Social, Behavioral, and Psychosocial Causes of Diseases: Type 2 Diabetes - Research Paper Example

Social, behavioral, and psychosocial causes of diseases: type 2 diabetes Diabetes mellitus is a metabolic syndrome that is characterized by poly-urea (increased urination), poly-dipsia (increased thirst), poly-phagia (increased hunger) and hyperglycemia (high blood glucose level). There are two types of diabetes mellitus that are most common, Type1 and type 2. Type 1 has been formerly known as insulin dependent diabetes mellitus, and caused by depletion of insulin in body and type 2 which has been known earlier as non insulin diabetes mellitus caused by insensitivity of insulin receptors to the secretion of insulin. Both these diseases occur as a result of environmental or genetic risk factors that may induce or progress disease to some serious complications. Some hereditary rare types of diabetes may include mitochondria/DNA mutation induced diabetes and MODY which is an abbreviation for maturity onset diabetes in young. This paper focuses on the epidemiological statistics of diabetes in United States, trends of disease in developing nations, comparison of statistics of diabetes in North Carolina and U.S.A., analyzing cost trend of diabetes, focusing on psychosocial interventions and management of diabetes in our community (Taylor et al., 2002). Diabetes type 2 is diagnosed on the basis of persistent blood sugar fasting ≥ 126mg/dL or 7mmol/L or random blood glucose ≥ 200 mg/dL or 11.1mmol/L (WHO, 1999). The major origin of this disease is a peripheral insulin resistance and impaired insulin secretion. Management of type 2 diabetes mellitus is done through life style changes, diet variation, exercise, oral hypoglycemic agents and sometimes insulin from an external source. Type 2 diabetes is becoming serious health problem worldwide and has increased rapidly with the increase in being citified trend, a social and culture variation, shift in food habits, physical inactivity, dense population, unhealthful way of life, and shifts in moods and behaviors etc (Cheng, 2005). Prevelance rate of type 2 is far more greater than that of type 1, as type 2 accounts for more than 85-95% of all diabetes cases in developed nations, and these figures are even more for developing ones (Cheng, 2005). The highest prevalent rate of diabetes exists in indigenous American residents, more specifically the native people of South Pacific islands e.g. Nauru or Pima Indians who are located in United States Arizona (Wild et al., 2004). As compared to whites, type 2 diabetes mellitus has high risk factor for African American and Hispanic. The International Diabetes Federation has projected that the numeral of diabetes sufferers will grow more than 50% i.e. from 285 million to incredible 438 million by the end of 2030 (CDC, 2010)Estimation report in year 2000 depicts that 2.8% of the whole world inhabitants had diabetes which makes up almost 171 million people. The more alarming situation will be observed by year 2030, when around double the figures i.e. 4.4% of the world’s population will be suffering from diabetes that makes up almost 366 million people. Highest figures pertaining countries are India having 31.7 million affectees in 2000, which will rise up to 79.4 million by 2030, China possessing 20.8 millions in 2000 and prospective 42.3 million by 2030 and the United States bearing 17.7 million people in 2000 and projected to have 30.3 million by the end of 2030. So, this havoc is turning into an epidemic in twenty first century (Wild et al., 2004) (Cheng, 2005). Age is another factor for diabetes mellitus as the chances of disease increases with the increase in age of people. The most prevalent age of this disease is 45-65 years among both men and women in developing nations and 65 or above 65 for the developed nation (Wild et al., 2004). These divergences in ages of population depict difference in disease prevelance between developed and developing countries. However gender is not affected by the rate of diabetes, both men and women are equally affected except the fact that age of men is less than 60 years while women prevalent age is more than 65 years (Cheng, 2005). A major emerging threat in domain of diabetes is the day by day increasing diagnosis of diabetes in children. it is estimated in a study done on Arizona’s pima Indians that it was in 1967 - 1976 and 1987 - 1996, that the frequency of diabetes type 2 has increased almost fold in young children. These are alarming figures and need much concentration for combating diabetes (Fagot-Campagna et al., 2000). The incidence was high in females around their age of pubescence and these possess a familial history of diabetes most importantly diabetes from maternal side. The increasing trend of diabetes in United States can be estimated from the fact that before 1992 the prevelance was 0.3-1.2 per one lakh population per year which boosted to 2.4 per one lakh population per year in 1994 (Weill et al., 2004). Diabetes is a pricey disease with devastating effects on human and economics cost and which demands financial assets for proper management and treatment. In United States, one dollar out of seven that is used for health care management is somehow or the other associated with diabetes (CDC, 2010) (Cheng, 2005). In one study the estimated yearly expense on diabetes are more than one hundred billion dollars with around fifteen million dollars on physician visits yearly and three million expenses on hospital stays. In another study the estimated expenditure on diabetes in United States is projected to be around one hundred and thirty two billion dollars that has forty billion dollars of indirect health care expenses like work loss, disability and premature mortality and ninety two billion dollars of direct health care expenditures (Konen and Page, 2011). This devastating endemic is also intensifying rapidly in the state of North Carolina. In 1999, estimation has shown more than 366,000 of population have been diagnosed with diabetes. Only after ten years i.e. in 2009 the figured have increased to an alarming rate i.e. 659,000. This is the fifth to sixth leading cause of death in the United States and has decreased life expectancy by more than fifteen years. Provided the increasing rate of diabetes if not checked properly, the yearly annual health care cost will surpass 17 billion dollars by 2025 (Konen and Page, 2011). The Centers for Disease Control and Prevention (CDC) has evaluated that around 366,000 people in North Carolina has been diagnosed diabetes in year 1999 .It was the similar year when in United States 11.1 million people were suffering from it . Ten years later in 2009, the statistics had approximately augmented twofold, with 673,000 cases of diabetes in North Carolina and 19.7 million cases in United States (CDC, 2010) (Cheng, 2005). It is a widespread belief of clinicians that depression and other psychosocial disorders are common in diabetes. Several innovative steps are needed to be taken to prevent the proliferation of psychosocial disorders associated with diabetes in community. These are, 1. Defining problem 2. Cooperative goal setting 3. Mutual problem solving 4. Bringing change 5. Enduring support 1. Defining problem Initial step of the psychosocial modification is to identify problem and it is frequently considered as obvious but remains attention less (Ridder, 2001). This is a complicated step, and if not performed properly the whole series of interventions fail (Glazier, 2006). There are two key steps in defining problem. First is starting with the problem of the patient and then specify it to get maximize benefits. The causes of psychosocial issues and the factors exacerbating it must also be pre-defined. 2. Cooperative goal setting It has been proved by research that the aims and objectives to deal with the issue holds a strong position in mapping the interventions strategies. Goal setting is a process in which the patient’s therapeutic execution and certain psychological management is done with the help of standard guidelines. (Jones, 2003) (Morrato,2006) (Vallis, 2003) Some short goals for diabetic type 2 patients may be as follows, Goals must be highly specific, provide line of action i.e. no snack taking after night meal instead of highlighting morals i.e. healthy eating is good for health. Goals must be quantifiable like how frequently? To what extent? i.e. a must walk for half hour thrice a week. Goals must be calling for action, emphasis on behavioral modification i.e. exercise than a mindset that weight must be reduced. Goals must be challenging but must be realistic too and not so complicated for patients to discourage or de-motivate them. 3. Mutual problem solving The ability to solve problem is connected with enhanced outcomes of wellbeing and these problem cracking issues are helpful in progressing towards healthy results (Glazier, 2006). 4. Bringing change The promises and pledges with the patients for attaining specific goals must be made during this step. This step is also known as “behavior agreement” (Vallis, 2003) between patient and his/her diabetic consultant. This is a type of self reminder that constantly reminds patient of the care that must be taken to combat the psychosocial outcomes of diabetes. 5. Continuing support Long term modifications are more effective than short-term modifications. Thus focus must be made for convincing and providing extended counseling and care to patient. Most significant step is to do proper planning for prevention of relapsing (Jones, 2003). Therefore a continuous effort is needed for bringing the patient out of the diabetic stress. Different steps have been proposed to combat diabetes in North Carolina. Some of them include increasing awareness about diabetes, shift in nutrition therapy, physical activity and exercise plan, blood glucose control, reduction of risks for chronic complications, anti diabetic medication as the disease progresses. The most important intervention that has beneficial effects includes life style modification with combined dietary interventions and physical activities. Lifestyle Interventions Both dietary interventions and augmented physical activity are the synergistic effects needed for combating diabetes at all stages. This should be mentioned that aggressive weight strategy and hard weight loss therapies are highly not recommended for children and adolescents. A consistent and smooth dietary change must be recommended. Less intake of sugar, low calorie diet, no fast foods, opting healthy snacks, preferring natural fruits and vegetables over synthetic ones. Physical activity is also very important in achieving milestone against the treatment of type 2 diabetes, as it decreases peripheral resistance to insulin and thus contributes in managing weight loss (Jones, 2003) (Schreiner, 2005) Thus intensive measures are needed to be taken to combat the havoc of diabetes which is spreading like a monster in our community. Both individual and community level measures are needed to be taken for beneficial effects. Diabetes is a costly disease and much finance is needed for proper management. Among all interventions life style modification is the best for not only treating but also preventing the chances of type 2 diabetes which has a strong association with obesity. References i. Centers for Disease Control and Prevention (CDC). Number of Americans with diabetes projected to double or triple by 2050 [press release].Released October 22, 2010. ii. Cheng, D. (2005). Nutr Metab (Lond), 2(1), 29. doi:10.1186/1743-7075-2-29 iii. Fagot-Campagna A, Pettitt D, Engelgau M, Burrows N, Geiss L, Valdez R, et al. Type 2 diabetes among North American children and adolescents: an epidemiologic review and a public health perspective. J Pediatr 2000;136(5):664-72. iv. Glazier RH, Bajcar J, Kennie NR, Willson K: A systematic review of interventions to improve diabetes care in socially disadvantaged populations. Diabetes Care 29:1675–1688, 2006 v. Jones H, Edwards L, Vallis TM, Ruggiero L, Rossi SR, Rossi JS, Greene G, Prochaska JO, Zinman B: Changes in self-care behaviors make a difference in glycemic control: the Diabetes Stages of Change (DiSC) study. Diabetes Care 26:732–737, 2003 vi. Konen, J., & Page, J. (2014). The state of diabetes in North Carolina. [N C Med J. 2011 Sep-Oct] - PubMed - NCBI. Ncbi.nlm.nih.gov. Retrieved 12 June 2014, from http://www.ncbi.nlm.nih.gov/pubmed/22416514 vii. Morrato EH, Hill JO, Wyatt HR, Ghushchyan V, Sullivan PW: Are health care professionals advising patients with diabetes or at risk for developing diabetes to exercise more? Diabetes Care 29:543–548, 2006 viii. Ridder D, Schreurs K: Developing interventions for chronically ill patients: is coping a helpful concept? Clin Psychol Rev 21:205–240, 2001 ix. Schreiner B. promoting lifestyle and behavior change in overweight children and adolescents with type 2 diabetes. Diabetes Spectrum. 2005;18(1):9-­12. x. Taylor et al, “Rural Health and Women of Color”, American Journal of Public Health, April 2002, Vol 92, No. 4 xi. Vallis M, Ruggiero L, Greene G, Jones H, Zinman B, Rossi S, Edwards L, Rossi JS, Prochaska JO: Stages of change for healthy eating in diabetes: relation to demographic, eating-related, health utilization, and psychosocial factors. Diabetes Care 26:1468–1474, 2003 xii. WHO, 1999. Definition, Diagnosis and Classification of Diabetes Mellitus and its complications. WHO/NCD/NCS/99.2. xiii. Wild, S., Roglic, G., Green, A., et al. Global prevalence of diabetes. Diabetes Care, 2004. 27: 1047-1053. Read More