A chronic illness can be described as a health condition in human whose effects are long-lasting and usually persist for more than three months. According to Mays, such conditions tend to be recurrent with patients experiencing relapses and periods of remission.  Chronic conditions account for about 60 percent of global mortality rate today. Recent studies have shown a close relationship between chronic conditions and patient’s lifestyle owing to practices such as diet. This is together with behaviours such as smoking.
In this paper the author will focus on the life of John, an obese family man in his mid thirties who has just been diagnosed with Type 2 Diabetes Mellitus. John is of Australian descent. He hails from an ethnic group that is known to have high prevalence rates of Type 2 Diabetes Mellitus. As a nurse, it is important to analyze the patient’s life in an attempt to identify the possible causes of the ailment as well as to determine approaches to be used in counselling as well as treatment of the condition. Roehrig states that nurses are vital in the provision of health care services. 
Relationship Between Determinants of Health and Chronic Conditions
Upon receiving the shocking news that he had been diagnosed with Type 2 Diabetes Mellitus, John and his family were in deep shock. They reflected back on his life to try and establish the likely causative agents of his condition. A keen study into John’s history revealed that his mother was also a diabetic. John had also been noted to indulge in junk foods with fried chicken as his favourite meal. Only in rare occasions did John have fruits. 
Being employed, John had less time to engage in physical body exercise and often took offs on weekends to spend time with his family. Gerard states that occupation and other commitments are largely to blame for physical inactivity among many individuals.  Financial constraints resulting from low income however hindered the family from enjoying picnics. From this study, it is possible that John inherited his condition from his mother. Mead states that lifestyle would also be a contributing factor to this condition with high glucose levels leading to diabetes. 
A Person-Centred Approach and Improving Outcomes of People Living With a Chronic Condition
Upon realizing his condition, John went through a period of depression. Together with his family he was in a state of denial. Roberts states that more often many people fail to accept their conditions and take time to come into terms with the change.  Interaction with close friends was however a turning point for John. He was advised to visit a medical consultant who gave him tips on how to cope with his condition. John started off with therapy which included insulin injections. He also enrolled for physical exercise sessions which greatly assisted him in shedding off some body weight. Halverson states that physical exercise is vital in the burning of calories which means reduced fat and glucose content in the blood. 
Healthy feeding habits also helped him greatly reduce his weight as well as reduce his glucose intake. After attending a few counselling sessions, John and his family were able to accept their predicament as well as learn ways on how to support him and protect themselves from contracting the disease through healthy living. John’s understanding of healthy lifestyles helped him engage in activities that would help him prolong his life. Danaei states that since Type 2 Diabetes Mellitus is a lifestyle related disease, it is only through leading a healthy life that one can survive the condition.  Fear of losing and abandoning his family motivates him to live a healthy life.
Nursing Care, Management and Self Management
Nurses played an important role in helping John cope with his health condition. John contacted a nurse who provided him with his insulin injections on a regular basis. Through the nurse, John was also able to establish contact with a health consultant who advised him on how to lead a healthy life. His experience in hospital prior to his diagnosis with Type 2 Diabetes Mellitus can also be attributed to his good relationship with the nurses who helped him in his feeding and provided him with timely medication. John’s determination to get well soon also saw him quickly adapt to a healthy living regimen.
Sondik states that medical interventions work best only through one’s determination to get well.  With practice, he gained skills on healthy feeding. He engaged in physical body exercise on a regular basis. This helped him maintain a healthy lifestyle. John and his wife later adapted to the lifestyle and they gained skills such as provision of insulin injections that enabled them deal with their new health condition more independently.
Role of Self Management and Personal-Centeredness in Improving Outcomes
Individual interventions in prevention as well as treatment of a disease are the most effective means of controlling a condition. John was particularly determined to prolong his life with his family being a source of inspiration. He frequently attended body fitness sessions and in collaboration with his family members strived to maintain a healthy diet to help him check on his weight. This has helped him reduce his susceptibility to other related chronic diseases such as heart failure as well as high blood pressure. Cutler states that measures to prevent a crisis (such as personal savings as well as insurance policies) aid in reducing a patient’s anxiety with regard to his condition. 
Type 2 Diabetes Mellitus can be considered as a lifestyle disease. Current statistics have shown that many individuals have continued to contract the condition in spite of wide spread campaign among members of the society to improve their lifestyles in order to reduce their susceptibility to the condition. Individual’s personal attitude is important in determining the ability to survive and manage the condition. Braveman states that the effectiveness of treatment is greatly dependent on both the patient as well as the medical service providers such as nurses. 
- Mays G. Evidence linking increases in public health spending to declines in preventable deaths. Health Affairs. 2011; 30(8):45-7.
- Roehrig C. National health spending by medical condition. Health Affairs. 2009; 4(1):358-376.
- Gerard A. The growing burden of chronic disease in America. Public Health Reports. 2004; 119(1):46-8.
- Mead H. Racial and ethnic disparities in U.S – health care. The Commonwealth Fund Journal. 2008; 27(3):57-9.
- Roberts W. Foundation & partnership for solutions. Baltimore. 2004; 4(2):454-8.
- Halverson P. Performing public health functions – the perceived contribution of public health and other community agencies. J Health Hum Serv Admin. 1996; 18(3):288-303.
- Danaei G. The preventable causes of death In the United States – comparative risk assessment of dietary, lifestyle, and metabolic risk factors. PLoS Medicine. 2009; 6(4):223-9.
- Sondik E. Progress toward the healthy people 2010 goals and objectives. Ann Rev Public Health. 2010; 31(4):271-281.
- Cutler D. Are we finally winning the war on cancer? J. Econ Perspect. 2008; 22(3):40-2.
- Braveman P. Socioeconomic disparities in health in The United States – what the patterns tell us. American Journal of Public Health. 2010; 100(1):186-196.