A. Topic selection and the reason for selecting
The World Health Organization (WHO) reports an increasing prevalence of diabetes worldwide (WHO, 2016). WHO links diabetes to other chronic condition such as kidney failure, stroke, heart attacks, retinopathy and neuropathy, conditions that lead to declined life expectancy. A new report published by the Centre for Disease Control and Prevention (CDC) indicates an increasing prevalence of diabetes in the US and diabetes as seventh leading cause of mortality, implying an increasing health burden (CDC, 2017).
B. Thoroughly define the disease/condition
NIH (2019) defines diabetes is a non-communicable chronic disease that manifests either when the body is ineffectively using produced, or the insulin produced by the pancreas is insufficient. Insulin is the blood sugar-regulating hormone whose inefficient regulation results in raised blood sugar condition referred to as Hyperglycemia. The occurrence of hyperglycemia is detrimental to the body system, particularly the blood vessels and the nerves. There are two types of diabetes; type 1 diabetes and type 2 diabetes (NIH, 2019). Type 1 diabetes formerly referred to as insulin-dependent diabetes occurs due to deficient of production of insulin. Patients with type 1 diabetes demonstrate symptoms such as constant hunger and thirst, excessive urine secretion, fatigue, weight loss, and vision impairment. Subsequently, patients with type 1 diabetes are managed by daily insulin administration. Type 2 diabetes commonly referenced as non-insulin-dependent diabetes occurs when the body is unable to effectively use produced insulin. Type 1 diabetes is the prevalent type of diabetes worldwide resulting mainly from low physical activity and excessive weight gain. CDC (2017) report indicate that although the risk of developing diabetes advances with age, the chronic condition prevalence in children is steadily increasing. Whilst the symptoms of type 2 is similar to the type 1 diabetes, they take more time for the complications to manifest hence takes more time prior to diagnosis.
C. History of the disease/condition
The first mention of diabetes dates back to the 1552BCE when a Hesy- Ra, an Egyptian physician referred the condition as excessive passing of urine. The word insulin was introduced in 1922 during a paper presented during the annual meeting of Association of American Physicians subsequently resulting to mass production of Insulin by the University of Toronto and Indianapolis Eli Lilly & Company and made commercially available in 1923. Other advancements in the diabetes control and treatment include the pancreas transplant in 1966, introduction of Humulin in 1982, islet transplant in 1999 and the designation of November 14th as World Diabetes Day by United Nations (Canadian Diabetes Association, 2019).
1. Statistical prevalence (e.g. overall, gender, age)
The incidence of diabetes more than tripled in the last three decades with the incidence of new cases doubling annually. The CDC estimates 30.3 Million American have diabetes which is equivalent to 9.4% of the American population with 23.1 million people already diagnosed and 7.2 million people not yet diagnosed despite having diabetes. In 2015, new cases of diabetes diagnosis amounted to approximately 1.5 million among the adults and 193,000 cases of diabetes among the children. The CDC estimates that 5 percent of the victims suffer from type 1 diabetes while the majority 95% suffer from type 2 diabetes (CDC, 2017)
2. Types of distributions (e.g. frequencies, patterns)
Diabetic condition is prevalent across the social and economic groups as well as the ethnic groups. The frequency of diabetes is highest among the Alaska Natives and American Indians amounting to 15.1% and lowest among the Non-Hispanic Whites amounting to 7.4%. The frequency among the Asia Americans, the Hispanic and the Non-Hispanic Black American are 8 %, 12.1% and 12.7% consecutively (CDC, 2017).
A. Types of determinants (e.g. causes, risk factors)
Several factors are associated with increased risk of developing diabetes including; smoking, obesity, physical inactivity, high blood pressure, hyperglycemia, and hyperlipidemia. The CDC (2017) report identified that 15.9% of the cases adult patients had a history of smoking, while 87.5% of the reported cases of adult diabetes were either overweight or obese. Additionally, 73.6% of the adult diabetic patients had systolic blood pressure while 40.8% reported physical inactivity. Lastly, 58.2% of the adult diabetic patients had Hyperlipidemia while (Hyperglycemia) was reported in 15.6% of diabetic patients.
B. Financial Costs:
1. Costs to the individual/family
Medical expenditures associated with diabetes management constrain familyâ€™s resources. Moreover, diabetes is linked to comorbid conditions such as cardiovascular diseases that further increase the economic burden on the family. Since the majority of the diabetes cases are reported among adults who are mostly the breadwinners, itâ€™s evident that diabetes constrains family welfare through loss of income (WHO, 2016).
2. Possible costs to society
The WHO (2016) reports a large economic burden imposed by diabetes on both the global economy and the healthcare system. The economic burden entails direct medical cost and resulting in indirect cost due to subdued productivity. Additionally, diabetes increases mortality rate which reduces the productive workforce. The WHO (2016) estimates an aggregate of US$827 billion as the annual cost of diabetes worldwide which had tripled in the last decade.
3. Loss of productivity
According to NIH (2019), diabetes has been linked to a decline in work productivity which implies a negative impact on a nationâ€™s gross productivity. Diabetes is associated with complications such as stress, fatigue which results in unforeseen and frequent absence from work which negatively affects a firmâ€™s bottom line.
C. Anatomy & Physiology/Etiology:
1. The normal and abnormal structure & function behind the disease/condition
Diabetes is associated with the failure of the pancreas to effectively utilize insulin or produce sufficient insulin resulting in higher levels of glucose in the blood system which yields health complications. Both types of diabetes is linked to polygenic implying defect or change of multiple genes (NIH, 2019).
2. Cause(s) of the disease/condition.
The causes of type 1 diabetes are linked to genetic interactions with environmental factors. The conditions manifest insulin-producing beta cells in the pancreas are attacked and destroyed by the immune system. Type 2 diabetes is associated with lifestyle, metabolic and genetic factors. Increased risk of type 2 diabetes is linked to physical inactivity, overweight, and obesity. Certain family heritage and genes are associated with a high prevalence of type 2 diabetes (WHO, 2016).
1. How this disease/condition is diagnosed (e.g. history, exam, diagnostic imaging, labs)
Healthcare providers diagnose diabetes by testing the level of blood glucose through a blood test. A1C test or Random plasma glucose (RPG) or the fasting plasma glucose (FPG) test are the common test undertaken by physicians to diagnose diabetes. Testing equipment such as the blood glucose meter available over the counter can be used for self-testing. A1C of below 5.7% indicates a normal condition, a 5.7-6.4% indicating prediabetes and 6.5 and above indicating diabetes condition (NIH, 2019).
2. The prediction of this disease/conditionâ€™s outcome (i.e., prognosis)
Uncontrolled or poorly controlled diabetes yields to fatal comorbid conditions such as cardiovascular disease, renal failure, blindness, and foot amputation. The CDC (2017) analysis identified a reduced life expectancy of people diagnosed with diabetes. The report further identifies type 1 diabetes patient diagnosed before adulthood were likely to develop acute diabetes complication and succumb before the age of 30 years. According to NIH (2019) complications such as cardiovascular diseases, neuropathy, limb amputation and depression are highly reported in patients with type 2 diabetes reducing the life expectancy by up to 10 years.
Itâ€™s irrefutable that the increasing prevalence of diabetes worldwide presents a global health challenge. The increasing prevalence poses a policy challenge of increasing resources allocated for research, control, and treatment of diabetes. The statistics as well as portrays a deteriorating lifestyle characterized by low physical activity coupled of high cholesterol consumption, a trend that ought to be reversed to reverse the diabetes trend globally.
Canadian Diabetes Association. (2019, 03 08). History of Diabetes. Retrieved from https://www.diabetes.ca/about-diabetes/history-of-diabetes
CDC. (2017). National Diabtes Statictics Report, 2017. Center for Disease Control and Prevention (CDC).
NIH. (2019, 03 08). Diabetes Overview . Retrieved from National Institute of Diabetes and Digestive And Kidnet Diseases : https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems
WHO. (2016). Global Report on Diabetes . Wolrd Health Organization.
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