because of their high blood pressure, they are at risk of heart attack, stroke and kidney damage (Delahanty, 2021). C stands for cholesterol.

Rachel’s medical history suggests hyperlipidemia, another risk factor that can increase her risk for many serious problems. Rachel should aim for an A1C <7%, blood pressure <140/90 or lower, and LDL cholesterol <100 (Delahanty, 2021). The Health Belief Model helps Rachel monitor her lifestyle and live better. Rachel should monitor her blood sugar daily if she believes in a healthy lifestyle. Rachel needs to be confident that her choices about the food she eats and the way she lives will have a huge impact on her overall health. She should make her healthy eating choices.

The Health Belief Model To Guide Health Behavior

High blood pressure puts too much pressure on arterial walls and can damage both blood vessels and organs. The higher the blood pressure and the longer it goes uncontrolled, the greater the damage. High blood pressure can accelerate hardening and thickening of arteries, also known as atherosclerosis, which can lead to heart attack, stroke, and other problems (Fuchs & Whelton, 2020). Aneurysms can develop when blood arteries degenerate and enlarge due to high blood pressure. Rupture of an aneurysm can be fatal. May cause heart failure. It can also cause weakness and narrowing of the kidney veins and arteries. A blood vessel in the eye that is thickened, narrowed, or ruptured due to high blood pressure. This can lead to vision loss (Riley, Hernandez & Kuznia, 2018).

The ability of hypertensive patients to seek medical attention and adhere to prescriptions is influenced by many factors related to treatment requests and treatment adherence. These include the patient’s personal understanding, benefits and beliefs, changing circumstances, and behavioral signals (Khalil & Tartour, 2017). High blood pressure can be controlled with dietary changes and sometimes drug therapy. Rachel should be convinced that she needs to devise a strategy to bring her blood pressure back into the normal range. She should be on a diet rich in fiber and potassium. The diet should be low in sodium, fat and added sugars. Rachel needs to eat a variety of fresh fruits and vegetables. You should eat whole grains such as whole grain pasta, brown rice, and whole grain bread.

She must consume low-fat dairy products. She should avoid fatty meat parts, cooked or canned meats, skinned poultry, and prepackaged cooked meals. Rachel needs to maintain her weight to be considered healthy. If she is overweight or obese, she should lose weight. She needs to be active and exercise for at least 30 minutes three times a week. She needs to incorporate exercises that can strengthen her muscles. She should not use items that contain nicotine or tobacco. She needs to manage long-term health issues such as diabetes and hyperlipidemia. She should manage stress and engage in activities such as yoga and meditation (Gabb, et al., 2016). Through this model, Rachel understands the severity of symptoms and the importance of managing them.

In summary, chronic diseases such as diabetes and hypertension can lead to many health problems such as cardiovascular disease and kidney problems. Appropriate nursing interventions and education can help her manage her condition and lead her healthy life. In the next step, nursing staff and health care providers discuss the importance of self-care in diabetes and hypertension. Topics like blood sugar monitoring, medication adherence, regular exercise, healthy eating, and weight management should be discussed. The education provided on these topics will control the patient’s HbA1C levels and blood sugar levels. Helps patients maintain a healthy weight and stay fit. It also helps treat high blood pressure and high blood sugar levels and improves quality of life.


Abedzadeh Zavareh, M. S., & Sayehmiri, K. (2018). Effect of educational intervention based on the Health Belief Model on promoting self-care behaviors of Type-2 diabetes patients in Ilam, Iran. Technology and Research Information System, 1(1), 0-0.

Agarwal, S. (2018). How Diabetes Affects Your Body (And What You Can Do About It). diabetes.

Bodman, M. A., & Varacallo, M. (2021). Peripheral diabetic neuropathy. In StatPearls [Internet]. StatPearls Publishing.

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Delahanty, L. M. (2021). Patient education: Type 1 diabetes and diet (Beyond the Basics). UpToDate. Retrieved February, 18, 2022.

DiMeglio, L. A., Evans-Molina, C., & Oram, R. A. (2018). Type 1 diabetes. The Lancet, 391(10138), 2449-2462.

Fuchs, F. D., & Whelton, P. K. (2020). High blood pressure and cardiovascular disease. Hypertension, 75(2), 285-292.Gabb, G. M., Mangoni, A. A., Anderson, C. S., Cowley, D., Dowden, J. S., Golledge, J., … & Arnolda, L. (2016). Guideline for the diagnosis and management of hypertension in adults—2016. Medical Journal of Australia, 205(2), 85-89.

Green, E. C., Murphy, E. M., & Gryboski, K. (2020). The health belief model. The Wiley encyclopedia of health psychology, 211-214.

Holland, K., & Jenkins, J. (Eds.). (2019). Applying the Roper-Logan-Tierney Model in Practice-E-Book. Elsevier Health Sciences.


Luquis, R. R., & Kensinger, W. S. (2019). Applying the health belief model to assess prevention services among young adults. International Journal of Health Promotion and Education, 57(1), 37-47.

NIDDK. (2016). Diabetes Diet, Eating, & Physical Activity.

Puspita, R. C., Tamtomo, D., & Indarto, D. (2017). Health belief model for the analysis of factors affecting hypertension preventive behavior among adolescents in Surakarta. Journal of Health Promotion and Behavior, 2(2), 183-196.

Shabibi, P., Zavareh, M. S. A., Sayehmiri, K., Qorbani, M., Safari, O., Rastegarimehr, B., & Mansourian, M. (2017). Effect of educational intervention based on the Health Belief Model on promoting self-care behaviors of type-2 diabetes patients. Electronic physician, 9(12), 5960.

Riley, M., Hernandez, A. K., & Kuznia, A. L. (2018). High blood pressure in children and adolescents. American family physician, 98(8), 486-494.

Williams, B. C. (2017). The Roper-Logan-Tierney model of nursing. Nursing2020 Critical Care, 12(1), 17-20

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