Introduction
The number of people with diabetes in Oxfordshire has significantly increased over the years, making it one of the primary concerns in the area. The health problem is brought about by many factors including lifestyle, lack of physical activity and unhealthy eating habits. Most often the onset of diabetes 2 type starts when people are over 50 because with age the production of insulin by cells diminishes. Moreover, reports show that people who have obesity are twice as likely to get diabetes 2 type as those who keep fit. Diabetes affects all systems and can cause various complications that lead to disability and shortening of life. These complications may include nephropathy accompanied by the development of chronic renal failure, retinopathy, leading not only to a decrease in vision, but also to blindness, diabetic foot, angina pectoris and myocardial infarction. This report analyses diabetes as health issue affecting Oxfordshire population of ages from 50 to 80 and discusses what health services are available for treatment of diabetes in the area. It identifies health and social policy aimed at diabetes prevention in older generation and considers the role of the nurse in supporting people in Oxfordshire in their use of services provided. Moreover, the report offers recommendations to tackle the decease and outlines limitations in treatment options.
Background
A research conducted by the Oxfordshire Clinical Commissioning group has found that “there are currently over 28,000 people registered as having diabetes in Oxfordshire and about 2,200 are newly diagnosed each year” (Oxfordshire Clinical Commissioning group, 2022, para. 1). The problem is exacerbated by the fact that Oxford area has a large proportion of minotiry population, including many Afro-Americans who are more prone to developing diabetes 2 type. The costs of diabetes treatment include medication and social care costs as well as the cost of complications treatment which can go as high as about half of all expenses associated with the decease. There is a sharp need to reduce diabetes so a number of healthcare services have been established to tackle the decease. On a national level, Diabetes Research and Wellness Foundation aims to prevent the spread of the decease through research of the causes and effective treatment of diabetes 2 type. Locally, there is the Oxfordshire diabetic eye screening service (ODES) provided by Oxford University Hospitals (OUH) NHS Foundation Trust. This service is based at John Radcliffe Hospital and Windrush Medical Practice and performs eye screening for people suffering from diabetes (Oxfordshire: diabetic eye screening service). Moreover, there are many adult support groups and clinics that specialize in diabetes treatment.
Literature Review
In order to tackle diabetes in adults in Oxfordshire, a multi-sectoral approach has been developed that includes governmental and local bodies initiatives aimed at decease prevention and its effective treatment.
Lifestyle modification strategy
Galaviz et al (2018) proposed lifestyle modification strategy aimed at prevention of diabetes 2 type development. This strategy includes instituting healthy eating habits, engagement into sports activities, reduction of stress and anxiety, and regular checkups of the levels of sugar in the blood. Galaviz et al (2018) studied the results of the application of the given strategy in diverse adult communities and found that the proposed measures significantly reduce the risks of diabetes 2 development. This strategy is partially adopted at local level in Oxfordshire where public health actors develop local programs to promote healthy eating habits and dietary patterns. Moreover, regular checkup services have been established for people over 50 who are at risk of diabetes 2 development.
Improving access to sports and physical training
Physical activity makes it possible to increase the susceptibility of cells to insulin, which allows the pancreas not to produce this hormone in large quantities, and, consequently, it becomes much easier to maintain sugar levels. Scientists have found out that high intensity physical exercises increase the body’s sensitivity to insulin by 85, and with moderate — by 51 percent (Li et al., 2021). The effect, unfortunately, persists only on training days. Engaging in various types of physical activity lowers sugar levels not only in people predisposed to diabetes, but also in obese people. Being a large city Oxford has a developed infrastructure for sports and activities. Local authorities have placed emphasis on the creation of recreation centers and green spaces (Department of Health and Social Care, 2017). As a result of such policy the number of people who do physical exercises on a regular basis significantly increased.
Policy aimed at promoting water as a main source of liquor
Many drinks unlike ordinary drinking water, especially purchased ones, contain sugar, preservatives and other additives not always known to the buyer. The use of carbonated drinks increases the likelihood of developing type 2 diabetes, especially in older ages. The study on this aspect covered about 2,800 people (Sheikh et al., 2019). In people who drank two bottles of carbonated sweet juices a day, the risk of developing type 2 diabetes increased by 20, and the first by 99 percent (Sheikh et sl., 2019). It should also be taken into account that fruit juices can also become a provoking factor. Unlike other sweet and carbonated liquids, water allows keeping insulin and sugar under control.
To promote water drinking local government has equipped clinics and workout zones with water coolers that stimulate people to view water as a desirable way to quench thirst. Moreover, many public and private organizations within Oxfordshire adopted this practice. Pricing policy with higher prices for carbonated drinks that contain high level of sugar has also contributed to this initiative.
Bring the weight to the optimal norm
Diabetes affects not only people with excess body weight, but they make up the vast majority. And if there is a predisposition to the disease, then fat accumulates around the liver and abdominal cavity. Its overabundance becomes the main reason that the body becomes less sensitive to insulin, which increases the risk of diabetes. To tackle the problem of obesity, the policy aimed at promoting healthy eating in Oxfordshire has been developed. To start, on a national level regulations that compel large restaurants, cafes, and takeaways joints to label the food they sell thus showing the number of calories this food contains have been adopted (Department of Health and Social Care, 2020). This initiative allows people to assess their health risks every time they go to eat out. Secondly, the UK government have banned advertising of all products that contain high levels of sugar, salt, and fat (Griffin et al. 2021). On the local level, CLAHRC’s new initiative called “Behaviour change: Diet and Obesity” was adopted (University of Oxford, 2017). The initiative comprises research into the most effective methods of lowering weight in adult population groups.
Discussion
From the literature findings, it can be deduced that health initiatives aimed and prevention and treatment of diabetes among people over the age of fifty are developed taking into account the needs of changing individual lifestyle and timely healthcare initiatives. There are specific factors that may lead to diabetes, including obesity, poor nutrition with an abundance of carbohydrates and refined foods, chronic violation of the water balance in the body, and low physical activity. The literature outlines specific measures that can be taken to prevent diabetes development in adults and shows which initiatives have been introduced in Oxfordshire. These initiatives include improving access to sports and physical training, promotion of water drinking within the community, forming healthy eating habits, regular checkups, and establishing specific programmes such as CLAHRC’s new initiative called “Behaviour change: Diet and Obesity”. Doubtlessly, awareness of the population and the availability of a coherent system of sanitary and hygienic education and medical and social assistance can contribute to diabetes prevention.
A huge role in the implementation of measures to improve the health of the nation belongs to nurses, whose education and experience allow them to provide high-quality nursing services. The quality of medical care is a set of characteristics confirming the compliance of the medical care provided with the available the needs of the patient (population), their expectations, the current level of medical science and technology.
As public health workers, nurses are responsible for sharing crucial information about individuals’ health, including health promotion information, which stimulates health awareness and the overall well-being of groups and communities. According to the Nursing and Midwifery Council (NMC) code of practice, nurses are mandated to “make sure that people’s physical, social and psychological needs are assessed and responded to” (NMC 2018, p 9). To ensure that this mandate is met, nurses should actively engage into promoting awareness of the patients of the cause of their decease and measures that can be taken to reduce risks of complications. Moreover, nurses are responsible for health checkups that should be done on a regular basis. In their practice, nurses should consider personal factors such as race and age that may be conducive to diabetes development and carefully assess risk group. m
Conclusion
Diabetes is a major health problem that has a significant impact on the quality and life expectancy of people over the age of fifty across the country. The increase in the number of people suffering from diabetes in recent years compels the government to take necessary steps to tackle this health issue. Considering that diabetes can lead to severe complications and significantly lower the quality of life, nurses are responsible for promoting the awareness of the problem across the country. Nurses should explain the reasons conducive to the decease development and outline the measures that can be taken to prevent diabetes.
The local government is responsible for implementing policies that can help in preventing diabetes development in Oxfordshire. The governmental policy to tackle diabetes includes measures for the early detection and treatment of diabetes as well as preventive measures — especially among people over fifty, providing them with medicines and materials for determining glucose levels. The policy also provides for informing citizens about risk factors, symptoms and complications. There is every reason to believe that the adopted policy plan will significantly help to manage diabetes in the community, prolonging people’s life through reducing the risk of complications and preventive measures aimed at increasing awareness of society of the problem.
References
Department of Health and Social Care (2017). Childhood obesity: a plan for action. [Online] GOV.UK. Web.
Department of Health and Social Care (2020). Tackling obesity: empowering adults and children to live healthier lives. [online] GOV.UK. Web.
Galaviz, K. I., Weber, M. B., Straus, A., Haw, J. S., Narayan, K. V., and Ali, M. K. (2018). Global diabetes prevention interventions: a systematic review and network meta-analysis of the real-world impact on incidence, weight, and glucose. Diabetes Care, 41(7), pp.1526-1534.
Griffin, N., Phillips, S.M., Hillier-Brown, F., Wistow, J., Fairbrother, H., Holding, E., Powell, K. and Summerbell, C., 2021. A critique of the English national policy from a social determinants of health perspective using a realist and problem representation approach: the ‘Childhood Obesity: a plan for action’(2016, 2018, 2019).BMC Public Health, 21(1), pp.1-10. Web.
Li, X., Zhou, T., Ma, H., Liang, Z., Fonseca, V. A., & Qi, L. (2021). Replacement of sedentary behavior by various daily-life physical activities and structured exercises: genetic risk and incident type 2 diabetes. Diabetes Care, 44(10), pp. 2403-2410.
NHS. Oxfordshire Clinical Commissioning group. Web.
Nursing and Midwifery Council (2018). The Code Professional Standards of Practice and Behaviour for Nurses and Midwives Nursing and Midwifery Council. [online] NMC. Nursing and Midwifery Council. Web.
Oxfordshire: diabetic eye screening service. Web.
Sheikh, M.S., Sheikh, I.S., Khan, S.M.S. et al. (2019). Prevalence of type 2 diabetes mellitus among adult population of District Srinagar. Int J Diabetes Dev Ctries 39, pp. 331–339.
University of Oxford (2017) Tackling obesity in Oxfordshire: soups, smartphones and supermarket shopping. Web.