Diabetes in England - Research Paper Example

Diabetes in England Introduction a. Aim The aim of this paper is to investigate diabetes in England. b. Purpose The purpose of this paper is to inform the general public and the policy makers on the state of diabetes in England and give recommendations on what need to be done to address the situation. c. Background Diabetes is a metabolic disorder. A diabetic patient has elevated amount of glucose in the blood. This condition where blood sugar is elevated is referred to as hyperglycemia (Diabetes, 2010). Diabetes results when the pancreas fails to produce sufficient insulin, produces no insulin or when body cells fail to respond to insulin produced by the pancreas (NHS, 2007). This leads to elevated blood sugar which is passed out of the body with urine. Thus, the body cells have insufficient sugar for metabolism due to inability to absorb it from the blood. Diabetes results in complications such as stroke, slow healing of wounds, heart diseases, kidney failure, impotence and erectile dysfunction, amputation of the foot and lower leg, stillbirth, congenital malformation, blindness and death (Hippisley-Cox et al 2009). Diabetes is one of the greatest challenges that face UK in health sector. The numbers and costs of prescriptions related to diabetes had increased by 2007 and were the highest in the prescribing budget of NHS. It was estimated that about 2000 people were being diagnosed weekly with diabetes in United Kingdom. It is estimated that for every £10 spent by NHS £1 is spend for treating diabetes and its complications (HM Government, 2009). d. Scope The paper discusses the types of diabetes and their etiology, prevalence of the condition in England, main cause of diabetes in England, the state of diabetes knowledge in England and management practices of the disease. e. Method This study will involve research and analysis of several studies, which relates to diabetes in England. This paper will use the various academic resources such as book, journals, and websites. f. Plan This paper will first discuss the types of diabetes that are in existence. It will discuss the prevalence of the condition in England and its causes. The paper will then take a look at the awareness state among the population about the condition and the management of diabetes in England.  A conclusion will be made on the findings. Findings and discussion a. Types of diabetes There are two types of diabetes. These are: Type 1 and Type 2. Both types of diabetes are related to the inability of the body to effectively control blood sugar (glucose) levels. However, the two diseases affect people differently. They also have different causes and therefore their management requires different strategies. There is a third type of diabetes called gestational diabetes. This affects pregnant women and involves increase of blood glucose to dangerous levels. Type 1 diabetes is characterized by the inability of the pancreas to produce insulin. It is an autoimmune condition which could have a genetic basis. It has been established that less than 20% of the children of diabetes Type 1 parents also develop Type 1 diabetes (Infinite Health Resources, 2007). The condition usually involves an autoimmune destruction of pancreatic cells resulting severe deficiency of insulin. The reason for this autoimmune destruction of pancreatic cell is still unclear (HM Government, 2009). However, several explanations have been proposed. First, it is proposed that infection with specific bacteria or virus could be the trigger of this autoimmune reaction. Second, exposure to food borne chemical toxins could also trigger the autoimmune reaction. It is also proposed that exposure of infants to cow’s milk could trigger the destruction of the pancreatic cells by the body immune system. It usually affects people who are aged below 40 years. It accounts for five to ten percent of diabetic population (Politics, 2009). However, its effects are the most severe. The condition is characterized with presence of ketones in urine and blood. Type 1 diabetes is associated with destruction of beta cells. Its treatment involves administration of insulin from the onset of the condition. Type 2 diabetes is characterized by insufficient production of insulin by the pancreas. It may also result from the insensitivity of body cells to insulin produced by the pancreas leading to improper functioning of the insulin (National Diabetes Support Team, 2008). In addition, the available insulin could be abnormal and thus does not function properly. It is in most cases it is a consequence of overweight since the body becomes unable to cope with the elevated amounts of blood sugar. It is also caused by aging. It also has strong genetic tendency.  It has been found that if both parents suffer from Type 2 diabetes, almost all their children will suffer from the condition. Furthermore, physical inactivity may result in the development of this condition. This type of diabetes is common in middle aged and above. However, younger people are also being diagnosed with this condition. Treatment involves diet improvement in addition to physical exercise during early stages of the condition. As the condition progresses tablets and insulin is administered. b. Prevalence of diabetes in England There is an increasing prevalence of diabetes in England. By the year 2006 there were about 2.4 million people suffering from diabetes in England. This accounted for about 4.75% of the England population. Of these, about 500,000 people had undiagnosed diabetes (Infinite Health Resources, 2007). The prevalence of the disease was expected to rise to 5.05% by 2010. Forty seven percent of the type 2 diabetes in England was attributed to obesity as suggested by the National Audit office. The number of obese women and men were expected to reach 28.6% and 29.4% respectively by 2010. The following figure illustrates the numbers of obese persons. The number of people diagnosed with diabetes has been increasing since 1996 from 1.4 million to over two million. This is expected to rise as the UK population ages and continues to become overweight. It is predicted that deaths related to diabetes will rise in the next ten years to about twenty five percent. The table below shows the number of people suffering from different types of diabetes in UK. It is clear from the table that type 2 diabetes is the most prevalent type of diabetes. Nation Type 1 Type 2 Total number England 211,000 1,555,000 1,766,000 Scotland 20,000 147,000 167,000 Wales 13,000 104,000 117,000 Northern Ireland 7,000 46,000 53,000 UK 251,000 1,852,000 2,103,000 Table: Diabetes in UK in 2006 Young people in UK are also being diagnosed with diabetes. It is estimated that about 1,500 children in UK have Type 2 diabetes. It is estimated that the current people suffering from diabetes in UK is about three million. The following figure shows the number of registered diabetics by the year 2007. c. Causes of diabetes in England Sedentary lifestyle and being obese increases the risk of developing diabetes. The number of obese people in England had increased dramatically between 1992 and 2006. The prevalence of diabetes was forecasted to increase by about 450,000 by 2010. Sixty percent of this was expected to be as a result of obesity while forty percent was expected to arise from aging. The figure below shows the increasing numbers of obese people in England. Thus in England the main causes of diabetes is obesity and aging. As the number of obese people continue to rise many people are expected to develop this condition especially Type 2 diabetes. In addition, the England population is experiencing an increase in aged population and therefore the numbers of aged persons expected to be diagnosed with Type 2 diabetes is bound to increase in tandem with the increasing number of aged persons in England. Since diabetes has some genetic underlying factors, those people who hail from families with history of diabetes are at higher risk of developing this condition especially those leading sedentary lifestyles and those who are obese. d. Knowledge of the condition in UK Many diabetes patients in UK are unaware of the fact that diabetes is a condition which will be experienced throughout their life time. In addition, about half of the patients are not aware that diabetes can drastically reduce their life expectancy (Department of Health, 2010). Furthermore, research has found out that one in every five diabetic patients think that taking their prescription is not important. This is because most of them are not aware of the complications that may arise from improper management of the condition. For instance only 19% of the diabetic patients are aware that stillbirth or congenital malformation may arise due to inadequate management of the condition during pregnancy. In addition, only a half of diabetic patients realize that erectile dysfunction could be a diabetic complication resulting from inadequate management of the condition in men. Only 17% of diabetic patients in UK receive information related to diabetic treatment as they receive their prescription and up to 8% do not receive any information from their health professionals. The limited information given to patients on proper management of the diabetic condition in UK, make many people to fail to adhere to the required medication. e. Diabetes management in UK Management of diabetes involves polypharmacy, multidisciplinary care, diabetes awareness and self management. Many diabetic patients are prescribed several different medications. Thus polypharmacy is a common problem among diabetic patients who live with the condition for prolonged period of time. For instance patients with Type 2 diabetes need to control blood pressure, blood glucose and other heart diseases to reduce the occurrence of the complications and death. Thus these patients need to take medications that lower blood pressure in addition to lipid lowering agents on daily basis. There is limited information concerning the way to take the medication, the side effects of the drugs, contra indication of the drugs and the need to take statins in UK diabetic patients. Many specialists are involved in diabetic patients especially those with uncontrolled diabetes. Such patients may require the services of podiatrist, eye specialist, kidney specialist, cardiologist, dietitian, GP and diabetes nurse and their diabetologist (Department of Health, 2010). This multidisciplinary approach to the management of diabetes condition is very difficult to adhere to. This calls for the patient to be his own care taker to be able to consult with the entire required specialist since the patient may live with the condition for over twenty years. Many people in UK are unaware that their lifestyles put them at diabetes risk. Few people also understand the seriousness of the condition. About half of the UK population understands that diabetes can result in death. In addition, many diabetic patients in UK are unaware of the seriousness of the condition (Roberts, 2007). This notion is attributed to the fact that diabetes is a silent condition during its early stages where body cells are usually being destroyed prior to development of clinical condition of the disease. In spite the fact that diabetes Type 2 is the second cause of heart diseases after cigarette smoking, very few people in UK understand that heart disease is a complication of diabetes (Royal College of Paediatrics and Child Health, 2009). In addition, it has been found out that many doctors in UK are still playing down the seriousness of diabetes diagnosis in spite of it being the leading cause of kidney ailments, limb amputations and blindness. Many patients do not comply with insulin treatment and complications due to non-compliance among young people in their early twenties have been reported in UK. Diabetes is a life long condition and therefore the patient is the most important person in the management of the condition. Thus patients are expected to monitor blood and urine glucose regularly in addition to modifying their behaviour in case the levels are found to be too low or too high (Roberts, 2007). Compliance to diabetes medication in UK is very poor. One study shows that only one in three Type 2 diabetes patients who are on oral medication comply with taking the medication as prescribed (Young, 2008). The study noted that compliance dropped to one in eight people complying with their medication if the patient is on more than one medication (HQIP, 2009). This poor compliance is the major stumbling block toward long term improvement of the health of the diabetic patients (Diabetes Research Network, 2010). Research among diabetic patients in UK has indicated that only one out of five diabetic patients complies with all aspects of diabetic management. The research further indicates that the cases of non-compliance are high among the aged and the teenagers (InstantAtlas, 2010). Non-compliance among teenagers is mainly due to wish for independency, desire to fit with peers and emotional, social and physical changes that they are undergoing. Conclusion Diabetes is a life long condition. There are two types of the condition: Type 1 and Type 2 diabetes. Type 1 result from autoimmune destruction of the pancreatic cells. The trigger of this destruction is unclear. Type 2 is related to aging, overweight and has a strong genetic linkage. The main cause of diabetes in England is obesity and aging. Thus people need to change their lifestyle to reduce obesity which will in turn reduce the numbers of people developing this condition. Very few people are aware of the effects of the condition and its management and thus many awareness programs need to be initiated to create awareness on diabetes and ways of managing it. This is expected to change the lifestyles of people and hence result in reduction of the incidences of diabetes related to lifestyles. Proper management awareness is expected to improve the care given to patients and compliance by the patients to take their medications. This in turn will translate in reduced complications which are associated with non-compliance and improper management of the condition. Recommendations Stakeholders and community should be brought together to ensure the extent of diabetes in their daily activities Enough resources should be availed to research institutions and other sectors that could contribute to developing means and strategies that could ensure the adverseness of the disease is controlled Communities, stakeholders, business and any other person(s) involved should be informed and educated regarding the threats associated with diabetes, means to reduce and prevent diabetes, and measures put in place to ensure all stakeholders access appropriate information regarding the issue. Reference Department of Health. 2010. Diabetes. 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