Population of Interest
The population of interest is comprised of juvenile children and adolescents who have type 1 or type 2 diabetes. According to the U.S. Department of Justice (2020), “a ‘juvenile’ is a person who has not attained his eighteenth birthday” (para. 1). In other words, a juvenile is a person whose age is below 18 years old, including all genders. Among those, only the ones affected by either type 1 or type 2 diabetes are the population of concern.
Diabetes is a chronic medical condition in which the body is unable to properly use and store glucose. Glucose levels in the blood become excessively high, leading to various symptoms and an increased risk of health complications. Both type 1 and type 2 diabetes are forms of the disease that are caused by different factors.
Type 1 diabetes is a disorder caused by an autoimmune response, in which insulin-producing cells are attacked by immune cells, resulting in an inability to produce insulin (Lawrence et al., 2021). Type 2 diabetes is a metabolic disorder characterized by high blood sugar levels resulting from either insulin resistance or inadequate insulin production.
Data Sources and Search Strategy
Three sources of information were of primary concern. For the first component, the search process aimed to analyze government data, including that of the Centers for Disease Control and Prevention (CDC). For the second component, the search process aimed to assess credible organizational data, such as the American Diabetes Association (ADA). For the third component, recently published (=<5 years) scholarly academic journal articles were searched in Google Scholar. The key journals include the Journal of the American Medical Association (JAMA) and the Pediatric Diabetes journal. The state and national resources are comprised of the CDC, ADA, and the Florida Diabetes Advisory Council.
The keywords utilized during the search include ‘juvenile diabetes,’ ‘diabetes among youth,’ ‘juvenile type 1 diabetes,’ ‘juvenile type 2 diabetes,’ and ‘juvenile diabetes statistics.’ The date of publication for journal articles and other sources needed to be no older than five years.
According to ADA (2022), around 283,000 American children and adolescents have been diagnosed with diabetes, which is 0.35% of all juveniles. Annually, almost 6,000 and 20,000 children and adolescents are diagnosed with type 2 diabetes and type 1 diabetes, respectively (ADA, 2022). However, type 1 diabetes remains the most predominant form among youth (Lawrence et al., 2021).
According to CDC (2021), “the number of people under age 20 living with type 1 diabetes increased by 45%, and the number living with type 2 diabetes grew by 95%” (para. 1). The global pattern for juvenile diabetes is upward, indicating that it is a worldwide issue (Rogers & Kim, 2019). This is an alarming trend since it used to be that type 1 diabetes was the most prevalent form among juveniles. Thus, if these patterns remain unchanged, type 2 diabetes will become the most common form of the disease among children and adolescents.
From a health aspect, diabetes is a metabolic disease that can cause severe complications if not properly managed. Type 1 diabetes essentially makes a person permanently dependent on external sources of insulin, such as injections. Type 2 diabetes can impair health if major lifestyle changes are not introduced, even if insulin is supplied. The key risk factors include maternal infections during pregnancy for type 1 diabetes, whereas type 2 diabetes is influenced by diet, excessive sugar consumption, sedentary lifestyle, poor sleep, and other factors (Rogers & Kim, 2019).
In the case of state-level statistics, “there were 7,889 students with reported diabetes in Florida schools” (Florida Diabetes Advisory Council, 2019, p. 14). In addition, in Florida, “the number of youth being diagnosed with both type 1 and type 2 diabetes is increasing” (Florida Diabetes Advisory Council, 2019, p. 6). Therefore, the problem among juveniles is not only prevalent in the state but also closely follows the national pattern. The global trend for juvenile diabetes is upwards, indicating that it is a worldwide issue.
Health Disparities and Evidence-Based Interventions
There is a statistical health disparity among juveniles with diabetes since it was shown that “the number of people under age 20 living with type 1 diabetes increased by 45%, and the number living with type 2 diabetes grew by 95%” (CDC, 2021, para. 1). There are multicultural factors, such as children of racial and ethnic minority backgrounds being more vulnerable to juvenile diabetes due to lower access and socioeconomic resources.
The two evidence-based clinical interventions designed to reduce specific disparities in the examined population are telehealth and diabetes self-management education (DSME). DSME programs are designed to teach individuals with diabetes the necessary skills to manage their condition (CDC, 2021). Telehealth interventions, such as remote monitoring and telemedicine, can be used to provide diabetes management and education to juveniles in a remote setting.
The first multicultural aspect of the DSME intervention is that it can be culturally sensitive towards minority groups. The main reason is that educating children from minority groups can involve cultural barriers and language obstacles, which is why cultural competence is needed. A second multicultural aspect of telehealth is notable, which involves cultural awareness issues when serving people from remote regions with predominantly minority backgrounds.
For the literature application, multiculturalism and diversity should be incorporated into all aspects of healthcare, including the development of clinical guidelines and evidence-based management and treatment of diabetes. This includes recognizing and addressing the cultural and linguistic needs of patients, as well as ensuring that healthcare providers are culturally competent and able to provide care that is sensitive to the unique needs and experiences of diverse patient populations.
One clinical guideline for addressing multiculturalism and diversity in diabetes management is the “Standards of Medical Care in Diabetes – 2021” from the ADA (CDC, 2021). Another clinical guideline is the “Cultural Competence in Diabetes Care” from the National Diabetes Education Program (NDEP).
In summary, multiculturalism and diversity are crucial considerations when managing and treating diabetes, particularly in pediatric patients. To successfully bridge cultural differences and establish effective relationships that lead to better health outcomes, healthcare must integrate these concepts into all areas, including the creation of clinical guidelines and evidence-based treatment plans.
References
American Diabetes Association. (2022). Statistics about diabetes.
Centers for Disease Control and Prevention. (2021). New research uncovers concerning increases in youth living with diabetes in the U.S.
Florida Diabetes Advisory Council. (2019). Florida diabetes report.
Lawrence, J. M., Divers, J., Isom, S., Saydah, S., Imperatore, G., Pihoker, C., Marcovina, S. M., Mayer-Davis, E. J., Hamman, R. F., Dolan, L., Dabelea, D., Pettitt, D. J., & Liese, A. D. (2021). Trends in prevalence of type 1 and type 2 diabetes in children and adolescents in the US, 2001-2017. The Journal of the American Medical Association, 326(8), 717-727.
Rogers, M. A. M., & Kim, C. (2019). Congenital infections as contributors to the onset of diabetes in children: A longitudinal study in the United States, 2001-2017. Pediatric Diabetes, 21(3), 456-459.
The U.S. Department of Justice. (2020). 38. “juvenile” defined.