Diabetes: A Common, Growing and Costly Health Problem - Term Paper Example

?DIABETES: A COMMON, GROWING AND COSTLY HEALTH PROBLEM Diabetes is one of the major health problems in the United s. It is a disordermarked by too much sugar in the blood. Diabetes affects an estimated 26 million Americans. Current estimates also show that about 57 million Americans can be considered pre-diabetic. The risk factors related to this escalating health crisis includes insulin resistance, genetic factors, obesity, physical inactivity and dietary factors. While there is no known cure for diabetes, early detection and treatment can reduce the burden of diabetes complications. DIABETES: A COMMON, GROWING AND COSTLY HEALTH PROBLEM 2 Diabetes: A Common, Growing and Costly Health Problem in the U.S. According to H. King in “Global burden of diabetes, 1995–2025: prevalence, numerical estimates, and projections”, an estimated 135 million people worldwide had diagnosed diabetes in 1995 and this number is expected to rise to 300 million by the year 2025. In other words, diabetes rates are expected to increase from 4.0% in 1995 to 5.4% by the year 2025. The countries with the largest number of people with diabetes are India, China and the U.S. Diabetes is a serious health problem in the United States. An estimated 26 million people are living with this disease. An estimated 57 million Americans have pre-diabetes or have high blood sugar levels, therefore putting them at high risk for developing the disease in the near future. Diabetes is also the seventh leading cause of death in 2007 accounting for more than 71,382 deaths (National Diabetes Statistics 2011). As the population ages and obesity rates increase, this trend is expected to worsen. Moreover, in 2007, the U.S. spent a mind-boggling $218 billion on direct and indirect costs (National Diabetes Statistics 2011). The growing number of diabetic cases is due to the lack of physical activity and excess calories accumulation as one ages. The problem can only be overcome through lifestyle modifications such as weight loss, regular physical activity and dietary changes. Given the human and economic toll of diabetes, as well as the increased risks for a host of other serious medical conditions, there is an imperative need to implement effective strategies to reduce the burden, create awareness of the disease and prevent it in order to promote a healthy lifestyle for Americans of all ethnic groups and ages. DIABETES: A COMMON, GROWING AND COSTLY HEALTH PROBLEM 3 What is Diabetes? Diabetes is a disease that occurs when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. Insulin is a hormone that regulates blood sugar. When a person has diabetes, the blood sugar increases and over time leads to serious damage of the nerves, blood vessels and other body systems. There are three main types of diabetes. Deficient insulin production causes type 1 diabetes and people with this disease require daily administrations of insulin. Type 2 diabetes occurs when the body does not effectively use insulin. Almost 90% of diabetics suffer from Type 2 diabetes. Gestational diabetes occurs in women and is first recognized during pregnancy. Diabetes in the U.S. – Past, Current and Projected Rates According to the U.S. Department of Health and Human Services, from 1997 through 2002, the number of new cases of diagnosed diabetes per year increased from 878,000 to 1,291,000 (a 47% increase). It is also projected that through 2050, there will be 165% increase, a rise from 11 million to 29 million diagnosed persons (Diabetes: A National Plan for Action). This does not including the number of undiagnosed cases. According to the 2011 National Diabetes Fact Sheet, diabetes affects 25.8 million people of all ages in the U.S. This is about 8.3 percent of the U.S. population. Of this, 18.8 million people were diagnosed while 7.0 million people were undiagnosed (2011 National Diabetes Fact Sheet). DIABETES: A COMMON, GROWING AND COSTLY HEALTH PROBLEM 4 Age, Gender and Racial Differences in Diabetes Rates According to data from the 2011 National Diabetes Statistics, 215,000 or 0.26 of all people in the under 20 years age group have diabetes in the U.S. in 2010. In the 20 years or older age group, 25.6 million or 11.3% of all people in this age group have diabetes. At the same time, 10.9 million or 26.9% of all people in the 65 years or older age group have diabetes (National Diabetes Statistics 2011). As F. Vinicor asserts type 2 diabetes mellitus has long been considered a disease of adults in whom it is the most prevalent form of diabetes (about 90%) and is associated with increased risk of cardiovascular disease, morbidity and mortality (Is diabetes a public health disorder? Diabetes Care). There are 13.0 million men aged 20 years or older in the U.S. who have diabetes in the U.S. in 2010. This represents 11.8% of all men. Meanwhile, 12.6 million women or 10.8% of all women in the same age group have the disease (National Diabetes Statistics 2011). For people of ages 20 years and over among the different ethnic groups, 7.1% of non-Hispanic whites, 8.4% of Asian Americans, 11.8% of Hispanics/ Latinos and12.6 percent of non-Hispanic Blacks have diabetes (National Diabetes Statistics 2011). Risk Factors for Diabetes There are several risk factors for diabetes. Diet As diabetes mellitus is a condition in which the blood sugar level increases, so a diet containing DIABETES: A COMMON, GROWING AND COSTLY HEALTH PROBLEM 5 carbohydrates or sugars will increase the body’s blood sugar levels. When we have unhealthy eating habits such as eating too much of sugary and fatty foods and not enough of foods that contain fiber, we can become overweight and this is one of the main factors causing diabetes. Obesity Obesity is the number one risk for diabetes. In his article, “U.S. Diabetes Rate Climbs Above 11%; Could Hit 15% by 2015. Obesity and exercise are crucial factors”, Dan Witters observes that the “[present] upward trends in obesity rates almost certainly play a substantive role in the increase of diabetes rates …….. Americans who are obese are nearly three times as likely as those who are not obese to report having diagnosed with diabetes” (Witters, 2011). The reason why obesity is a risk factor for diabetes is that fat interferes with the body’s ability to use insulin that the body manufactures. Sedentary Lifestyle or Inactivity People who live sedentary lifestyles are more vulnerable to type 2 diabetes mellitus. This is because people who are inactive have unexercised muscles and tissues that reduce insulin’s capacity of using glucose as energy. Exercise helps to build muscles and muscle cells use up large quantities of glucose. Therefore, if you do not get enough exercise, you will have less muscle tissue and hence, you will use less glucose and this will make the glucose levels in the blood increase. On the other hand, physical activity increases insulin’s capacity to utilize glucose. Since physical activity uses up glucose, less glucose accumulates in the bloodstream. Therefore, being active lowers blood sugar levels by helping insulin to be more effective. DIABETES: A COMMON, GROWING AND COSTLY HEALTH PROBLEM 6 Until recently type 2 diabetes was not frequent in children and adolescents. However, today the prevalence of type 2 diabetes appears to be increasing considerably among children and adolescents and the cause of this trend is physical inactivity and weight gain. Age It is said that the risk of type 2 diabetes mellitus increases with age, especially after 45. This is probably because people at this age tend to engage in less physical activity or exercise and hence gain weight. As we age, our organs such as the pancreas also ages and may not produce insulin as efficiently as it did when we were younger. Hereditary Connection According to the article “Factors that Cause Diabetes – Diabetes Causes”, diabetes mellitus shows “a very strong hereditary connection”. It asserts that type 2 is definitely hereditary. The risk of type 2 diabetes increases if a parent or sibling has the disease. On the other hand, “people who have the human leukocyte antigen (HLA) in their blood, which is obtained from the parents, they have a strong propensity towards developing diabetes mellitus type 1” (Factors that Cause Diabetes – Diabetes Causes). Race People of certain races or ethnic groups including blacks, Hispanics, American Indians and Asian-Americans are more likely to develop type 2 diabetes than whites are (National Diabetes Statistics 2011). Stress and Depression Stress can also cause diabetes. Stress can cause the malfunctioning of the pancreas and hence, DIABETES: A COMMON, GROWING AND COSTLY HEALTH PROBLEM 7 the secretion of insulin. Some common stress-causing factors are injury, infections, pregnancy, surgery and other kinds of mental tensions and worry (Factors that Cause Diabetes – Diabetes Causes). Depression increases the risk of developing type 2 diabetes by 60% (National Diabetes Statistics 2011). Impact of Diabetes Economic Impact Diabetes has large financial burdens on national health care systems. Direct medical costs include resources that are used to treat the disease. Indirect costs include loss of productivity due to morbidity, disability and premature mortality. The impact of early mortality and morbidity from diabetes on productivity and financial and social cost to the community are immense. In the U.S., the national cost of diabetes exceeds $174 billion. This includes $116 billion in excess medical expenditures attributed to diabetes, as well as $58 billion in reduced national productivity. On the average, people diagnosed with diabetes have medical expenditures that are approximately 2.3 times higher than the expenditures would be in the absence of diabetes (National Diabetes Statistics 2011). Social Impact Diabetes affects the daily lives of not only those who have the disease but also their family and friends. It affects what people can and cannot eat and drink. Adults who attend social functions may find their temptations to eat sugary foods and carbohydrate-rich food increase. DIABETES: A COMMON, GROWING AND COSTLY HEALTH PROBLEM 8 Resisting such food at social gatherings can incur snide remarks from people who may be unaware of the diabetic’s condition. In the end, he will give in and his condition worsens. Family members, too, have to adjust to these changes. Complications of diabetes can result in disability for some people. If people with diabetes suffer loss of vision, it may cause limitations on their daily activities such as reading, walking or restrictions in community involvement. Losing a limb due to amputation may affect the person’s ability to participate in social activities and their independence in performing daily activities. In addition, diabetics who suffer kidney failure may have to make frequent trips to hospitals for dialysis which can be time-consuming. Diabetics also suffer from the reduced quality of life brought about by stress, pain and anxiety. Young children and adolescents are the subjects of ridicule and curiosity for being unable to eat certain food. This may cause them to have low self-esteem. Low self esteem is the precursor of depression and other medical conditions. Similarly, obese children who have diabetes may suffer from peer ridicule and lack of social invitations. As F. Vinicor acknowledges, diabetes during the adolescent years takes its toll on the individual teen with diabetes, on parents and other family members, on school systems and on society (Is diabetes a public health disorder? Diabetes Care). Social Impact on Families Complications of diabetes can burden both the diabetic and his family. Complications such as hypertension, heart attacks, nerve diseases and strokes not only affect the diabetic’s quality of DIABETES: A COMMON, GROWING AND COSTLY HEALTH PROBLEM 9 life but also affect the lives of family members who are care givers. Diabetes complications can have adverse effects on the role of men as bread winners or providers of family resources and the position of women as care providers. It can cause physical, financial, emotional and financial strain on families. Diabetes, definitely, has an impact on family life. Diabetes can affect the physical side of a relationship. Women with diabetes have higher infertility rates compared to women without diabetes. Men who have diabetes are more likely to experience impotence or erectile dysfunction. The Social Construction of Gender and Race in Diabetes Diabetes represents a growing and significant health threat to women in the U.S. According to H. King, there were 13.9 million adults with diabetes in 1995 of whom 5,697,000 were men and 8,156,000 were women. There were more women than men with diabetes. In 2000, there were 8,817,000 women with diabetes compared to 6,192,000 men with diabetes. It is also projected that in 2025, there will be 12,430,000 women with diabetes compared with 9,462,000 men (Global burden of diabetes, 1995–2025: prevalence, numerical estimates, and projections). Though the disease has almost reached epidemic proportions among both sexes, yet, for some unexplained reasons, diabetes runs a more severe course in women than in men. The risk of heart disease, one of the most common complications of diabetes, is more serious in women. Moreover, among people with diabetes who had suffered heart attacks, women have lower survival rates and a poorer quality of life compared with men (Diabetes and DIABETES: A COMMON, GROWING AND COSTLY HEALTH PROBLEM 10 Women’s Health Across the Life Stages: A Public Health Perspective). According to the Department of Health and Human Services, women of minority racial and ethnic groups are hardest hit by type 2 diabetes. It is at least 2 to 4 times higher among minority racial and ethnic groups like blacks, Hispanics, American Indians and Asian Pacific Islander women than among white women (Diabetes and Women’s Health Across the Life Stages: A Public Health Perspective). The reason why diabetic rates and diabetic risks are greater in women could be due to a combination of several factors. The life expectancy of women, in general, is greater than men and with longer life spans, women have increased chances of developing the disease. “Because women live an average of 7 years longer than men ……… [the number of] elderly women with diabetes outnumber elderly men with diabetes in the U.S.” (Diabetes and Women’s Health Across the Life Stages: A Public Health Perspective). Women are more likely than men to be obese, have hypertension, poor glucose control and unhealthy cholesterol levels. With such symptoms, women have higher chances of developing diabetes. Another factor to consider why women have higher chances of getting diabetes is that women can get pregnant and develop gestational diabetes, the form of diabetes that occurs only during pregnancy. “It is unique to women because it can affect the health of both a mother and her unborn children” (Diabetes and Women’s Health Across the Life Stages: A Public Health Perspective). Women who have had gestational diabetes are at a greater risk of developing type 2 diabetes after pregnancy. Moreover, children of women who are diagnosed with gestational diabetes are more likely to become obese during childhood and develop diabetes later in life. DIABETES: A COMMON, GROWING AND COSTLY HEALTH PROBLEM 11 Conclusion Diabetes is a debilitating disease that has dire consequences for the individual. It diminishes the quality of life for those suffering from the disease and affects their families and friends. Without preventive action, diabetes will be approaching epidemic proportions in the U.S. To prevent diabetes from growing, steps must be taken to prevent, detect and treat diabetes in its early stages before complications develop. Since specific risk factors such as a sedentary lifestyle and obesity are related to the development of type 2 diabetes, Americans must make lifestyle changes. Maintaining a healthy weight reduces one’s risk for developing the disease. Regular physical activity and eating a healthy diet can help attain a healthy weight and thus prevent diabetes. Rather than rely on expensive medical treatment of diabetes after the complications have developed, Americans must work to prevent and control diabetes. DIABETES: A COMMON, GROWING AND COSTLY HEALTH PROBLEM 12 References U.S. Department of Health and Human Services. (December 2004). Diabetes: A National Plan for Action. Retrieved from aspe.hhs.gov/health/NDAP/NDAP04.pdf U.S. Department of Health and Human Services. National Diabetes Information Clearinghouse. National Diabetes Statistics. ( Feb. 2011). NIH Publication No. 11–3892 .Retrieved from diabetes.niddk.nih.gov/dm/pubs/statistics/ Vinicor, F. Is diabetes a public health disorder? Diabetes Care (1994). 17 (Suppl. 1) 22-27. Witters, Dan. (2011). U.S. Diabetes Rate Climbs Above 11%; Could Hit 15% by 2015. Obesity and exercise are crucial factors. Retrieved from www.gallup.com/.../u.s.-diabetes-rate-climbs-above-11-could-hit-15-. H. King, R.E. Aubert, W.H. Herman, Global burden of diabetes, 1995–2025: prevalence, numerical estimates, and projections, Diabetes Care 21 (1998) 1414–1431. Factors that Cause Diabetes – Diabetes Causes. (20 Jan. 2011). Retrieved from www.diabetesmellitus-information.com/diabetes-causes.htm Department of Health and Human Services, CDC. Diabetes and Women’s Health Across the Life Stages: A Public Health Perspective. Retrieved from www.cdc.gov/diabetes/pubs/pdf/womenshort.pdf Read More