Prevention of Type 2 Diabetes Mellitus by Changes in Lifestyle - Research Paper Example

? Diabetes Diabetes Diabetes is a pathological condition which occurs due to the deficiency of insulin in the human body or owing to the resistance of the body cells to insulin. The lack of insulin results in altering the normal levels of glucose in the human body which are mainly regulated by this hormone. Diabetes is classified as a syndrome because it affects most of the organs in the human body resulting in other disease states. Diabetes is classified into types which are Type I diabetes mellitus and Type II diabetes mellitus. Type I diabetes mellitus mostly occurs at an early age and it is an autoimmune disease where the cells of the pancreas are destroyed. This results in a lack of insulin. Type II diabetes mellitus mainly occurs in individuals above the age of 40 years. It is characterized by a reduction in the insulin secretion as well as resistance of the cells of the body to the action of insulin. This results in reduced effectiveness of the hormone. Obesity, reduced physical activity as well as unhealthy eating habits are considered as risk factors of type II diabetes (Colledge et al 2010). Diabetes mellitus tends to disturb the normal physiology of the other systems in the human body which include the renal system, the nervous system and the cardiovascular system. The normal functioning of the kidneys may become altered which results in metabolic derangements. Neuropathies are also a common presentation in the diabetics and loss of sensory and motor reflexes in the distal limbs are seen. The cardiovascular functioning is also affected and the risk of myocardial infarctions is raised in these patients. The eyes of the diabetic patients need regular assessment as cataracts and retinopathies tend to develop in these patients. The assessment is also important as in severe cases of uncontrolled diabetes, blindness can develop. Diabetes can result in decreased blood supply to the distal limbs and this along with the neuropathy can result in ulceration of the foot mainly (Longmore 2007). Various blood tests can be used to diagnose diabetes. These include fasting and random levels of glucose in the blood and oral glucose tolerance test. After the confirmation of the diagnosis, the treatment is commenced which includes medications that increase the sensitivity of insulin like glitazones and metformin. Insulin itself is also given to the patients (Colledge et al 2010; Longmore 2007). Statistics of Diabetes in the United States of America According to the statistics for the year 2010 which were revealed in the National Diabetes Fact Sheet 2011, the number of Americans suffering from diabetes was 25.8 million. This accounted for approximately 8.3 percent of the total population of the United States. The number of diagnosed cases was indicated as 18.8 million whereas the undiagnosed cases were 7 million. 25.6 million, diabetics were mainly adults above the age of 20 years. Out of these 25.6 million people, 13.0 million were males whereas 12.6 million were females. Furthermore, 1.9 million adult Americans were diagnosed as new cases of diabetes in the year 2010. On the other hand, approximately 215,000 American under the age group of 20 were known to suffer from diabetes in the year 2010. The National Diabetes Fact Sheet also revealed the occurrence of diabetes in different races in the United States. In the year 2010, 15.7 million non-Hispanic white adults and 4.9 million non-Hispanic blacks were known to suffer from diabetes (Centers for Disease Control and Prevention 2011). Diabetes mellitus serves as a burden on the healthcare system of the United States owing to the high medical costs associated with it. In the year 2007, the approximate direct medical expenditure incurred due to diabetes was 116 billion and indirect cost was approximately 58 billion dollars (Centers for Disease Control and Prevention 2011). This is due to the rise in the statistics of diabetes in the United States. According to a research by the Centers for Disease Control and Prevention (CDC) in the year 2010, one in ten Americans suffered from diabetes mellitus. With this continued pace, the CDC explained that by the year 2050, one out of every three people in the United States would be afflicted with diabetes. The report further shed light upon the fact that in the year 2008, the new diagnosed patients of diabetes were eight out of every 1000 individuals but these would also increase in the year 2050 to fifteen per 1000 (CBS AP 2010). Psychosocial Challenges of People Suffering From Diabetes Diabetes is a chronic condition which persists for the entire life of an individual. It tends to affect the living of the person suffering from the disease and it also affects his family. This is owing to the chronicity of the condition and the associated pathologies which may require regular hospital visits and modification in the lifestyle of a person. Diabetes itself is not a direct cause of psychiatric diseases but the susceptibility of psychosocial issues increases in certain individuals suffering from diabetes. This is particularly implied to young individuals who have type I diabetes and they have a greater risk of suffering from eating disorders. Depression and anxiety are psychiatric pathologies which mainly occur in adults who suffer from diabetes as well as its associated pathologies since many years (Gulledge et al 1999). Stress and anxiety is also mainly seen in family members of diabetics. This is most commonly seen in parents of young children who suffer from diabetes type I. The main reason for this stress and anxiety amongst the parents of these children is due to the consideration of the pathologies that may affect their children owing to diabetes. Another reason is the difficulty that the parents experience in telling other people about their child’s disease (Young and Unachukwu 2012). The psychosocial challenges afflicting the diabetic patients need to be tackled because they lay a great impact on the management of this disease. This is because the patients become disheartened and do not seek proper medical advice. Furthermore, they do not follow the management strategies advised. This can be harmful as it can lead to further deterioration of health. These problems can best be managed by the medical practitioner. The healthcare provider should cover not only the physical aspects of the disease but he should also try to address the psychological problems of the patient and work towards relieving their stress (Gulledge et al 1999). Research Projects Related to Diabetes A research project depicting very interesting findings with regard to diabetes mellitus and its association with the distribution of body fat was published in the year 1985. The research was conducted over a period of 13.5 years and assessed 792 men who were of the year 54 years and were all born in the year 1913. The subjects were all residents of Goteborg, Sweden. These men had risk factors of diabetes but were not suffering from the condition. The body weight of these patients along with the measurement of the fat distribution was done in the year 1967. The abdominal body fat was measured by the ratio of the waist and the hip. These patients were followed and assessed after the end of 13.5 years. The results of their final assessment revealed that subjects who had greater abdominal body fat had a higher susceptibility of developing diabetes mellitus in comparison to the other subjects (Ohlson et al 1985). Another research project conducted by Tuomilehto and his colleagues shed light upon the impact of obesity and physical inactivity on the occurrence of diabetes mellitus. The research was conducted in Finland and the participants of the research equaled to 522. 172 of these were males and 350 were females. These subjects had weight above normal and had an increased risk of suffering from diabetes. The subjects were divided into two groups which included the control group and the intervention group. The intervention group was counseled with regard to the benefits of physical activity and healthy eating and modifications in lifestyle were suggested. These subjected were followed over a period of four years and the final results upheld the fact that the occurrence of diabetes was higher in the control group whereas decreased incidence was noted amongst the group that was undergoing interventional therapy (Tuomilehto et al 2001). Community Based Programs for Diabetes Community Based Programs have proven to be successful in the management of diabetes. A community based program of interest was that conducted with the assistance of Kramer and his colleagues. This program aimed at reducing the risk of cardiovascular pathologies in diabetic patients. The program merged with the already running community programs where educators of diabetes taught their patients with regard to self-management. This program had 12 sessions and was referred to as the Group Lifestyle Balance Program. The basic purpose of this community based program was the assessment in the reduction of cardiovascular pathologies linked with diabetes by using already running community based programs. The funding and support for the running of this program came from the Diabetes Prevention Support Center of the University of Pittsburgh. There were eight participants in this program which comprised of seventy one females and ten males. After the completion of the sessions of this program, a reduction in the weight of the participants was seen and hence it was observed that the program was successful in decreasing the susceptibility of the development of cardiovascular disease in the diabetic patients (Kramer et al 2011). Another effective Community Based Program was conducted by the Wake Forest Baptist Medical Center where community health workers were used to impart knowledge and information to the risk groups with regard to the development of diabetes. This community based program was run in the Forsyth County of North Carolina and focused on weight loss strategies through changes in lifestyle and the assessment of this weight loss was done in every 6 months for two years. The participants in this program were mainly individuals whose weight was above the normal limit and they had high glucose and insulin levels. The effects of weight loss in the correction of glucose as well as insulin levels in the human body were proved by this program. The community healthcare program served as an eye opener that education and awareness should be spread amongst the local masses by health workers as this would serve as a great preventive measure in the occurrence of diabetes (Wake Forest Baptist Medical Center 2013). Interventions to Minimize the Impact of Diabetes Psychosocial interventions are a very important tool in the management of diabetes. These interventions are of utmost importance because diabetes is a chronic health condition having a psychosocial impact on the patient. This needs great attention owing to the fact that patients who seem to be psychologically disturbed do not tend to stick to management measures which are necessary for the diabetic patients. These patients become greatly disturbed if other medical pathologies associated with diabetes occur. This accounts for significant morbidity associated with diabetes. The impact of diabetes on patients can be reduced if the medical practitioner takes good interest in treating the patient. The healthcare provider should not only consider the medical condition of the patient but he should also provide the patient comfort and assess his psychological state. It is the work of the practitioner to gain the confidence of the patient so that the patient can easily confide in the practitioner and present all his physical as well as psychological issues. This psychosocial intervention would provide for better management of the patients (Gulledge et al 1999). Research work has provided for effective treatment options for diabetes. Continuous subcutaneous insulin infusion (CSSI) is a new interventional measure which can prove to be very useful for diabetic patients. This CSSI is basically an insulin pump which has proved to be very beneficial for patients who utilize insulin as the form of treatment for diabetes. This provides as an easier alternative to the regular subcutaneous injections of insulin that are given to the patient. Furthermore, better regulation and control of blood glucose is achieved through CSSI. The CSSI also tends to improve the quality of life of the diabetic patients and works towards improving compliance in the patients who find this method easy (Benchell et al 2003). References Benchell,J.W., Lomaglio, J.A. & Seshadri. R. (2003).Insulin Pump Therapy: A meta-analysis. American Diabetes Association; Diabetes Care Journal, 26, 1079-1087. CBS AP. (2010, October 22). “CDC: 1/3 of Adults Could Have Diabetes by 2050.” CBS News. Retrieved from http://www.cbsnews.com/2100-204_162-6981889.html Centers for Disease Control and Prevention (2011, May 23). “2011 National Diabetes Fact Sheet.” Diabetes Public Health Source. Retrieved from http://www.cdc.gov/diabetes/pubs/estimates11.htm Colledge, N. R., Walker, B. R., Ralston, S. H., & Davidson, S. (2010). Davidson's principles and practice of medicine. Edinburgh: Churchill Livingstone/Elsevier. Gulledge, J., Beard, S., & Health and Administration Development Group (Aspen Publishers). (1999). Diabetes management: Clinical pathways, guidelines, and patient education. Gaithersburg, Md: Aspen Publishers. Kramer, M. K., McWilliams, J. R., Chen, H. Y., & Siminerio, L. M. (January 01, 2011). A community-based diabetes prevention program: evaluation of the group lifestyle balance program delivered by diabetes educators. The Diabetes Educator, 37, 5.) Longmore, J. M. (2007). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Ohlson, L. O., Larsson, B., Sva?rdsudd, K., Welin, L., Eriksson, H., Wilhelmsen, L., Bjo?rntorp, P., ... Tibblin, G. (January 01, 1985). The influence of body fat distribution on the incidence of diabetes mellitus. 13.5 years of follow-up of the participants in the study of men born in 1913. Diabetes, 34, 10, 1055-8.Top of Form Tuomilehto, J., Lindstrom, J., Eriksson, J. G., & Finnish, D. P. S. G. (January 01, 2001). Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. Acp Journal Club, 135, 101.Bottom of Form Wake Forest Baptist Medical Center. (2013, March 18). “New research shows community-based prevention program reduces diabetes.” News Medical. Retrieved from http://www.news-medical.net/news/20130318/New-research-shows-community-based-prevention-program-reduces-diabetes.aspx Young, E.E., & Unachukwu, C.N. (2012). Psychosocial aspects of diabetes mellitus. African Journal of Diabetes Medicine. 20.5-7. Read More