Cure for Type 2 Diabetes Disease - Case Study Example

Executive Summary It is agreed that type 2 diabetes is the main health problem haunting the Aboriginal population. Given that the prevalence of type 2 diabetes illness among Aboriginal people is close to four times more than that of the other population, it has a higher impact on hospitalization as well as mortality in Australia. The high extent of the mortality along with morbidity that come from several macrovascular and microvascular complications associated with type 2 diabetes continues to increase and yet it is not documented well. The type 2 diabetes development along with its succession to complications can be reduced and prevented. Thus, more is expected from public health care system in Australia. Although, like majority other regions of Aboriginal health, strategies that are committed to dealing with such areas of national health concern are lacking for Aboriginal population. Hence it is necessary to reveal current public health programs relating to type 2 diabetes disease in the Aboriginal population so that effective health programs are developed to target Aboriginal Australians. Following federal governments policy, there was release of National Diabetes Strategy 2000-2004 in Australia. According to the Garnero1, the strategy was aimed at ensuring efficient, effective, economically viable and evidence-based access to health programs and services for preventing type 2 diabetes illnesses and caring for all patients with the same disease in Australia. Despite the fact that the Commonwealth budget of 2001-02 allocated $43.2 million four years ago to National Integrated Diabetes Program, progress of implementing the stipulated strategies is slow. Introduction Type 2 diabetes is a chronic disease that arises when human body is unable to use insulin for breaking down sugar. The Public Health Care of Australia has recognized type 2 diabetes as a main concern for health care among the Aboriginal community. The prevalence of type 2 diabetes in this community is four times more than the general population in Australia. Aboriginal population of Australia comprise of Métis, Inuit and First Nations. Whereas, type 2 diabetes was uncommonly observed among the Aboriginal communities as early as 1900s, presently the majority of Aboriginal people report high rates of prevalence. It is even publicly considered that Aboriginal descent is a major risk factor for causing the illness. Women of Aboriginal population have higher chances of developing the disease as compared to male counterparts. This study provides information on prevalence rates of type 2 diabetes among Métis, Inuit and First Nations population. It also reviews recent/current public health programs relating to the disease in the Aboriginal population and critically analysis how these health programs are effective in targeting Aboriginal Australians for type 2 diabetes disease. According to the Becker2, The 2004-2005 National Aboriginal and Torres Strait Islander Health Survey indicated that the First Nations population had the highest diagnosis of type 2 diabetes with a mark of 15.3%. They were followed by Inuit community which registered 8.7%. The Métis had a prevalence of 5.8%. Based on the recognition of type 2 diabetes in 1996 as a major national health area to be given high priority in Australia, various public health care policies, initiatives and strategies have been put forward. The Federal Government laid down a policy to assist in reducing the impact of type 2 diabetes on the health care system. Australian National Diabetes Strategy and Implementation Plan, while responding to that policy, came up with standards for developing strategies and approaches for managing, reducing and preventing type 2 diabetes among Aboriginal population. The strategies of health care system encompassed training local Indigenous Health staff and employees of Aboriginal communities. It also involved building of controlled health services to fully deliver services and training with no external intervention in Australia. The developed health care strategies were based on requirements that were determined by the Aboriginal community. The health care programs were developed to support and be run by the Aboriginal population itself. In addition, the ongoing prevention of type 2 diabetes included establishment of tools for helping locals, coordinate and implement controlling measures of type 2 diabetes diseases. Registering of locals was part of the approach so that they could help in controlling chronic diseases related to type 2 diabetes illness. Or all these strategies, monitoring principles of care have to be undertaken to enable delivery of optimized health care. Following federal governments policy, there was release of National Diabetes Strategy 2000-2004 in Australia. The strategy was aimed at ensuring efficient, effective, economically viable and evidence-based access to health programs and services for preventing type 2 diabetes illness and caring for all patients with the same disease in Australia. Barrier3 purported that despite the fact that the Commonwealth budget of 2001-02 allocated $43.2 million four years ago to National Integrated Diabetes Program, progress of implementing the stipulated strategies is slow. Out of the eleven planned guiding principles developed to approve the National Health and Medical Research Council in Australia, only the first eight guidelines have been taken to and supported by the Australian National Health and Medical Research Council. The strategies included control of lipid in type 2 diabetes, management and identification of all diabetic diseases, control of blood glucose, educating patients, case diagnosis and detection of the disease. During the release of the National Diabetes Strategy and Implementation Plan, the government of Australia commissioned public health care system to fully examine the type 2 diabetes epidemiology among Aboriginal people and avail the evidence that support the primary prevention care of the illness. That work led to production of two important reports: Systematic examination of present primary care guiding principles and evidence on the prevention of non-insulin-dependent diabetes among Aboriginal community and Torres Strait Islander people; Analysis of the epidemiology, pathogenesis as well as preventability of type 2 diabetes among Torres Strait Islander and Aboriginal and populations. Webb purported4 that to be in line with the policy of federal government, the Western Australian Department of Health formally developed and released the Western Australian Diabetes Strategy in 2002. The strategy focused on the basic principle that was based on Aboriginal population. It stipulated the development of culturally and appropriate principles after deriving help from local Aboriginal people, health organizations of Aboriginal communities together with neighboring health services of Aboriginal people. The strategy also supported a higher degree of empowerment among health services and Aboriginal communities in order for the community to get more health resources to enable them effectively implement their type 2 diabetes management programs. To realize this, the principles of the strategy emphasized that more weight should be allocated on ways of strengthening the primary infrastructure of Aboriginal communities and support health plans in the regions of Aboriginal people. In 2002, Healthy lifestyles – A strategic framework for the primary prevention of diabetes and cardiovascular disease in Western Australia 2002-2007 strategy was also released. The strategy was expected to respond to the outlined seven National Health Priority sections that included type 2 diabetes diseases. Webb5 also purports that the development of that 2002 strategy was passed through broad literature review and various focus group discussions that had a number of major stakeholders from medical services in Aboriginal communities. However, it is not known how that Strategy will find be applicability in a culturally appropriate and specific manner to Aboriginal population and the benefits the Aboriginal communities will get from it. New South Wales Health Department, in response to national health initiative, developed New South Wales Health Department chronic disease prevention strategy 2003-2007 which it released recently to outline the key chronic type 2 disease in New South Wales. The guiding principles of the Strategy were designed to focus on the seven deadly chronic conditions of type 2 disease that affect the New South Wales communities. The Strategy revealed that figures showing the mortality and prevalence of type 2 diabetes disease for New South Wales Aboriginal population were lacking because of under-reporting about the status of Aboriginal population. The coordination of health programs targeting type 2 diabetes disease among Aboriginal community was highly promoted. The development of that promotion program led to establishment of the Collaborative Centre for Aboriginal Health Promotion in the regions occupied by Aboriginal community. Part of the Centre’s aim was to implement a more health initiatives to prevent type 2 diabetes disease. It proposed to perform this by development of workforce encouragement, strengthening workforce leadership, maintaining and liaising with major networks, encouraging information sharing that was related to type 2 diabetes diseases. Enhancement of information sharing was done by collaborating with the Aboriginal people where the centre provided support and technical advice on matters regarding promotions of Aboriginal health programs. Due to the seriousness of type 2 diabetes disease, the progress of the disease detection, prevention, and management was not only aimed at focusing on Aboriginal people alone, but it also focused on Australian general population. In order to respond to the increasing rates of risk factors of type 2 diabetes disease among Aboriginal community, the federal government established and released the Aboriginal Diabetes policy in 1999. With an earlier $58 million funding for around five years, the initiative received expansion in the year 2005, where the figure for funding was renewed and increased to $190 million for a period of five years. Yet again, the federal budget was expanded in 2010 when it received $275 million funding for five years to enhance the Aboriginal Diabetes Initiative’s activities in Indigenous people. The Aboriginal Diabetes Initiative aimed at reduction and prevention of type 2 diabetes disease by supporting services and activities that were focused on preventing the disease and promoting health programs in Indigenous people. Health services and activities were delivered by well trained health workers and service providers in the Aboriginal community that has high rates of type 2 diabetes disease. Through the activities of Aboriginal Diabetes Initiative, the federal government collaborates with First Nations population and organizations, Inuit groups and communities, and territorial as well as provincial governments to ensure disease prevention, promotion of good health programs, care and screening initiatives of managing the disease that are appropriate culturally and based on aboriginal community. The proposed 2010-2015 funding initiatives will support Inuit along with First Nations population to carry on building on previous successful health programs in over six hundred Inuit and First Nations communities in entire regions of Australia. Conclusion Type 2 diabetes disease prevalence rates are considerably high among the Aboriginal communities. While the risk of developing type 2 diabetes disease in Aboriginal men is one for every two men, the lifetime risk in Aboriginal women is two for every three women. There are various recommendations and additional strategies to improve on the current health care initiatives in the next five years. Recommendations First, there is call for primary, secondary and tertiary means of preventing type 2 diabetes disease. Primary prevention method involves modification and removal of both environmental and behavioral risk factors. These risk factors consist of sedentary lifestyle, obesity and use of poor diet before the onset of type 2 diabetes disease or prior to symptoms of the disease manifest (Clinic 48). Encouragement of healthy physical activities, good eating habits and preservation of average body weight of Aboriginal people should be promoted. In some cases, health care programs that targets the primary ways of preventing type 2 diabetes disease must focus on healthy lifestyle activities like eating only food that does not lead to development of the disease. The secondary ways of preventing the disease comprise of untimely diagnosis of asymptomatic type 2 diabetes disease followed by quick interventions that are effective to lessen the impact of type 2 diabetes conditions. As discussed above, the type 2 diabetes disease risk factors are very common to cardiovascular illness and cancer conditions. As a result, strategies that aim at preventing as well as reduce degrees of those risk factors will widely benefit the Aboriginal communities in a broader health care spectrum. Activities of secondary prevention can target at the entire Australian population before aiming to remove environmental and lifestyle factors that only target Aboriginal population that has high risk rates of the disease. Since more time elapses before the actual commencement of type 2 diabetes disease and the real period of recognizing the disease, it is recommended that all active detection cases must be carried out for all groups that prove to be at high risk. All individuals that have impaired tolerance to blood glucose and all Aboriginal people that have more than thirty five years as well as younger children in other communities that have high type 2 diabetes’ prevalence must undergo active detection. Moreover, screening for type 2 diabetes in populations that have high risk of disease development will be justified as untimely treatment of type 2 diabetes disease eliminates the morbidity of developing into continuing complications. Tertiary prevention methods of the disease consist of eliminating or lessening enduring impairments like eye and foot problems that could be caused by type 2 diabetes disease. There are many health care programs that target to address the entire population of Australia. Health programs that are based in the community have proved to be effectual in Aboriginal communities that reside in Kimberley areas and central Australia. Therefore, it is crucial, that conventional health programs should be integrated in Aboriginal initiatives that are specific to type 2 diabetes disease that will require health resources at both community and regional level The second recommendation is to increase utilization of health service in many parts of the country, especially among indigenous communities. Most of the health services for Métis, First Nations and Inuit populations are only delivered through a number of federal, Aboriginal and territorial/provincial -run programs. Even though, there are high rates of type 2 diabetes diseases, primary utilization of health care is much poor among the Indigenous communities as compared to the other population of Australia. However, there are higher rates of hospitalization in some Aboriginal people. As a way of example, in 2000 alone, the separation rate of age-homogeneous hospital for patients of type 2 diabetes disease was seven times more among the First Nations communities that dwell on and off-reserve areas as compared to other population in Australia. Thirdly, given that currently there is no medical cure for type 2 diabetes disease, recommendation of efficient management of type 2 diabetes condition is important. From the diagnosis period of the disease, focus is directed on ways of developing glycaemic control to reduce the macrovascular and microvascular complications associated with the disease. It is appropriate and effective to address this population as a homogenous group. This is because efficient management of unhealthy eating, physical inactivity, obesity and overweight, can help in reducing and preventing complications of type 2 diabetes disease. Bernard6 explains as a result, it is recommended to initiate additional health programs that are based in the community so as to reflect the distinct languages, heritages, spiritual beliefs and cultural practices of Inuit, First Nations and Métis communities. There are tree recommendations for measuring the efficacy of these strategies: measuring the rate of prevalence of type 2 diabetes, measuring the impact of the disease based on mortality rate and measuring the impact of the disease based on hospitalization. Type 2 diabetes is considered the main contributor of mortality of Aboriginal population. It claims over eight percent of Aboriginal people that live in Australia. There were cases of deaths that resulted from many nutritional, endocrine and metabolic illnesses. Around ninety percent of that death was caused by type 2 diabetes disease. That was seven point five times more for Aboriginal males as compared to the expected figure from males in the other population. The number was ten point five times more than the rate expected among the Aboriginal females. For individuals whose age group ranged from thirty five years and fifty four years, the rate of death among Aboriginal males was actually twenty one times higher than the mortality rate of males from the other population. Similarly, the mortality rate of Aboriginal females was thirty seven times higher than of non-Aboriginal females. Measuring the hospitalization impacts caused by prevalence of type 2diabetes disease would be efficient way of determining these strategies. At the moment, the only problem to this measuring indicator is that there is no available systematic gathering of new instances of type 2 diabetes disease in Aboriginal population. Cases of type 2 diabetes were only documented during diagnosis in one percent of all hospitalization cases for both Aboriginal females and males in 2003 and 2004. It was ten and eight times more than cases of non-Aboriginal females and males respectively. In essence, type 2 diabetes leads to various cases of hospitalization, though it goes unrecorded during the diagnosis period. Additionally, diabetic admissions were also reported as extra diagnosis in health care consisting of cardiovascular disease, dialysis, bacterial diseases and respiratory diseases. Works Cited Barnard N. Dr. Neal Barnard's Program for Reversing Diabetes: … New York: Rodale Press, Inc; 2012. Barrier. P. Type 2 Diabetes for Beginners. Alexandria: American Diabetes Association; 2002. Becker G. The First Year: Type 2 Diabetes: An Essential … New York: McGraw-Hill Audio; 1996. Clinic M. Essential Diabetes Book. New York: Time Home Entertainment; 2008. Crocker B. Betty Crocker's Diabetes Cookbook: Everyday. New York: Betty Crocker; 2003 Garnero T. Your First Year with Diabetes: What To Do. Alexandria: American Diabetes Association; 2004. Holzmeister L. The Diabetes Carbohydrate and Fat Gram Guide. Alexandria: American Diabetes Association; 2010. Rubin, Alan. Diabetes For Dummies. California: For Dummies; 2010. Warshaw H. Diabetes Meal Planning Made Easy. Alexandria: American Diabetes Association; 2010. Webb R. The American Diabetes Association Diabetes. Alexandria: American Diabetes Association; 2011. Read More