In epidemiologic research, reliable statistical analysis is critical for drawing high-quality conclusions. Often a false association is created between cause and effect, which has the potential to harm the national health care system. OR and RR tests are used to test association hypotheses between variables as options for examining the quantitative strength of associations between cause and effect. The present paper tests causality for diabetes and allergies as family history factors, using formulas (1) and (2) to test OR and RR, respectively.
OR = a*d / b*c (1)
RR = (a / a+b) / (c / (c+d)) (2)
Diabetes
One way in which a patient’s diabetes is thought to occur is through inherited mechanisms that result in mutations that disrupt natural pancreatic function. The current dataset allowed us to test the OR for the relationship between family history of diabetes (column L) and the presence of diabetes in a particular patient (column J): all variables were dichotomous and discrete and could take no values other than “yes” or “no.” The total number of values was thus 300. For OR, Ratio Table #1 was created to divide the entire sample into four groups at once using a 2-by-2 system (MedCalc, 2016). Then, using the formula to determine the OR, the specific result for this relationship was calculated as shown in equation (3).
Diabetes
No Diabetes
Total
Family History
Yes (Exposed)
89
23
112
No (Not exposed)
20
168
188
Total
109
191
300
Table 1. Relationships between family history of diabetes and the presence of diabetes in a patient.
OR = 89*168 / 20*23 = 14 952 / 460 = 32,5 (3)
Using the 95% confidence interval calculation, the correct entry for the result obtained is an expression (3). Such a wide interval is justified by the fact that the number of patients diagnosed without a family history is relatively small compared to patients with a family history.
OR = 32,5 ⌈95% CI: from 16.9 to 63.4⌉ (4)
Allergies
In addition, the presence of allergies can also be related to family history. Using the relative risk formula (2) allows for estimating this value for the data set. Table 2 follows the logic of Table 1 but now uses data not for diabetes but for the presence of allergies in the patient. Then, using formula (2), it became possible to determine the relative risk for this table, which is reflected in equation (5). The value obtained means that people with a family history of the disease and people without a family history had allergies at the same frequency. It is essential to say that the transposition of the table led to the same outcome, which means that the obtained conclusion is formulated correctly.
Allergies
No Allergies
Total
Family History
Yes (Exposed)
89
59
148
No (Not exposed)
91
61
152
Total
180
120
300
Table 2. Relationships between family history of allergies and the presence of allergies in the patient.
Thus, summarizing the results leads to some interesting conclusions. First, the OR for diabetes turns out to be higher than 1, which means that the probability of the two events being related is high. In other words, having a family history of the disease, according to the criterion of effect severity, is related to diabetes. An additional RR check for Table 1 shows that the event is more frequent in the experimental group than in the group of patients without a family history of the disease (RR = 7.47). This is plausible because it is consistent with the scientific evidence (Franklin & Muthukumar, 2020). For allergic reactions, the RR level meant an equal risk of having allergies in both types of patients, and an additional OR check for these data (OR = 1.01, 95% CI: 0.64…1.61) confirms that having a family history does not affect the occurrence of allergies. It is essential to understand that OR and RR are not the same, which motivates additional examinations (Davies et al., 1998). The 95% confidence interval for the diabetes analysis proved the statistical significance of the result because it includes the OR. However, one cannot exclude the specificity criterion of the sample collected, resulting in a causality bias (Bradford Hill, 2020). In contrast, because the confidence interval for allergy studies included 1, the result was not statistically significant.
Conclusion
Epidemiological accuracy requires qualitative validation of data sets, and the OR and RR tests can be used for this purpose. The present work showed that diabetes does show a strong association with a family history of the disease, and the association is statistically significant. In contrast, the relationship between an individual’s allergies and family history was shown to be absent, with the result not being statistically significant. Thus, the main statistical patterns were identified, and relevant conclusions were formed, which can be used in practice.
In this research, 3600 diabetic patients were surveyed from twelve hospitals, but due to exclusion criterion, only 1,200 were considered for this particular research. Out of the tools provided, I applied randomizer in selection of the participants. This tool categorized the whole population in to 12 sets with 300 participants each. The system allocated numbers to the participants out of which 100 were picked randomly.
Research question
Do the diabetic patients benefit from sharing knowledge on diabetic condition with the physicians?
Inclusion criteria
Only patients whose age ranged from 40 to 65 were included. This age category represents the healthy class not susceptible to any ailment.
Patient diagnosed as having either diabetes type 1& 2 for 2 years prior to research. A period of two years gives a clear confirmation for those suffering from diabetes.
Those having HbA1c above 8% (HbA1c refers to Glycosylated hemoglobin, a measure of long terms sugar levels). Normal sugar levels range between 1-8% and anything above 8% gives a clear indication of diabetes case.
Exclusion Criteria
Patients, who prematurely interrupted, discontinued or had dose adjustment due to tolerability issues are excluded because they may have sugar levels which may give distorting information.
Patients who have been treated for Hepatitis C Virus within 3 months prior to screening. Hepatitis C therapy is known to affect the body sugar levels and in most cases causing them to rise beyond the normal levels.
Known HIV infection or chronic Hepatitis B Virus infection. These chronic problems are known to cause irregular changes in body sugar levels as they are known to drain the stored glucose and. The patient may in turn take much more glucose causing irregular sugar levels.
Reasons why the sample is a representative of entire population
Sample representativeness basically expresses the degree to which a given sample data precisely and accurately represents a characteristic of the entire population (Davis, Wagner & Groves, 2000). Therefore, through application of scientific methods, the entire sample proved to be a true representative of the entire population as the selection procedure was free from bias. The sample size was also sufficient and efficient in relation to the whole population, and more so, the method used in selection in all the twelve hospitals was consistent.
Generalizing the sample results to the entire population
Researchers cannot make observations for every individual in the population under study and as such they collect data from a sub set of individuals and use such observations to make inferences about the entire population (Denzin, 1994). Ideally, the sample represents the entire population if it bears the characteristics under interest. For that matter, the researchers’ conclusion becomes applicable to the entire population. Many strategies can be used to create a probability sample which defines the target population from which the sample is drawn and to which the sample data will eventually be generalized. Systematic sampling method was used to divide the entire area under consideration after which random sampling was used to recruit the participants. Thus the sample is a true representative of the entire population and as such, the sample results can be generalized to the entire population.
Determining if the sample size is large enough to represent the entire population
Besides using the appropriate methods and considering participants adequate response rate, the sample size must also be evaluated to determine the representativeness of the sample under study. Important to note is that smaller samples (those with fewer than 1,000 respondents) bears a greater sampling error unlike larger samples (Cooper et al., 2001). Sampling error refers to the number that describes preciseness of an estimate from any one given sample. Therefore, considering that the sample put under study has 1,200 respondents, it can be taken to be large enough to form a good representative of the entire population.
Expression of sampling error:
e = z√ (p %( 100-p %))
√ s
Where:
e = sampling error (proportion of error that is acceptable)
s = sample size
z = degree of confidence
p = estimate of the proportion of patients falling into the group suffering from diabetes
Applying the sampling error formula at 95% confidence level, sample of 1,200 respondents with an estimate of 20% suffering from diabetes is calculated as follows.
e = 1.96√ (20(80))
√ 1200
= +/- 2.6%
This means that, based on a sample of 1,200, we can be 95% sure that the true measure from the whole population from which the sample was drawn will be within +/-2.6% of 20%, that is, between 17.4% and 22.6%. This range is not very large and, hence, the sample size is large enough.
Ways of determining the sample size
It is always important to determine the sample size failure to which a researcher may end up with a sample that is too large, which may waste resources and time (Cooper, 1994). However, the sample may also be too small such that it leads to inaccurate results. To determine the minimum sample size needed to estimate whether the selected sample is a true representative of the entire population, a researcher must determine the below listed parameters:
Population mean
Sample mean
Notably, the above two parameters should yield a similar figure but in most cases they differ due to the margin of error which the researcher ought to have established the acceptable level before carrying out the research.
References
Cooper, H. (1994). Laying the foundations of diabetes care. Practice Nurse Journal, 7(5), pp.78–82.
Cooper, H., Booth, K., Fear, S., & Gill, G. (2001). Lessons from chronic disease patient education. Patient Education and Counselling, 44(15), pp.107–117.
Davis, R. M., Wagner, E. G., & Groves, T. (2000). Advances in managing chronic disease. British Medical Journal, 320 (27), pp.525–526.
Denzin, N. K. (1994). The art and politics of interpretation. Handbook of Qualitative Research. 49(7), pp. 500–515.
Food is essential to human beings, but when someone has diabetes, diet becomes the only solution. In our modern society, ambition is usually considered to be a positive word: “…it is a strong or ardent desire of anything considered advantageous, honoring, or creditable” (OED, def.#2). Look around the world, most the people are working hard to fulfill their ambitions: wealth and power. Are the ambitions still something that will give people hope and happiness? No! Ambitions are giving people another kind of “Diabetes,” and it is time to “Diet.”
Readers can learn more about how ambitions are causing sickness by analyzing one of the most famous William Shakespeare’s tragedies—- Macbeth. By analyzing Shakespeare’s work from the perspective of character, setting, symbolism, and plot, readers can understand how these ambitions destroyed the Macbeths step by step. Although ambition could destroy one’s future, Shakespeare also showed us another tragedy caused by a lack of ambition in Hamlet. Therefore, ambition is just like food, which is important, but one cannot have too much, and for someone who has “Ambition Diabetes” like Macbeths and Claudius, a “Logo Diet” would be a good choice.
One of the big three tragedies from Shakespeare, Macbeth, mainly focuses on describing how Macbeths, who have an “ambition diabetes” disease, go to death. At the beginning of this play, Macbeth was an honorable general; he just came back from tough combat. His “ambition diabetes” start from when three witches said: “All hail, Macbeth! Hail to thee, thane of Glamis! / All hail, Macbeth! Hail to thee, thane of Cawdor! /All hail, Macbeth! That shalt be king hereafter” (Shakespeare 1.3, line 49-51)!
His response was that: “Stay, your imperfect speakers, tell me more” (Shakespeare 1.3, line 71). His response shows his curiosity for these three witches, and it also reflects his ambition or hope at this time to be the thane of Cawdor and king. This fact is undeniable, as the Academy concluded that the man was affected so greatly that he decided to “seize a throne” (170).
However, it is significant to realize that, in this case, ambitiousness characterizes not only Macbeth but also the witches. When the soldier meets the witches, they start interacting with them in order to meet their goal of changing the lives of the whole kingdom. These characters make the man think that he is able to do everything, but they are the ones who trigger all the following actions. Macbeth becomes a puppet in their hands, and he assists the witches without realizing it. There is a possibility that he would remain an honorable soldier if he did not interact with them and acknowledge that he will turn into a king in the future.
Under this influence, Macbeth becomes the most ambitious man in the play, and this trait of character makes him a murderer. He states: “I have no spur / To prick the sides of my intent, but only / Vaulting ambition, which overleaps itself / And falls on the other” (Shakespeare 1.7, line 26-29). The man kills his kinsman, Duncan, because he wants to be a king but understands that he is suspected of this crime. As a result, he also murders Banquo, with whom he had friendly relationships.
The man also tries to kill his son and then sends people to deal with Macduff, his wife, and his child. In this way, ambitions turned a great soldier into a serial killer and a bloody tyrant, which proves that they are a disease that requires restriction. The lives of many individuals could be saved if Macbeth kept to a “diet.” The main character commits suicide eventually, so it can be said that “diabetes” led to his death. This idea is supported by Langis, who believes that Shakespeare’s characters often act on the basis of their passions, paying little attention to reasoning (45).
One more character who experiences different influences of ambitiousness is Malcolm. Being the son of the king, he is initially expected to follow his path. Thus, when realizing that Macbeth starts ruling England, Malcolm (who was abroad initially) decides to take his kingdom back. His ablations are associated with his duty to be an heir, which makes him act more reasonably.
Malcolm realizes that he is not the best possible king yet, so he tries to ensure that people are willing to follow him: “I am young; but something / You may deserve of him through me, and wisdom / To offer up a weak, innocent lamb / To appease an angry god” (Shakespeare 4.3, line 14-18). Just as a person who realizes that he needs to intake food, Malcolm allows his ambition to become a king to lead him. However, unlike Macbeth, he realizes that it is critical to remain clever in this situation and to use different tricks, being supported by friends. The prince limits his ambition and “keeps to a diet.”
Ambition is familiar to Lady Macbeth as well, as she takes to the husband’s idea to become a king and wants to benefit from his position. When Macbeth reconsiders his idea of killing Duncan, the woman starts questioning his masculinity in order to make him act: “When you durst do it, then you were a man; / And, to be more than what you were, you would / Be so much more the man” (Shakespeare 1.7, line 41-51). Moreover, her ambition goes so far that she becomes willing to act instead of her husband. Lady Macbeth emphasizes that she is able to cope with the man’s job to control Macbeth’s actions and make him follow her plan.
It can be proved, as she states: “Come, you spirits / That tend on mortal thoughts, unsex me here, / And fill me from the crown to the toe top-full / Of direst cruelty” (Shakespeare 1.5, line 30-34). However, the woman goes mad because of her ambitions. She “eats too much” and cannot live with Duncan’s blood on her hands, so she kills herself. Here, blood also appears as a symbol of guilt that tortures people who spill it, which is supported by de Jongh, who mentions that Lady Macbeth disintegrates into sleep-walking gilt (240).
The setting of the play affects the characters’ ambitions as well. Initially, the story shows Macbeth on a gloomy battlefield that influences his state of mind. Darkness symbolizes evil and danger. It puts the whole kingdom in disorder and makes the main character crueler than he really is. Macbeth seems to be a noble soldier who fights for this country in order to ensure the safety of its population. However, the setting makes him evil and ready to kill for his ambitions.
As the environment becomes darker, the man turns out to become more and more dangerous. It is also possible to see that all characters are murdered at night. In this way, this part of a day appears to symbolize death. When the sun goes down, people become vulnerable because darkness hides all crimes and sins. This setting provides characters with an opportunity to act blindly and to fulfill their ambitions by any means. When Macbeth comes to murder his king, he wants stars to hide everything so that he can commit a crime even without seeing his actions. Night affects not only humans but also animals, as Duncan’s horses seemed to “make war with mankind,” as they became aggressive that day (Shakespeare 2.4, line 18).
Castles that can be seen in the play turn out to be deceiving and make it easier for their owners to follow their ambitions. For instance, Macbeth’s castle seems to be peaceful and appealing initially: “This castle hath a pleasant seat. The air / Nimbly and sweetly recommends itself / Unto our gentle senses” (Shakespeare 1.6, line 1-3). However, this building remains cold inside, which can be associated with Macbeth’s behavior, as he is convinced by his wife to kill the king while acting like a noble soldier at the same time. Moreover, Lady Macbeth deceives her husband as she makes him murder Duncan. In this way, castles have the same nature as their owners and are associated with negative actions conducted under the influence of ambition.
The setting of Birnam Wood makes Macbeth believe that he is invincible and that he should follow this ambition to become a king. The witches mention: “Macbeth shall never be vanquished be until / Great Birnam Wood to high Dunsinane Hill / Shall come against him” (Shakespeare 4.1, line 93-94). Believing that he is the one who can “impress the forest, bid the tree / Unfix his earth-bound root,” Macbeth becomes even more ambitious, which leads him to destruction (Shakespeare 4.1, line 95-96). Thus, this place makes the main character believe in his own powers to change his life and the life of the whole kingdom.
While the characters of Macbeth face adverse outcomes of their ambitiousness, Hamlet proves that it is required and should not be totally abandoned. The man doubts himself: “How stand I, then, / That have a father killed, a mother stained,… / And let all sleep, while to my shame I see / The imminent death of twenty thousand men… / O, from this time forth / My thoughts be bloody or be nothing worth!” (Shakespeare 4.5, line 57-69). Hamlet parents were murdered and corrupted, and he faces the necessity to revenge for them. Even though he is not looking for fame or power, Hamlet lacks ambition, because it can be treated as “a desire for activity or exertion” (Merriam-Webster).
The lack of it makes him passive, and the character does nothing to fulfill his goal. He spends hours considering whether his inaction is shameful and trying to improve the situation but often loses his revenge focus: “Do not forget. This visitation / Is but to whet thy almost blunted purpose” (Shakespeare 3.4, line 126-127). However, the absence of proactiveness makes him a victim of a conspiracy and leads to his death. Payne believes that answering his questions, Hamlet could have an opportunity to alter his faith and act another way (34). Thus, he could have benefited if he had decided to take another path and to revenge for his parents initially.
It can be clouded that ambition is a trait the performance of which should be controlled. The characters of Macbeth were too focused on their desire to obtain the benefits of kingship. They acted cruelly and were ready to kill for this goal even though they did not really have a legal right to be monarchs. In this way, Macbeth and his wife consumed too much ambition, which led to “diabetes” that ended with their death. However, the absence of this food made another Shakespeare’s character, Hamlet, die. The man was not ambitious at all, so he was easy to manipulate. Thus, a healthy diet is required to ensure positive outcomes of ambitiousness.
The bill number H.R.4550, named Minority Diabetes Initiative Act, was introduced in House on 27 September 2019. The bill provides the right to the Department of Health and Human Services (HHS) to generate grants to public and nonprofit private health care institutions with the aim of providing treatment for diabetes in minority communities (Congress, 2021). The office of minority health in the USA includes Black/African American health, American Indian/Alaska native health, Asian American health, Hispanic/Latino health, and native Hawaiian and Pacific Islander health offices.
Diabetes Control with H.R.4550 Public Health Bill
Diabetes is a health disease that may cause significant consequences without liable medical care and treatment. According to Haire-Joshu and Hill-Briggs (2019), 1 out of 11 people in the USA is diabetics. For instance, referring to the American Centers of Disease Control and Prevention, the percentage of Hispanic adults who were diagnosed with diabetes has increased dramatically from 8.8 to12.4 during the period from 2000 to 2019 (US Department of Health and Human Services Office of Minority Health, 2021). Taylor et al. (2017) outline a challenge caused by political interference that negatively influences the development of science, clinical training, and research. Therefore, the main objective of HHS is to ensure that grants given by the secretary are used to finance the diabetes-related health care services, “including routine care for diabetic patients, public education on diabetes prevention and control, eye care, foot care, and treatment for kidney disease and other complications of diabetes” (Congress, 2021, p.2). Furthermore, the public health grants that are established by this bill authorize health promotion and bring society into a healthy state.
National diversification in H.R.4550 Public Health Bill
Minority communities may experience a lower-level professional healthcare treatment or a lack of financial resources to fund better medical services. H.R.4550 Bill will help overcome this problem by developing an appropriate health programs administration that includes cultural diversification. A constant funding source gives the advantage of providing reasonable health care and controlling the state of patients with diabetes in minority communities by considering all specific national characteristics of the patient. The Minority Diabetes Initiative Act raises the voice in support of policies and regulations that ensure people’s access in minority communities to high-level medical care and treatment in case of digestive and metabolic diseases.
Conclusion
H.R4550 Bill confronts the humanitarian gap in the American healthcare system, which affects people with diabetes in minority communities. This is an evidence-based problem that results from the increasing percentage of patients with this disease. Unfortunately, the shortage of well-structured medical help and the appropriate disease treatment affects explicitly those levels of the population that are represented as the minor ones. Therefore, this bill provides both humanitarian and political solutions that cover cultural dimensions, ethnic differences, and public health problems at the level of minority communities in the USA.
Currently, research studies indicate that diabetes mellitus (type 1 diabetes) is one of the leading causes of deaths throughout the world, threatening human lives. Statistics indicate that the number of people living with diabetes mellitus is about 370 million, with an annual increase of over 60% in developed countries and 20% in the developing world. It is estimated that the number of people living with the condition will be more than 550 million by 2030.
Destruction of beta cells (β-cells) in the islets is the cause of a decrease in the volume of insulin released from the pancreas (Amour et al. 1392). Studies have shown that an autoimmune-mediated process is the principal cause of the condition (Lakey, Mirbolooki, and Shapiro 78). Specifically, the autoimmune-mediated process is responsible for a TID etiology, the principle aspect of the β-cell death (Soria, Skoudy, and Martin 407). In this case, antigen-presenting cells infiltrate the islets of Langerhans, attracting CD8 and CD4 T cells, B cells, and NK cells. Macrophages are responsible for producing IL-12, which activates Th1 CD4 T cells. In turn, the activated CD4 cells release IL-2 and pro-inflammatory cytokines, TNF, and interferon-γ, leading to activation of CD8 T cells (Reubinoff et al. 400). This enhances the death of β-cells through apoptosis.
Principle
There is evidence that transplants of islets of Langerhans with β-cells can reverse the death of these cells in the pancreas to counter diabetes mellitus (Kroon et al. 458). Human embryonic stem cells have been directed to proliferate and develop into β-cells (Thomson et al. 1146). It is, therefore, expected that induced pluripotent stem cells (iPS) can be directed in the same manner. In this method, the iPS stem cell line will be developed as directed to become full β-cells for placement in human kidneys to generate insulin (Odorico, Kaufman, and Thomson 193).
Study problem
Despite the presence of knowledge, few studies have produced effective cell lines because the problem is to generate an adequate source of these cells in practice and research (Sams and Powers 83).
Materials and methods
The study will work with human iPSCs line RSCB0082 to be purchased from a stem cell bank. The cells will be reproduced from reprogramming human dermal fibrobrast cells. They will be grown in a cell medium with mitotically inactivated rat or mouse embryonic fibroblasts and 70% Gibco medium. Gibco Medium has 20% knockout serum, 0.1mM of amino acids, mercaptoethanol, transferrin, penicillin, and streptomycin (Cowan et al. 1355).
Procedure
The method will involve four steps that will lead to the development of mass iPCs with the capacity to reverse diabetes mellitus.
Step 1
After obtaining the cells, the colonies will be trypsinized with an agent such as EDTA. A single-cell suspension will be developed through sipping cells gently in an up and down manner using a pipette. Then, the cells will be counted. Hanging drops will be made using 30µl, each with about 3000 cells in a media high in DMEM and 10% fetal bovine serum but deficient in bFGF (Bonner-Weir and Weir 853). Then, the cells will be placed on the lids of Petri dishes and incubated for 72 hours.
Step 2
After 72 hours, the embryonic bodies of cells will be plated again in 6-well culture plates and a density of 100 bodies per well (Chen et al. 266). The culture plates will be coated with gelatin (about 0.1%) and incubated for 14 days in a DMEM medium with insulin, selenium, and transferrin (Hwang et al. 1672). They will be incubated for 7 days
Step 3
After incubation, the cells will be separated with EDTA rich in 0.05% trypsin. They will be placed on 6-well cultures at a concentration of about 300,000 per well. The wells will be supplied with DMEM media-rich in Nitrogen 2 supplement (1%), B-2 supplement (3%), and fibroblast growth factor (FbGF). In addition, the culture wells in the plates will be coated with sigma gelatin of about 0.2%. It is expected that after 7 days, cell clusters will be formed on the plates (Murtaugh 429).
Step 4
Before removing the fibroblast growth factor, the cells will be supplied with 1% and 2% of N-2 and B-27, respectively. After the removal of the fibroblast growth factor, nicotinic acid will be added to the cultures (Jiang et al. 1948).
Quantification processes
Quantification of a pancreatic specific factor of transcription in the cell lines will be done using a real-time polymerized chain reaction (PCR). The purpose is to determine the amount of RNA produced from the cells because it is expected that after the four steps above, they will produce mRNAs.
The secretion of insulin in the cell lines will be investigated through a final analysis involving the centrifugation of some cells and radioimmunoassay of their supernatants. In this case, some clusters of the cell lines will be rinsed with Krebs-Ringer buffer (HEPES) rich in glucose. The cell line clusters will be incubated in this medium for 10 minutes, 20 minutes, 30 minutes, 50 minutes, and 60 minutes in the buffer. Then centrifugation of each of the cells will be done, and a radioimmunoassay did on the supernatant to determine the presence of insulin protein from the cell lines (Maehr et al. 15769).
Statistical analysis with SPSS or ANOVA will be used to develop and analyze data from each of the 6 sets of radioimmunoassay tests.
Expected results
It is expected that iPCS will differentiate into ILCs using this protocol. It is also expected that the cells will produce endocrine progenitors, which will then be transmitted into the kidney of a mouse model deficient in insulin to observe their possible effects on humans.
Works Cited
Bonner-Weir, Susan and Gordon Weir. “New sources of pancreatic β-cells.” Nature biotechnology 23.7 (2005): 857-861. Print
Chen, Shuibing, Malgorzata Borowiak, Julia L Fox, René Maehr, Kenji Osafune, et al. “A small molecule that directs differentiation of human ESCs into the pancreatic lineage.” Nature chemical biology 5.4 (2009): 258-265. Print.
Cowan, Chad A. Irina Klimanskaya, Jill McMahon, Jocelyn Atienza et al. “Derivation of embryonic stem-cell lines from human blastocysts.” New England Journal of Medicine 350.13 (2004): 1353-1356. Print
D’Amour, Kevin Anne Bang, Susan Eliazer, Olivia Kelly, et al. “Production of pancreatic hormone–expressing endocrine cells from human embryonic stem cells.” Nature biotechnology 24.11 (2006): 1392-1401. Print.
Hwang, Woo Suk Young June Ryu, Jong Hyuk Park, Eul Soon Park, et al. “Evidence of a pluripotent human embryonic stem cell line derived from a cloned blastocyst.” Science 303.5664 (2004): 1669-1674. Print
Jiang, Jianjie, Melinda Au, Kuanghui Lu, Aliana Esthpeter, et al. “Generation of Insulin‐Producing Islet‐Like Clusters from Human Embryonic Stem Cells.” Stem cells 25.8 (2007): 1940-1953. Print.
Kroon, Evert, Laura Martinson, Kuniko Kadoya, Anne Bang, et al. “Pancreatic endoderm derived from human embryonic stem cells generates glucose-responsive insulin-secreting cells in vivo.” Nature biotechnology 26.4 (2008): 443-452. Print
Lakey, Jonathan RT, Mohammadreza Mirbolooki and AM James Shapiro. Current status of clinical islet cell transplantation. Humana Press, 2006. Print
Maehr, René, Shuibing Chena, Melinda Snitowa, Thomas Ludwigb, et al. “Generation of pluripotent stem cells from patients with type 1 diabetes.” Proceedings of the National Academy of Sciences 106.37 (2009): 15768-15773. Print.
Murtaugh, Charles L. “Pancreas and beta-cell development: from the actual to the possible”. Development, 134.3, (2009): 427-438. Print
Odorico, Jon S, Dan Kaufman and James Thomson. “Multilineage differentiation from human embryonic stem cell lines.” Stem cells 19.3 (2001): 193-204. Print
Reubinoff, Benjamin Martin Pera, Chui-Yee Fong, Alan Trounson and Ariff Bongso. “Embryonic stem cell lines from human blastocysts: somatic differentiation in vitro.” Nature biotechnology 18.4 (2000): 399-404. Print
Sams A and Powers MJ. “Feeder-free substrates for pluripotent stem cell culture”. Methods Mol Biol 997.6 (2013): 73-89. Print.
Soria, B, Arthur Skoudy and Fred Martin. “From stem cells to beta cells: new strategies in cell therapy of diabetes mellitus.” Diabetologia 44.4 (2001): 407-415. Print
Thomson, James Joseph Itskovitz-Eldor, Sander S. Shapiro, Michelle A. Waknitz, et al. “Embryonic stem cell lines derived from human blastocysts.” science 282.5391 (1998): 1145-1147. Print
The quality of life is determined by the Health and Diseases. There are various ailments /conditions that put life in trouble which could range from systemic disorders to cancer. In the present context, metabolic disorder type 2 diabetes mellitus was discussed. Diabetes is a metabolic disorder that results when sufficient insulin is not produced by the pancreas (WHO Report, 2009).
This condition also results if insulin is not utilized by the body (WHO Report, 2009). Insulin is type of hormone that has control on blood sugar (WHO Report, 2009). The level of blood sugar raises and leads to Hyperglycaemia, when the diabetes is not manageable and finally causes destruction to blood vessels and nerves (WHO Report, 2009).
There are two types of Diabetes most common in the population. They are type 1 and type 2.Type 2 diabetes also known as non-insulin-dependent or adult-onset occurs when body fails to use insulin. Nearly 90% of diabetic individuals are present globally which is the merely the reflection of the result of physical inactivity and over body weight (WHO Report, 2009). Although, the symptoms of Type 2 diabetes are same as that of Type 1, it may take many years to get diagnosed after the onset (WHO Report, 2009).
Type 2 diabetes most frequent in adults but in the modern society children are also falling victims to this disorder. The present day life style is exposing wide range of individuals to develop various disorders where type 2 Diabetes is the frequent. The causes of this disorder are not completely understood although clinical data persists. This could be due to the existence of multiple factors that could predispose the people to diabetes.
The inclusion criteria for type 2 diabetic individuals could be elevated glucose levels observed in fasting or post lunch sessions. The exclusion criteria would for those with normal values. The parameters that help in understanding the development of type 2 diabetes may be those that reflect levels of blood glucose, insulin, lipid, other suspected agents with genetic etiology etc. There is need to carry out a thorough literature review.
Therefore, keeping in view of the above background information, the topic was selected and there is need to carry out a thorough literature review. Recently, it was reported that Insulin resistance (hyperinsulinemia) is the sole factor and could play important role in the development of type 2 diabetes mellitus (Jannetta et al., 2010).
This was revealed when patients with type 2 diabetes had pulsatile arterial compression when retromastoid craniectomy of Brain was performed (Jannetta et al., 2010). These patients gradually have shown improvement of glucose regulation (Jannetta et al., 2010).
Thus, when right anterolateral medulla region gets compressed it could lead to type 2 diabetes mellitus (Jannetta et al., 2010). In children with Type 2 diabetes, it was reported that a sort of insulin resistance marked by pubertal rise and insufficient beta-cell insulin response could lead to hyperglycemic condition (Banerji, 2002). Adult individuals have a low response to glucose levels intravenously and delay in oral glucose oral response Loss of beta cell function is reported in adults but not in children (Banerji, 2002).
To investigate this problem, the researchers have supplemented mixed meal and given glucagon intravenously and performed oral glucose tolerance test (Banerji, 2002).This resulted in the significant restoration of alpha and beta cell function with good C- peptide response indicating that they are essential in the diagnosis of type 2 diabetes mellitus(Banerji, 2002).
The pathophysiology of Type 2 diabetes has genetic basis. In an experiment New Zealand obese (NZO) mouse was chosen as a model of type 2 diabetes. By employing lean strains, researchers have detected many quantitative trait loci (QTL) susceptible for hyperglycemia (Joost, 2010).The transcription factor Zfp69, the genes RabGAP, Tbc1d1 were Lepr, Pctp, Abcg1, and Nmur2 identified(Joost, 2010).They were considered as the candidate genes in sequencing investigations (Joost, 2010).
Since, Type 2 diabetic individuals are presented with fasting and postprandial hyperglycemia much research emphasis was given in this context (Rizza, 2010). Glucose synthesis is high prior to eating and does not to get diminish after a diet in type 2 diabetes(Rizza, 2010). This could be due to the fact that altered impaired insulin produced suppression of endogenous glucose synthesis.
High rates of glycogenolysis and gluconeogenesis play role to develop hepatic insulin resistance (Rizza, 2010). These stages of carbohydrate metabolism get altered leading to decreased hepatic glucose uptake and hepatic glycogen production which are insulin stimulated processes (Rizza, 2010). This also leads to low uptake of extracellular glucose due to poor activation of hepatic glucokinase.
Finally, there would be delayed or very slow insulin secretion that could lead to increased glucose concentrations at the peak level(Rizza, 2010). This occurs due to altered suppression of glucagon. Thus, insulin resistance increases the time period of hyperglycemia (Rizza, 2010). The therapy of type 2 diabetes has become a complex task. Although, there is knowledge about the occurrence of the disease and risk factors, thorough metabolic control type 2 diabetes is lacking (Triplitt , 2010).
This needs an assessment of clinical inertia which is considered as a failure to begin or further the therapy (Triplitt, 2010). This strategy is for those patients who are unable to receive the care in an evidence-based approach. Hence, this aspect serves as a important factor in the therapeutic management of type 2 diabetes (Triplitt, 2010).
Further, there are several reasons for the clinical inertia and they are inter associated among the diabetic individuals, care providers, and health systems and from definite treatment approaches (Triplitt, 2010). Very often, antihyperglycemic agents also contribute to the clinical criteria (Triplitt, 2010).
This takes place due to the self reactive drugs and their side effects like gastrointestinal discomfort, edema, weight gain, hypoglycemia and finally the complexity treatment regimen (Triplitt, 2010). There is no independent therapy to cease the pancreatic beta-cell defect, as such treatments in a combined manner could be necessary involving thiazolidinediones and glucagon-like protein-1 agonists that are connected to prolonged A1C level decrease.
This aspect has good implications for the diagnosis of type 2 diabetes mellitus (Triplitt , 2010). Recently, it was described that incretin hormones, glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), are potential in the management of type 2 diabetes mellitus(Knop , Vilsbøll, & Holst 2009).
This is because , the actions of GLP-1 and GIP, have tremendous therapeutic effect on the enhancement of meal driven insulin secretion and trophic effects on the beta-cell GLP-1 reduces glucagon secretion, and diminishes food intake and appetite (Knop , Vilsbøll, & Holst 2009). Thus, two novel drug classes are related to potential benefits of incretin hormones and are recommended for treating T2DM (Knop , Vilsbøll, & Holst 2009).
Here, long-acting stable analogues of GLP-1 which are injectibles incretin mimetics, and oral inhibitors of dipeptidyl peptidase 4 (DPP4; the enzyme responsible for the rapid degradation of GLP-1 and GIP), belong to the category of incretin enhancers (Knop , Vilsbøll, & Holst 2009). This was strengthened by another report that emphasized the physiological role of incretin hormones (William, 2010).
The two classes of incretin-directed therapies are exert their action by enhancing increasing endogenous levels of glucagon-like peptide-1 (GLP-1) or by resembling the action of endogenous GLP-1 (ie, GLP-1 agonists) (William, 2010). Since the management of type 2 diabetes mellitus (T2DM) is a complex process, incretin therapy could be a key therapy as it does not induce bogy weight increase and hypoglycemia as seen in conventional therapies (William, 2010).
Therefore, it is reasonable to mention that incretin related parameters could serve as novel diagnostic markers and help reduce the burden of type 2 diabetes mellitus. Adult individuals are becoming more favorable targets and contributing the rising prevalence and incidence of type 2 diabetes mellitus (DM) (Chen et al., 2010).This could be due to age associated complications like weakness multiple comorbidities, and functional defects(Chen et al., 2010).
Insluin resistance plays role in predicting weakness and diabetes increases loss of muscular power (Chen et al., 2010).Thus, for aged people with type 2 DM , there is a need to consider multiple factors like physical discomfort, tube feeding, cognitive defects. Here, glycemic control of these patient could raise the chances of hypoglycemia and significant functional decrease (Chen et al., 2010).
Thus, diagnosing type 2 diabetes mellitus in old individuals is a complex process and need further research on new emerging parameters that reflect hypo or hyperglycemia and insulin resistance.
In conclusion, Type 2 diabetes is a metabolic disorder with emerging etiological factors that vary in response to changing life style or environmental hazard exposure. The pathophysiology of this disorder is interrelated with carbohydrate metabolism. As such, parameters that indicate the normal o abnormal levels of glucose, insulin, should be considered from all corners of the investigation. The cause of diabetes may also have genetic susceptibility.
Large number of individuals from children to the old age is now becoming targets of this disorder. There is a need to undertake appropriate screening programs to precisely identify the type 2 diabetic individuals. Concomitant factors like obesity, cardiovascular problems mat also further aggravate the problem, contributing to the overall incidence. An evidence based approach is more suggestive for proper diagnosis.
References
Type 2 Dabetes. WHO report. Web.
Banerji, M,A. 2002. Impaired beta-cell and alpha-cell function in African-American children with type 2 diabetes mellitus – “Flatbush diabetes”.J Pediatr Endocrinol Metab. 15 Suppl 1:493-501.
Chen, L,K., Chen, Y, M., Lin, M, H., Peng, L, N., Hwang, S, J. 2010. Care of elderly patients with diabetes mellitus: A focus on frailty. Ageing Res Rev. 2010
Jannetta, P, J., Fletcher, L, H., Grondziowski, P,M., Casey, K,F., Sekula, R,F Jr. 2010. Type 2 diabetes mellitus: A central nervous system etiology. Surg Neurol Int, 16;1. pii: 31.
Joost, H,G 2010. The genetic basis of obesity and type 2 diabetes: lessons from the new zealand obese mouse, a polygenic model of the metabolic syndrome. Results Probl Cell Differ. 52:1-11.
Knop, F, K., Vilsbøll, T., Holst, J, J. 2009. Incretin-based therapy of type 2 diabetes mellitus. Curr Protein Pept Sci. 10(1):46-55.
Rizza, A. 2010. Pathogenesis of Fasting and Postprandial Hyperglycemia in Type 2 Diabetes: Implications for Therapy. Diabetes.
Triplitt, C. 2010. Improving treatment success rates for type 2 diabetes: recommendations for a changing environment. Am J Manag Care 16(7 Suppl):S195-200.
William T. Cefalu M, D. 2010. The Physiologic Role of Incretin Hormones: Clinical Applications.2010. JAOA • 110 (3).8-14.
Despite numerous attempts at preventing and treating diabetes, the subject matter still remains an essential topic in 21st-century healthcare (Fulton Community Health Care Center, 2014). The allocation of the financial resources available, however, leaves much to be desired, as the programs aimed at spreading awareness concerning the threats of diabetes, as well as the factors that enhance its development, do not receive as much funding as they deserve (Johnson, 2014).
The program in question, i.e., the Diabetes Assistance Program, is obviously aimed at providing unflinching support to the patients that have been diagnosed with diabetes. As far as the ascertainable objectives of the project are concerned, however, it seems that the strategy in question lacks clarity. Specifically, the funding for diabetes in general and spreading awareness concerning diabetes, in particular, does not seem to create an auspicious environment for the provision of proper healthcare services. According to the official financial statement issued by the Fulton County Healthcare Department, $2,971,528 has been supplied for the enhancement of healthcare services (Centers for Disease Control and Prevention, 2014). A rather modest part of this sum, however, has been used for the purposes of diabetes treatment and prevention.
As a result, not all stakeholders involved may enjoy an auspicious environment for diabetes awareness and treatment enhancement. The patients, which are clearly the key stakeholders, may be deprived of the opportunity to learn more about the disease and the means to fight or prevent it. The funding, however, allows for updating the equipment and creating a more elaborate system of tests, therefore, increasing the chances for diabetes patients to fight the disease (Suarez, Lesneski, & Denison, 2011).
Denying the fact that the Fulton County Healthcare supports the programs related to diabetes, however, would be wrong – the local healthcare services have designed a range of strategies, which allow for a terse yet very informative introduction to the key concepts of diabetes prevention and treatment options. However, a closer look at the implementation of these programs will reveal that the budget for the latter is quite small and that a better allocation of the key costs will be pertinent. For example, the 2012 grant received from the Atlanta Falcons Youth Foundation and estimating $ 25,000 could have been used for designing a new approach towards spreading awareness concerning diabetes, as well as the implementation of new ways of treating the disease. Moreover, reports show that the organization has made an impressive foot forward in facilitating the access to information concerning diabetes treatment and prevention for the specified denizens of the U.S. population (Shi & Johnson, 2014a).
Though the efforts that have been put into promoting awareness regarding diabetes treatment and prevention have been implemented in a rather dexterous manner, the current strategy for allocating the financial resources available is far from perfect. It would be much more adequate to focus on short-term goals, such as the increase in awareness rates among the target population. Focusing on making the information concerning diabetes available among the residents of the Fulton community may become the watershed moment that will improve health rates among the denizens of the community (Shi & Johnson, 2014).
Therefore, to make the current system of information transfer to the target audience more pliable, it will be an adequate solution to the ditches in the healthcare system of the state (Public Health Finance and Management, 2014). The project in question, thus, needs to be funded as the preeminent tool for informing the residents of the area under consideration on the issue of diabetes and the methods of its treatment. Among the potential funding resources, charity organizations such as Alfred P. Sloan Foundation (About the foundation, 2014) and U.S. Department of Health and Human Services (2014) can be suggested, as they will help enhance the technological aspect of the programs (Grants.gov, n. d.) and, therefore, create the premises for greater amount of people to enroll into the program.
Reference List
About the foundation. (2014). Alfred P. Sloan Foundation. Web.
Centers for Disease Control and Prevention. (2014). CDC announces FY 2014 funding awards for chronic disease prevention and health promotion. CDC. Web.
Fulton Community Health Care Center. (2014). Diabetes education. Fulton Community Health Care Center. Web.
Grants.gov. (n. d.). About Grants.gov. Web.
Johnson, T. D. (2014). Prevention and public health fund paying off in communities: Success threatened by cuts to fund. Web.
Shi, L., & Johnson, J. A. (2014). Novick and Morrow’s public health administration: Principles for population-based management (3rd ed.). Sudbury, MA: Jones & Bartlett Learning.
Shi, L., & Johnson, J. A. (2014a). Public Health Finance. Novick and Morrow’s public health administration: Principles for population-based management (pp. 181–199) (3rd ed.). Sudbury, MA: Jones & Bartlett Learning.
Suarez, V., Lesneski, C., & Denison, D. (2011). Making the case for using financial indicators in local public health agencies. American Journal of Public Health, 101(3), 419–425.
U.S. Department of Health and Human Services. (2014). Grants/funding. Web.
Diabetes is a condition that describes a group of metabolic diseases where a person’s blood sugar tends to rise above the usual and required standard (McCarthy, 2014).
Individuals with high blood sugar typically experience several symptoms. One of the symptoms is the frequent passing of urine. They get thirsty most often. They also get hungry every time. It is a long-term condition. Sometimes intense weight loss or weight gain can be a symptom (McCarthy, 2014).
The disease has two categories. Type 1 Diabetes is a condition where the body does not produce insulin (McCarthy, 2014). It is a condition that affects ten percent of all diabetes cases. There is also type 2 diabetes. The pancreas makes less insulin than is required by the body.
The Burden of the Disease in the United States of America
The population estimates of the United States in the year 2014 were approximately about three hundred million. The undiagnosed make up 27.8%. Diagnosed people add up to 21 Million Americans (Lobo, 2014).
The 2009-2012 National Health and Nutrition Examination Survey revealed that more men were living with diabetes than women. 15.5 million Men had diabetes as compared to 13.4 million women. The comparison by age showed some facts too. There were 13.4 million people from the ages of 45 years to 64 years old who had Diabetes as compared to 4.3 million people between 20-44 years. From the age of 65 and above, there were only 11.2 million persons (McCarthy, 2014).
The disease has become a burden to the city of Baltimore in the state of Maryland. When people, especially the very active adults die of diabetes, it robs the city of very productive citizens. The city has to reallocate billions of money to control the disease. The city has to concentrate on prevention awareness campaigns and treatment. It makes it costly both to the city and to the population.
Another problem is that one can only manage diabetes. Most of the research work is yet to find a cure. There are myths people have come up with about what causes the disease. Once someone acquires the disease, it becomes part of him/her for life. With a greater percentage of people suffering from the condition, it causes laxity in the labor force and a lot of expenses in the budget.
Diabetes can result in kidney damage, cardiovascular diseases, blindness, lower-limb amputations, and other expensive and incurable complications. It reduces the city’s productive labor force. Diabetes causes many complications in the body. As a result, people become unsettled at their workstations and insurance companies also have the trouble of catering for the ailments.
The prevalence of diabetic adults in Baltimore and Houston, Texas has drastically risen. It has been a tense process trying to educate people about the disease. People have had to adopt a different lifestyle to avoid having the disease. Another concern is the myths surrounding the disease which the government has to address. The CDC has a program that outlines the requirement and lifestyle program to prevent diabetes. Organizations can adopt it.
People with Type 1 can receive an injection or pump to survive. Type 2 case people can just watch their diet and healthy living. There are prevention campaign measures on social networks (Sepah, Jiang & Peters, 2014).
They can also take medication to control their blood pressure. Diabetes has caused people to develop a series of complications. Some of them are heart disease and stroke, blindness and or eye problem, kidney disease, and amputations.
References
Lobo, P. (2014). New diabetes screening recommendations in the USA. The Lancet Diabetes & Endocrinology, 2(12), 934. Web.
McCarthy, M. (2014). Nearly one in 10 US residents has diabetes, CDC reports. BMJ, 348(jun11 10), g3962-g3962. Web.
Sepah, S., Jiang, L., & Peters, A. (2014). Translating the Diabetes Prevention Program into an Online Social Network: Validation against CDC Standards. The Diabetes Educator, 40(4), 435-443. Web.
Diabetes mellitus is a disease associated with insulin deficiency in the organism. Depending on the type of condition, it affects individuals from different age groups. A more common type 2 is typically diagnosed in the older population (40-80 years) and is characterized by a slow onset while type 1 is more prevalent in children and has a rapid onset. The condition is characterized by weight loss, hunger, frequent urination, thirst, and tiredness. Associated symptoms include dryness of skin, slow recovery of sores, and more frequent infections. The most prominent aggravating factor for the condition is obesity, and the respective alleviating factor is a healthy weight.
The most common concomitant diseases associated with diabetes are cardiovascular disease, hypertension, and vascular diseases. Since their treatment affects blood sugar levels, the treatment of diabetes must be adjusted accordingly.
The pathophysiology of type 2 diabetes can be described as a relative deficiency of insulin in contrast to the absolute deficiency characteristic for type 1 diabetes. In absolute deficiency, beta cells responsible for insulin production are destroyed by the malfunctioning immune system, which leads to the eventual insulin deficiency. The relative deficiency is caused by insulin resistance, where the available insulin is insufficient for normal body functioning. This prompts increased production and eventually wears off beta cells. Since insulin resistance usually increases over time, the condition aggravates unless addressed.
The primary differential diagnosis is diabetes mellitus type 2. The most reliable indicators of the diagnosis are the elevated levels of glycosylated hemoglobin and a high amount of plasma glucose. The patient diagnosed with type 2 diabetes usually reports being constantly tired and sleepy. Abdominal obesity or even excessive weight are corroborating factors. The tests are expected to show abnormally high blood sugar levels. Fatigue may occur in patients with severe forms of the disorder. Blurred vision, slow recovery of injuries, unreasonable weight loss, and frequent infectious diseases further increase the likelihood of the diagnosis.
Secondary differential diagnosis is hyperglycemia due to insulin resistance. Once the insulin-related tissues (e.g. liver) lose the ability to process insulin, an insulin deficiency develops. The rationale for the condition would be polydipsia (excessive thirst) and polyphagia (excessive hunger), blurred vision, tingling in lower extremities, dryness in the mouth, and restlessness. Cardiac arrhythmia may develop in severe cases of the condition.
Another secondary differential diagnosis is the hyperglycemia caused by the reduced secretion of insulin. In this scenario, the beta cells work at an abnormally high rate due to the reduced insulin absorption. This leads t their eventual decline and creates severe deficiency. The rationale for the conditions is mostly consistent with insulin resistance-induced hyperglycemia but can include pancreatic disorders and seizures in extreme cases.
The evidence-based practices that yield the best results for conditions identified in the differential diagnoses can be categorized into the lifestyle changes and pharmacological interventions. The former include physical exercise and healthy dietary habits. Since blood sugar can be decreased through regular exercise, moderate food intake, and avoidance of high-sugar foods, hyperglycemia can be controlled in this way, thus enhancing the effectiveness of the medications (American Diabetes Association, 2016). The latter includes consistent medication intake, blood sugar monitoring, and insulin intake adjustment. The combination of these practices decreases the severity of hyperglycemia-associated symptoms and alleviates the stress of the beta-cells (Inzucchi et al., 2015).
Once all of the identified components of the intervention are responsibly maintained by the individual, the condition can be maintained at the low-risk level. For the patient, the outcome can be described as the alleviation of the majority of symptoms and the elimination of risks associated with the condition, and, by extension, the improved quality of life.
References
American Diabetes Association. (2016). Standards of medical care in diabetes—2016 abridged for primary care providers. Clinical Diabetes: A Publication of the American Diabetes Association, 34(1), 3-21. Web.
Inzucchi, S. E., Bergenstal, R. M., Buse, J. B., Diamant, M., Ferrannini, E., Nauck, M.,… Matthews, D. R. (2015). Management of hyperglycemia in type 2 diabetes, 2015: A patient-centered approach: Update to a position statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care, 38(1), 140-149. Web.
Nowadays, diabetes is one of the most serious healthcare concerns. According to the findings of the World Health Organization (2016a), type II diabetes affects the lives of around 8 percent of adults around the globe. It means that more than 422 million people in different countries require help in combating the disease. Moreover, more than 80 percent of diabetes mellitus instances are registered in countries with low and middle income (World Health Organization, 2016b). Among them, more than 1 million people are suffering from type II diabetes in the United Arab Emirates (International Diabetes Federation, 2015). Due to the severity of the problem, primary attention should be paid to preventative measures. However, to develop and promote them, an in-depth understanding of the causes of type II diabetes is essential.
The education and financial status of an individual are often seen as factors that lead to increased risks of type II diabetes (Rivera, Rosenbaum, & Rosela, 2015; Saydah & Lohner, 2010). They are major determinants of socioeconomic status because their social value remains unchanged over time (Saydah, Imperatore, & Beckles, 2013). Nevertheless, socioeconomic status is a complex multi-dimensional phenomenon that influences a position occupied by an individual in a community. Except for the level of education and income, it as well includes immigration status, age, gender, and ethnic background (Rivera et al., 2015). Because of the comprehensiveness of this concept and severity of the problem, this study will take into account only two determinants of socioeconomic status – education and income because they are easy to estimate. That said, qualitatively, what is the influence of socioeconomic status on susceptibility to type II diabetes, and how can healthcare institutions and policymakers use it to combat this modern-day epidemic?
Purpose of the Study
The purpose of the study is to deepen an understanding of factors that determine susceptibility to type II diabetes. It will focus on investigating experiences of people living in the United Arab Emirates, a country with predominantly high incomes, to find out whether there is a strong correlation between socioeconomic status and predisposition to diabetes. A major goal is to help doctors, policymakers, and ordinary people to become more conscious of the causes of type II diabetes and launch a productive educational program that will help eliminate manageable risks and combat the epidemic of this health concern. My hope is that this paper will be useful for putting an end to health disparities and improving the lives of thousands of ordinary people.
Preliminary Research Questions
To achieve the research objective and carry out the study as planned, the following research questions will be addressed:
What are the determinants of socioeconomic status in a high-income country like the United Arab Emirates?
What are the primary causes of type II diabetes that are linked to socioeconomic status?
What is the influence of socioeconomic status on the risk of type II diabetes?
What other socioeconomic factors (outside of education and income level) might contribute to the success of combating the type II diabetes epidemic?
Potential Significance and Design
This research will help obtain an in-depth understanding of type II diabetes and its causes connected to socioeconomic status. My general approach to this study is to conduct a comprehensive investigation based on a thorough literature review and interviewing those having diabetes mellitus with the aim of determining the impact of educational background and income level on susceptibility to this disease. Stress will be laid on people living in the United Arab Emirates to find out whether the influence of socioeconomic factors on increased risks of type II diabetes is as high as it is in low- and middle-income countries. No stress will be laid on gender and age to obtain an apprehension of the overall situation in the UAE healthcare sector. However, only those who were diagnosed with diabetes mellitus during the last five years will be interviewed. The rationale behind this decision is the desire to minimize the risks of drawing inaccurate conclusions connected to the overextended timeframe.
References
International Diabetes Federation. (2015). United Arab Emirates. Web.
Rivera, L. A., Rosenbaum, M., & Rosela, L. C. (2015). The influence of socioeconomic status on future risk for developing Type 2 diabetes in the Canadian population between 2011 and 2022: differential associations by sex. International Journal for Equity in Health, 14(1), 101-112.
Saydah, S. H., Imperatore, G., & Beckles, G. L. (2013). Socioeconomic status and mortality. Diabetes Care, 36(1), 49-55.
Saydah, S., & Lohner, K. (2010). Socioeconomic status and risk of diabetes-related mortality in the U.S. Public Health Reports, 125(3), 377-388.