Impact of Diabetes among the Lebanese Community in Sydney - Research Paper Example

 Impact of Diabetes among the Lebanese Community in Sydney Diabetes is a disease that affects people of all ages, races, and backgrounds. There are multiple types of diabetes, the most common being Type 2. Type 2 diabetes most often develops in adults but can occur in younger people as well. The person’s pancreas does not secrete enough insulin to maintain normal levels of glucose and his or her body can begin to respond poorly to insulin. With obesity numbers rising and people exercising less and less, Type 2 diabetes is seen at a growing rate and many of the people diagnosed are completely unaware that they were affected. Type 2 diabetes is a dangerous disease to leave untreated, particularly when it can go largely unnoticed. This is especially true in ethnic groups who are not native to a particular place but have instead migrated there. Because migrant ethnic groups often practice different social, familial, and cultural beliefs than those of their new neighbors, medical diagnosis and treatment can be difficult. One such example is Lebanese people living in Australia, particularly Sydney. As data regarding ethnic minorities tends to be very limited, a survey was created in order to analyze this group’s experiences based on history, diagnosis, complications, side effects, and the impact on life diabetes has had. The information obtained in such a survey may be used to not only get a general idea of how this ethnic group views the disease and its subsequent treatment but to improve upon treatment by identifying factors that allow the number of people with this disease to increase. Of the Lebanese people in Australia, twenty-five adults ranging in age from 40-55 were given a survey consisting of eleven questions which encompassed their experiences with Type 2 diabetes. Their collective answers will begin to show common themes that can be used to improve the diagnosis and treatment of this disease. The first question in this survey simply asked patients to list the age at which they were diagnosed with diabetes. The participants in this group were diagnosed with Type 2 diabetes at ages ranging from 31 to 50, the youngest being a woman who initially developed Gestational diabetes during a pregnancy. Eighty-four percent of the participants were diagnosed when they were in the range of 40 to 49-years-old, supporting the evidence showing that this type of diabetes is most commonly found in adults. Answers referring to the diagnosis of the participants show a trend that most people are unaware that they even suffer from the disease until they are diagnosed by a medical professional. Participants were asked how they were diagnosed with diabetes with the second question of the survey. Almost half of the surveyed group – forty-eight percent – went to their general practitioner based on symptoms that the patients recognized as possibly being linked to diabetes because of family members with the disease or for symptoms ranging from wounds that would not heal to dizziness to rapid weight loss or gain. Glucose tests were then performed to diagnose the disease. Conversely, the other fifty-two percent of the participants were surprised by a diagnosis of diabetes. Three women developed Gestational diabetes during or after pregnancies when no history of the disease was present. The other ten participants were all incidentally diagnosed because of other health problems. Half were being hospitalized for other illnesses and blood tests showed abnormal glucose levels. The other half was having routine blood tests, pre-surgery blood tests, and even an insurance screening when their diabetes was diagnosed. Thus, while almost half of the group was aware of present symptoms of the disease, over half had no idea they had any blood glucose abnormalities until the lab test results were stumbled upon. This half of the group was therefore surprised and shocked by such a diagnosis and ill-prepared to make sudden lifestyle changes in order to cope. Effects on physical health are a major concern when dealing with diabetes. Questions three and four asked participants about how their physical health was affected by diabetes, including complications and side effects due to treatment of the disease. Table 1 illustrates the six most frequently listed side effects or complications due to having diabetes; weight gain, high blood pressure, high cholesterol, fatigue, frequent infections and slow healing, and deterioration of vision. Table 1 At least twenty percent of the survey participants reported having at least one of the six side effects or complications in the above graph. Most patients suffered from both fatigue and high blood pressure and rapid weight gain or fluctuation. In addition to fatigue, deterioration of vision was the second leading complication due to diabetes, though most of the complainants suffered significantly only from a loss of vision, not multiple maladies. So far the results of the survey most likely reflect those of other research done about the onset, side effects, and complications of Type 2 diabetes. In no way are these ailments unique to the Australian-Lebanese-diabetic community. These are all just as likely to affect the physical health other ethic and racial groups. However, the second part of the third question in the survey asked specifically about the participant’s emotional health. Eighty percent of the participants expressed feelings of depression, shame, anxiety, worry, and/or fear with depression and fear being the most commonly felt emotions. One participant even feels that the only thing he can do is sit and wait to die. The Lebanese community consists of close family structures with many of the women staying home as housewives and child bearers while the men support the family. The women in this group often worry about how they are going to take care of themselves and maintain a healthy lifestyle when their days are consumed with cooking, cleaning, and looking after the children. The men are easily fatigued and many suffer from a need to frequently urinate and thus feel like they are no longer able to adequately perform their jobs. As a result a feeling of uselessness and helplessness is shared by both sexes. Frequently, in answers to question three and randomly through the sample, participants stated they had feelings of alienation or isolation from other members of their community. Only three of the twenty-five diabetic participants reported that they suffered no significant emotional problems as a result for their diagnoses. A common theme was that if a person does not suffer from diabetes, he cannot truly understand the impact of the disease. Participants were frustrated by the lack of understanding by their support system of family and friends. Lebanese families also consist of many members. In some minds it is unreasonable for a diabetic member to expect to have separate foods prepared for him from those that everyone else will be eating. Therefore the diabetic member of the family tends to stay at home instead of visiting relatives to avoid the fuss and difficulty of having dietary restraints. Participants in this survey were asked in questions five and six whether they actively took a role in designing their treatments plans and if alternative treatment options were discussed. Almost half of the participants stated that they played no active part in their treatment for a variety of reasons. One important ethnic and cultural problem arose in a lack of communication. Many Lebanese immigrants in Australia do no speak English well and therefore do not completely understand the disease and its implications. One participant specifically stated that he wished that he could speak to someone in his own language in order to gain a better understanding of his health. Another major problem involving communication revolves around the exchange of information between doctor and patient. It was frequently stated that doctors simply did not have enough time to sit down and patiently explain the disease, its complications, and its treatment. Patients were directly told to take a specific medication, lose weight, exercise more, and make other specific lifestyle changes in order to maintain appropriate glucose levels. Unfortunately the participants in this group feel imposed upon when they are told they must do something but are not given reasons as to why they should do so, as is often the case. If a person does not understand the reason behind an action, it is unlikely he will perform it if it is outside of his comfort zone. Patients do not understand the importance of testing their blood sugar often. Finger sticks can be quite painful and many doctors never ask to see home records of blood glucose levels. Subsequently, patients feel testing is pointless because the results are inconsequential to them and seem to be of no use to their doctors. The diabetic Lebanese participants want to be talked to about their disease. They feel they are not involved in their treatment and healing if they do not understand the mechanisms behind the disease. Telling someone and showing him are two different things and being told to do something that is uncomfortable and inconvenient is not a practical option for this group. The following chart (Table 2) shows what participants found most difficult about their diabetes in question seven: Table 2 Participants were then asked why the areas above were considered difficult. The twelve participants who found exercise to be the most difficult part of having diabetes complained that they often felt too tired to walk normally, let alone exercise. Even when they have the energy, familial duties and work take precedent over exercise. Injections and testing glucose levels are said to be painful and many patients do not understand their glucose values and are not confident in their ability to give themselves a correct insulin dose. As a result patients do not monitor their blood glucose and do not regulate it with proper insulin injections. The other major problem with diabetes for the Lebanese Australian population is having a healthy diet. Patients are advised by their doctors to avoid starch-filled foods and cut certain f foods out of the diet and replace them with others. Lebanese people have specific types of food that are eaten commonly throughout their culture. Many foods that are suggested are seen as Western and not considered part of a proper Lebanese diet. This in addition to the imposition of preparing separate food for a diabetic make it extremely hard for a participant to eat foods that are considered health to the patient’s doctor. Questions nine, ten, and eleven all ask participants whether they feel different from people who do not have diabetes and how the disease has affected their quality of life, particularly economically and socially. Most participants repeated answers given throughout the survey involving side effects, complications, and consequences of being diagnosed with Type 2 diabetes, especially answers to questions three, four, seven, and eight. Seventy-six percent of the participants feel isolated and different from those not suffering from diabetes. Most are uncomfortable or embarrassed by tiring easily and frequent urination. They also find it irritating and are resentful that others do not have to constantly worry about what they eat. Some even feel shame in suffering from the disease. As mentioned earlier, participants also feel that those who do not share the disease cannot possibly share in understanding its effects. A majority of participants feel their lives revolve around their diabetes. Ten of the participants stated that they suffer a significant loss of income due to their inability to work and the expense of treating their diabetes. Five participants state that their illness has caused family problems but on the positive side, sixty-eight percent of the participants state their illness has no effect on their family life and in two of these cases participants actually stated that their families are very supportive. As a group the Lebanese population in Sydney, Australia suffers the same effects of Type 2 diabetes as any other ethnic group in the world. What this survey of twenty-five Lebanese immigrants does show is that differences in culture, from the language spoken to the types of food eaten, can greatly impact the emotional health of diabetics as well as their physical health. In order for the diabetic Lebanese participants to have more positive experiences involving their diabetes, services must be made available to specifically cater to this group. The same is true for any other ethnic minority. An immigrant who does not natively speak the language in which his illness is explained can certainly never have a full understanding of the disease. These patients must also have time to sit with their doctors and be given explanations on what is happening in their bodies, what they can do to improve their health, and how their lifestyle changes specifically improve their living. They currently feel no one else understands how they feel. In this case they may very well be correct. If a doctor does not ask a patient what his or her preferences are regarding diet, exercise, and taking or injecting medications, the patient will never feel that their treatment is specifically tailored to him or her and will continue to believe that the doctor simply does not understand. If a doctor refuses to take these extra measures in order to improve the patient’s quality of life, the patient certainly has a right to feel as he does. Doctors, dieticians, and patients must work together to mold the treatment of the disease around each patient’s life, not try to mold each patient’s life around treating the disease. Read More