As the prevalence of diabetes continues to rise worldwide, it becomes increasingly important to identify high-risk populations and to implement strategies that help to delay or prevent its onset.
Type 1 diabetes mellitus is considered one of the most dangerous forms of diabetes because it’s associated with the absence of pancreatic B cells which produce insulin necessary for the breakdown of glucose.Gestational--It is important to manage gestational diabetes because women who are diagnosed with gestational diabetes mellitus are at high risk for future diabetes, with approximately 50% of women developing type 2 diabetes within 5 years of delivery. Furthermore, their children are at increased risk for perinatal morbidity and, in the long term, obesity, and glucose intolerance .Some pregnant women have misconception about gestational diabetes. They assume that since the disease status is temporary, - it will resolve on its own. The reality is that they are unaware of true consequences of gestational diabetes. Diabetes is a chronic disease which really pre-supposes lifelong management of not only the condition itself but also its complications.
Populations with lower income significantly outgrow populations with higher income. Due to socioeconomic disparities, poor people have a heavier burden when it comes to management of diabetes and other illnesses.
Lack of knowledge-Despite having long-standing disease and the out-patient care for diabetes, many lower income patients frequently hold beliefs regarding the disease and medications that are inconsistent with chronic disease model . The costs of medications could be viewed as one of multiple potential causes for underuse rather than the sole cause. Cultural beliefs, misconceptions and related predictors shall be seen as important opportunities for targeting barriers to successful diabetes prevention and management.Low income is a barrier to diabetes management, but alongside with other factors such as depression and disbelief about pharmacotherapy. Education is a very important aspect of diabetes management in low income populations. Due to lack of knowledge, misconceptions are common.Depressive symptoms and negative medication related beliefs increase patients' odds of cutting back selectively on medications for diabetes. Levels of health quality as well as self-efficacy are reduced among low income populations with the presence of depression and/or mood disorders.
Regular physical activity is another important component for diabetes prevention and management. Often, low income populations do not have access to exercise facilities due to a combination of factors including income, crime and lack of appropriate facilities. Decreased physical activity and/or improper diet regimen are barriers to diabetes prevention and management. By addressing these issues, we will address other chronic conditions as well.
It is very important to provide low literacy materials that can improve knowledge among readers of all literacy levels. Free educational workshops in low income urban neighborhood settings may help to increase knowledge and confidence in diabetes management and the methods of choosing healthy foods when shopping . A cost effective approach that may help to effectively reach communities, and even regions, and the nation is through the increase of healthier choices, and promotion of these choices in community settings.
2050 Projection<br />one in three adults will have diabetes in 2050 <br /><ul><li>An aging population is more likely to develop the disease.
Ethnic populations are at high risk for type 2 diabetes. The prevalence of diabetes in ethnic populations is increasing.
Better treatment allows diabetics to live longer.</li></li></ul><li> Types of Diabetes and Causes<br />Type 1 – insulin dependent or juvenile onset diabetes (body immune system destroys pancreatic beta cells (need insulin)<br />Type 2 – non-insulin dependent or adult onset diabetes (the most common type when insulin is no longer used properly)<br />Gestational diabetes (occurs during pregnancy as a result of glucose intolerance)<br />Other types (genetic conditions, surgeries, pancreatic disease, other illnesses).<br />
Other Barriers<br />Lack of Knowledge ( fear, anxiety, incorrect self-testing, and medication dosages).<br /> Cultural Beliefs and/or misconceptions (preferred dietary choices, mistrust of healthcare system, self interpretation of disease).<br /> Income<br /> Mood disorders<br /> Ethnicity<br />
Type 1 and type 2 diabetes have different causes. Yet two factors are important in both.<br />1) one must inherit a predisposition. <br />2) something in one’s environment must trigger diabetes. <br />Genes alone are not enough. <br />
Diabetes prevention (large scale)<br />Prolong life expectancy by expanding knowledge of population<br /> awareness<br />medical costs (prevention is the key)<br />Healthcare Education of target populations (ex. Healthy diets, mobile educational units, workshops, etc.)<br />Equal access to health care basing <br /> onneeds, and not one’s ability to pay! <br />(Social Justice)<br />
Something to think about:<br />1) Are there unrecognized financial and social costs to the adaptation of healthy behaviors?<br />2) How might neighborhood characteristics (environmental stress) be altered to improve health and health care for persons with/without diabetes?<br />3) How to eliminate/reduce socio-economic disparities? <br />