Chronic illness of a child has an influence over the whole family system. Despite this fact healthy siblings have been overlooked by the majority of research. Some foreign studies declare that this population is in higher risk of developing psychsocial problems. The purpose of this thesis is to conduct a closer study on psychosocial characteristics of the siblings of children with diabetes mellitus type 1. The main concern of the theoretical part is the review of current literature dealing with the topic of siblings of chronically ill child and their families. The conducted research included quantitative and qualitative methods exploring sibling psychosocial problems and prosocial behaviour, self-esteem, siblings attitude towards illness and family functioning. The results stress out the important relationship between sibling adjustment, self-esteem and individual and family characteristics. The results also present the main themes connected with siblings feeling of fear, sadness and anger, with applied coping strategies and perceived rewards and costs of the illness for family. Keywords: siblings, diabetes mellitus type 1, psychosocial situation

>Magister Scientiae - MSc / About 180 million people have been estimated to suffer from type 2 diabetes (T2DM) in 2006 and the annual death rate due to this disease was 3 million by that time. More than 400 medicinal plants used for the treatment of diabetes mellitus have been recorded, but only a small number of these plants have received scientific and medical evaluation to assess their efficacy. The most common plant used to treat diabetes mellitus is Hypoxis hemerocallidea (HH). The present study was undertaken to investigate the effects of Hypoxis hemerocallidea (HH) on T2DM in rats. Male Wistar rats weighing 200-250 g were used in this experiment. Hypoxis hemerocallidea (HH) corm was used as plant material in the experiment. The study was based on three parts, an acute diabetes study, chronic diabetes study and insulin secretion study. In the acute study, the rats were randomly divided into 2 groups (control and diabetes). The saline solution was added to different concentrations of HH corm to produce concentration of (50, 200, 400, 800 mg/ml). Diabetes was induced by intraperitoneal injections of STZ (65mg/kg). Two weeks after the injection (STZ 65 mg/kg), different concentrations of HHS was administered intraperitoneally after an overnight fast. The blood glucose levels were monitored in the diabetic and control rats at, 30, 60, 120, 180 and 240 minutes post injection. In the chronic study, the rats were randomly divided into 6 different groups (control, HFD, DM, DM-HH, DM-PTHH, and HH). Diabetes mellitus was then induced in the groups of diabetic rats by intraperitoneal injections of STZ (40 mg/kg) and rats were fed a high fat diet (HFD). The body weight of the rats were measured weekly for 7 weeks. An intraperitoneal glucose tolerance test (IPGTT) was performed at the end of week 6. At the end of week 7, rats were killed and serum sample were collected for determination of fatty acid and insulin. Liver and pancreatic tissue was collected for histological evaluation. In the insulin secretion study, Hypoxis hemerocallidea was tested for its effects on insulin secretion by pancreatic islet cells exposed to low (3mM) and high (20mM) glucose medium. Results of the acute study indicated that HHS at a dose 800 mg/ml decreased blood glucose levels fastest in both normal and diabetic rats reaching significance after 30 minutes and 60 minutes respectively and remained below the baseline value until 240 minutes. In the chronic study, it was illustrated that HH had no effect in normal rats on any of the parameters evaluated. Animals in the DM group gained weight the first two weeks, but thereafter began to lose weight. At the end of seven weeks the animals gained significantly less weight than the rest. Animals fed a HFD have more visceral fat compared to the control group. The visceral fat gain occurred in the absence of a significant increase in body weight. We found a markedly lower fasting glucose level in HH treated diabetic animals compared to untreated DM animals. At time zero the blood glucose level of the HFD group (5.8±0.5mmol/l) and the HH group (4.9±0.7mmol/l) were in the normal range, and were not significantly different (P > 0.05) from the control group (5.0±0.2mmol/l). After glucose load peak blood glucose levels was measured after 30 minutes in the control group (9.0±0.6mmol/l), the HFD group (9.8±0.4 mmol/l), the DM-HH group (21±5.7 mmol/l) and the DM-HHPT group (27.8±5.3 mmol/l). In the HH group the blood glucose level reached a peak at 60 minutes (7.6±0.6 mmol/l). In the DM group two peaks were recorded one after 10 minutes (27.2±7.1mmol/l) and another after 60 minutes (31±5.2 mmol/l). In the groups control, HFD, DMHH, DM-HHPT and HH groups the blood glucose level after 120 minutes were not significantly different from the time zero value. The blood glucose level after 120 minutes in the DM group (28.2±7.1 mmol/L) was significantly higher (P ≤ 0.01) than from the time zero value. Serum fatty acid levels were increased in all groups fed a high fat diet. The serum insulin levels in the HFD group (6.2 ± 0.76 μUI/ml protein; P ≤ 0.05 ), the DM group (2.0 ± 0.9 μUI/ml protein; P ≤ 0.001), the DMHH group (3.4 ± 0.7 μUI/ml protein; P ≤ 0.001) and the DM-HHPT group (3.0 ± 1.1 μUI/ml protein; P ≤ 0.001) were significantly lower than the control group. The β-cell function in the HFD group (62 ± 8 %; P ≤ 0.001), the DM group (3 ± 1 %; P ≤ 0.001), the DM-HH (11 ± 9 %; P ≤ 0.001) group and the DM-HHPT group (4 ± 2 %; P ≤ 0.001) were significantly lower than the control group. The histological observation of the liver and the pancreas in rats after 7 weeks on different dietary regimes showed some morphological changes within the liver and pancreas parenchyma of some rats. In the insulin secretion study, glucose stimulated insulin secretion in low (3mM) and high (2mM) glucose concentration. Furthermore, insulin secretion was significantly higher when the glucose concentration was increased from 3mM to 20 mM (1.10 ± 0.13 μUI/ml protein and 1.5 ± 0.17 mIU/mg protein respectively P≤ 0.01). In the presence of low HH (100 µg/ml), there was a marked increase in insulin secretion when exposure to high glucose compared to low glucose concentration, while in the presence of high HH (500 µg/ml), there was no significant different in insulin secretion in the presence of low or high glucose. In conclusion, the results of this experimental study indicate that a concentration 800 mg/kg of HHS produces maximal hypoglycaemic effect in fasted normal and diabetic rats. HH has an antidiabetic activity as it lowers serum glucose levels in T2DM rats and significantly increases glucose tolerance. It also increases body weight of diabetic rats. HH treatment was found to improve insulin secretion in pancreatic islet cells.

Bakgrund: Diabetes Mellitus typ 1 debuterar under barn- och ungdomsåren. Behandlingen är egenvård som innebär blodglukoskontroller, läkemedelsbehandling och att följa rekommendationer om kost och motion. Sjuksköterskans yrkesområde innefattar barn- och ungdomar. Avvikande från egenvårdsaktiviteter och hemlighetsmakeri kring sjukdomen påverkar vårdkvaliteten för ungdomar. Syfte: Att beskriva ungdomars upplevelse av att leva med Diabetes Mellitus typ 1 samt att beskriva de granskade studiernas undersökningsgrupper. Metod: Deskriptiv litteraturstudie med tolv vetenskapliga artiklar med kvalitativ samt kvalitativ- och kvantitativ ansats. Samstämmigheter och olikheter i artiklarnas resultat har kategoriserats och teman och subteman har identifierats. Huvudresultat: En del ungdomar upplevde svårigheter att acceptera sin sjukdom och önskade ha kontroll över och ta eget ansvar för sin sjukdom och öka oberoendet. Ungdomar upplevde känslan av att vara annorlunda och undvek att utföra egenvård i sociala sammanhang. Svårigheter att följa kostrekommendationer varierade och att utföra blodglukoskontroller upplevdes ansträngande. Stöd från vänner och jämnåriga underlättade utförandet av egenvård. Det upplevdes positivt att sjuksköterskor visade intresse för ungdomarnas liv utöver deras DMT1. Sjuksköterskor upplevdes brista i att kunna sätta sig in i ungdomarnas situation och vara ett känslomässigt stöd. Slutsats: Det finns ett behov av ökat stöd och förståelse från sjuksköterskor. Genom ökad förståelse kan sjuksköterskan bidra med stöd för att underlätta överföringen av ansvar. Detta kan leda till en ökad trygghet och känsla av kontroll hos ungdomarna, vilket kan bidra till att de vågar dela med sig av sin sjukdom till omgivningen. / Background: Diabetes Mellitus Type 1 debuts in childhood and adolescence. The treatment is self-care that involves blood glucose control, drug treatment and following recommendations on diet and exercise. Nursing's professional area includes children and adolescents. Deviating from self-care activities and secrecy around the disease affects the quality of care for young people. Purpose: To describe the young people's experience of living with Diabetes Mellitus type 1 as well as describing the study groups of the studies examined. Method: Descriptive literature study with twelve scientific articles with qualitative as well as qualitative and quantitative approach. Consequences and differences in the results of the articles have been categorized and themes and subthemes have been identified. Results: Young people experienced difficulties in accepting their illness and wanted to have control over and take responsibility for their illness and increase independence. Young people experienced the feeling of being different and avoiding self-care in social contexts. Difficulties to follow dietary recommendations varied and blood glucose controls were exerted. Support from friends and peers facilitated the performance of self-care. It was positive that nurses showed interest in the lives of adolescents in addition to their DMT1. Nurses were found to fail to get into the situation of young people and to be an emotional support. Conclusion: There is a need for increased support and understanding from nurses. Through increased understanding, the nurse can help to facilitate the transfer of responsibility. This can lead to increased safety and sense of control among adolescents, which may help them dare to share their illness with the environment.

Bakgrund: Diabetes mellitus typ 1 är en kronisk sjukdom som i Sverige drabbar cirka 800 barn årligen och kräver daglig behandling med insulin. Sjukdomen innebär begränsningar i det dagliga livet. Ungdomar har ett ökat behov av att frigöra sig från föräldrar och att bli självständig är en naturlig del i ungdomars utveckling. Syfte: Beskriva ungdomars upplevelse av att leva med diabetes mellitus typ 1 samt att granska vilken undersökningsgrupp som återfinns i de inkluderade artiklarna. Metod: Beskrivande litteraturstudie. Databaserna Medline via Pubmed och Cinahl användes för att söka underlag till studien. Elva vetenskapliga artiklar återfinns i resultatet. Huvudresultat: Ungdomar med diabetes mellitus typ 1 upplevde en känsla av att vara annorlunda och att sjukdomen var en börda. Ungdomarna upplevde även att de hade fler konflikter med sina föräldrar än sina kamrater och att föräldrarna hade svårt att släppa kontrollen. För att acceptera sin sjukdom beskrev ungdomarna att de behövde integrera sjukdomen som en del i sin identitet och sitt dagliga liv. På så vis kunde ungdomarna nå självständighet och utveckla sin förmåga att ta eget ansvar gällande egenvård. Slutsats: Resultatet påvisade att majoriteten av ungdomar med diabetes mellitus typ 1 kände sig annorlunda i jämförelse med jämnåriga. Många ungdomar upplevde svårigheter i relationen till sina föräldrar relaterat till ansvar för egenvården. Ungdomarna beskrev processen att acceptera och integrera sin sjukdom som en del i deras identitet. Sjuksköterskor har en viktig uppgift att stötta och vägleda ungdomar med diabetes mellitus typ 1 mot självständighet och ge dem förutsättningar att klara av egenvård. / Background: Diabetes mellitus type1 is a chronic disease which yearly afflicts around 800 children in Sweden and requires daily insulin treatment. The disease entails limitations in everyday life. Adolescents have an increased need to liberate themselves from their parents and gaining independence is a natural part of youths’ development.  Aim: Describe adolescents´ experience of living with diabetes mellitus type 1 and to examine which research group is found in the included articles.  Method: Descriptive literature study. The databases Medline via Pubmed and Cinahl were used in searching for study material. Eleven scientific articles are included in the results. Main findings: Adolescents with diabetes mellitus type1 had an experience of being different and that the disease was a burden. The adolescents also had the experience of having more conflicts with their parents than with their friends, and that their parents had difficulties letting go of control. In order to accept the disease, the adolescents described the need to integrate the disease as a part of their identity and daily life. In this way the adolescents could gain independence and grow in their ability to take responsibility and manage their self care. Conclusion: The findings showed that the majority of adolescents with diabetes mellitus type1 had an experience of being different compared to their peers. Many adolescents experienced difficulties in the relationship with their parents regarding the responsibility for selfcare. The adolescents described to process of acceptans and the need to integrate their disease as part of their identity. Nurses have an important task of supporting and guiding adolescents with diabetes mellitus type 1 towards independence and giving them the conditions for coping with selfcare.

Background: In Sweden type 1-diabetes is the most common chronic disease among children. When a child suffers from type 1-diabetes the parents gets affected as well. The children’s need of support from the parents depends on the child’s age, maturity and individual needs. Aim: The purpose of this study was to describe the parents’ experience of living with a child that suffers from type 1-diabetes, as well as describe the articles research groups. Method: A descriptive literature study that’s based on 11 articles, nine of qualitative approach and two of qualitative- and quantitative approach. Result: Parents to children with type 1-diabetes experienced fear, grief, anxiety and frustration. Type 1-diabetes among children influences parents’ life in many ways. The disease required planning, attention and adjustment. Parents experienced that type 1-diabetes affected school, work, sleep, diet and physical activity. Conclusion: Parents of children with type 1 diabetes experiences that the disease required a great commitment and responsibility. The majority of the care and treatment is handled by the parents, due to the children's lack of self-care. The nurse therefore has an important role to provide information, support and encourage both to patients and their families regarding care and treatment. / Bakgrund: I Sverige är typ 1-diabetes den kroniska sjukdomen som är vanligast förekommande hos barn. När ett barn drabbas av typ 1-diabetes berörs även föräldrarna. Barns behov av stöd från föräldrar varierar efter barnets ålder, mognad och individuella behov. Syfte: Syftet med studien var att beskriva hur föräldrar upplever att det är att leva med ett barn med typ 1-diabetes samt att beskriva artiklarnas undersökningsgrupper. Metod: En beskrivande litteraturstudie som baserats på 11 artiklar, nio av kvalitativ ansats och två av kvalitativ- och kvantitativ ansats. Resultat: Föräldrar till barn med typ 1-diabetes upplevde rädsla, sorg, oro och frustration. Typ 1-diabetes hos ett barn påverkade föräldrarnas liv på många olika sätt. Sjukdomen krävde planering, uppmärksamhet och anpassning. Föräldrarna upplevde att typ 1-diabetes påverkade skola, jobb, sömn, kost och fysisk aktivitet. Slutsats: Föräldrar till barn med typ 1-diabetes upplevde att sjukdomen krävde ett stort engagemang och ansvar. Vård och behandling hanterades till större del av föräldrarna vilket berodde på barnens bristande egenvård. Sjuksköterskan har därmed en viktig roll att ge information, stötta och uppmuntra både patient samt dess anhöriga vad gäller vård och behandling.

Orientador: Carlos Eduardo Steiner / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-07T13:53:01Z (GMT). No. of bitstreams: 1 Assis_NilmaAlmeidade_M.pdf: 1405023 bytes, checksum: 12e3861c31dae0e759ab571d2d029476 (MD5) Previous issue date: 2006 / Resumo: A retinopatia diabética é uma complicação freqüente no diabetes melito tipo 1, acometendo quase a totalidade de pacientes, em graus variados, após 20 anos de doença. A interferência de fatores ambientais como a manutenção de um estado hiperglicêmico na sua fisiopatologia já foi comprovada, mas ainda não foi esclarecido porque alguns pacientes desenvolvem essa complicação de maneira grave e precoce. Nos últimos anos, diversos estudos têm sugerido a participação de fatores genéticos nesse processo. O fator de crescimento endotelial vascular (VEGF), potente indutor da angiogênese, foi associado à retinopatia diabética por alguns autores, pelo aumento da sua expressão, em virtude de mutações em sua região promotora. Neste trabalho foi realizada uma avaliação clínico-laboratorial, a análise do SNP rs833061 (- 460) e a pequisa da deleção de 18 pares de bases em -2549, ambas na região promotora do gene VEGF em 114 pacientes com diabetes melito tipo 1, de três centros de referência em diabetes no Brasil ¿ Hospital das Clínicas da Unicamp, Instituto Estadual de Diabetes e Endocrinologia Luiz Capriglione (RJ) e Santa Casa da Misericórdia de São Paulo (SP). Houve associação entre retinopatia diabética proliferativa e nefropatia, porém nenhum paciente apresentou a deleção em -2549, nem o alelo -460 C em homozigose. Tais resultados sugerem que esses polimorfismos na região promotora do gene VEGF não interferem na predisposição à retinopatia diabética na população estudada e que outros agentes ambientais e/ou genéticos devem ser significativos / Abstract: Diabetic retinopathy is a frequent complication of diabetes mellitus type 1 and almost all patients develop it after twenty years of disease. The causes of these complications are not clear, but several environmental factors such as chronic hyperglicaemia may act in this predisposition, however, it is not clearly understood why some individuals develop it in a severe and precocious way. The participation of genetic factors as the vascular endothelial growth factor (VEGF), a potent angiogenic mediator, was already confirmed for some authors. In this study we investigate whether polymorphisms in VEGF gene are associated with proliferative diabetic retinopathy. One hundred-fourteen patients with diabetes mellitus type 1 underwent a clinical and laboratorial study, as well as the analysis of two polymorphisms: rs833061 and the deletion of 18 bp at -2549 both on the promoter region of the VEGF gene. There was an association between nephropathy and retinopathy in our patients but none of the individuals presented the deletion at -2549 or the allele C in rs833061 in homozygous state. These results suggest that such polymorphisms in the promoter region of the VEGF gene do not interfere in the predisposition to diabetic retinopathy in our population and that other environmental and/or genetic factor may be more relevant / Mestrado / Genetica Medica / Mestre em Ciências Médicas

Perdas gestacionais, malformações, restrição de crescimento intrauterino (IUGR) são associadas a gestações diabéticas. Para ampliar o conhecimento nesse tema, nosso grupo desenvolveu um modelo de gestação complicada por diabetes tipo 1 em camundongos que, nessa tese, foi utilizado para analisar o ciclo estral, desenvolvimento fetal e organização placentária. O diabetes foi induzido por aloxana e estudado em dois períodos 30-50D (curto prazo) e 90-110D (longo prazo). Placentas e fetos foram coletados, pesados, e submetidos a técnicas moleculares, bioquímicas e morfológicas. Detectaram-se alterações no perfil temporal do ciclo estral. O grupo 30-50D apresentou altas taxas de perdas embrionárias e IUGR, e o 90-110D malformações, mortes fetais, IUGR e aumento no peso placentário. As placentas diabéticas apresentaram aumento e desorganização da zona juncional, redução do labirinto e vasodilatação. A expressão dos colágenos I e III aumentou e a do V diminuiu em 30-50D, porém, a deposição destes aumentou concomitante com a redução da atividade da MMP9. A deposição dos colágenos III e V e a atividade da MMP2 aumentaram em 90-110D. Nossos resultados reiteram a importância do fator temporal nas complicações do diabetes sobre a gestação. / Gestational loss, malformations and intrauterine growth restriction (IUGR) are often associated with pregnancies. To increase the knowledge about this topic, our group has developed a model of pregnancy complicated by type 1 diabetes in mice. In this study, was analyzed the estrous cycle and the fetal and placental development. For this, diabetes was induced by alloxan and studied in two time-periods 30-50D (short term) and 90-110D (long term). Placentas and fetuses were collected, weighed and analyzed by biochemical, morphological and molecular procedures. We detected changes in the temporal profile of the estrous cycle. The 30-50D group showed high rates of embryonic loss and IUGR whereas malformations, fetal death, IUGR and increased placental weight was detected in 90-110D. Increase and disorganization of junctional zone, reducing labirinth and vasodilation characterize diabetic placentas. The expression of collagen I and III was increased whereas collagen V decreased in the 30-50D. The deposition of this collagen, however increased concomitant with the reduction of MMP9 activity. In 90-110D deposition of collagen III and V and the MMP2 activity was increased. Together, our results reinforce the relevance of the time factor in the complications of diabetes on pregnancy.

Avaliou-se a velocidade da onda de pulso (VOP) carótido-femoral (CF) e carótido-radial (CR), por meio de técnica não-invasiva, em 14 indivíduos diabéticos do tipo 2 normotensos, A sensibilidade do barorreflexo (SBR) foi avaliada pela manobra de Valsalva e por testes com nitroglicerina e fenilefrina, durante monitorização não-invasiva batimento-a-batimento da pressão arterial. Os resultados foram comparados aos obtidos em 13 indívíduos saudáveis pareados por idade, índice de massa corporal e sexo. O grupo diabetes apresentou maiores níveis de glicose de jejum e HbA1c. As VOP CF e CR foram mais elevadas no grupo diabetes. A SBR estava reduzida nos diabéticos, nos testes com nitroglicerina, fenilefrina e, no reflexo de taquicardia da fase II da manobra de Valsalva. O aumento da VOP CF foi significativamente correlacionado à redução da SBR. Os resultados demonstram que em diabéticos do tipo 2 há maior rigidez arterial e a SBR está reduzida. A SBR é inversamente correlacionada ao aumento da rigidez arterial / Fourteen normotensive diabetic subjects were submitted to carotid-femoral (CF) and carotid-radial (CR) pulse wave velocity (PWV) analysis by non-invasive automatic device. The baroreflex sensitivity (BRS) was evaluated by Valsalva manoeuvre, phenylephrine and nitroglycerin tests during non-invasive beat-to-beat blood pressure monitoring. The data were compared with those obtained in 13 age, body mass index and sex-matched healthy subjects. The diabetes group showed a higher fasting glucose level and HbA1c. The CF PWV and CR PWV were higher in diabetic patients. The BRS was impaired in diabetic individuals in nitroglycerine and phenylephrine tests and, also, in the tachycardic reflex in phase II of Valsalva manoeuvre. The increase of CF PWV was significantly correlated to the decrease of BRS. The data demonstrated that, in diabetic normotensive individuals, arterial stiffness is increased and the BRS is impaired. The BRS is inverselly correlated to increase of aortic stiffness

Bakgrund: Diabetes Mellitus typ 2 (DMT2) är en vanlig sjukdom över hela världen, den största orsaken bakom DMT2 är levnadsvanor och därför kan sjukdomen påverkas av livsstilsförändringar. Människors livskvalitet kan påverkas negativt av sjukdom och livskvaliteten kan variera stort mellan olika individer utifrån olika faktorer som hur de lever, hur de tänker och hur de hanterar olika situationer. Syfte: Syftet var att beskriva vilken betydelse livsstilsförändringar kan ha på livskvaliteten vid diabetes typ 2. Metod: Studiens design var en beskrivande litteraturstudie. Studien baserades på elva vetenskapliga artiklar som söktes fram via databasen PubMed. För att analysera artiklarnas resultat användes en tematisk dataanalys. Huvudresultat: I vissa fall bidrog livsstilsförändringar inte till några större skillnader i livskvalitet hos personer med DMT2 och i andra fall gav det positiva effekter. Över lag gav livsstilsförändringarna någon typ av positiv effekt inom en eller flera undergrupper för livskvalitet. Slutsats: Livskvalitet är något som skattas individuellt och kan innebära olika från person till person. Därför varierar även betydelsen av livsstilsförändringar relaterat till livskvalitet. Det är viktigt att ha denna kunskap som sjuksköterska för att ha förståelse för patienter och kunna individanpassa vården och det stöd som ges. / Background: Type 2 diabetes (T2D) is a common disease all over the world and the biggest reason behind T2D is lifestyle behavior and because of that it can be affected by making lifestyle changes. The quality of life can be affected negatively by disease and the quality of life can differ between individuals depending on factors such as lifestyle, mindset and coping strategies. Aim: The aim of the study was to describe how the quality of life can be affected by lifestyle changes among type 2 diabetes patients. Method: The design of the study was a descriptive literature review. The study was based on eleven articles that were found searching the database PubMed. The data analysis that was used to analyze the results of the articles was a thematic data analysis. Main Result: In some cases, the lifestyle changes did not tribute to any significant changes in the quality of life amongst people with T2D and in other cases it had a positive effect. The lifestyle changes did overall give some sort of positive effect on one or more of the subscales of quality of life. Conclusion: The quality of life is very individual and has a different meaning to each and everyone. Because of that, the lifestyle changes may have various effect on the quality of life. This knowledge is important to have as a nurse to be able to give patient-centered care and to support and understand the patients’ needs.

Bakgrund: Diabetes mellitus är en folksjukdom som kan leda till tidig död, främst på grund av hjärt- och kärlsjukdom. Diabetes mellitus har två typer av sjukdomar, vilket är typ ett och två. Båda är kända med förhöjda blodsockernivåer. Diabetes mellitus typ två handlar om insulinresistens och delvis insulinbrist. Sjukdomen kan yttra sig med två typer av komplikationer, nämligen mikrovaskulära och makrovaskulära. Behandlingen av Diabetes mellitus typ två är främst medicinering, kost och motion som förändrar livsstilen. Här är egenvård mycket viktigt och sjuksköterskan måste undervisa och informera på rätt sätt. Syfte: Syftet med studien är att beskriva patientens upplevelse av att leva med diabetes mellitus typ två. Metod: Metod som används är en litteraturöversikt med nio vetenskapliga artiklar. Datainsamlingen gjordes med sökord i databaserna CINAHL och Medline. Resultat: Resultatet visar att patientens upplevelser av att behöva göra förändringar i livsstilen handlar om att få stöd och känna hopp i framtiden i förhållande till diabetes mellitus typ två. Kost- och motionsförändringar påverkar patientens upplevelser och känslor. Patienten kan även ha emotionella upplevelser vid diabetes mellitus typ två, vilket kan vara känslor som skuld och skam. I det här läget ska patienten acceptera sjukdomen. Patienten kan ha upplevelser som ånger, motivationsbrist, hopplös, utmaning, ångest, skuld, skam och svårt att acceptera sjukdomen.y Diskussion: Patienten med diabetes mellitus typ två bör ändra sin kost och motion för att kunna få en bättre hälsa. Samtidigt ska sjuksköterskan inte glömma bort patientens upplevelser som kan leda till olika konsekvenser. Kost och motion har varit en utmaning för vissa patienter i livsstilen, som kan associeras med livslidande.