Indigenous Australians and Diabetes - Essay Example

Indigenous Australians and diabetes Your name:   Course name:         Professors’ name: Date: Introduction Indigenous Australians (Torress Strait Islander and Aboriginal) who are over 34 years old are more affected by type 2 diabetes than most non-indigenous Australians. It is estimated that type 2 diabetes prevalence in Indigenous people is at least 2-4 times that of non-indigenous Australians; and in some communities is as much as 10 times. Type 2 diabetes is also begins at an earlier age in Indigenous people than in other Australian populations, this means Indigenous people are at risk of developing type 2 diabetes complication can start at a younger age. In addition, death rates due to type 2 diabetes in Indigenous people are 17 times as compared to that of non-indigenous people. Impact of Type 2 Diabetes on an individual Quality of life for a person suffering from diabetes decreases (Mathers et el 2002). Studies indicate that individual with diabetes say they are willing to sacrifice two-months of life per year to avoid diabetes-caused blindness, one-to-three months per year to avoid amputation, one-month per-year to avoid kidney dialysis, and one-to-two months per year to avoid a stroke (Mathers et el 2002). WHO, found that diabetes-caused blindness have been found to reduce the value of a year of life of a person suffering from the disease by more than half (Chatterji and Ustun, 2002). A good deal of Indigenous Australians socialization takes place during meal-times. An individual suffering from diabetes may feel like an outcast when he/she cannot eat the same kind of food like other members of the family (Chatterji and Ustun, 2002). Others get worried that they might offend their friends or relatives when they have to avoid eating homemade dessert or feel embarrassed when she stop eating before other member of the family or eating special prepared kind of foods (Chatterji and Ustun, 2002). People suffering from diabetes often feel very thirsty, tired and most times they don’t get enough sleep at night (Redekop and Koopmanschap, 2002). This makes it difficult for diabetes person to do normal things like preparing food or stick to with their daily exercise routine. Most women suffering from Type 2 diabetes have been found to experience a decreased in vaginal lubrication (which can make sex to be a painful experience) and less interest in sex (Redekop and Koopmanschap, 2002). A person with diabetes disease can do any kind of a job, but there are some jobs which are restrictive due to the nature of things involved. Diabetes patients inject themselves with insulin. In the workplace environment, this can be an embarrassment to a diabetic person and his/her colleagues at work (Redekop and Koopmanschap, 2002). Impact on family A diagnosis diabetes affects the whole family, often causing unexpected reactions. A newly diagnosed patient may take him/her many months to learn how to manage the disease, and this period of time may be stressful for other family members. According to the American Diabetes Association indicates that to some people with diabetes management of the disease will be a continual, stressful challenge (Clarke, Gray, and Holman, 2002). In many cases diabetes have been found to induce sadness and fear among family members who worry that the diagnosed patient may become disabled or die (Ezzat, Vander and Hoorn, 2005). Other fear may include members of the family worrying about the sufferer going blind, having a heart attack or needing dialysis, if other members in the past have witnessed these complications of diabetes (Ezzat, Vander and Hoorn, 2005). Siblings or blood relatives may become anxious for fear of being diagnosed with the disease. In mealtimes, significant changes may occur due to the diabetes diagnosis (Clarke, Gray, and Holman, 2002). For example, whole milk, fried foods, sugary desserts and greasy side dishes may be replaced with skim milk, baked food, fresh fruits and raw vegetables, possibly causing confusion or dissent within the family setting (Coffey and Brandle, 2002). These changes that may occur during mealtimes might make family members to feel as if these changes are being forced upon them although they are not ill. Management of diabetes will have a toll on the family finances (Ezzat, Vander and Hoorn, 2005). In 2008, the American Diabetes Associated indicated that a newly diagnosed diabetes patient is expected to spend more than 4,000 dollars more in health care costs than a peer without the disease (Coffey and Brandle, 2002). The diabetes suffer is also may be forced to find a less labor-intensive job or lower-paying but less stressful employment or may miss days of work, creating further financial distress. Family dynamics may change- especially among young children- due to jealousy over one member of family being given all the attentions of the others. The diabetes suffer may be allowed to avoid certain chores, have special prepared food, causing hatred (Coffey and Brandle, 2002). A parent suffering from diabetes may need help from his/her children, upsetting the established family role. Impact on Population The World Health Report 2004 states that diabetes has been found to reduce life expectancy of its patients when blood pressure (World Health Organization, 2004), glucose and lipids are not controlled. In the same report, it is estimated 3.8 million deaths globally occurred globally in 2007; approximately 6 per cent total global mortality (Ezzat, Vander and Hoorn, 2005). In poor regions, where majority of inhabitant are indigenous people, and who lack health insurance, or because they don’t have money to buy insulin (Ezzat, Vander and Hoorn, 2005). Additionally, in these places untreated type-1 diabetes can be costly in terms of life years lost, because it attacks younger indigenous adults and children who would otherwise live for many years if they were able to managed type-1 diabetes earlier (Coffey and Brandle, 2002). The yearly cost the Australian government to manage and treat type 2 diabetes is up to 6 billion dollars, this includes the cost of carers and health costs, while the average yearly cost per person with type-2 diabetes is approximately 4,000 dollars. These moneys could have been used to alleviate the many problems that affect Indigenous people in Australia if diabetes was not a serious problem affecting indigenous Australians. Roles of Nutritionists In Australia in 2005, the highest ranked factors contributing to the burden of diabetes were physical inactivity, tobacco use, hypertensions and diet. In 2007, Codde and Unwin reported diet-attributable diseases contribute nearly one sixth of mortality deaths in Western Australian. This region is where majority of indigenous people (such as Aboriginals people) are found. Furthermore, lifestyle factors contributed to major diseases and were responsible for many deaths than either alcohol or tobacco (Codde and Unwin, 2007). Among indigenous Australians, 25 per cent were obese and 56 per cent overweight. One-third of that particular population was either participating at inadequate levels for cardiovascular benefits or physically inactive. These figures parallel the increased occurrence of diabetes among the indigenous Australians. Prevention of diabetes among indigenous people can be considered at 3 different levels. Primary prevention involves activities that prevent diabetes from occurring. Secondary preventions cover activities such as early diagnosis of diabetes and controlling the disease in order to delay progress of already existing diabetes disease. Tertiary prevention involves activities that will prevent disability and complications due to diabetes. One of the roles of nutritionist is to use community approach to reduce diabetes. Ezzati and Vander (2005) indicate that greatest success in the reduction of diabetes is through targeting the general population with programs that have been integrated rather than attempting to treat and screen high-risk individuals (Mathers and Shibuya, 2003). One such prevention programs is physical exercise and diet intervention. This program has been mostly cited in the prevention of Type-2 diabetes mellitus. physical exercise and diet intervention has also been successful improving in the level of weight control and physical activity observed amongst Indigenous Australians (Mathers and Shibuya, 2003). In research trials carried out in China on impaired glucose tolerance patients, it was found that progression to diabetes over five years, was reduced by 46 per cent through exercise and by 31 per cent through dietary interventions. In most Indigenous communities, traditional type of community based interventions focused on the entire community. The objective of this approach is to create a supportive environment for diabetes interventions (Mathers and Shibuya, 2003). On this level, nutritionists have involved local project and local taskforces leaders in building networks for changes of healthy lifestyles. Organizers of physical activity, voluntary organizations and purveyors of food have been involved in the implementing strategies that relates to dietary change, physical activities and weight reduction (Mathers and Shibuya, 2003). School based diabetes prevention project is another strategies being used by nutritionist to reduce prevalence of diabetes among Indigenous students. Ezzati and Vander (2005) have indicated that lifestyles factors associated with diabetes are learned from early in the child’s life and are well ingrained by adulthood. The concepts of behavior change theory and social learning theory have been incorporated into community-based prevention programs for diabetes (Ezzati and Vander, 2005). These programs are then reinforced by a new community advisory board, and school events. Results for these programs indicate positive outcomes for those students who participated in these primary prevention programs (Ezzati and Vander, 2005). Most nutritionist working in schools prefer using school-based primary prevention program to enhance knowledge of diabetes and to support increased fruit and vegetable intake, increased physical activity, and reduced soft-drink consumption among indigenous students. Using a pervasive and insidious intervention model have been seen to have an impact on the behavioral and physiological change among indigenous Australians. Numerous studies have been conducted on the benefits of weight loss on cardiovascular illnesses, especially in obese children or people (Redekop and Koopmanschap, 2002). In Australia, nutritionists are using Aboriginal parents as agents of change to treat obesity in children with weight reduction programs. The use of behavioral interventions in five to 12-years- old children have been a success story in the reduction of diabetes among Indigenous Australians when parents are exclusive agents of change instead of approaching school going children directly (Redekop and Koopmanschap, 2002). In another study conducted over a period of 10-year for obese children, the study indicate when both parents and children were targeted for weight reduction. A significant reduction of weight among over weight Indigenous children was noted after four and 12 years (Chatterji and Ustun, 2002). Many reasons have been given for the increase in obesity rates among indigenous Australians such as increase in availability of fast foods, increase in food dollars spent away from the home and availability of TV entertainment (Budetti, 2006). The reasons have been found to contribute to obesity especially among Aboriginal children by making physical activity less attractive and making eating more attractive. Budetti (2006) question whether television viewing and fast foods contribute to obesity in Australia. He found that food eaten at fast food restaurants and hour of TV viewing per day were both positively associated with body mass index cross sectionally (Chatterji and Ustun, 2002). Therefore, Australians nutritionists have identified numerous weight-loss programs that focus on the general population. One such program is sensitizing the population of the danger of fast food and too much television watching (Budetti, 2006). The importance of involving friends and family in the reduction of weight has been noted. There has been a correlation between environmental and family support for weight loss efforts and amount of weight lost (Chatterji and Ustun, 2002). Self-help groups, such as Weight Watchers and interventions conducted in the Aboriginal communities, use ‘similar peers’ as one type of social support intervention (Redekop and Koopmanschap, 2002). In Indigenous communities family is an important entity in diabetes treatment, this usually coincides with traditional values among Aboriginal families that promote strong family loyalty and ties. Therefore, nutritionists in part of their treatment strategies have been using Aboriginal families in the treatment of diabetes (Redekop and Koopmanschap, 2002). Conclusion Diabetes disease represents a major challenge to the health, family and Australia economy. The impact of diabetes on families’ individuals and Indigenous communities mandates the government to expand the management of diabetes. New interventions are needed, and already established interventions must be made available to all citizens especially indigenous Australians. Adoption of healthy lifestyles is essential for preventing diabetes, but more progress in the program will occur within a framework of government and societal support for and encouragement of appropriate lifestyles choices among Indigenous Australians. Provision of accurate, up to date and detailed information on diabetes disease burden among indigenous Australians and on successful intervention strategies is another essential plank of improving the outlook for Indigenous people with diabetes Reference List Budetti, P. (2006). 10 years beyond the Health Security Act failure: subsequent developments and persistent problems. JAMA.2004; 292(16): 2000-2006 Chatterji, S and Ustun, B. (2002) Global patterns of healthy life expectency in the year 2002. BMC Public Health.2002; 4: 66-77 Clarke. P, Gray, A and Holman, R. (2002). Estimating utility values for health states of type 2 diabetic patients using the EQ-5D (UKPDS 62). Med Decis.Making.2002; 22(4): 340- 349 Coffey, J.T and Brandle, M. (2002). Valuing health-related quality of life in diabetes. Diabetes Care, 25(12): 2238-2243 Codde, J. and Unwin, E. (2007) ‘Diet-attributable mortality and hospitalisation in Western Australia’. 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