Public Awareness of Diabetes

Public Awareness of Diabetes Lynn A. Bailey HCA/240 August 21, 2011 Dr. Monica Reed, PhD, MPH Diabetes is a disease that affects millions of people every year, and in most cases, this is a disease that is preventable. Increasing public awareness regarding risk factors and how this debilitating disease can be controlled and prevented may reduce the number of cases diagnosed each year. Throughout the years, scientists have developed a variety of treatment options and medications that are available for individuals diagnosed with diabetes. Future treatments for diabetes may include an artificial pancreas and stem cell therapy (Yoffee, 2009). Along with community support through awareness programs and advances in technology and treatment options, this disease is controllable and in some cases, may even be prevented. Diabetes and who it Affects Most Diabetes mellitus (DM), more commonly known as diabetes, is the result of insufficient insulin production or the body’s inability to respond to insulin (Forth & Jude, 2011). Diabetes is a disease that affects how the body uses blood glucose, or blood sugar. Blood glucose is vital to health because it is an essential source of energy for cells of the muscles and other tissues as well as the brain’s fuel (Mayo Clinic, 2011). Individuals that suffer from diabetes have difficulty regulating and maintaining healthy blood glucose levels. If an individual is diagnosed with diabetes, no matter type, he or she has too much glucose. Some genetic factors do play a role in an individual’s risk for developing diabetes along with other factors such as race, but lifestyle is to blame for most diagnosed cases of diabetes (Centers for Disease Control and Prevention (CDC), 2011). Anyone who is 45 years or older should consider testing for diabetes, especially if he or she is overweight or has a family history of this disease. Race may also play a role in the development of this disease. Individuals who are African American, American Indian, Asian American, Pacific Islander, or Hispanic American/Latino should also consider prescreening (CDC, 2011). Another group of people that are more susceptible to DM2 are lower income groups, especially women (Lega, Ross, Zhong, & Dasgupta, 2011). Diabetes affects the whole body including the most important hormonal system, the endocrine system. The Body System Affected by Diabetes and its Causes The endocrine system is a group of organs or glands that secrete hormones into the bloodstream, which can affect the entire body. Glands of the endocrine system include the hypothalamus, pituitary, thyroid, parathyroid, pancreas, adrenal, testes, and the ovaries. The glands of the endocrine system release hormones into the bloodstream. The pancreas is the organ of the endocrine system, and when it is not functioning properly, the result is diabetes. Diabetes occurs when the pancreas malfunctions. One of the pancreas’s functions is to control the glucose level in the blood (Mulvihill, Zelman, Holdaway, Tompary, & Raymond, 2006). The pancreas secretes two hormones known as glucagon and insulin, which raise and lower glucose levels in the blood (Mulvihill et al. 2006). When insulin is secreted, blood glucose levels rise, and when glucagon is released, blood glucose levels decrease. If an individual is diagnosed with diabetes, his or her pancreas is not secreting enough insulin or target cells are not responding to the insulin that is being secreted (Mulvihill et al. , 2006). This malfunction of the pancreas results in either Type One (DM1) or Type Two (DM2) diabetes. DM1 diabetes occurs when the pancreas fails to produce insulin, and DM2 diabetes occurs when the pancreatic islets fail to secrete enough insulin or when target cells ignore the insulin (American Diabetes Association, 2011). The most common cause of diabetes is obesity, but other risk factors are involved as well. Risk Factors Some common risk factors for DM1 include genetics from both parents, environmental factors such as cold climates, viruses, race, and early dietary factors such as low vitamin D or exposure to cow’s milk (Mayo Clinic, 2011). Risk factors for DM2 consist of obesity, high or low birth weight, rapid weight gain in childhood, sedentary lifestyle, fetal exposure to gestational diabetes, family history, and race (Schub & Caple, 2010). Some of these risk factors may be controlled, whereas others cannot e controlled. Risk factors that are controllable include dietary needs and lifestyle choices. Obesity is the number one cause of DM2 among children and adolescents, and is commonly describes as body mass index, or BMI, which is a measurement of body fat that is based on height and weight (Schub & Caple, 2010). Obesity is a risk factor that is modifiable and may decrease an individualà ¢â‚¬â„¢s risk for developing DM2, and it may either prevent or reduce the onset. Obesity is a risk factor of DM1 as well. Although it may not prevent DM1, healthy lifestyle choices may help manage this type of diabetes as well. Other factors that cannot be controlled include genetics, fetal exposure to gestational diabetes, low birth rate, some environmental factors, and race. In today’s world, advances in medicine and technology have increased the availability of treatment options for patients diagnosed with diabetes compared to the past. Evolution of Treatment Options Over past several years, the list of medications used to treat diabetes has increased creating more options for patients and healthcare providers (Davis, 2011). In the past, insulin was the only treatment available for diabetes, and medications were limited. Metformin is an oral drug that has been used for many years as a treatment for DM2, but it is not always effective because of side effects such as gas, bloating, and diarrhea (Davis, 2011). With new advances in technology, this drug is now available in an extended-release formula, which reduces its side effects and makes is much more tolerable for many patients, and it is also available in a generic version, which is much less expensive for numerous individuals suffering from DM2 (Davis, 2011). Advances in treatment options have also led to the availability of drugs such as Byetta, Januvia, Onglyza, Tradjenta, and Symlin (CDC, 2011). Januvia, Onglyza, and Tradjenta are drugs that work with natural enzymes and the body’s own insulin to control blood glucose, Symlin is a synthetic hormone that helps lower blood glucose after meals, and Byetta is an injectable drug that assaults high blood sugar and diminishes one’s appetite (Davis, 2010). Diagnosis and treatments depend on which type of diabetes and individual may have. A healthcare professional will conduct different types of medical tests and procedures to determine the proper diagnosis. Current Treatment Methods When a patient suspects that he or she may have diabetes, the first thing they should do is see their doctor. The physician can perform tests and procedures that will determine whether or not he or she has diabetes, and if so, which type they have. These tests may include a fasting blood glucose level test, random (non-fasting) blood glucose level test, oral glucose tolerance test, hemoglobin A1c test, or a ketone test, which is used to diagnose DM1 (Right Health, 2010). A fasting blood glucose level test is a test that indicates a patient’s blood glucose level after a period of eight hours of fasting. At the doctor’s office, a medical professional will take a sample of blood from the vein in the inner bend of the elbow. The fasting blood glucose level should be below 99mg/dl, which is considered normal. Results that indicate levels of 100 to 125 are indications of pre-diabetes and 126 or higher indicate diabetes (CDC, 2011). Another test is random blood glucose level. Random blood glucose level test is a blood glucose test conducted on a patient that has not been fasting. Normal levels in and average adult are 70 to 130 mg/dl (CDC, 2011). If an individual’s test results reflect a level of 130 to 200, this may be an indication of pre-diabetes, and a patient with a level above 200 is considered a diabetic (CDC, 2011). A glucose tolerance test may also be used to diagnose diabetes. A glucose tolerance test is in which the patient, who has been fasting for about 10 hours, drinks a solution of glucose. After the patient drinks the solution, his or her blood and urine is sample are taken and analyzed over a period of three hours (Mulvihill, et al. , 2006). The urine test shows the presence or absence of glucose in the urine, or ketones (Mulvihill, et al. 2006). The A1c test is a test used for diabetics as well. An A1c is a test which indicates blood sugar levels over a period of three months (Medicine Net, 2011). This is a test that benefits the patient and the physician by giving an indication of how well a medication may be working. Normal range is 4-5. 9%, a level of 8% or more is an indication of poorly controlle d diabetes (Medicine Net, 2009). With advancing technology and medicine, the future holds more treatment options. Future Treatment Options Advancement in technology is making new treatment options available for many diabetic patients. Research has indicated new treatments such as an artificial pancreas and pancreatic cell transplantation (Yoffee, 2009). Medtronic, a medical device company, is combining glucose monitoring systems with insulin pumps to recreate the delivery system of insulin in the body (Yoffee, 2009). Scientists are also working on transferring pancreatic cells from pigs into humans (Yoffee, 2009). Even though advances in technology are allowing scientists and other professionals to invent new and exciting treatments for diabetes, prevention is the best defense against this disease. Evaluation of an Existing Educational Program One educational program that has made great strides to combat the growing threat of diabetes among children and adolescents is the Adolescent Health and Youth Development (AHYD) Unit of the Georgia Division of Public Health. They have helped fund 30 Teen Center Programs in 28 counties in the state of Georgia (Georgia Division of Public Health, 2011). One of these programs is the Diabetes Prevention and Control Program (DPCP), which was established to reduce the burden of diabetes on the communities of Georgia. This program provides communication to increase awareness, improve quality of care, increase screening, and reduce costs (Georgia Division of Public Health, 2011). This program has made some impact on communities, but there is still a lot of work that needs to be done. The DPCP was recognized by the CDC for achievement in A1c screening and improving the well-being of people affected by diabetes. Scholarships have been awarded to 374 medical professionals that help them pay for the Certified Diabetes Educators (CDE) exam. These are great accomplishments, but it is not enough. More needs to be done to reach out to the communities that are hardest hit by this disease. In addition to the A1c screening, a lifestyle initiative should be added. Adding a lifestyle initiative that would include local restaurants and other businesses to come out into their communities and get involved. Six annual picnics that included A1c screening, lunch, activities, and educational materials would be beneficial for many communities throughout Georgia. Local businesses could ban together and donated good to raffle off, which would draw families and community members to the event. The event could be held at a different area parks around the state. The hardest hit areas would be the first on the list. People need to be educated about the risks, causes, and prevention of diabetes, and our communities must come together in order to combat the onset of diabetes in our children and adolescents. An Effective way of Spreading the News No program will be successful without the proper advertising or spokesperson. In today’s world children and adolescents are drawn to Sponge Bob. If he were the spokesperson for healthy eating and exercise, children would react with enthusiasm and excitement. His picture on fliers that promote a healthy lifestyle could be mailed to surrounding area residents alerting them of the upcoming events. Children could come to the event and get their picture taken with Sponge Bob. Sponge Bob could lead a relay race for children and adolescents. An ad in the local newspaper would benefit the event as well. A website could be created for this event with links to Facebook and Twitter. With the help of Sponge Bob and the community, education on the benefits of a healthy lifestyle would reach a greater number of people, and help promote the prevention of diabetes. Conclusion Diabetes is a disease that affects millions of people. In some cases, this disease can be prevented by teaching and promoting healthy lifestyle choices. Over the years, many treatment options have changed, and with increasing advances in technology and medicine, there will be more changes in the future. The key to the prevention and treatment of many cases of diabetes is to provide sufficient public awareness. References American Diabetes Association. (2011). Type I. Retrieved from http://www. diabetes. org/diabetes-basics/type-1/. American Diabetes Association. (2011). Type 2. Retrieved from http://www. diabetes. org/diabetes-basics/type-2/. Centers for Disease Control and Prevention. (2011). National diabetes fact sheet. Retrieved from http://www. cdc. gov/diabetes/. Davis, J. L. (2011). 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