The Global Diabetes Epidemic: Prevalence, Challenges, and Strategies

Introduction

Diabetes has stood out as one of the major health concerns globally. According to the world health organization, the condition is not only a serious but also a chronic condition that occurs in an inability of the pancreas to produce insulin which is a hormone that regulates the blood sugar levels or commonly referred to as the glucose levels (2016). The condition also occurs in instances where the body cannot effectively use the insulin produced from the pancreas. The disease is a significant public health problem that has been targeted for action world leaders. Over the past few years, the prevalence as well as the cases of diabetes has seen a dramatic upsurge, a factor that has created alert and the need to address the condition. In a global overview of diabetes, 422 million adults have been identified to report with diabetes by 2014 (Atlas, 2015).For individuals facing issues with understanding and tackling the complexities of diabetes, seeking professional guidance from a healthcare dissertation help.

In a span of five decades, the prevalence of the disease has been noted to have increased by almost a double from 4.7% in 1980 to 8.5% in 2014. The increased has also been noted o be more for the low and middle income countries relative to the high income nations. Traditional studies have documented two main types of diabetes as the type 1 and the type 2 diabetes (Atlas, 2015). The type 1 diabetes is characterized by the absolute deficiency and the presence of autoantibodies against the pancreas islet beta cells. On the other hand, type 2 diabetes is characterized by predominantly by insulin resistance (Mellitus, 2020). Though there are other types of diabetes such as the maturity-onset diabetes of the young and the latent autoimmune diabetes in adults, the discussion will focus on the type 2 diabetes as it is the main focus of the dissertation. Type 2 diabetes is an expanding global health problem that has been associated with epidemic of obesity. The condition mainly affects the body’s metabolism of sugar; mainly glucose. When one suffers from type 2 diabetes, the body resists the effects of insulin or fails to produce enough insulin that would maintain normal glucose levels. The condition has no cure but can be managed through a variety of ways that the dissertation aims to address. The condition has varied symptoms that are inclusive of increased thirst, frequent urination, increased hunger, unintended weight loss, fatigue, blurred vision, slow-healing sores, frequent infections, and areas of darkened skin that are observed in the armpits or the neck. Type 2 diabetes has various negative impacts that are felt by the patients (Atlas, 2015). The disease leads to complications in various parts of the body increasing the potential risk of dying. Other complications include heart attack, stroke, kidney failure, leg amputation, vision loss, and nerve damage. The disease has also been noted to have serious economic impact due to substantial economic loss to people with diabetes and their families as well as the health systems and the national economics. The condition is thus a major problem not only to individuals but to the world as a whole. Consequently, this dissertation aims to explore and discuss the various ways of managing type 2 diabetes from a nursing perspective.

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Background

About 3.5 million people in the UK have been reported with diabetes. The condition is more common in children and young adults that are linked to conditions of being overweight and inactive physically. 2 million people in the UK are at a risk of developing type 2 diabetes. Type 2 diabetes describes a metabolic disorder that has heterogeneous aetiologies with chronic hyperglycinemia and disturbances in the metabolism of carbohydrates, proteins and fats due to the insulin defects of secretion and action or a combination of the two. The condition has long term effects that are inclusive of the risk of micro and macrovascular complications (Diabetes, 2004). The type 2 diabetes is a heterogeneous category of disorders. Studies have reported an association of family history of the type 2 diabetes and a risk of future occurrence of the same. The core pathological defects of the condition have been reported as the insulin defects in the liver or the muscle and failure of the beta cells of the pancreas. The onset of the type 2 diabetes heralds a drastic and permanent change in the lives of individuals that are affected by the condition. The condition presents with an array of dysfunctions that when poorly controlled results in complications that can either be vascular or neuropathic (Mellitus, 2020). The microvascular complications are like the retinal, renal as well as neuropathic disease while the macrovascular conditions include the coronary artery and the peripheral vascular disease. The diabetic neuropathy affects autonomic and the peripheral nerves (Diabetes, 2004). Many patients with type 2 diabetes are ultimately treated with insulin though not all depend absolutely on the same. This is so since the patients retain the ability to secrete insulin and thus require the hormone but do not depend on it (Candler et al., 2018). Diabetes requires prolonged medical attention to curb the development of the devastating complications besides managing the complications in case they occur.

Beta cell dysfunction is a major factor that plays a significant impact from the prediabetes to diabetes (Candler et al., 2018). The dysfunction develops during the early stages of the pathologic process. As glucose tolerance progresses from normal to abnormal, the postprandial glucose levels upsurges followed by the development of the fasting hyperglycemia due to the suppression of the hepatic gluconeogenesis failure (Mellitus, 2020). Insulin resistance is coupled with an increase in the glucagon levels as well as an increase in glucose dependent insulinotropic polypeptide levels (Candler et al., 2018). Also, studies on single-nucleotide polymorphisms (SNPs) have noted various genetic variants that are lined with the beta-cell dysfunction and the insulin resistance that contribute to type 2 diabetes. In summary, the type 2 diabetes is caused by a decrease in the beta-cell responsiveness that results in an impairment of the insulin processing and a decrease in the secretion of insulin (Diabetes, 2004). Besides, a lowered early glucose-stimulated insulin release and altered unsaturated fatty acids metabolism contribute to the occurrence of type 2 diabetes. Dysregulation of fat metabolism has been noted by various researchers alongside inhibition of serum glucose release both as contributing factors to the condition. Upsurge in the resistance of the hormone insulin and increased adiposity in the body have a significant impact on type 2 diabetes (Atlas, 2015). The condition is diagnosed through the glycated hemoglobin test that indicates the average blood sugar level in the boy for the past three to two months. Other tests that have been used in the diagnosis of type 2 diabetes include the random blood sugar test, the fasting blood sugar test, and the oral glucose tolerance test (Diabetes, 2004). Effective approaches are available that can be applied to prevent the complications as well as the mortality reports that result from type 2 diabetes (Abusaib et al., 2020).

The preventive measures include policies and practices that are applicable for all populations. The measures contribute significantly to good health to diabetic and non-diabetic individuals. Studies have noted that taking a life-course perspective is crucial to the prevention of type 2 diabetes. Various techniques have been deployed in the management of the condition. These have included the weight loss, healthy eating, regular exercise, medications as well as blood sugar monitoring. Early diagnosis has been noted as the starting point for living well with diabetes (Atlas, 2015). The health outcomes of an individual are worsened by the longer they stay with the undiagnosed diabetes condition. Healthcare providers and governments have thus opted to enable easy access to basic diagnostics such as the blood glucose testing. For individuals that are diagnosed with diabetes, various cost-effective interventions can be put in place to manage the condition. Use of standards and protocols has been used to strengthen the management of diabetes (Atlas, 2015). There is a need to better understand the management of type 2 diabetes in a nursing perspective as it is a global health concern and nurses are the core care givers to the diabetic patients.

Rationale

The prevalence and complications of type 2 diabetes in the UK and across the globe is an alarming issue. The condition has created potent harm not only to human health but to the community health, health systems and the world as a whole. Consequently, the rationale of the present study lies in exploring the management of the condition from a nursing perspective, to understand the policies and the measures that have been put in place to manage the condition as well as to understand the clinical presentations of the disease. Diabetes as a condition is widely investigated and the most investigated type is the type 2 diabetes. `It is significant to address the issue since those who are diagnosed with diabetes experience significant health concerns as the disease is a contributing factor to many other health complications. The diseases also kill individuals at an annual rate that is higher relative to other medical conditions. The disease affects a diverse range of age groups of people globally.

Aim

The present study is focused on the aim to explore and discuss the management of type 2 diabetes in a nursing perspective.

Based on the preset research aim, particular research objectives have been developed to conduct the research in the correct direction. The specific research h objectives are as presented below.

To explore the ways in which nurses have managed type 2 diabetes in health systems To discuss the policies that have been put in place in healthcare settings to manage type 2 diabetes by nurses To explore new measures and techniques that nurses can adopt to manage type 2 diabetes

Research Questions

Q1) What are the various ways in which nurses have managed type 2 diabetes in health systems?

Q2) Which policies have been put in place in healthcare settings to manage type 2 diabetes by nurses?

Q3) Which new measures and techniques can nurses adopt to better the management of type 2 diabetes?

Literature review

Various studies have explored the features and the presentations of type 2 diabetes as well as the consequences and the management of the disease. For instance, according to Holden et al (2013), there has been an upsurge in the incidence of diagnosed type 2 diabetes in the past three decades. Also, the author notes that the proportions of the people that are diagnosed with the condition at a relatively early age have also seen a gradual increase. In a different literature, Haines et al makes similar observations of a continued rising incidence of type 2 diabetes in children in the UK (2007). The research notes that type 2 diabetes is more common relative to the type 1diabetes in UK children. The frequency of type 2 diabetes has been on the increase over the past few years and the incidence have also been noted to be more for the ethnic communities compared to the white counterparts (Candler et al., 2018). Also, increased adiposity and family history of type 2 diabetes are greatly linked to the diagnosis of the type 2 diabetes in UK children (Hansen et al., 2007, Candler et al., 2018).

According to Fox et al, (2006), the prevalence of inadequate glycemic control has remained high despite the introduction of the new OAs and treatment guidelines for type 2 diabetes in the United Kingdom. According to Blak et al, basal and premixed insulin are the most common types of insulin that are initiated and in for most patients that have noted no changes (2012). On studies that have explored the causes of type 2 diabetes, Minton et al states that mutations in the WFS1 gene result in the death of the beta cells (2002). Diabetes has had a major burden on the economy of individual as well as countries. According to Currie et al, the diabetes related primary care has adjusted the cost increased considerably (2007).

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Literature review to be continued…

References

Abusaib, M., Ahmed, M., Nwayyir, H.A., Alidrisi, H.A., Al-Abbood, M., Al-Bayati, A., Al-Ibrahimi, S., Al-Kharasani, A., Al-Rubaye, H., Mahwi, T. and Ashor, A., 2020. Iraqi Experts Consensus on the Management of Type 2 Diabetes/Prediabetes in Adults. Clinical Medicine Insights: Endocrinology and Diabetes, 13, p.1179551420942232.

Atlas, D., 2015. International diabetes federation. IDF Diabetes Atlas, 7th edn. Brussels, Belgium: International Diabetes Federation.

Bains, K.K., 2020. Delivering a community intervention on Type 2 Diabetes with UK Punjabi South Asians via radio.

Candler, T.P., Mahmoud, O., Lynn, R.M., Majbar, A.A., Barrett, T.G. and Shield, J.P.H., 2018. Continuing rise of type 2 diabetes incidence in children and young people in the UK. Diabetic Medicine, 35(6), pp.737-744.

Currie, C.J., Gale, E.A.M. and Poole, C.D., 2010. Estimation of primary care treatment costs and treatment efficacy for people with type 1 and type 2 diabetes in the United Kingdom from 1997 to 2007. Diabetic Medicine, 27(8), pp.938-948.

Dyson, P.A., Kelly, T., Deakin, T., Duncan, A., Frost, G., Harrison, Z., Khatri, D., Kunka, D., McArdle, P., Mellor, D. and Oliver, L., 2011. Diabetes UK evidence‐based nutrition guidelines for the prevention and management of diabetes. Diabetic Medicine, 28(11), pp.1282-1288.

Dyson, P.A., Twenefour, D., Breen, C., Duncan, A., Elvin, E., Goff, L., Hill, A., Kalsi, P., Marsland, N., McArdle, P. and Mellor, D., 2018. Diabetes UK evidence‐based nutrition guidelines for the prevention and management of diabetes. Diabetic medicine, 35(5), pp.541-547.

Fox, K.M., Bolinder, B., Chen, J. and Kumar, S., 2006. Prevalence of inadequate glycemic control among patients with type 2 diabetes in the United Kingdom general practice research database: a series of retrospective analyses of data from 1998 through 2002. Clinical therapeutics, 28(3), pp.388-395.

Haines, L., Wan, K.C., Lynn, R., Barrett, T.G. and Shield, J.P., 2007. Rising incidence of type 2 diabetes in children in the UK. Diabetes care, 30(5), pp.1097-1101.

Holden, S.E., Barnett, A.H., Peters, J.R., Jenkins‐Jones, S., Poole, C.D., Morgan, C.L. and Currie, C.J., 2013. The incidence of type 2 diabetes in the United Kingdom from 1991 to 2010. Diabetes, Obesity and Metabolism, 15(9), pp.844-852.

Mellitus, D., 2005. Diagnosis and classification of diabetes mellitus. Diabetes care, 28(S37), pp.S5-S10.

Mellitus, D.I.A.B.E.T.E.S., 2006. Diagnosis and classification of diabetes mellitus. Diabetes care, 29, p.S43.

Ojo, O., Ojo, O.O., Adebowale, F. and Wang, X.H., 2018. The effect of dietary glycaemic index on glycaemia in patients with type 2 diabetes: a systematic review and meta-analysis of randomized controlled trials. Nutrients, 10(3), p.373.

Slåtsve, K.B., Claudi, T., Lappegård, K.T., Jenum, A.K., Larsen, M., Cooper, J.G., Sandberg, S. and Julsrud Berg, T., 2020. The total prevalence of diagnosed diabetes and the quality of diabetes care for the adult population in Salten, Norway. Scandinavian Journal of Public Health, p.1403494820951004.

Stettler, C., Allemann, S., Jüni, P., Cull, C.A., Holman, R.R., Egger, M., Krähenbühl, S. and Diem, P., 2006. Glycemic control and macrovascular disease in types 1 and 2 diabetes mellitus: meta-analysis of randomized trials. American heart journal, 152(1), pp.27-38.

Vetter, C., Dashti, H.S., Lane, J.M., Anderson, S.G., Schernhammer, E.S., Rutter, M.K., Saxena, R. and Scheer, F.A., 2018. Night shift work, genetic risk, and type 2 diabetes in the UK biobank. Diabetes care, 41(4), pp.762-769.

Whicher, C.A., O’Neill, S. and Holt, R.G., 2020. Diabetes in the UK: 2019. Diabetic Medicine, 37(2), pp.242-247.

Williams, G. and Pickup, J.C., 2004. Handbook of diabetes. Blackwell Pub..


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