Introduction
Diabetes mellitus is one of the critical issues of world medicine as a disease associated with a high level of human and economic costs. According to the World Health Organization (WHO) experts, type 2 diabetes is a problem of all ages and populations, which is due to its wide geographic prevalence and an exceptionally rapid increase in morbidity (Unnikrishnan, Pradeepa, Joshi, & Mohan, 2017). High mortality rates are caused by the disease complications that gradually progress, significantly reducing the quality and duration of one’s life. This paper aims to examine type 2 diabetes, including the related problems, potential solutions, and recommendations.
Discussion
In recent years, a steady increase in the incidence and prevalence of diabetes is observed in almost all countries of the world. This allows for qualifying these processes as a new non-communicable epidemic of the end of the 21st century. As stated by the WHO, there are currently 160 million people with diabetes in the world, which represents 2-3 percent of the total population of the planet. It is anticipated that by 2025, their number will reach 330 million (Unnikrishnan et al., 2017). The most problematic point of diabetes is that it includes a range of issues, which affect human health. Namely, the comorbid diseases and high prevalence, care costs, and underreporting should be mentioned.
Speaking of diabetes as of the global epidemic, it should be stressed that with regard to age, the data show that after 40 years, the risk of developing this disease increases. The prevalence rate among people aged between 65 and 74 is almost 20 percent (World Health Organization, 2016). Type 2 diabetes is more common among ethnic group minorities. Compared to six percent of the disease prevalence among White people, it is about ten percent among people of African-American and Asian-American origin.
For the Hispanic population, 12.5 percent are likely to develop the mentioned chronic condition (Schneiderman et al., 2014). In certain communities of the indigenous American population, diabetes is likely to be developed by 20-50 percent of the population. In general, diabetes is more common in women who have already had diabetes in the family. This data points to the need to implement an immediate action to reduce diabetes morbidity.
Another critical aspect is that there are a lot of comorbid states that worsen health outcomes of patients. The majority of people with type 2 diabetes develop cardiovascular problems, including chronic heart failure, cerebrovascular accident, and heart attack myocardium (Krug, 2016). The second place among the related states is occupied by the terminal stage of renal failure and oncological diseases (World Health Organization, 2016). However, it is also noted that the mentioned issues lead to death, but many cases remain unknown to the doctors. Among other aggravating factors, there are obesity, unhealthy lifestyles, unawareness of one’s disease, and the failure to start treatment timely.
The proportion of comatose states, both hyperglycemic and hypoglycemic, among the causes of death is small: it does not exceed 0.5 percent (Krug, 2016). The specificity of the formation of the epidemiological situation with regard to diabetes is that understating the importance of diabetes among public health problems is affected by underreporting the actual number of patients. In addition, the associated symptoms of the disease can be misinterpreted.
In turn, the combination of these factors leads to underfunding of the diabetes problem, insufficient information programs for groups at risk of diabetes, low and late accessibility of medical care (Merlotti, Morabito, & Pontiroli, 2014). The decrease in care affordability is likely to cause a decrease in the number of registered cases.
Diabetes is a great economic burden for health systems, especially in developed countries such as the US. In most countries, the cost of treating patients with diabetes ranges from five to twenty percent of the total health budget, which depends on interventions and policies that regulate care processes and procedures. According to estimates of Seuring, Archangelidi, and Suhrcke (2015), based on the fact that the cost of treating patients with diabetes is 2-3 times higher than that of people without diabetes, the cost of treating diabetes in the US surpassed those in all countries of the world and amounted to $ 320 billion.
To compare, in China and Germany, occupying the second and third places in the cost of treatment of diabetes – $51 and $35 billion, respectively (Seuring et al., 2015). To reduce the costs, a comprehensive plan is required to join forces of care providers, patients, and governments.
Physicians, nutritionists, cardiac care specialists, nurses, and other care providers should be aware of the diabetes epidemic. Their actions need to be coordinated and properly managed by leaders to ensure that they have the necessary skills and knowledge. The role of patients in managing their disease lies in self-assessment and timely reporting to care providers. The study by Jaacks, Siegel, Gujral, and Narayan (2016) shows that a significant underestimation of the actual number of patients and complications compromise the importance of diabetes among public health problems.
The improvement in the effectiveness of preventing the progression of diabetes and the development of avoidance strategies are important. The increase in quality and life expectancy is associated with the efforts of the patients who should monitor their condition and follow medical recommendations.
Representing a significant public health issue, diabetes is one of the priority non-communicable diseases. The measures to combat it can also be planned at the highest level of public health. The international organizations noted that over the past few decades, the incidence and prevalence of diabetes have steadily increased. This first WHO Global Diabetes Report highlights the enormity of the problem of diabetes and the potential to change the current situation (World Health Organization, 2016).
Namely, a political framework has already been formed for concerted action on diabetes. It is identified in the Sustainable Development Goals by the United Nations’ Political Declaration on non-communicable diseases and the WHO’s Global NCD Action Plan. It is proposed to introduce education and assistance with self-monitoring as well as qualified care from experienced professionals.
A National Diabetes Prevention Program (National DPP) prepared by the Centers for Disease Control and Prevention (CDC) is the most relevant solution that integrates the efforts of all the mentioned stakeholders. The DPP promotes the cooperation of the governmental bodies, clinics, care providers, and communities to combat diabetes. In the course of the experimental trials, it was revealed that such an approach is useful to reduce the negative impacts of this non-communicable illness (Diabetes Prevention Program Research Group, 2015).
This solution also presents the recommendations associated with the pharmacological aspect of this health problem based on Metformin. It increases insulin sensitivity in peripheral tissues by up to 50 percent and inhibits glucose production by the liver (Dunkley et al., 2017). The synthesis of glucose in the liver in patients with pre-diabetes is significantly increased compared with that in healthy people, Metformin helps in normalizing fasting glucose. The advantage of using metformin for the prevention of diabetes is its high safety, which is confirmed by the years of experience and the results of randomized-controlled studies (Diabetes Prevention Program Research Group, 2015).
The serious lifestyle interventions can be recommended to lessen the threat of developing diabetes mellitus. Metformin had the greatest effect in young patients with more pronounced glucose disorders and obesity. In combination, lifestyle changes and pharmacological therapy can decrease the incidence of diabetes in people at high risk (Dunkley et al., 2017). Adults with overweight and obesity should consider the ways to balance their weight by engaging in adequate physical activity (Merlotti, et al., 2014).
Moreover, moderately intense physical exertion is accompanied by the growth in the rate of proliferation of capillaries in the muscles, the volume of muscle tissue, and the sensitivity of peripheral tissues and muscles to insulin. Food should be healthy and balances, including high-grade proteins, lean meat, fish, milk, dairy products, and so on (Ley, Hamdy, Mohan, & Hu, 2014).
Lessons Learned
The public health issue of diabetes requires the attention of a greater number of people since there are a lot of factors that can cause it. In this connection, it seems important to think about the need for early detection of diabetes. Often, insurance does not include screening and blood tests for diabetes, and people fail to reveal the onset of their disease, which leads to complications (Seuring et al., 2015). One may suggest that a special fund should be organized to support and promote a diabetes prevention program. It was learned that money should be spent not only on improving diagnostics but also on working with patients to ensure their adherence to treatment.
It is significant that a patient follows the rules of nutrition, actively moves, constantly independently monitors the level of glucose in the blood, and regularly passes examinations, following a doctor’s prescriptions. If the disease is diagnosed on time, there is an opportunity to stop it without medical treatment. It was clarified that the prevention of diabetes can reduce the risk of this dangerous disease. Learning to control his or her diabetes and keeping blood glucose levels at optimum levels. A patient achieves the main goal of treatment. While it requires high awareness and motivation from the patient, preventative measures allow saving funds and improving care quality.
Conclusion
To conclude, it should be stressed that type 2 diabetes is a public health concern that turned out to become an epidemic in recent years. People of different ages and cultures across the globe struggle to prevent and combat it. The evidence shows that the prevalence of the disease tends to increase, and many comorbid diseases complicate the situation. The national DPP initiative introduced in the US is expected to contribute to the early recognition of diabetes through patient and care provider education. While nurses and physicians can diagnose and prescribe treatment options, the patients should also participate through self-monitoring and timely reporting if any changes. More people should pay attention to this public health issue to make a significant step towards protecting their health from diabetes impact.
References
Diabetes Prevention Program Research Group. (2015). Long-term effects of lifestyle intervention or Metformin on diabetes development and microvascular complications over 15-year follow-up: The Diabetes Prevention Program outcomes study. The Lancet Diabetes & Endocrinology, 3(11), 866-875.
Dunkley, A. J., Bodicoat, D. H., Greaves, C. J., Russell, C., Yates, T., Davies, M. J., & Khunti, K. (2014). Diabetes prevention in the real world: Effectiveness of pragmatic lifestyle interventions for the prevention of type 2 diabetes and of the impact of adherence to guideline recommendations: A systematic review and meta-analysis. Diabetes Care, 37(4), 922-933.
Jaacks, L. M., Siegel, K. R., Gujral, U. P., & Narayan, K. V. (2016). Type 2 diabetes: A 21st century epidemic. Best Practice & Research Clinical Endocrinology & Metabolism, 30(3), 331-343.
Krug, E. G. (2016). Trends in diabetes: Sounding the alarm. The Lancet, 387(10027), 1485-1486.
Ley, S. H., Hamdy, O., Mohan, V., & Hu, F. B. (2014). Prevention and management of type 2 diabetes: Dietary components and nutritional strategies. The Lancet, 383(9933), 1999-2007.
Merlotti, C., Morabito, A., & Pontiroli, A. E. (2014). Prevention of type 2 diabetes; A systematic review and meta‐analysis of different intervention strategies. Diabetes, Obesity and Metabolism, 16(8), 719-727.
Schneiderman, N., Llabre, M., Cowie, C. C., Barnhart, J., Carnethon, M., Gallo, L. C.,… Teng, Y. (2014). Prevalence of diabetes among Hispanics/Latinos from diverse backgrounds: The Hispanic community health study/study of Latinos (HCHS/SOL). Diabetes Care, 37(8), 2233-2239.
Seuring, T., Archangelidi, O., & Suhrcke, M. (2015). The economic costs of type 2 diabetes: A global systematic review. Pharmacoeconomics, 33(8), 811-831.
Unnikrishnan, R., Pradeepa, R., Joshi, S. R., & Mohan, V. (2017). Type 2 diabetes: Demystifying the global epidemic. Diabetes, 66(6), 1432-1442.
World Health Organization. (2016). Global report on diabetes. Web.