Diabetes mellitus - Literature review Example

?DIABETES MELLITUS of Introduction Approximately thirty one million people in the whole world die from the four major chronic, non-communicable diseases. The diseases are such as diabetes, cancer, respiratory disease and heart disease. Chronic disease term refers to the above four named non-communicable diseases according to Oxford Health Alliance (www. Oxha.org). These diseases result to premature deaths (WHO 2005). Approximately eighty percent (80%) of the deaths occur in middle and low-income countries. In relation to other infectious diseases, chronic diseases claim lives of numerous individuals in developing countries. Chronic diseases have been on the rise for the past decades and concentrated in the developing countries. Diabetes has been recognized as the top chronic disease and has displaced some of the initial Global Burden of Disease’s forecasts “pessimistic scenario” [2] The chronic disease outlook is not promising. Chronic diseases in 2002 constituted 46% of deaths in developing countries. The deaths are projected to rise by 13 %( 59%) by 2030. This is inclusive of all world major regions. Hence, chronic diseases such as Diabetes Mellitus will continue rising as infectious diseases declines. For instance, in the Pacific and East Asia countries, mortality rates as a result of chronic diseases are expected to rise. On the contrary, mortality rates of infectious diseases are expected to decline [22] Diabetes Mellitus is one of the widespread chronic diseases. It is an endocrine disorder and results from insufficient release of insulin [21]. In addition to that, it can be caused due to the reduction in insulin sensitivity. For purposes of reducing its complication risks, an individual needs to undergo a continuous medical attention and care. It causes coronary artery, a disease known for causing death and new cases of kidney and blindness disease in grownups. Diabetes aggressive treatment and intensive treatment strategies aids in reducing its complication through earlier management and detection. Diabetes Types Diabetes is a condition characterized by a body not making proper utilization of carbohydrates in the food. The reason being that, the insulin produced by the pancreas is not adequate enough or it is ineffective thus making the body unable to utilize the food carbohydrates. Apart from inadequate insulin, diabetes can also be caused by pancreas diseases. However, they are extremely rare. There are two major types of diabetes namely Type 1 and Type 2 diabetes [23] Type 1 Diabetes This type develops when cells producing insulin in the pancreas gets destroyed. There exist no conventional reasons why these cells get damaged. However, the most obvious reason is the body showing a reaction that is abnormal to the cells. The abnormal reaction might be inflamed by a viral or existing body infection. Type 1 diabetes is also referred to as Insulin Dependent Diabetes (IDD). Individuals under the age of forty (40yrs) are susceptible to this type of diabetes. Nevertheless, it can occur under any age bracket [23]. Type 2 Diabetes Middle-aged individuals and older people are highly vulnerable to this type of diabetes. Most frequently, it is diagnosed among the younger overweight individuals. This type of diabetes is prevalent among the South Asian and African-Caribbean young aged people. Failure of the insulin produced by the body to work effectively is the principal cause of Type 2 diabetes. Individuals in medical field have described Type 2 diabetes wrongly via referring to it as mild diabetes. In that case, diabetes should be properly treated and taken seriously. Type 2 diabetes is also known as insulin dependent diabetes (NIDD)[23]. Diabetes Causes and Symptoms There exist various causes for Type 1 and Type 2 diabetes. Type 1 diabetes is an autoimmune disease. In that case, the pancreas cells responsible for producing insulin get attacked by the body immune system. However, environmental factors such as viral infections that are unavoidable but common contribute to this type of diabetes. It is more prevalent in men compared to women [23]. On the other hand, Type 2 diabetes exhibits strong genetic connections. This means that it is a hereditary disease. Various genes are responsible for the cause of this type of diabetes and are still under scrutiny. There exist various risk factors that trigger Type 2 diabetes development. These are such as, high blood pressure levels, high-fat diet, gestational diabetes, alcohol intake at high levels, sedentary lifestyle, ethnicity, aging and obesity [10]. Symptoms of Diabetes The principle symptoms of diabetes are such as extreme tiredness, increased thirst, unexplained loss of weight, blurred vision, regular thrush episodes or genital itching, frequent toilet visit to be precise at night, slow healing of wounds and cuts. Type 2 diabetes takes long to develop making it extremely difficult to identify symptoms. On the other hand, Type 1 diabetes is quickly recognized. It can take a few days or weeks. However, the diabetes symptoms of the two types can be eliminated if treated early. Early screening and treatment reduces diabetes complication and seriousness [23]. Diabetes complication Diabetes and depression are spread worldly. For instance, approximately 11.4% of the population in the US suffering from diabetes inhibit major depressive disorder (MDD) in comparison to 7% who do not suffer from diabetes [15][4]. Depression and diabetes result to greater disabilities and extremely high mortality rates [20][8]. According to empirical researches carried out on primary care and population in general, it is proved that diabetes patients suffer most from depression as compared to other complications such as, poor self-management and glycaemic control [16][18]. According to hypothesis made, it is evident that there exists a reciprocal relationship between depression and hyperglycaemia [16][18]. A bidirectional correlation between diabetes and depression has been suggested [22][6]. Diabetes and depression combination is common. Patients having severe complications that are diabetes-related such as late macro-and macro-vascular which consist of nephropathy, retinopathy, cardiovascular diseases and neuropathy have higher chances of being referred to clinics that are highly specialized [17, 25]. If patients suffering from these complications are treated adequately, they get satisfied with their overall functioning and care [14, 15]. It is noted by systematic reviews that diabetes patients shows improvement with regards to depressive symptoms and also in blood glucose levels and self-management [24]. It is therefore of great clinical significance if research is conducted on specific population of diabetes patients. There is need to increase depression awareness among diabetes patients. This aids in early diabetes detection and treatment among the health care professional. The outcome is co-morbid improved treatment and improved patients’ quality of life [26] Treatment of Diabetes Diabetes cannot be successfully cured. However, it can be managed effectively. The main objective of managing diabetes is to diminish levels of blood glucose to normal (4-7mmol/l before taking any meals and to 10mmol/l after taking a meal)[23]. Treatment of Type 1 diabetes Individuals with Type 1 diabetes require insulin injections. Furthermore, they need to maintain a healthy diet through taking meals containing perfect food balance. Additionally, physical activities are significant. As a matter of fact, individuals with this type of diabetes cannot swallow insulin. This is because; the digestive juices present in the stomach destroy insulin. That is why individuals with Type 1 diabetes are recommended to take two or more insulin injections each day [23]. Treatment of Type 2 diabetes Individual with Type 2 diabetes are required to eat diets that are healthy and also take physical exercises regularly. In case the two does not work for an individual, a healthcare professional always recommends some tablets for purposes of keeping glucose blood levels normal. There exist various categories of tablets to manage Type 2 diabetes. Some are significant in producing insulin while others are vital in effective utilization of the produced insulin. Some slows down the intestine speed of absorbing glucose. An individual can be prescribed numerous tablets depending on his or her condition. Insulin can also be taken instead of tablets[23]. Self-management and Self-care Self-care and aided self-management are terms used while describing an individual suffering from a long-term condition and has devised ways of dealing with the conditions and keeping themselves healthy. Self-care are those activities that an individual performs on a daily basis regardless of his/her condition. These activities are extremely difficult for individuals leaving with a permanent condition. On the other hand, self management is the action taken by an individual for purposes of managing their condition. Self care and self-management are social and health care responsibility and are frequently provided free of charge [9]. Self-management to be effective requires deep understanding of the condition. For instance, its successful treatment and how to go about it. In order to succeed, behavior need to be changed, adequate problem-solving skills need to be learned and coping with difficult situations for instance, if things do not go according to the patients’ way should be devised. To achieve successful self-management, it is advisable to offer patients with information about their conditions. This can be achieved through training and education to enable the patients to acquire skills of managing distinct wants of their conditions. The crucial self-management activities for diabetes care and individuals living with the condition are such as, Managing the correlation between medications, activity and food Blood pressure, blood glucose self-monitoring and carrying out of retinal screening Targeting individual need tailored goals revolving around weight loss, foot care techniques of injection and self monitoring activities Understanding diabetes through having a clue on the expected care and services to access Managing complications that are acute such as hyperglycaemia and hypoglycemia Legislative issues understanding like those related to driving and employment. Importance of Diabetes self-management Self management is vital for individuals living with diabetes. Once individuals have been diagnosed with diabetes, self-management should be part and parcel of their lives. Self-management results to outcomes that are positive. For instance, fewer consultations in primary care, visits reduction in outpatient departments, reduced periods of staying in hospital, improved communication between patients and professionals, change in behavior resulting to life styles that are healthy, better management of system whose outcome is reduced anxiety, pain, depression, tiredness and stress, improved life quality and health results, improved acknowledgment of patients condition and increased satisfaction and independence on the side of the patient[9]. Social and health care professional, family members and peers should support diabetes individuals via providing them with tailored and relevant support. Individuals suffering from diabetes have to make a variety of decisions based on the diet, physical activities to be performed and how to confront various situations such as stresses and how to adhere to their prescribed medications. In conclusion, aided self-management allows individuals to develop self skills and confidence in dealing with diabetes. The self-management programs are such as education structures that are programmed, high quality provision of information, peer support and care planning for individuals with diabetes. This helps in improving their diabetes condition. Apart from provision of these services, there is need to equip health care professionals with adequate knowledge to improve their significance in care planning. Diabetes as public health problem Incidents and prevalence of diabetes are quite alarming. Thus, there is need to address diabetes as a public health issue. This will enhance a broader understanding and appreciation that diabetes not only affects individuals, but also society, community and families [1] Diabetes in the World According to 2011 statistics released by IDF, approximately three hundred and sixty six million (366M) individuals are living with diabetes. Diabetes causes four point six million (4.6M) deaths annually. According to the International Diabetes Federation (IDF), the countries with the largest population suffering from diabetes are such as United States, China, India, Brazil and Russia. The countries with highest prevalence of diabetes among the adult population are such as the United Arab Emirates, Nauru, Saudi Arabia, Bahrain and Mauritius. The highest burden of diabetes is experienced in middle and low-income countries [11]. Diabetes and Impaired Glucose Tolerance in the world 2010 2030 Total world population in billions 7.0 8.4 Adult population(20-79 yrs, billions) 4.3 5.6 World Diabetes and Impaired Glucose Tolerance(20-79 age group) Comparative prevalence of diabetes (%) Number of people with diabetes in millions Comparative prevalence of Impaired Glucose Tolerance (%) Number of people with Impaired glucose tolerance (millions) 6.4% 285million 7.8% 344 Million 7.7% 439 Million 8.4% 472 million Data source: IDF Diabetes Atlas fourth edition Diabetes in Kingdom of Saudi Arabia Prevalence of diabetes* (20-79 age group), 2010 and 2030 in Saudi Arabia Country Person/per millions(2010) Person/ per million(2030) Saudi Arabia 16.8% 18.9% According to the above data obtained from IDF diabetes Atlas, Diabetes mellitus prevalence in KSA is increasing. Various factors help in explaining why there exists such significance. This is because, the selected Saudi population composed of young and older individuals (20-79yrs). As a matter of fact, the prevalence of diabetes increases with age. Another reason for recorded increase in diabetes according to the study might be the increased risk factors in KSA responsible for causing diabetes mellitus. These factors are such as sedentary life, obesity and reduced physical activities [5] Challenges of Diabetes Management in Kingdom Saudi Arabia Diabetes epidemiologic transition has been complete and fast in the KSA (Kingdom of Saudi Arabia). The countries rapid growth in economy over the previous four decades has significantly affected the living standards of its population. In addition to that, there is an adoption of unhealthy eating habits and limited physical activities [3]. Type 2 diabetes mellitus prevalence has been elevated as a result in life style change, diabetes genetic predisposition among the Saudi population and their consanguineous marriages [13]. Managing diabetes in Kingdom Saudi Arabia is an uphill task. Various factors are contributing to its spread. According to the Qatar regional study, factors such as family history, obesity and smoking habits are highly associated with the disease. In Kingdom Saudi Arabia, hypertension, diabetes along with coronary artery diseases has become an extreme challenge to the countries health care system. According to the World Health organization, it is estimated that, non-communicable diseases will be the principal cause of deaths in Kingdom Saudi Arabia [7] The major challenge affecting Kingdom Saudi Arabia is the lack of epidemiological studies among the population on Type 2 diabetes. There is lack of information on the interactivity between environmental and genetic diabetes risk factors. In addition to that, some eating habits are native in Kingdom of Saudi Arabia. The eating habits are such as eating of bakery items, dates, meat dishes, desserts and rice that are composed of high carbohydrates and fat content. To make matters worse, no single study has been conducted to document the correlation between the risk of conducting Type 2 diabetes and dietary patterns while keeping other factors such as education, age, gender and diabetes history in family constant [19] Overcoming the Challenges of Diabetes Management in Kingdom of Saudi Arabia Diabetes mellitus overall prevalence is increasing in the Kingdom of Saudi Arabia, which records an alarming prevalence rate (23.7%). Majority of individuals suffering from diabetes are unaware of the existing diagnosis despite medical care availability. Diabetes mellitus delayed diagnosis results in various complications that disrupt individual productivity and increasing disease burden. As such, more and more emphasis should be directed in early management of the condition through screening and creation of awareness among the public on Diabetes mellitus. A huge prospective trial should be recommended for purposes of modifying Saudi population life style through exercise increase, weight reduction and adoption of eating habits that are healthy. If all these are implemented, Diabetes mellitus prevalence will decline [ 5]. References 1. Abright, A.. Public Health Practice and Diabetes- What more can be done to halt the epidemic. Touch Briefings 2011: p.16-19. 2. Alfadda, AS., Bin-Adulrahman, KA., Saad, HA., Deanna, C, Angkaya-Bagayawa, FF., & Talbot F, Nouwen A. A review of the relationship between depression and diabetes in adults: is there a link? Diabetes Care 2000; 23: 1556–1562 3. Al-Hazzaa, HM. Prevalence of physical inactivity in Saudi Arabia: a brief review. East Mediterr Health J 2004 , 10: p. 663-670. 4. Anderson RJ, Freedland EF, Clouse RE, Lustman PJ. 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