Diabetes Mellitus type 2 is a metabolic disorder associated with high blood glucose, insulin resistance and insulin deficiency, which results due to lack of enough insulin production in the body. 90% of people diagnosed with diabetes suffer from diabetes mellitus type 2 (Milchovich & Long, 2011).
The following factors have the possibility of increasing the risk of contracting diabetes mellitus type 2. For example, exessive weight due to increased persantage of fatty tissues in the body makes the cells become resistant to insulin. In addition, age is also a risk factor for diabetes type 2 especially as a person gets older, for instance, above 45 years. Another factor is a family history, especially where one’s parents or siblings have had a history of diabetes type 2.
Further, failure to do exercise makes one gain weight. Another factor is a race where blacks, Hispanics, American Indian and Asian Americans are at higher risk of developing type 2 diabetes mellitus than the whites are. Finally, pregnant women who have developed gestational diabetes are at a risk of developing type 2 diabetes mellitus (Duckett, 2004).
Diabetes mellitus type 2 is more likely to occur to indigenous (Aboriginal or Torres Strait Islander) children and adolescents living in remote areas as compared to their non-indigenous counterparts. These people have various challenges in terms of delivery of health care. This poses a great challenge in managing this type of diabetes in rural and remote areas (Venbrux, 1995).
In fact, in 2004/2005, the National Survey carried among the Aboriginal and Torres Strait Islander communities reported diabetes among these people were at 6%. The Australian government has come with the following policies to respond to diabetes mellitus type 2, putting in mind the demographic, social and cultural needs of the indigenous communities (Byng, 2012).
Government Policies
Investments in diabetes research are done through the National Health and Medical Research Council. They have set up a special program grant that provides funds for carrying out research in collaboration with the Juvenile Diabetes Research Foundation. This also helps to offer opportunities in international clinical trials (Willis, Reynolds & Keleher, 2012).
Offering appropriate funding and resources to manage diabetes mellitus type 2 is done through investment in improving maternal and child health care. Maternal nutrition is emphasized through encouragement of breast feeding and diagnosis, and treatment of gestational diabetes in pregnant women. In 2011-2012, the government released over US $300 million that was to be used to improve access to comprehensive health care services to the Aboriginal and Torres Strait Islander communities (Kim & Ferrara, 2010).
Consultation and engagement of the community should then be encouraged. This is achieved through making clinics adolescent friendly and offering a comprehensive health assessment to young people in order to prevent childhood obesity (Dzebisashvili, 2011). The community is actively engaged in working with indigenous health workers to help stop those who are in danger of contracting the disease especially the obese children and encouraging the measures preventing the disease, such as healthy eating. They also help in registering pregnant women who are at a high risk of contracting gestational diabetes (Rubin, 2010).
The government also offers support to people living with diabetes mellitus type 2 through making sure that people with diabetes have access to effective, up to date and strong means for managing and treating this disease (Dunning, 2006). The government through Pharmaceutical Benefits Schemes gives subsidized medicine and treatment to people living with diabetes.
Through the Medicare Benefits Scheme, the government supports diabetes’ management by giving a discount to patients,and allied health services (Kopple, 2013). Moreover, through the Quality Assurance for indigenous people program, the government supports the provision of cultural and clinically means of managing diabetes mellitus type 2 to these communities.
The government participates in monitoring diabetes through funding the National Center for Monitoring Diabetes and Australian Institute of Health and Welfare Center that collects data on people who are using insulin to help in diabetes management (Australian Bureau of Statistics, 2002).
In addition, the government analyzes data from the National Diabetes Scheme that helps monitor trends in the prevalence of diabetes. It also supports the Australian Health Survey that collects data on diagnosed and un-diagnosed cases of diseases with an aim of providing accurate preference estimates that help in diabetes mellitus type 2 management (Rubin & Jarvis, 2008).
Conclusion
The government needs to attain success in managing diabetes barriers that limit proper management of diabetes mellitus type 2 among the indigenous children and adolescents living in rural areas. These barriers include food insecurity, limited resources that hinder lifestyle modifications, lack of infrastructure to store insulin, understaffing and high staff turnover that makes clinic staffs over worked.
This limits well-coordinated visits to attend to the patients and telecommunication facilities and makes essential resources unavailabile, for example, glycated hemoglobin testing in remote clinics. Despite all these challenges, the government has put commendable efforts in curbing and managing this first growing disease.
Reference List
Australian Bureau of Statistics. (2002). Year book Australia. Canberra: Australian Bureau of Statistics.
Byng, K. (2012). Insulin pump use in Australia. Canberra: Australian Institute of Health and Welfare.
Duckett, S.J. (2004). The Australian health care system. South Melbourne, Vic: Oxford University Press.
Dunning, T. (2006). Complementary therapies and the management of diabetes and vascular disease: A matter of balance. Chichester: John Wiley & Sons.
Dzebisashvili, T. (2011). SP4-11 Metabolic Profile Influence on HBA1C in diagnosing diabetes mellitus. Journal of Epidemiology & Community Health, 65(1), 437-437.
Kim, C., & Ferrara, A. (2010). Gestational diabetes during and after pregnancy. New York: Springer.
Milchovich, S.K., & Long, B. (2011). Diabetes mellitus a practical handbook. Chicago: Bull Publishers.
Rubin, A.L., & Jarvis, S. (2008). Diabetes for dummies. Hoboken, NJ: John Wiley & Sons Publishers.
Rubin, A.L. (2010). Prediabetes for dummies. Hoboken, N.J.: John Wiley & Sons Publishers.
Venbrux, E. (1995). A death in the Tiwi islands: Conflict, ritual, and social life in an Australian aboriginal community. Cambridge: Cambridge University Press.
Willis, E., Reynolds, L., & Keleher, H. (2012). Understanding the Australian health care system. (2nd ed.) Sydney: Churchill Livingstone/Elsevier.
The role of behavior and cultural perceptions cannot be overestimated in terms of health aspects. In that regard, it can be stated that the success of many interventions is largely linked to the behavior and cultural and social constructs. The latter is not only connected to treating diseases and illnesses such as alcoholism, but also to preventive measures in lifestyle illnesses such as diabetes. In “Formative Research to Inform Intervention Development for Diabetes Prevention in the Republic of the Marshall Islands” by Cortes, Gittelsohn, Alfred, and Palafox (2001), formative research was conducted to investigate behavioral patterns and traditional belief systems in the Republic of the Marshall Islands, in order to help to develop a diabetes prevention intervention. This paper provides a critical analysis of the aforementioned article, in terms of its methodological considerations.
As qualitative studies, in general, are aimed to provide “target audience perceptions and reactions” (Siegel & Doner, 2007, p. 264), it can be stated that the choice of employing a qualitative method in Cortes et al. (2001) is successful. It can be seen that many of the variables such as typical meals, the typical way of eating, and access to food are quantifiable, and can be categorized into distinct categories, and thus, questions such as how many and how often can be applicable. Nevertheless, it should be stated that such variables are not related to the main research questions of the article, which are founded on getting an insight into the perceptions and the local cultural norms of the population. The household quantitative survey in the study served as audience segmentation, in which dimensions related to the context of the study were grouped, i.e. anthropometric measurements, demographics, food frequency, etc (Cortes, Gittelsohn, Alfred, & Palafox, 2001, p. 700). The choice of demographics, however, is often criticized for grouping “people together based on variables that are meaningless in the context of changing behavior in question” (Siegel & Doner, 2007, pp. 265-266).
It can be stated that the main aim of formative studies is in adequately crafting the initiatives (278). Accordingly, the findings of the study as well as its implications should be directly linked with the intended outcome. As the findings of the study are already incorporated in the program at the time of the publication, their assessment can be generally performed with an evaluation of the program’s outcome. Nevertheless, it can be stated that the study failed to provide a link between the rationale of the study, its research questions, and its implications. In that regard, it can be assumed that the answer to the fourth research question should be interpreted from the findings, i.e. “how the information can be used to develop effective interventions” (Cortes, et al., 2001, p. 699). The connection between the guiding principles developed in the program and the outcomes of the research is vague, given that these guidelines represent the answer to the question of how information can be used.
The article can be considered academically valuable, in terms of providing directions for actions. The incorporation of the guiding principles can be separated from the scope of the article as the connection between the results and the implementation should be explained in detail. Nevertheless, the article provides a valuable insight into the behavioral patterns hindering effective prevention interventions.
References
Cortes, L. M., Gittelsohn, J., Alfred, J., & Palafox, N. A. (2001). Formative Research to Inform Intervention Development for Diabetes Prevention in the Republic of the Marshall Islands. Health Education & Behavior, 28(6), 696-715. Web.
Siegel, M., & Doner, L. (2007). Marketing public health : strategies to promote social change (2nd ed.). Sudbury, Mass.: Jones and Bartlett Publishers.
Diabetes is a state of glucose intolerance that requires the management of blood glucose. Evidence-based practice has been identified as a means of improving most areas of healthcare services (Fox, 2010). This approach is equally helpful in diabetes care. Abu-Gamar and Wilson (2007) examined evidence-based practice in diabetes care and made several findings. They pointed out that good glycemic control is important in reducing the incidence or severity of complications associated with diabetes. To make this approach more effective, they suggested that patients suffering from diabetes play a vital role in diabetes management. Glycemic control is a major intervention in the management of diabetes. Since diabetes is a state of glucose intolerance, management of the blood glucose level is necessary (Abu-Qamar & Wilson, 2007).
The emphasis on patient education (about the importance of glucose management) was made due to the realization that there was poor adherence of diabetic patients to treatments (An & Kim, 2012). An and Kim (2012) stated that over 56% of patients in Korea did not comply with diabetes control norms and glycemic control measures.
When the optimal blood glucose level is achieved, several complications related to diabetes are kept at bay. This finding has been supported by those from two main bodies – the UK Prospective Diabetes Study and the Diabetes Control and Complication Trial.
Summary Of Finding
Evidence suggests that glycemic control is an effective way of managing diabetes in adults. Good glycemic control ensures that the level of glucose in a diabetic patient is maintained at levels similar to that of a non-diabetic one. This way, the development of complications is delayed or eliminated. Pogach and Walder (2004) gave an example of hypertension as one of the complications related to diabetes. There are various ways the level of glucose in the blood can be managed. These include oral anti-diabetic drugs, exercise, adopting a healthy diet, and the use of insulin therapy.
Patients with type 1 diabetes require insulin replacement daily. This should mimic the insulin levels in a normal individual (non-diabetic).
As for type 2 diabetes, different treatment options should be provided. These include oral medication, exercise, and proper diet. Hailu, Mariam, Belachew, and Birhanu (2012, p. 2) also mentioned the importance of diet and exercise in the management of diabetes.
The emphasis on patient education (about the importance of glucose management) was made due to the realization that there was poor adherence of diabetic patients to treatments. It has been argued that diabetes is mainly a self-managed disease (An & Kim, 2012).
How to integrate into practice
One of the ways glucose levels are maintained at normal levels is through medication (Clissold1 & Clissold2, 2007). Medication is used to maintain the level of glucose in a diabetic patient to that similar to a non-diabetic one. When glucose is maintained at normal levels, the occurrence of complications associated with diabetes is reduced. Such complications include hypertension.
Diabetic patients, and those with type 1 diabetes, in particular, require being administered with replacement insulin daily. Insulin therapy involves providing artificial insulin that mimics the insulin that is produced by a healthy individual. Therefore, diabetic patients should be able to have normal biological functions
Patients with type 2 diabetes may receive oral medication in addition to exercising and having a proper diet. Diabetic patients should decrease the intake of foods that increase the glycemic index and ensure that they maintain a healthy weight.
Patient compliance to self-monitoring of blood glucose levels is required if treatment is to be effective.
Treatment cannot be effective if the patient does not comply with the treatment provided. It has been identified that depression is one of the factors that contributed to poor glycemic control. Approximately 30% of adult diabetic patients suffered from depression. However, nurses play a big role in motivating these patients. Patient education is an effective way of ensuring glycemic control in diabetic patients. It is important in empowering self-management behavior. In this regard, diabetic patients should be provided with information about the disease process, treatment options, possible complications, and the way self-monitoring of glucose levels is done.
Even though glycemic control is important in diabetes management, tight glycemic control may be harmful to certain individuals (Lee, Boscardin, Cenzer, Huang, Rice-Trumble, & Eng, 2011). The frail older adults, in particular, were thought to be vulnerable.
It is argued that the harmful effects of the intensive glycemic control measures outweighed the benefits. Pogach and Walder (2004, p. 85) agree with this view since they argued that such intense measures increased the incidence and severity of hypoglycemia.
Therefore, health practitioners should determine the proper intensity of glycemic control for individual patients to ensure that the treatment is beneficial and effective.
References
Abu-Qamar, M., & Wilson, A. (2007). Evidence-based decision-making: The case for diabetes care. Int J Evid Based Healthcare, 5(1), 254-260.
An, G., & Kim, Mi-Ja, K. (2012). Powerlessness, social support, and glycemic control in Korean adults with type 2 diabetes. Contemporary Nurse, 42(2), 272-279.
Clissold1, R., & Clissold2, S. (2007). Insulin glargine in the management of diabetes mellitus: An evidence-based assessment of its clinical efficacy and economic value. Core evidence, 2(2), 89-110.
Fox, A. (2010). Intensive diabetes management: Negotiating Evidence-based practice. Can J Diet Prac Res, 71(1), 62-68.
Hailu, E., Mariam, W., Belachew, T., & Birhanu, Z. (2012). Self-care practice and glycaemic control amongst adults with diabetes at the Jimma University Specialised Hospital in South-west Ethiopia: A cross-sectional study. Df. Afr J Prm Health Care Fam Med., 4(1), 1-6.
Lee, S., Boscardin, J., Cenzer, I., Huang, E., Rice-Trumble, K., & Eng, C. (2011). The risks and benefits of implementing glycemic control guidelines in frail older adults with diabetes mellitus. JAGS, 59(4), 666-672.
Pogach, L., & Walder, D. (2004). Development of evidence-based clinical practice guidelines for diabetes. Diabetes Care, 27(5), 82-89.
In this scenario, EM, the 52-year-old alcoholic, has battled type 2 diabetes for long. EM consumes alcohol while taking medication, thereby going against the recommendations of care providers. Evidence shows that doctors discourage alcohol intake when taking type 2 diabetes medications such as extended-release glyburide and sustained-release metformin (Glucophage) (Alromaihi, Zielke & Bhan, 2010). This analysis shows that the death of EM is a result of various factors associated with inappropriate use of prescription medicines.
The factors that are involved in the death of EM include glucose utilization, inappropriate use of prescription drugs, and effects of alcohol. EM is diagnosed with type 2 diabetes and the doctor advises him to take the prescribed drugs, but to keep of alcohol, due to its negative reactionary effects with medications. Diabetes mellitus occurs when the pancreas fails to produce insulin hormones that help in regulating blood sugar levels (Dunning, 2013). Diabetes occurs in pancreases that fail to produce enough insulin.
While insulin transfers glucose into cells for energy creation, diabetes makes sure that patients cannot utilize glucose properly, creating blood buildups. Although it is manageable, diabetes development mixes genes and lifestyle that if not well managed may create serious complications.
Metformin extended-release tablets such as Glucophage, create lactic acidosis, a near-fatal condition (Dunning, 2013). These cases exist among patients with particular problems too. Lactic acidosis is greater for patients that are taking alcohol and have problems with their hearts, liver, and kidneys. Further, the pancreas of a type-2 diabetic patient responds to insulin inappropriately. Thus, consuming alcohol makes the management of blood sugar worse among these patients.
With a poor pancreas, the patient is prone to chronic elevations in blood sugar levels, contributing to the patient’s death (Dunning, 2013). From the case, EM is indulging in alcohol drinking while aware that alcohol reacts negatively with the prescription drugs. This is a case of blatant ignorance on the part of EM.
Next, Hypoglycemia is an imbalance between insulin intake and the psychological needs of a body (Becker, 2001). Hypoglycemia occurs in patients who drink a lot of alcohol, particularly because alcohol intoxication is prone to hypoglycemic impacts. Alcohol restrains gluconeogenesis thereby worsening hypoglycemia. The patient could have severe organ illnesses, given his long-term addiction to alcohol. A possible cause for EM’s death is liver or kidney disease, associated with alcohol and hypoglycemia.
Indeed, doctors often advise patients to limit their alcohol intake when taking extended-release tablets (Becker, 2001). Patients should avoid binge drinking or habitual alcohol drinking; because, alcohol increases the possibility of acquiring lactic acidosis. According to the author, the upsurge of blood lactic acid often causes serious damages.
Although lactic acidosis is rare, it occurs in patients with abnormal working kidneys (Becker, 2001). Lactic acidosis occurs and is fatal to the majority of those who consume it. Additionally, alcohol initiates the effects of Metformin hydrochloride because of its impact on lactate metabolism. Healthcare providers should thus caution patients against taking in excessive alcohol when using extended release drugs such as glyburide.
This case brings to life the documented effects of alcohol use when taking medication. Taking extended-release glyburide and sustained-release metformin (Glucophage) while indulging in alcohol blatantly, despite the doctor’s precautions, is ignorance on EM’s part. The documented near-fatal effects of alcohol on the lives of medicating patients come to life in this paper.
Furthermore, contraindications often state that type 2 diabetes medications have a negative reaction on patients that may lead to their death. It is therefore important that patients follow the indications from doctors regardless of their addiction to alcohol.
References
Alromaihi, D., Zielke, J. & Bhan, A. (2010). Challenges of Type 2 Diabetes in Patients with Alcohol Dependence. Clinical Diabetes, 30(3), 120-122.
Becker, K. (2001). Principles and Practice of Endocrinology and Metabolism. New York: Lippincott Williams & Wilkins.
Dunning, T. (2013). Care of People with Diabetes: A Manual of Nursing Practice. New York: John Wiley & Sons.
Diabetes type 2 is a chronic condition that alters metabolism of blood sugar in the body of an individual. This situation forces the body to either resist or fail to produce insulin. Insulin maintains blood sugar level. Food, especially carbohydrates, contains starch. The liver converts starch into glucose that is stored in the body. When the glucose is released in the blood system, the pancreas is triggered to produce insulin. Production of insulin leads to regulation of blood sugar and other metabolism processes. This essay explores effects of under or overconsumption of fats and proteins in relation to type 2 diabetes with a view of providing an insight into the appropriate nutritional ways to curb the condition.
The Etiology of Diabetes type 2
Insensitivity to insulin is the main cause of diabetes type 2. This condition is detected when insulin receptors are unable to function properly. As a result, the insulin receptors fail to normalize blood sugar in the body (Alberti, Zimmet, & Shaw, 2007). Absence or insufficient production of insulin leads to accumulation of sugar in the blood. This condition results in diabetes type 2. Various symptoms that are associated with such diabetes type 2 include frequent thirst, extreme tiredness, weight loss, frequent urge to urinate, and blurred vision among others. Numerous researchers attest that numerous risk factors such as age, family history, race, and past health records among others increase the chances of developing diabetes type 2 (Alberti et al., 2007).
Age
The risk of developing type 2 diabetes increases with the age of an individual. Alberti, Zimmet, and Shaw (2007) reveal that individuals who have attained the age of 40 years and above have higher risks of developing the condition. Nonetheless, people who are aged above 65 years are at the highest risk. However, people who are below 45 years old are also vulnerable to development of diabetes type 2 because of shifting lifestyles (Alberti et al., 2007).
Family history
Family history also exposes individuals to risks of developing diabetes type 2. Alberti, Zimmet, and Shaw (2007) posit that some families are vulnerable to diabetes type 2 due to hereditary factors. For example, if a parent or a sibling is a type 2 diabetic patient, there is a high probability that one or all of the members of the family are at a risk of developing diabetes type 2 (Alberti et al., 2007).
Race
Alberti, Zimmet, and Shaw (2007) reveal that diabetes type 2 is most common amongst some races. For instance, African Americans, Latino Americans, American Indians, Asian Americans, and Pacific Islander Americans are at higher risks of having the type 2 diabetes than any other Americans in the United States.
Previous Health Records
Notably, some women usually have gestational diabetes during their various trimesters. Delivering a child who weighs over 10 kilograms exposes the mother to a higher risk of developing diabetes type 2. Other illnesses that predispose an individual to diabetes type 2 include pre-diabetic conditions such as inability of the pancreas to produce insulin, pancreatitis, elevated blood pressure, high levels of saturated fatty acids and cholesterols, impaired glucose tolerance, heart attacks, stroke, and metabolic syndromes (Alberti et al., 2007).
Overweight and Obesity
Type 2 diabetes is usually associated with obese people. Numerous surveys have revealed that almost 80-percent of overweight individuals are vulnerable to type 2diabetes since their bodies have lower response to insulin production (Alberti et al., 2007).
Consumption of Fats and Proteins in Relation to Diabetes Type 2
Consumption of Fats
Gerhard et al. (2004) reveal high intake of fats is a primary factor that leads to diabetes type 2. Consumption of animal products such as milk and red meat results in generation of excess energy that cannot be utilized completely. Excess energy is stored in the body in form of fats. Fats are usually categorized into bad and good fats. Bad saturated and Trans fats are responsible for the production of low-density cholesterols while good monounsaturated and polyunsaturated fats lower LDL-cholesterols in the blood (Gerhard et al., 2004).
Consumption of diets that contain large amounts of saturated fats can increase the risk of developing diabetes type 2. The saturated fatty acids activate immune cells to produce interleukin-1beta, an inflammatory protein. This protein acts on liver and adipose tissues, rendering them insensitive to insulin (Lewis, Carpentier, Adeli, & Giacca, 2002). This situation leads to insulin resistance; hence, the level of blood sugar is increased. Eventually, this state of metabolic imbalance develops into diabetes type 2.
Leptin is a crucial hormone in metabolism processes. Its main functions are regulation of appetite and moderation of body weight (Gavrilova, Marcus-Samuels, Leon, Vinson, & Reitman, 2000). It also communicates with the brain on metabolic functions that pertain to utilization and storage of energy in the body. Therefore, the leptin hormone triggers the liver to convert starch to glucose and vice versa depending on bodily requirements. Leptin is also responsible for detection of correct signaling and resistance of insulin in the body. According to Gavrilova et al. (2000), obese and overweight individuals have insufficient insulin due to production, underutilization, and storage of excess fats in the body.
Consumption of Proteins
Uncontrolled consumption of proteins leads to acidosis (increase in acidity). Acidosis reduces the ability of insulin to bind at the surfaces of receptors in the body. For instance, Li et al. (2006) reveal that augmented consumption of meat products significantly elevate acidity levels upon digestion. This situation promotes development type 2 diabetes in individuals. Higher levels of acidity further lead to production of amino acids that increase susceptibility of the individual to type 2 diabetes (Li et al., 2006). However, alkaline balance moderates acidity rise in the body.
Various genetic factors that are derived from proteins enhance the of risk developing diabetes type 2. For instance, fatty-acid binding protein gene (FABP2) is responsible for the production of large amounts of triglycerides (Li et al., 2006). Production of triglyceride is linked to insulin resistance that promotes development of diabetes type 2.
Nutritional Steps that Delay Development of Diabetes Type 2
Numerous researchers attest that high fiber content carbohydrates are essential for promoting the health of diabetic type 2 patients. Whole grains such as brown bread are rich in compact fibers and bran that slow down digestion and conversion of starches to glucose. This situation lowers the rate at which blood sugar and insulin are released to the bloodstream; hence, it lowers the glycemic index. The whole grains also provide various vitamins and minerals that promote reduction of diabetes type 2 (Alberti et al., 2007).
Reduction of Sugary Drinks
People who often drink large amounts of sugary drinks such as sodas and beverages are at higher risks of developing diabetes type 2 since they gain a lot of weight due to excess glucose that is stored in their bodies in form of fats. This situation leads to chronic inflammation, cholesterol levels, and amplified production of triglycerides that are responsible for insulin resistance. Therefore, patients should replace sugary drinks or sweetened drinks with unsweetened drinks that contain low sugar (Alberti et al., 2007).
Inclusion of Moderate Good Fats in Diets
The types of fats that are incorporated in diets can raise or lower the risk of developing diabetes type 2. Polyunsaturated and monounsaturated fats should be included in the diets since they delay development of diabetes type 2. Bad fats that are contained in margarine and fried foods among others sources should be excluded in diets (Gerhard et al., 2004).
Exclusion of red and processed meats
Alberti, Zimmet, and Shaw (2007) posit that people who consume red meat have a 20-percent higher risk of developing diabetes than vegetarians. Meat contains high amounts of iron and protein that diminishes or completely damages cells that are responsible for production of insulin (Alberti et al., 2007).
Dietary recommendations for the management of diabetes type 2
Dietary management of diabetes type 2 involves implementation of various food groups that are categorized into starchy foods, fruits and vegetables, dairy products, and meat, fish, eggs, and pulse.
Starchy foods
Starchy foods include rice, potatoes, and pasta among others. These foods contain carbohydrates that are digested into glucose. Although starches have low fat contents, individuals should choose foods that are rich in fiber and bran such as whole grains. High fiber content and bran lower the rate of digestion of blood sugar. The recommended intake per day is 5 to 14 portions (a portion is 2-4 table spoon of cereals, a slice of bread, 2-3 table spoons of rice, 2-3 crackers) or one-third of the diet (Brand-Miller, Hayne, Petocz, & Colagiuri, 2003).
Fruits and vegetables
Fruits and vegetables contain low fats and calories. These foods reduce other complications such as heart attack and blood pressure. Specialists recommend that individuals should consume five portions in a day. Each portion should include both fresh and frozen dried fruits and vegetables (Brand-Miller et al., 2003).
Dairy products
An individual should choose low fat dairy products such as skimmed milk and yoghurt. Daily intake of three portions that include 190ml (or one-third pint) of milk, a minimal portion of yoghurt, and 2 tablespoons of cottage cheese is recommended (Gerhard et al., 2004).
Meat, fish, eggs and pulse
These foods contain high amounts of proteins and iron. Iron is necessary for bodybuilding and production of blood cells. Omega-3 fatty oils that are found in mackerel and salmon fish offer the body protection from heart diseases. The vegetarian sources include pulses, beans, and soya among others. The recommended dietary intake per day is 2 to 3 portions. A portion equals to 80g of meat or 120g fish, 2 table nuts, and 3 tablespoons of beans or lentils (Alberti et al., 2007).
Conclusion
In the light of the above discussion, resistance or absence of insulin to regulate blood sugar in the body increases the vulnerability of individuals to diabetes type 2. Increased consumption of saturated fats and proteins that are obtained from red meat and other sources intensify the risk of developing diabetes type 2. Management of diabetes type 2 requires that food choices that comprise balanced diets must be taken into consideration. However, the aforementioned steps should only serve as precautionary measures. Therefore, patients should seek appropriate medical attentions from health specialists.
Reference List
Alberti, K., Zimmet, P., & Shaw, J. (2007). International Diabetes Federation: a consensus on Type 2 diabetes prevention. Diabetic Medicine, 24(5), 451-63.
Brand-Miller, J., Hayne, S., Petocz, P., & Colagiuri, S. (2003). Low–Glycemic Index Diets in the Management of Diabetes A meta-analysis of randomized controlled trials. Diabetes care, 26(8), 2261-7.
Gavrilova, O., Marcus-Samuels, B., Leon, L., Vinson, C., & Reitman, M. (2000). Hormones: Leptin and diabetes in lipoatrophic mice. Nature, 403(6772), 850.
Gerhard, G., Ahmann, A., Meeuws, K., McMurry, M., Duell, P., & Connor, W. (2004). Effects of a low-fat diet compared with those of a high-monounsaturated fat diet on body weight, plasma lipids and lipoproteins, and glycemic control in type 2 diabetes. The American journal of clinical nutrition, 80(3), 668-73.
Lewis, G., Carpentier, A., Adeli, K., & Giacca, A. (2002). Disordered fat storage and mobilization in the pathogenesis of insulin resistance and type 2 diabetes. Endocrine reviews, 23(2), 201-29.
Li, Y., Fisher, E., Klapper, M., Boeing, H., Pfeiffer, A., Hampe, J.,…Döring, F. (2006). Association between functional FABP2 promoter haplotype and type 2 diabetes. Hormone and metabolic research, 38(5), 300-7.
More than 180 million people in the world are diagnosed with diabetes, and the alarming number is expected to double by 2030 (Corser & Xu, 2009). These alarming statistics make diabetes a major health concern, and as patients have to struggle with the disease for the rest of their lives, the educational strategies for diabetes education to patients need to be developed and enhanced.
It is true that considerable success has been made in the treatment of diabetes, however very little is published on the limitations and difficulties in applying effective strategies that patients with diabetes may successfully integrate into their lifestyles (Nagelkerk, Reick, & Meengs, 2005). The Journal of Advanced Nursing reports that “The most frequently reported barriers were lack of knowledge of a specific diet plan, lack of understanding of the plan” (p.156). With this in mind, it becomes absolutely essential to implement a strategy of educating newly diagnosed diabetic patients, since they have little to zero knowledge on how to maintain and manage normal blood sugar. An effective education strategy lies in developing a collaborative relationship between nurses, registered dieticians, physicians, and patients. The educational strategy needs to be two-sided, implying that not only the patients, but also the nurses, dietitians, and health-care professionals need to be educated on how to communicate with the patients in simple terms, and ensure that the patients perceive the information.
A positive learning environment needs to be established with the support group encouraging patients to make alterations to their life style. Furthermore, the newly-diagnosed patients need to be educated on how to manage blood sugar when the body is stressed, and how to handle high and low blood sugars. The success of patients in taking diabetes under control may be measured by their ability to adhere to specific educational strategies, however as practice shows, patients reluctantly follow a predetermined set of strategies over the course of their life (Funnell & Anderson, 2004). This phenomenon of patients’ behavior highlights the importance of early implementation of strategies for newly-diagnosed patients. The patients who incorporate diabetes educational strategies from the genesis of the disease are more likely to stick to them than those who realize the need for educational strategies to be implemented long after they’d been diagnosed with diabetes.
The common mistake in applying strategies for diabetes education is when the strategy is designed to fit patients’ diabetes, but is not tailored to fit patients’ priorities, values, and lifestyle (Funnell & Anderson, 2004). With this in mind, educational strategies designed within our project take into account personal and psychological factors of the patient. The health-care professionals examine the adult learning style characteristics along with the culture and ethnicity, age and aging, gender and literacy levels before coming up with a strategy tailored to individual patient’s needs.
To align the educational strategies with patients’ goals and objectives, each patient will be taught how to manage the blood sugar level in his particular case, whether the blood sugar drops due to illness, pregnancy, or in stressful situations. The patients will share their signs and symptoms, and the most appropriate strategy will be offered to them on a case-by-case basis. The patients also need to be armed with the strategies preparing them for potentially stressful situations, such as eating out or exercising. Examples should be given on how to plan, prepare, and tackle the challenges so that they eventually become an integral part of their life.
It is also crucial for doctors to teach patients when they can manage complications on their own, and when they need to seek emergency care. Educational strategies for diabetes education in the past were focused on doctor-patient relations mainly, where the doctor was viewed as an authority, and great effort was made to encourage the patient to follow the recommendations made by the health professionals. Practice shows that this strategy is not effective in diabetes care (Funnell & Anderson, 2004). Taking the above into account, the educational strategies offered within our project make a shift from doctor-patient relations to patient-patient interaction. The educational strategy, where doctors are viewed as mentors or moderators, and patients interact and share their experiences within a group, is deemed more effective and provides better patient engagement. The learning strategy within our project invites a patient to make his own choices and decisions following the support group interaction. Furthermore, when patients interact with other patients, they may be more open and share more among each other. In developing successful educational strategies, it is important to realize that even doctors with over 20 years of experience in treating diabetes are not always adequately trained in educating patients. While they possess profound knowledge in the subject matter, they often don’t have the right methodology in conveying their knowledge to patients. Taking this phenomenon into consideration, our project educates not only the patients but also the health- care professionals who are trained in adult learner characteristics.
Summing up, the dynamic interaction of patients and health-care professionals may streamline and enhance the educational strategies for diabetes education to patients. The appropriate strategies in educating diabetes patients may be instrumental in making a positive change in their lives.
Diabetes mellitus (DM) is one of the prevailing diseases that acquires epidemic features in many countries. At that, diabetes mellitus type 2 is regarded as the major threat since it accounts for around 90% of all cases. Thus, it has been estimated that 336 million people suffer from this disorder worldwide (Ofori and Unachukwu 159). It is expected that the number of people diagnosed with DM will increase significantly. For instance, it is predicted that one-third of US adults will suffer from the disorder by 2050 (Shubrook and Johnson 531). The disease is a considerable concern as according to statistics, people having diabetes tend to develop blindness, kidney disorders, cardiovascular diseases and are “30-40 times more likely to undergo amputation” (Kutty and Raju 606). Researchers and healthcare professionals have come up with numerous methods and strategies to treat the disease as well as prevent it. Nonetheless, it is clear that the effort is not sufficient (Wilkinson, Randhawa and Singh 2). It has been acknowledged that a holistic approach is necessary to effectively prevent DM, and particular steps have been undertaken in this direction.
Main body
It has been acknowledged that the management and prevention strategies should lead to multidisciplinary care. Clearly, it is crucial to focus on the primary risk factors including obesity, high blood pressure, smoking, dyslipidemia and so on (Ofori and Unachukwu 160). The prevention effort involves such two basic spheres as lifestyle-related methods and medical management. The holistic approach implies the use of a set of strategies to prevent the development of the disorder. The cornerstone of this approach is the patient-centered care. Training is central to the efficiency of prevention strategies. Self-management is the major outcome of DM management as well as prevention strategies.
As far as the lifestyle-related strategies are concerned, it is necessary to note that one of the most important facets of the prevention effort is nutrition. It is essential to develop proper diets for people of different ages that would decrease the risk of developing diabetes. Clearly, specific attention should be paid to adults and the elderly who are at a higher risk of developing DM. The diets have to be in a form of recommendations. The existing research shows that the development of nutrition guidelines is an efficient strategy. It can be a good idea to develop particular recommendations for people with certain diseasing including specific guidelines concerning effective fasting (Dyson et al. 1282). Dyson et al. also stress that nutrition guidelines should put “an emphasis on carbohydrate management and a more flexible approach to weight loss” (1282).
Furthermore, lifelong changes to lifestyle are vital for DM prevention. This calls for the counselling in many cases. Motivational interviews are often effective methods to increase people’s commitment to change their lifestyles. It has been found that effective counselling enabled people to adjust their lifestyles and improve their health conditions (Ofori and Unachukwu 161). Numerous studies have been implemented to check the effectiveness of such training and counselling. It is reported that the lifestyle strategies are cost-effective although they often require significant funds. Importantly, unlike the pharmacotherapy that addresses one risk factor, the lifestyle approach addresses numerous risk factors, which leads to considerable improvements in people’s health conditions (Ofori and Unachukwu 163).
As for medical management, it often involves the focus on the use of glucose-lowering medication. It is necessary to note that this part of the holistic approach is especially important with certain groups of people (elderly, obese people and so on). At that, the prevention of hyperglycemia, hypertension as well as hyperlipidemia is crucial (Ofori and Unachukwu 165). Obviously, the treatment should be developed in accordance with age, health conditions and other meaningful peculiarities.
It is necessary to note that the strategies mentioned above are becoming more common worldwide. In such countries as the USA and the UK, there is extensive research on the matter and an ongoing effort to incorporate the holistic approach in DM prevention. The cost-effectiveness of the method has been acknowledged. The healthcare of the 21st century aims at prevention rather than effective treatment. Hence, it is clear that DM prevention will receive the necessary attention. The holistic approach is also seen as a potential solution to the problem of the epidemic threat of DM. Multidisciplinary teams should be created in every healthcare facility (Dyson et al. 1282). The educational sphere is the next step in the implementation of the holistic approach as young generations should also be aware of the hazards associated with certain lifestyles and some health conditions.
Conclusion
In conclusion, it is possible to note that the holistic approach to diabetes mellitus prevention is becoming more popular worldwide. The lifestyle-related changes and medical management are two components of this strategy that has already proved to be efficient. Clearly, the adoption of this approach will require significant funds, but the US healthcare aims at prevention rather than treatment of diseases. Therefore, the holistic image of DM prevention is the near future of the US healthcare system.
References
Dyson, Pamela A., T. Kelly, T. Deakin, A. Duncan, G. Frost, Z. Harrison, D. Khatri, D. Kunka, P. McArdle, D. Mellor, L. Oliver and J. Worth. “Diabetes UK Position Statements and Care Recommendations: Diabetes UK evidence-based nutrition guidelines for the prevention and management of diabetes.” Diabetic Medicine 28.11 (2011): 1282-1288. Print.
Kutty, Bindu M. and T.R. Raju. “New Vistas in Treating Diabetes – Insight into a Holistic Approach.” Indian Journal of Medical Research 131.1 (2010): 606-607. Print.
Ofori, Sandra N. and Unachukwu, Chioma N. “Holistic approach to prevention and management of type 2 diabetes mellitus in a family setting.” Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy 7.1 (2014): 159-168. Print.
Sanders, Lee J., Jeffrey M. Robbins, Michael E. Edmonds. “History of the team approach to amputation prevention: Pioneers and milestones.” Journal of Vascular Surgery 52.3 (2010): 3S-16S. Print.
Shubrook, Jay H. and Amy W. Johnson. “An Osteopathic Approach to Type 2 Diabetes Mellitus.” Evidence-Based Clinical Review 111.9 (2011): 531-537. Print.
Wilkinson, Emma, Gurch Randhawa and Maninder Singh. “Quality Improvements in diabetes Care, How Holistic Have They Been? A Case-Study from the United Kingdom.” International Journal for Equity in Health 13.1 (2014): 1-9. Print.
This paper examines research studies that were conducted in the field of diabetes. It is composed of four articles that offer information on the various types of diabetes, predisposing factors, diagnosis, treatment, and prevention. Each of these articles offers a detailed analysis of the challenge posed by diabetes in the modern world. From the articles, it can be noticed that there is a steady increase in the cases of diabetics. Statistics reveal that the victims of diabetes may be close to half a billion worldwide before the close of 2035. The articles offer available diagnostic measures for handling diabetics as well as the signs and symptoms of the problem. From all the articles, it can be observed that diet has been discussed as a major contributing factor in the increasing cases of diabetics in the modern society and especially among the young people. All the articles reiterate on the need of increasing public awareness on diabetes and its predisposing factors. It is prudent that the information on diabetics that is available to the public is minimal. This has resulted into increased cases of late diagnosis and deaths related to diabetics.
Background and Discussion
This paper provides a review and analysis of four medical research papers conducted on diabetes. The information presented in the articles offers an insight in the diagnosis of diabetes among various groups of persons and the related preventive and treatment measures.
The first article researched by Rewers et al (2008) analyses diabetes among the youth in the United States. The researchers carried out several studies to determine the predictors and commonness of diabetic Ketoacidosis among the American youth during the diagnosis stage. The research was conducted between 2002 and 2004. The patients used in this study were under 20 years of age. The research was based on a diabetes registry of young individuals who were diagnosed with diabetes before attaining twenty years of age. The study identified 3666 cases of initial stages of diabetes that were within the age bracket of the sample population (Rewers et al., 2008).
The medical charts for 2824 patients who took part in the survey were reviewed by the researchers. These were done with the aim of ascertaining the existence of diabetic Ketoacidosis during diagnosis. The standards used to define diabetic Ketoacidosis were <15mmol/L of blood bicarbonate and <7.25 venous pH. These standards were based on the international classification of diseases listings.
More than half of the study population was in critical stages of diabetes and had been hospitalized immediately after being diagnosed with the disease. 93% of all the patients with diabetic Ketoacidosis were among the newly hospitalized diabetic patients. The study population had a diabetic Ketoacidosis prevalence of 25.5%. However, these values decreased with the age of the individuals. As such, children recorded the lowest levels of diabetic Ketoacidosis. Moreover, the prevalence of diabetic Ketoacidosis was more pronounced among patients with type 1 diabetes (Rewers et al., 2008).
The research went further to analyze the causative agent of diabetic Ketoacidosis. Several factors such as family history, gender, ethnicity, age, and the type of diabetes were analyzed. The findings indicated that individuals from poor backgrounds recorded the highest prevalence level of diabetic Ketoacidosis. The study found out that in every four youths diagnosed with diabetes, one had diabetic Ketoacidosis. In addition, they were more likely to be hospitalized. Lack of public awareness on this disease accounted for the high levels of diabetic Ketoacidosis (Rewers et al., 2008).
The second article entitled “Risk of development of diabetes mellitus after diagnosis of gestational diabetes” by Feig et al (2008) offers information on the risk of the development of type 2 diabetes because of exposure to gestational diabetes. The authors acknowledge the lack of information that links the two types of diabetes. However, the research tries to link the two incidences with the aim of bridging the gap. The study was carried out in the province of Ontario. The study used a population database from hospitals in identifying all deliveries in this province between 1995 and 2002. The researchers further analyzed the records in order to identify the mothers who were diagnosed with gestational diabetes. The nine years medical records of the identified mothers were scrutinized in order to determine the development and prevalence of diabetes mellitus based on the adopted definitions of the condition.
The data collected identified 659164 pregnant women who were non-diabetic. Gestational diabetes was prevalent among 3.3 percent of women who were taken through the diagnosis process. The prevalence of gestational diabetes increased from 1995 to 2004, with 2004 recording the highest level of gestational diabetes. According to the study, the possibility of type 2 diabetes developing because of gestational diabetes was 3.7% within the first nine months after delivery. This value rose to about 18.9% within a period of nine years after delivery. The study further analyzed the results by incorporating factors such as age, residence, number of pregnancies, hypertension factor, income, and prenatal care. The most significant causative agent of type 2 diabetes amongst these women was the availability of gestational diabetes, with the risk percentage being at about 37.3%. Poor income, emergence of substandard settlements in urban setups and age bracket of an individual are major predisposing factors. Women who delivered in the late 1990s had a higher prevalence of diabetes compared to those who delivered in the early 1990s.
The study concluded by linking gestational diabetes with the type-2 diabetes. The researchers further identified increased incidences if diabetes in the current years compared to the past with the prevalence of about 20%. The study recommended the use of the data collected in the provision of the necessary guidance and counseling among pregnant women. The research further recommended on policy makers’ need of targeting pregnant women for screening in order to curb the increasing levels of diabetes among the women in the population.
The third research conducted by Riaz, (2009) analyzes diabetes mellitus. In this article, diabetes mellitus is defined as a disorder in which the body has problems with the manufacture and use of insulin (a hormone produced in the pancreas). The research identified the core causes of diabetes mellitus (DM). These were metabolism related to type two diabetes, and gestational diabetes. The author identifies unhealthy lifestyles as being the metabolic cause of diabetes mellitus. This results into the inability of the body to synthesize or use insulin. However, genetics play a major role in this case. The highest prevalence of diabetes in the US is associated with type-two diabetes, according to the study. The article acknowledges the increased instances of type 2 diabetes among the young generation in the U.S. It is associated with increased cases of childhood obesity. Gestational diabetes is also a causative agent for diabetes. This is attributed to hormonal imbalances during and after pregnancy. The latter might trigger diabetes if not well monitored.
Autoimmune response also accounts for the development of diabetes mellitus. The body cells that destroy the insulin manufacturing cells can trigger the disease. However, the author argues that in most cases, it results due to unhealthy diets and genetic factors. The author further analyses the contributing factors on the development of other diseases because of being diabetic. These diseases include kidney failures, vascular disease such as stroke and heart conditions, nerve damage, eye diseases, impaired thinking, wounds, cancer, musculoskeletal disorders, pregnancy complications, emotional difficulties, insulin shock, and diabetic Ketoacidosis. Patients who are diagnosed with these diseases have the highest probability of being diabetic.
The article also highlights the trends of diabetes. It indicates that diabetes is on a steady increase. Metabolic diabetes has been on the rise in the recent past according to the study. The number has been rising steadily. It was 30 million in 1985. The number rose to 246 million in 2007. About 70% of Americans are diabetic. It is ranked as the sixth leading cause of death in the United States.
The paper identifies five major types of diabetes with information on the differences between the given types. These include type 1 diabetes, type 2 diabetes, gestational diabetes, secondary diabetes, autoimmune polygranduler, and wolfram syndrome.
The author offers detailed information on the symptoms that can be used in the diagnosis of diabetes. Some of these factors include polydipsia, dehydration, polyuria, polyphagia, weight loss, vision problems, mood swings, skin problems, and fainting. The article analyses several clinical diagnostic methods that are used in the diagnosis of diabetes. These methods are glucose tests, C-peptide tests, autoantibody tests, genetic tests and thyroid blood tests. All these tests are carried out concurrently in order to ascertain the type of diabetes and the level of the infection.
The article concludes by analyzing the available prevention and treatment methods for the syndrome. Dieting and exercise are the requirements for effective management of DM apart from the oral medications and injections available for control of the problem. Control measures of diabetes are limited to the type. Autoimmune diabetes is unpreventable. However, these other forms of diabetes can be controlled by avoiding the risk factors. The article concludes by appreciating current scientific advancements in the management of diabetes.
The fourth article analyses the medical nutritional treatment as a probable way of managing diabetes (Morris & Rosett, 2010). These articles begin by recognizing the link between diet and increased levels of diabetes. The authors admit that diet management is prudent in controlling the increasing rate of diabetic victims worldwide. The use of diet that is medically proven has the potential of producing better results in diabetes management compared to the traditional medical interventions as stated in the study. The article provides detailed evidence that links diabetes management to effective dieting. The information in the article addresses how physicians can be used in the management of diabetes with minimal application of medicines.
From the article, it is obvious that there is a close link between personal diet and the development of diabetes. Hence, diabetes can be managed in advance because it is a lifestyle disease. The research study establishes the importance of the primary care physicians in diabetes management as the patients fully depend on them for advice on the management of the condition. According to the article studies reveals that medical practitioners avoid giving advices to the patients on issues such as diet and weight loss. Furthermore, the article reiterates on the relevance of correct diet advice on management and treatment of diabetes by physicians.
The article highlights the American Diabetes Associations (ADA) regulations of 2009, which advocates for individualized Medical Nutrition Therapy for pre and post-diabetic patients. This will enhance the effectiveness of diabetes management. More so, the ADA emphasizes on the need of effective ways of managing diabetes such as exercising and dieting. The paper concludes by advocating for the application of the procedures in the management of the complication in an effort of reducing the prevalence of the condition. Consequently, the costs of managing the condition will reduce if public awareness about the condition is increased.
In summing up, it is vital to emphasize that the four articles offer detailed information about diabetes. Information on the prevalence and management of diabetes among young Americans is analyzed in the first article. This article offers comprehensive information on the reasons to why the recent years have witnessed increased cases of diabetes (Rewers et al., 2008). The most pronounced reason being increased predisposing factors such as obesity and poor diet. The authors use the information obtained from the study to provide advice on the necessary clinical action that can be taken in dealing with predisposing factors that exposes individuals to diabetes at a very early age. This paper is a rich source that can be used by medical practitioners in handling cases of diabetes among the youth.
This research examines gestational diabetes and the risks of developing diabetes (Feig et al., 2008). It is a rich source of information that can be used to minimize cases of diabetic outbreak among the female population. The realization of increased cases of d9iabetics in the recent years calls for further research to ascertain the reasons and provide amicable solutions to the epidemic.
References
Feig, D. S., Zinman, B., Wang, X., & Hux, J. E. (2008). Risk of development of diabetes mellitus after diagnosis of gestational diabetes. CMAJ, 179(3), 229-234.
Morris, S. F. & Rosett, J. W. (2010). Medical Nutrition Therapy: A Key to Diabetes Management and Prevention. Clinical Diabetes, 28(1), 12-18.
Rewers, A., Klingensmith, G., Davis, C., Petitti, D. B., Pihoker, C., Rodriguez, B., Schwartz, D., Imperatore, G., Williams, D., Dolan, L. M. & Dabelea, D. (2008). Presence of Diabetic Ketoacidosis at Diagnosis of Diabetes Mellitus in Youth: The Search for Diabetes in Youth Study. Pediatrics, 121(5), 1258-1266.
Riaz, S. (2009). Diabetes Mellitus. Scientific Research and Essay, 4 (5), 367-373.
Diabetes Mellitus type 2 or Non-Insulin-Dependent Diabetes Mellitus is a metabolic disease. The patients experience an increased level of sugar in the blood as a result of insulin resistance or deficiency (Votey & Peters par.1). The disorder usually occurs during the adulthood stage hence it is sometimes referred to as Adult-onset Diabetes (Library &Isley par.1). Unlike type 1 diabetes, T2DM patients are not necessarily dependent on insulin because they can produce the hormone though in small amounts. The disorder is associated with complications of the micro-vessels (retinal vessels), macro-vessels (coronary vessels), and the neurons (neuropathy of peripheral and automatic neurons). However, there are no major incidences of acidosis associated with the disorder (Brian & Ivana 198).
Despite the disorder being reported in patients aged 40 years and above, recent studies indicate that it can also occur in children as young as 2 years old. This arises from increased rates of obesity and overweight cases among children besides their familial or genetic predispositions. Marginal insulin resistance and defects in insulin secretion are the main factors that cause the disorder when they occur in a normal person at that age (Boden 394). All overweight individuals experience insulin resistance. In case their body fails to increase insulin production, there is a high probability of them suffering from diabetes. Research findings reveal that over 90% of obese individuals will develop diabetes-related complications at some point in their lives. Other forms of the disorder have also been associated with genetic defects (Walley et al. 124).
Research studies conducted in 2005 indicate that over 70% of all United States citizens are diabetic. This represents approximately 20.8 million people of whom 14.6 million people are diagnosed with the disorder while 6.2million are undiagnosed. Approximately 90-95% of these people are type II diabetics while 5-10% suffer from type I diabetes. A small percentage of these individuals suffer from both types of the disorder while about 54 million people show blood sugar levels that are indicative of pre-diabetes (Ryden et al. 25). Globally, almost 171 million individuals suffer from diabetes. Scientific studies project that the number may increase up to 366 million people by 2030.
This essay examines the incidence rates of the disorder in the USA and globally including a variation of the prevalence rates amongst genders, populations, and countries. It also describes the associated causative factors of type II diabetes in addition to its impact on the United States and internationally. The essay also highlights reasons why the incidence of the disorder has been increasing over the past two decades and its potential effect on the health and economies of countries.
Diabetes Mellitus, Type II
The Incidence Rates of T2DM amongst Genders, Populations, and Countries
According to Wild et al (1047), there were approximately 177 million people with diabetes in the year 2000. About 2.8% of individuals of all age groups worldwide were diabetic while about 4.4 % of the world population is projected to be diabetic by 2030. This represents a total population of 366 million who will be diabetic by 2030. The prevalence of diabetes was also shown to be higher in males than females despite that there are more diabetic women than men.
Source: Wild et al. (1049).
The graph above shows the worldwide prevalence of diabetes based on patient’s age and gender by 2000. On the other hand, the estimates for the prevalence of diabetes among countries are as indicated in the graphs below.
Source: Wild et al. (1050).
This graph indicates the estimates for adult diabetic patients in developed countries such as the United States and most European countries in the years 2000 and 2030.
Source: Wild et al. (1050).
This graph shows the adult estimates for diabetic patients in developing countries such as most African countries and the economically unstable communities in developed countries in the years 2000 and 2030.
Source: Amos et al. (23).
The graph above indicates the worldwide estimates for adult diabetic patients for the years 2000 and 2030.
By the end of 2010, the prevalence rate of diabetes is estimated to be approximately 6.4% among adults aged between 20 to 78 years worldwide (King & Rewers 157). This represents approximately 285 million people who will be suffering from diabetes worldwide. On the other hand, the rates are projected to increase to 7.7% by 2030, which is equivalent to 439 million adults with diabetes mellitus. Moreover, the results indicate that there will be an increment of 69% in the prevalence of diabetes in developing countries compared to a 20% increase in the developed countries (Shaw et al. 4).
Source: Shaw et al. (4).
The graph indicates the estimated numbers of diabetic patients in 2010 and 2030 in developed and developing countries based on different age groups.
The Causative Factors Associated with Diabetes Mellitus, Type II
Several factors are identified to cause or aggravate the disorder. These include lifestyle factors, medical conditions, and genetic factors. Studies indicate that lifestyle factors are associated with a lack of physical activities among the susceptible groups of people in addition to leading sedentary lifestyles (Lovejoy 435). In addition, relying on unhealthy diets such as foods with high levels of saturated and trans-fatty acids which are associated with the development of obesity is also a cause of diabetes. Other lifestyle risk factors such as smoking, consumption of alcohol, and other environmental toxins cause the condition (Bloomgarden 1429).
Medical conditions associated with diabetes include combined hyperlipidemia disorder (high cholesterol levels), obesity, acromegaly, hypertension, cancer, and other metabolic syndromes. Hormonal imbalances particularly hypogonadism are also associated with diabetes (Farrell et al. 799). On the other hand, genetic factors and environmental changes are also a cause of diabetes type 2. For example, when an individual has first-degree relatives who are diabetic, the probability of that individual suffering from diabetes is relatively high. The same is true with obesity which contributes to about 55% of all T2DM cases.
Certain hereditary complications such as myotonic dystrophy and Wolfram’s syndrome are also associated with diabetes. Finally, the process of gene expression which is dependent on the levels of fats and glucose is also associated with the development of diabetes. This is because any changes in the levels of these food components can cause insulin resistance which is a major risk factor in the development of T2DM (Walley et al. 124).
The Impact of T2DM at the National and Global Levels
Diabetes mellitus is associated with the development of complications that lead to neuropathic, optic, cardiovascular, and renal diseases. Diabetes mellitus is one of the causes of increased morbidity and mortality rates in the United States. Studies indicate that cardiovascular complications associated with the disorder represent approximately 50-75% of the total expenditure by most patients. In addition, two-thirds of deaths among the diabetic population are related to heart failure and stroke (Lee et al. 187). Further, studies indicated the cost of treating diabetes compared to other diseases is about one to seven times the total cost of healthcare provision in the United States in 1994. By 2002, it was estimated that diabetes cost the United States economy more than $92 billion in direct funds with an additional $40 billion lost indirectly due to the disorder. This represents about 20% of the total healthcare cost per annum (Clement et al. 553). On the other hand, diabetes causes about 12,000-24,000 new cases of blindness in the United States annually. The disorder causes high levels of End-Stage Renal Disease (ESRD) and non-traumatic lower-limb amputations in the United States. Globally, the disease causes the highest incidences of blindness among adults aged 20-74 years besides being a major risk factor in the development of non-traumatic lower-limb amputations and ESRD.
A Critical Review of the Available Literature on the Shifting Incidence rates of Diabetes Mellitus in the Last 10-20 years
Diabetes Mellitus is a chronic disease whose symptoms and related complications take a long period to develop (Harris et al. 815). Studies indicate that the prevalence rates of the disorder increase exponentially annually (Center for Disease Control and Prevention par.3). In addition, studies conducted by employing the published materials on the recent and the projected future prevalence rates for the disorder based on gender, age groups, countries, and different populations, indicate that in 1997, an estimated 124 million people were diabetic worldwide. About 97% of these people were suffering from type II diabetes mellitus. During the same year, it was estimated that the number of diabetics would rise to 221 million people by 2010. The study also predicted that most of the cases would be in Asia, Africa, and among the economically challenged communities in the developed countries (Shaw et al. 13). In 2000, available resources indicate that the global diabetes prevalence rate was 2.8%. This represents about 177 million people worldwide. In the same year, the projections for the year 2030 indicated that about 4.4% of the world population, which is equivalent to 366 million people, will be diabetic. This represents a significant increase compared to data generated in 1997. The rise in the prevalence rate was attributed to increased rates of obesity worldwide. Moreover, the studies indicate that if the prevalence rates for obesity were to remain high for the next 25 years as from the year 2000, the estimated rates for diabetes would be higher than the current estimates.
Data released in 2001 indicate that approximately 150 million people in the world were diabetic. The projections for the years 2010 and 2025 indicated that the number would rise to 220 and 300 million people respectively. The greatest number of cases related to type II diabetes as a result of the rise in obesity cases and adoption of sedentary lifestyles (Mozaffarian et al 788). Additional studies estimated that the number of diabetic patients in the United States would increase with a margin of 23.7-44.1 million during the period ranging from 2009 to 2034. In line with the increase, the studies indicate that the number of obese and overweight individuals would be over 65% among the diabetic populations.
Source: Huag (2227).
The graph indicates the estimated prevalence rates for diabetes mellitus among the newly diagnosed, the unknown causes, and the previously diagnosed patients during the period ranging from 2009 to 2034.
Limitations of the Available Literature
The studies indicate that the rates have been on the rise and the future projections indicate that the rates will continue to rise. However, the studies fail to provide ways of controlling the increment in the prevalence rates despite that they are providing the major causes and the impact of the disorder on world economies. On the other hand, the studies incorporate published resources only and fail to include the unpublished materials which can give additional information that can confirm or refute the claims made in such studies.
The Potential Effects of the Shifting prevalence rates on the health and economies of countries
Diabetes is a chronic disorder associated with several deleterious complications such as heart disease and stroke which are the leading risk factors in mortality and morbidity rates recorded worldwide. Its high prevalence implies that more deaths from such complications will be recorded (Zimmet et al 782). Many people will continue to suffer from complications associated with the disorder such as optic, renal, neuropathic, and cardiovascular diseases (Haffner et al. 562). The result is that many economies will suffer direct and indirect losses in terms of healthcare costs, lost time, and an ailing workforce (American Diabetes Association 596).
It is also estimated that the number of diabetic patients in the United States will increase with a margin of 23.7-44.1 million people in the years during the period ranging from 2009 to 2034. This implies that the total increase in the cost of healthcare will be $336 billion up from $113 billion in 2007 (Jonnson 5).
Source: Huag (2228).
The graph above shows the estimated expenditure on diabetes and its related complications in the United States for the years 2008-2033. This increase is bound to have a negative direct impact on the budgetary allotment of many federal governments (Laditka et al 1301).
Source: American Diabetes association (917).
The graph indicates the estimated impact of the changing prevalence rates on the economies of many countries and governments in terms of direct, indirect, and total costs for the years 2002, 2009, and 2020.
The Future Areas of Research
From the above discussion, one can note that many of the studies carried out on diabetes mellitus are limited to estimations and projections of current and future prevalence rates of the disorder. However, more needs to be done about prevention. Numerous studies have identified the major risk factors in the development of diabetes. However, there is the need to devise intervention mechanisms to help in eliminating the risk factors before they advance to aggravate the problem. In addition, research should be conducted about the development of policies for education and intervention mechanisms that can enable many countries to control the prevalence rates of diabetes mellitus.
Conclusion
The essay provides a detailed account of type II diabetes mellitus which is a metabolic disorder characterized by increased blood sugar levels as a result of insulin resistance and insulin deficiency. The essay further provides the prevalence rates of the disorder amongst genders, populations, and various economies in addition to providing the causative factors associated with the disorder.
The essay also reviews available literature on the impact of the disease in the United States and globally based on the condition’s prevalence rates over the past two decades. Finally, the major areas for future research studies are also identified in the study.
It is worth noting that diabetes mellitus, type II is not a single disease in itself but comprises several complications which are mainly chronic and affect the micro-vessels of the eyes, the kidneys, and the neurons. Its impact on the economies of most countries comprises both direct and indirect costs incurred in terms of healthcare provision, lost time, and an underperforming workforce. As a result, there is a need to develop policies for education and intervention mechanisms to help in the control of the condition’s prevalence rate.
Works Cited
Amos, Antonio, McCarty, Daniel and Zimmet, Paul. The rising global burden of diabetes and its complications: estimates and projections to the year 2010. Diabetic Medicine. 1997; 14(5): 7-85.
American Diabetes Association. Economic costs of diabetes in the U.S. in 2007. Diabetes Care. 2008; 31:596–615.
American Diabetes Association. Economic costs of diabetes in the U.S. in 2002. Diabetes care, 2003; 26(3): 917-932.
Bloomgarden, Zachary. Approaches to treatment of pre-diabetes and obesity and promising new approaches to type II diabetes. Diabetes Care. 2008; 31(7): 1461-1466.
Brian, Welch and Ivana Zib. Case study: diabetic Ketoacidosis in type II diabetes. Clinical Diabetes, 2004; 22(4): 198-200.
Clement, Siegel; Braithwaite, Song; Magee, Folli et al. Management of diabetes and hyperglycemia in hospitals. Diabetes Care. 2004; 27(2):553-591.
Centers for Disease Control and Prevention. National Diabetes Fact Sheet. United States. 2005. Web.
Farrell, Bowen, Deshmukh, Ann and Baghaie, Arnold. Low testosterone and the association with type 2 diabetes. The Diabetes Educator. 2008; 34 (5): 799–806.
Huang, Elbert, Basu, Anirban, O’Grady, Michael and Capretta, James. Projecting the future diabetes population size and related costs for the U.S. Diabetes Care, 2009; 32(12): 2225-2229.
Haffner, Simon, D’Agostino, Robert and Mykkanen, Loyd et al. Insulin sensitivity in subjects with type 2 diabetes. Relationship to cardiovascular risk factors: the Insulin Resistance Atherosclerosis Study. Diabetes Care. 1999; 22(4):562-568.
Harris, Ian, Klein, Ronald, Welborn, Timothy and Knuiman, Mathew. Onset of NIDDM occurs at least 4 – 7 yr before clinical diagnosis. Diabetes Care. 1992; 15(7):815-819.
Jonnson, Brewd. Revealing the Cost of Type II diabetes in Europe. Diabetologia. 2002; 45(7): 5-7.
King, Hans and Rewers, Martel. Global estimates for prevalence of diabetes mellitus and impaired glucose tolerance in adults: WHO Ad Hoc diabetes reporting group. Diabetes Care. 1993; 16(1): 157-177.
Laditka, Siegel, Mastanduno, Paul and Laditka, Newman. Health care use of individuals with diabetes in an employer-based insurance population. Arch Intern Med. 2001; 161(10):1301-8.
Lovejoy, Jones. The influence of dietary fat on insulin resistance. Curr. Diab. Rep. 2002; 2 (5): 435–40.
Lee, Cannon, Huxley, Robert , Lam, Harold et al. Prevalence of diabetes mellitus and population attributable fractions for coronary heart disease and stroke mortality in the WHO South-East Asia and Western Pacific regions. Asia Pacific Journal of Clinical Nutrition. 2007; 16(1): 187–92.
Mozaffarian, Dariush, Kamineni, Aruna, Carnethon, Mercedes, Djoussé, Luc, Mukamal, K.enneth and Siscovick, David. Lifestyle risk factors and new-onset diabetes mellitus in older adults: the cardiovascular health study. Archives of Internal Medicine. 2009; 169(8): 798–807.
Ryden, Lars et al. Guidelines on diabetes, pre-diabetes, and cardiovascular diseases. European Heart journal supplements. 2007; 9: 3-74.
Shaw, Jons, Sicree, Robert and Zimmet, Parlet. Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetic Research and Clinical Practice. 2010; 87(1): 4-25.
Wild, Sarah, Roglic, Gojka, Green, Anders, Sicree, Richard and King, Hilary. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care. 2004; 27(5): 1047-1053.
Walley, Andrew, Blakemore, Alexandra and Froguel, Philipe. Genetics of obesity and The prediction of risk for health. Human Molecular Genetics. 2006; 15(2): 124–130.
Zimmet, Paul, Alberti, Kenneth and Shaw, Jonathan. Global and societal Implications of the diabetes epidemic. Trans. Med. Soc. Lond. 2001; 78(16): 782-787.
The holistic approach to medicine is based on the assumption that healing should rely on the knowledge about the whole person – that means that not only the organ or the body system suffering from certain dysfunction should be considered while choosing the methods of treatment but the whole body, spirit, and mind should be taken into account. According to holistic medicine the process of achieving and maintaining the optimal health can give excellent results only if the physical, emotional, and spiritual aspects are kept in balance (“What Is Holistic Medicine?” par.1).
Diabetes is one of the most common diseases among the population of Western countries. The causes of Diabetes Type 2 mostly depend on the diet and physical activity of the person, which means that the disease can be relatively easily prevented. Diabetes Type 1 is currently considered to have no ways of prevention. However, increasing the chances of getting serious complications of this disease mostly depends on the same methods that are used for prevention of Diabetes Type 2. As the second type of diabetes is the most prevalent one (nearly 85-90 %), it can be said that prevention is the key to decreasing the rates of diabetes (“Type 2 Diabetes” par.1). The analysis of the options and limits related to applying the holistic approach to prevention of diabetes reveals that the number of people suffering from this disease can reduce if people are aware of the importance of maintaining body, mind, and spirit balanced and healthy.
The use of the holistic approach to prevention of Diabetes means that the person needs to follow the advice aimed at supporting physical, spiritual, and emotional health. Holistic doctors pay special attention to eliminating all factors that can be potentially harmful to human health and take into consideration such aspects as sleeping habits, stress, personal problems, spiritual activities, etc.
Physical health is one of the cornerstones of the prevention of diabetes. Therefore, the main options include following the healthy diet, participating in physical activities, maintaining normal body weight, sleeping enough amount of time, etc. Eating a lot of vegetables, fruits, and grains, cutting the consumption fat, avoiding refined sugar and products containing it in large amount (sodas, sweets, cookies, etc.), excluding processed foods, and drinking a lot of water are just a few habits able to make the diet beneficial for the body. Addressing nutritional deficiencies is also an important and useful step, as by remedying them we can significantly increase the effectiveness of functioning of all of the body systems (Ofori and Unachukwu 162). Physical activity is another component of keeping your body healthy. Avoiding spending long hours sitting in front of the laptop or TV without any gymnastics, participating in regular lessons on any kind of sport, doing exercises, walking instead of driving when possible, and many other methods help your body to stay fit and have low chances of developing obesity, which is known as a frequent companion of diabetes. Giving up smoking, drinking alcohol and coffee, and other unhealthy habits are also of vital importance.
All of the steps discussed above have the primary aim of keeping the body healthy and fit. However, as everything in our organisms is interrelated, the mentioned methods not only help to address the physical health, but also keep the mind and spirit in a good condition. It is a well-known truth that diet influences the mood and motivation of the person. When we eat a lot of unwholesome food and experience certain nutrient deficiencies, our nervous system cannot function properly, which leads to sleeping problems, depressions, high irritability, etc. From the other side, spiritual frame influences the appetite and the motivation to lead a healthy lifestyle, as people who experience any psychological problems or lose the sense of life are vulnerable to getting unhealthy habits and experience decrease in willingness to do anything beneficial for functioning of the body. Many people who practice positive thinking admit significant elevation in motivation to benefit the organism by getting healthy eating habits and doing exercises and vice versa. Dealing with stress related to personal problems or the specifics of everyday life is another step that does not only improve the spirits but directly impacts the functioning of the body. It is well known that many diseases are triggered by stress and abundance of negative emotions, which means that making your life less stressful and finding solutions to personal problems are effective ways of preventing your organism from developing such disease as Diabetes. Besides, numerous spiritual practices motivate people to live the life full of meaning, which can be done if the person is healthy enough to be not bounded in his/her activities by diseases. Many people claim that participation in such practices aimed at making the life more purposeful and happy has a positive influence on the overall health.
The main limitations related to applying a holistic approach to preventing diabetes are caused by the absence of scientific evidence of the possibility of avoiding Diabetes Type 1 by using any strategy aimed at eliminating the risks of developing the disease. Since the causes of Type 1 are unknown, it is rather difficult to suggest effective preventing strategies (Mayo Clinic Staff par. 1). However, since the disease is directly associated with the pancreases dysfunction, prevention of pancreatic problems through avoiding intake of chemical and drugs destroying pancreatic cells can be considered the possible way of contributing to preventing Type 1 Diabetes.
The severity of the complications caused by diabetes appears to be directly related to the general health of the organism. For example, the hypoglycemia unawareness, which is a syndrome seriously threatening the safety of patients suffering from Diabetes, appears to be directly related to the quality of brain function, as most hypothesis about the causes of the syndrome are based on the assumption that it has neurobiological origin (e.g. The brain fuel hypothesis, The brain neuronal communication hypothesis) (Martin-Timon and Canizo-Gomez 915). This fact illustrates the importance of applying the holistic approach to eliminating the manifestations of diabetes through revealing the interrelation between different body systems.
The process of reversing Diabetes is mostly effective for Type 2 and includes the basic rules that need to be followed for its prevention. The tendencies of relying on the holistic treatment of the body instead of taking regular medicines and insulin injections can be seen worldwide (Brown-Riggs 28). More and more people suffering from Diabetes Type 2 choose the combination of healthy diet, physical activity, and spiritual well-being as the alternative way of treating and reversing the disease and getting amazing results.
The analysis of the main options for preventing diabetes by applying the holistic approach to medicine reveals that though Type 1 Diabetes appears to have no ways of prevention, Type 2 Diabetes can be easily avoided by leading the lifestyle based on keeping the balance between the well-being of body, mind, and spirit. Moreover, the same strategy can be used for reversing the disease, as the experience of millions of people worldwide demonstrates.
References
Brown-Riggs, Constance. “Reversing Type 2 Diabetes with Natural Therapies.” Today’s Dietitian 14.11 (2012): 28. Print.
Martin-Timon, Iciar, and Francisco Javier del Canizo-Gomez. “Mechanisms of Hypoglycemia Unawareness and Implications in Diabetic Patients.” World Journal of Diabetes 6.7 (2010): 912-926. Print.
Ofori, Sandra, and Chioma Unachukwu. “Holistic Approach to Prevention and Management of Type 2 Diabetes Mellitus in a Family Setting.” Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy 7 (2014): 169-168. Print.