The Relationship between Obesity and Diabetes - Research Proposal Example

A RESEARCH PROPOSAL ON THE RELATIONSHIP BETWEEN OBESITY AND DIABETES By (Name) Course Tutor University Date The City and State where it is Located A Research Proposal on the Relationship between Obesity and Diabetes Introduction Initially, diabetes and obesity were viewed as diseases that affected individuals leading a sedentary lifestyle especially in the developed countries such as U.S., UK, and Canada (IDF, 2016, 2). However, the prevalence and incidence of these two diseases has experienced a rapid increase and are currently prevalent in all parts of the world including the developing countries. Today, the prevalence of diabetes in adults bearing the age of 20 years and above stands at 9.6% in the United States. This percentage transforms into 20.4 million people in U.S., yet the combined set of statistics of the entire world possesses a worrying trend (ADA, 2016, 20). The primary aim of this proposal is to provide a detailed description of the relationship existing between obesity and diabetes. This association will help in providing necessary support to the developers of public health policies and practitioners. The proposal includes different sections with a detailed literature review that offers an overview of obesity and diabetes. This article also describes the epidemiology of each disease, their relationship, and the reasons why they cause a major challenge for the public health sector. Currently available data and evidence demonstrate prevalence drifts in both obesity and diabetes not only at the local but also at the national level coupled with the possible implications in the form of health effects, inequalities, and cost. Literature Review According to IDF (2016, 3), Different comparative studies have shown a close association between obesity, which refers to excess gain in weight and the growing prevalence rates of type II diabetes. Obesity is also a risk factor for the development of different disorders of public health importance (ADA, 2016, 21). These conditions include hypertension, gastroesophageal reflux, dyslipidemia, and some types of cancers. However, diabetes and obesity are closely linked to increased risks of mortality, which results mainly from cardiovascular diseases. Diabetes mellitus, commonly referred to as diabetes relates to a chronic disorder whose occurrence is associated with the failure of the pancreas to produce insulin (Colberg, et.al. 2010, 31). IDF (2016, 3) adds that diabetes may also occur as a failure of the body to utilize of the insulin produced by the pancreas. Insulin, which is a hormone manufactured and secreted by the pancreas plays a key role in allowing glucose which originates from various food sources consumed by individuals. Insulin allows this glucose to pass through the blood stream and enter the body cells to yield energy. All food sources rich in carbohydrates are mechanically and chemically broken down with the help of enzymes to produces glucose in the body (Bagchi, 2011, 50). According to ADA (2016, 22), the inability of an individual’s body to either produce or utilize the available insulin results hyperglycemia, which is a condition characterized by raised levels of glucose in the body. Hyperglycaemia has a close association with destruction and failure of different body organs and tissues in the long-run. There are three main types of diabetes which are considered to be of public health importance. The type I diabetes, traditionally referred to as juvenile-onset diabetes, begins at birth (Bagchi, 2011, 52). This kind of diabetes comes as a result of the auto-immune reaction, a condition characterized by the attack of insulin-producing cells by the individual’s body defense system. Colberg, et.al (2010, 31) contends that many scientific studies have failed to provide an official explanation for the occurrence of type I diabetes, which is mainly characterized by the pancreas producing little or no insulin. This disorder affects everyone regardless of their age despite its onset and development beginning in children or young adults (Ybarra, 2006, 40). Individuals who have type I diabetes require an injection of insulin on a daily basis so as to regulate glucose levels in their blood. Insulin inaccessibility results in automatic death in people suffering from this disorder (IDF, 2016, 2). Ybarra (2006, 45) avers that the second type of diabetes currently referred to as Type II was traditionally called adult-onset or non-insulin dependent diabetes. This kind of diabetes accounts for 90 percent of all global cases of diabetes while the recent accounts for only 10 percent. Type II diabetes is commonly characterized by constant resistance to insulin with a relative deficiency of insulin, either or both of which may be present in the individual’s body at the time when he or she is diagnosed with diabetes (Kaufman, 2006, 2). This diagnosis may occur in a person at any moment regardless of his age. Unfortunately, the second type of diabetes has the ability to remain undetected for an extended period with its diagnosis being achieved on the appearance of a complication (Ybarra, 2006, 45). In addition, diagnosis of this disorder may also be achieved by the use of urine glucose or the routine blood test. Diabetes type II is often associated with obesity or excessive gain in weight. This overweight condition can result in resistance to the insulin and increase the levels of glucose in the blood. In most cases, people suffering from this disorder can be trained to manage their condition by sticking to a balanced diet and exercising on a daily basis (Colberg, et.al. 2010, 31). However, most of these individuals end up using insulin and oral drugs in the long-run for active management (Kaufman, 2006, 4). Both the first and the second type of diabetes are known to be serious public health issues of concern with nothing like mild diabetes. The last form of diabetes commonly affects pregnant women and is known as Gestational diabetes (GDM). GDM is a type of diabetes characterized by increased levels of glucose in the blood during pregnancy. Research indicates that GDM develops in one in 25 pregnancies in the world with complications that affect both the mother and her developing baby. This disorder is known to disappear immediately after delivery, but both the pregnant woman and her baby have increased the probability of developing Type II diabetes in future (Freudenberg, Klitzman & Saegert, 2009, 24). Kaufman (2006, 5) estimate that approximately half of women suffering from GDM during pregnancy end up developing type II diabetes in the next five to ten years after giving birth. There exist other forms of diabetes. However, the three are the most widely known. It is also important to understand that obesity is only linked to type II diabetes. The probability and severity of suffering from type II diabetes shares a close relationship with the body mass index (BMI) (Freudenberg, Klitzman & Saegert, 2009, 26). The probability of people suffering from obesity to develop diabetes is seven times greater when compared to those of healthy weight. Kaufman (2006, 8) avows that there is also an associated increase in the threefold increase in risk for obese individuals. The precise mechanism of association of body fat distribution among obese individuals remains unclear despite its popularity as a critical determinant of the high risk of diabetes. Scientific researchers and medical physicians have not yet also established the exact reasons as to why not all individuals suffering from obesity develop type II diabetes and why not all people with this disorder are obese (Chadt. et al., 2014, 54). Nevertheless, the two continue to influence each other leaving diabetes to remain as a critical condition of public health importance. An Overview of the Risk Factors for Developing Diabetes According to IDF (2016, 4), researchers have failed to identify specific risk factors for an individual’s development of type II diabetes. However, this disorder has a genetic association whereby having a member of the family suffering from type I diabetes increases the risk of developing the malady. Exposure to some viral infections and environmental factors are also associated with the risk of developing this disorder (Ybarra, 2006, 45). Risk factors for the individual development of type II diabetes include having a diabetes family history, obesity, and unhealthy diet, lack of physical exercises, old age, and high blood pressure. Additional factors include ethnicity, history of the gestational diabetes, impaired glucose tolerance (IGT) and increased poor nutrition during pregnancy (Freudenberg, Klitzman & Saegert, 2009, 27). Signs and Symptoms of Diabetes According to Ybarra (2006, 45), there are different signs and symptoms experienced by people who have diabetes. However, sometimes some individuals may not show any signs and symptoms of interest. Most of these individuals suffer from sudden excessive thirst, frequently urinate, feelings of increased levels of hunger, severe loss in weight, and increased exhaustion (Chadt. et al., 2014, 54). Diabetic individuals may also demonstrate a continuous lack of concentration and interest with numbness and a prickly sensation in the feet or hands. Frequent infections characterized with wounds that heal slowly and blurred vision and vomiting associated with stomach aches are additional common symptoms (Freudenberg, Klitzman & Saegert, 2009, 30). Pain in the stomach is often assumed to be flu. Type I diabetes develops suddenly and dramatically with mild and sometimes absent symptoms in people who have type II diabetes. These combined conditions make this type of diabetes difficult to detect and diagnose (Chadt. et al., 2014, 54). It is, therefore, important to seek medical intervention as soon as these signs and symptoms are detected. Complications Associated with Diabetes McGarty (2010, 27) ascertains that different individuals who have diabetes have high risks of developing a plethora of severe health complications. The continuous increase of blood glucose may result in serious disorders with adverse effects on an individual’s heart, kidneys, blood vessels, eyes, teeth, and nerves (Chadt. et al., 2014, 54). Additionally, people who have diabetes have increased the probability of developing further compactions and infections. For instance, diabetes is a leading risk factor contributing to the development of blindness, cardiovascular disease, and amputation of the lower limb, kidney failure and finally death in almost all high-income countries. Research Methodology According to McGarty (2010, 34), understanding the relationship between obesity and diabetes is a long-term process that needs a well-guided research that can help the researchers to collect vital data to be used in decision making. As such, this study will use both qualitative and quantitative techniques to carry out the research. The use of mixed strategies is advantageous as one technique compensates for the flaws associated with the other. For instance, this research suggests using authentic government institutions to conduct a survey regarding personal weight gain and the subsequent diagnosis of diabetes. The survey will target a civic participation of 5,000 participants from U.S. civilians on an annual basis. These participants will be sourced from fifteen different counties across the country. The entire survey will consist of an extensive health information interview of key health informants, a complete and progressive physical examination with comprehensive laboratory testing. Physical examination will be conducted in mobile examination center located in Florida, United States. Secondary data will be drawn from various health communication literatures such as journals, magazines, National Centre for Health Statistics reports, Centers for Disease Control and Prevention reports and additional websites such as Mayo clinic. More information will be drawn from newspapers, study reports, publications, and documents from research projects and books dealing with diabetes and obesity issues. Accurate and reliable data from secondary sources provides opportunities for replication and also complements the primary data (Allet, et.al, 2016). As a result, data collected from the four current surveys conducted by National Health and Nutrition Examination Survey (NHANES) will be merged for critical analysis. These Data Sets include study undertaken in 2009–2010, 2011–2012, 2013–2014, and 2015–2016. The data files which will be extracted to be used in the study will include demographic information, measurements of the systolic blood pressure, the history of the participant’s medical disease, history of smoking, and different laboratory measures. Such measures will include insulin level determination, fasting glucose, individual’s lipid profile, c-peptide, and the measure of hemoglobin A1C levels. Standardized protocols will be used when measuring height and weight of the participants. There are different conditions that will be used in consideration of the participants having diabetes mellitus. These conditions will include being diagnosed by their doctors as suffering from diabetes, having been identified with a fasting plasma glucose concentration of 125 mg/dL, having a hemoglobin A1C level of 6.0%, as well as using medications employed in the treatment of diabetes such as the oral hypoglycemic agents and insulin. This survey technique will be applied in the assessment of the incidence of behaviors among the target group. Semi-structured questionnaires will be used when gathering data from respondents on the types of diabetes, risk factors such as obesity, complications and the effectiveness of the techniques used for prevention. According to McGarty (2010, 30), close-ended questions limit a respondent‘s answers to the survey and avoid too much extraneous information and training. The participants choose from a set of responses such as yes or no, or multiple choices. Open ended questions are phrased so that respondents can explain their answers and reactions to the question with more information, which the research captures on the questionnaire. One of the advantages of using questionnaire is that it helps avoid the potential embarrassment of face-to face dialogue as well as to guarantee anonymity (Akabas, Lederman & Moore, 2012, 56). As a result, questionnaires will be combined with other techniques such as interviewing and Focussed Group Discussions to collect vital information. McGarty (2010, 34) adds that deploying self-administered questionnaires is particularly useful in the collection of data on sensitive topics, such as health issues. With no probes, the inquiries will be kept short, simple and easy to follow. The respondents will be expected to fill the questionnaires from their homes and schools as the researcher will supervise the exercise with the help of other research assistants. FGDs increases the ability of an individual to participate in the survey due to the chance taking that allows everyone to share out his or her views (Allet, et.al, 2016). Key informant interviews will be conducted using open-ended discussion guide with the utilization of the conversational style to encourage active participation. Data Analysis According to Allet, et.al (2016, 9), data analysis is the process of examining and evaluating the data collected to develop detailed explanations. This study will employ both quantitative and qualitative data analysis process to compensate for the limitations associated with either method. The data gathered will be rectified through proper editing for completeness and consistency. The data will be coded ensuring accuracy by the aid of a well-developed database which integrates various measures to enable grouping (Akabas, Lederman & Moore, 2012, 56). Statistical Package for Social Sciences (SPSS) allows data to be stored and analyzed efficiently and quickly. SPSS will be used to manipulate and analyze data. Data presentation will also use mixed strategies to enable proper understanding. Such methods will entail using pie-charts, histograms, and graphs to compare the results gathered from different schools and classes. Logistical and Ethical Consideration The research team will seek permission from the necessary authority such as CDC who will provide an official letter to authenticate the study. The researcher will begin by assuring the participants their confidentiality. Assurance of confidentiality will be followed strictly by creating awareness and sensitizing people on the purpose of the research to the respondents. Participation will be set free and encouraged to participate on voluntary basis especially during filling of questionnaires, key informant interviews, and FGDs. Everyone will also be given a chance to seek for further clarification where needed. Results The study findings will demonstrate a close relationship between increases classes of obesity and diabetes prevalence and incidence rates. Approximately a quarter of the respondents are known to have poor control and management of the glycemic levels. However, an estimated half of the adult diabetic participants will be considered to be suffering from obesity basing on the 8-year period survey ranging from 2009 to 2016 data collected by a cross-sectional representative of the US population. Conclusion Obesity remains one of the most critical modifiable risk factors that can be used in the global prevention of type II diabetes. However, obesity has ultimately evolved into one of the most significant epidemics affecting both the developed and the developing countries. The probability of an individual to develop obesity is directly proportional to some combined variables which transform into type diabetes in the long run. Lack of physical exercises, alcoholism, and poor eating habits which are characterized with unbalanced diet are the leading causes of obesity. A critical implication drawn from this research proposal is that surgical or medical loss in weight with subsequent prevention of obesity can be crucial interventions in an attempt to minimize the effect of diabetes on the national and global health care system.  References Akabas, S. R., Lederman, S. A., & Moore, B. J. (2012). Textbook of obesity: Biological, psychological, and cultural influences. Chichester, West Sussex, UK: Wiley-Blackwell. Allet, K. et.al. 2016. Educational Level Is Related to Physical Fitnessin Patients with Type 2 Diabetes – A Cross-Sectional Study. American Diabetes Association (ADA) (2016). Statistics About Diabetes Bagchi, D. (2011). Global perspectives on childhood obesity: Current status, consequences and prevention. London: Academic. Chadt, A. et al. (2014). Molecular links between Obesity and Diabetes: “Diabesity.” Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK279051/. Colberg, P. et.al. 2010. Exercise and Type 2 Diabetes. The American College of Sports Medicine and the American Diabetes Association: joint position statement executive summary Freudenberg, N., Klitzman, S., & Saegert, S. (2009). Urban health and society: Interdisciplinary approaches to research and practice. San Francisco, CA: Jossey-Bass. International Diabetes Federation (IDF). 2016. About Diabetes: Complications, Risk Factors, Signs and Symptoms, Prevention, Facts and Figures. Retrieved from: http://www.idf.org/who-we-are. Kaufman, F. R. 2006. Diabesity: A doctor and her patients on the front lines of the obesity-diabetes epidemic. New York: Bantam Books. McGarty, T.P. (2010). Obesity and Type 2 Diabetes: Cause And Effect. The Talmarc Group. Retrieved from: http://www.telmarc.com/Documents/Books/Obesity%20Diabetes%2002.pdf. Overall Numbers, Diabetes and Prediabetes. Retrieved from: http://www.diabetes.org/diabetes-basics/statistics/?referrer=https://www.google.com/. Public Health England (PHE). (2014).Adult obesity and type 2 diabetes. Retrieved from: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/338934/Adult_obesity_and_type_2_diabetes_.pdf. Ybarra, J. (2006). Link between Obesity and Type 2 Diabetes. Retrieved from: https://www.researchgate.net/publication/7458198_Link_between_obesity_and_type_2_diabetes. Read More