Prevalence and Importance of Diabetes Mellitus
Diabetes is among the most important and widespread consequence of such conditions as obesity or general poor life quality. It is common, complex and expensive in treatment, has multiple serious complications, and may reduce life expectancy by eight to ten years (Astrup, 2001). Type 2 diabetes mellitus is becoming the most common non-communicable disease in the European Union and the United States. According to the World Health Organization (2016) report on diabetes, 422 million people (aged 18 and older) were living with diabetes in 2014, and the prevalence of the condition continues to increase. Approximately half of the diabetes cases on a global scale are attributed to the Western Pacific and South-East Asia regions. The complexity of diabetes mellitus lies in the fact that the determinants of the condition are wide, especially given the family history component contributing to the increased risks.
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Studying the problem of type 2 diabetes is important because of the range of adverse health effects for the population. While some impacts of diabetes can be managed, there are still such complications as cardiovascular diseases, kidney disease, issues during pregnancy, eye disease, poor oral health, and multiple others. It should also be mentioned that many interventions presented in the research literature are focused on managing the condition once it occurs, and there is a lack of substantial evidence to support the implementation of prevention programs targeted at high-risk populations.
Determinants of the Issue
Type 2 diabetes has a range of determinants, ranging from social to hereditary. From the environmental perspective, the condition can develop on the basis of a person’s geographic location and the availability of resources necessary for keeping health under control (Giles-Corti & Donovan, 2002). For instance, in areas where fresh produce is readily available and accessible to communities, the likelihoods of effective health behaviors increase. However, in developed countries that have an abundant selection of fast food chains, different restaurants, and various methods of transportation, the prevalence of diabetes is higher than in developing countries. From the social perspective, such determinants as education, economic stability, access to medical care, community support, and multiple other factors can determine the likelihood of diabetes occurrence (Clark & Utz, 2014).
Importantly, type II diabetes also has close connections to the history of family health, which means that people whose relatives were diagnosed with the condition were more likely to get diabetes at some point of their lives. Sakurai et al. (2013) concluded that type 2 diabetes was directly associated with the incidence of diabetes among individuals. Also, the risks of getting diabetes were not connected to other risk factors such as poor lifestyle habits or obesity among both men and women. This shows that there is no one determinant that could explain why diabetes develops in some people and not in others. Rather, it is a combination of different risk factors that can include any aspects ranging from environmental to hereditary factors.
Reducing the Prevalence and Incidence by Paying Attention to Determinants
Since the risks of developing type 2 diabetes can range from one individual to another, there are several generalized interventions helping to reduce the prevalence and incidence of the condition. For example, people are usually advised to lose weight and keep it off; it is usually recommended to lose between 5% to 7% of the starting weight in cases when obesity is a problem. It is also recommended to engage in regular physical activity and eat healthy foods because of the overall benefits that come with healthy lifestyle choices. Thus, reducing the prevalence and occurrence of type 2 diabetes by considering its determinants is predominantly linked to the condition. According to the report by Mayo Clinic Staff (2016), improving the diet, boosting physical activity, and balancing mental health by avoiding stressful situations are the most common risk prevention efforts. Thus, there is a gap in studies as to how to address other determinants of type 2 diabetes that do not include poor diet.
When it comes to environmental factors, increased attention should be paid to individuals who do not understand their risks of developing diabetes and thus do not make any changes in order to reduce the impact of their environment on health. Since not only poor diet or sedentary lifestyles increase obesity risks, it has been advised for people to improve their housing environment and the quality and duration of rest. As found by Kolb and Martin (2017), there is “an association between increased exposure to residential traffic, noise, and fine airborne particulate matter and a higher risk of type 2 diabetes diagnosis” (p. 131). Because of this association, people are advised to make changes in their environments by going to rural areas and spending some time in the fresh air. Also, to improve the quality and the duration of sleep and rest, high-risk populations are recommended to reduce their levels of stress and implement holistic behaviors such as meditation or yoga. In cases of symptoms of depression, anxiety, and other personality issues, it is advised to refer to healthcare specialists for reducing the adverse impact on physical health.
Unfortunately, the socioeconomic status can also act as a determinant of type 2 diabetes, with low levels of income being connected to higher risks of developing the condition. Addressing this problem is only possible through the engagement of governmental stakeholders. For instance, providing free consultations and education to high-risk low-income individuals may be a beneficial strategy that accounts for the socioeconomic determinant. Unfortunately, there is no magical cure that will help individuals with a family history of diabetes avoid the diagnosis altogether; however, preventative measures outlined above can also be applied to this population of high-risk individuals.
In summary, it should be mentioned that there is a variety of unfavorable environmental and behavioral conditions ranging from diet to genetics that can contribute to the increased likelihood of type 2 diabetes development. Therefore, it is unlikely that the general lifestyle and environment changes will yield the same results in all high-risk populations. Because of this, assessing individuals’ risks, needs, environments, behaviors, and other determinants of diabetes is necessary for reducing the occurrence of the condition.
Assisting People with Identified Risk Factors
Following healthy lifestyle habits is the most likely method of helping people with high-risk factors to avoid getting diabetes. Lowering risks can mean anything from knowing one’s family health history to quitting smoking. However, in order to help high-risk individuals avoid getting diabetes, community support and patient education are needed. In this section, several methods of assisting people with high-risk factors will be discussed.
Community-based diabetes prevention programs have been widely studied in the research literature and were shown to affect people with high-risk factors positively. As argued by Philis-Tsimikas and Gallo (2014), with the support of health systems, local communities could successfully use community-based programs that could influence health outcomes across a wide spectrum of care settings. Peer education is a crucial component of community-based programs and includes the participation of nurses, psychologists, and dietitians to deliver them successfully. As found by Phillis-Tsimikas and Gallo (2014), community-based programs for addressing such issues as type 2 diabetes allow for the development of other prevention programs within the health care system, especially given that the number of people requiring wider access to programs of diabetes prevention is growing around the world.
While community-based programs are effective on a narrow scale since they target smaller sections of populations, it is also important to consider large-scale diabetes prevention interventions that require the establishment of frameworks that include health information technologies, a collaboration between healthcare facilities, and community support. Such programs were studied by Vojta, Koehler, Longjohn, Lever, and Caputo (2013) who concluded that large-scale prevention programs could be sustainable and effective in preventing diabetes by means of combining the following aspects:
- Lower-cost, evidence-based interventions and community-based delivery in order to overcome the prevalence of diabetes and reduce the risks of developing the condition;
- Management of national programs of diabetes prevention for ensuring patients’ adherence to lifestyle changes;
- Novel structures of payment that support the implementation of the program and incentivize the outcomes of efficiency;
- Strong efforts for identifying individuals with high risks of developing type 2 diabetes.
The review of available studies on the occurrence and prevention of type 2 diabetes showed that the condition has an array of determinants, not all of which can be taken under the control of high-risk individuals. In most cases, making healthy lifestyle choices concerning the diet and physical activity was recommended to individuals with high risks of developing diabetes, especially when it comes to patients diagnosed with obesity. Stress and the lack of rest could contribute to the condition, which explains the recommendation to reduce the occurrence of stress factors and get the appropriate amount of sleep. Community support and large-scale interventions can be helpful for assisting high-risk individuals in making healthy decisions to reduce the occurrence of the condition. More research on this issue is needed due to the variability of type 2 diabetes risks among the population.
Astrup, A. (2001). Health lifestyles in Europe: Prevention of obesity and diabetes by diet and physical activity. Public Health Nutrition, 4(1), 499-515.
Clark, M. L., & Utz, S. W. (2014). Social determinants of type 2 diabetes and health in the United States. World Journal of Diabetes, 5(3), 296-304.
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Giles-Corti, B., & Donovan, R. J. (2002). The relative influence of individual, social and physical environment determinants of physical activity. Social Science & Medicine, 54, 1973-1812.
Kolb, H., & Martin, S. (2017). Environmental/lifestyle factors in the pathogenesis and prevention of type 2 diabetes. BMC Medicine, 15, 131. Web.
Mayo Clinic Staff. (2016). Diabetes prevention: 5 tips for taking control. Web.
Philis-Tsimikas, A., & Gallo, L. C. (2014). Implementing Community-Based Diabetes Programs: The Scripps Whittier Diabetes Institute Experience. Current Diabetes Reports, 14(2), 462. Web.
Sakurai, M., Nakamura, K., Miura, K., Takamura, T., Yoshita, K., Sasaki, S., … Nakagawa, H. (2013). Family history of diabetes, lifestyle factors, and the 7‐year incident risk of type 2 diabetes mellitus in middle‐aged Japanese men and women. Journal of Diabetes Investigation, 4(3), 261–268.
Vojta, D., Koehler, T. B., Longjohn, M., Lever, J. A., & Caputo, N. F. (2013). A coordinated national model for diabetes prevention: Linking health systems to an evidence-based community program. American Journal of Preventive Medicine, 44(4), 301-306.
World Health Organization. (2016). Global report on diabetes. Web.