Epidemiology of Diabetes
The number of individuals with diabetes in different parts of the world has tremendously increased in the past two decades. One of the worrying features of this rapid increase has been the emergence of type two diabetes in different age groups ranging from children to young adults. Diabetes encompasses a group of disorders characterized by high glucose levels that cause unique eye kidneys and an increased risk for cardiovascular diseases.
According to recent studies, the number of individuals who have diabetes is expected to reach 438 million by 2030. The studies go ahead and explain that the most massive increases will be in countries experiencing high economic growth like China. Countries experiencing high economic growth see their people consume high energy foods and engage in reduced physical exercises, which exposes them to lifestyle diseases like obesity and, eventually, diabetes (Khan et al., 2020) An increase in the number of individuals who have diabetes can lead to a rise in healthcare costs and interfere with individuals’ overall quality of life in the given neighborhood.
In the recent past, several methods have been used in different parts of the world to diagnose diabetes. Some of the ways have been based on statistical approaches to defining abnormal or high glucose levels and others on the risk of complications. These methods have significant implications on the interpretations of current and future epidemiologic studies on diabetes.
Risk factors for type two diabetes
Healthcare leaders have associated increased rates of type two diabetes with several risk factors. For instance, increasing age, obesity, dietary factors like increased intake of animal fats, and sedentary lifestyle.
Obesity and type 2 diabetes
Some individuals can argue that obesity is a condition that affects older people because the likelihood of developing obesity increases with age. However, what individuals should realize is the fact that even young people develop obesity. Obesity is a complex disease that involves an excessive amount of body fat. Individuals suffering from obesity are at a higher risk of suffering from other diseases like type 2 diabetes (Tan et al., 2018). Individuals who are overweight and especially those with excess weight around the tummy, have higher chances of suffering from type 2 diabetes than individuals who are not overweight.
According to studies, abdominal fats cause fat cells to release pro-inflammatory chemicals, making the body less sensitive to the insulin it produces by tampering with the function of insulin-responsive cells and their ability to respond to insulin. Also, obesity plays a substantial role in triggering changes to the body’s metabolism by reducing insulin sensitivity.
Increasing age and type 2 diabetes
An individual’s age plays an essential role in the type of diabetes a person is likely to be diagnosed with. Although young people are more exposed to type 1 diabetes, older individuals are more exposed to type 2 diabetes. This is because of lifelong eating and lifestyle habits that contribute to diabetes (Tan et al., 2018). Simply put, older individuals have been exposed to sugar for longer compared to younger individuals. As a result, they have higher chances of developing abnormally high glucose levels and eventually type 2 diabetes. Also, different ethnic groups have varying chances of suffering from type 2 diabetes.
Sedentary lifestyles and type 2 diabetes
A sedentary lifestyle encompasses sitting for long hours, which does not consume a lot of energy. According to scholars, reducing the amount of time an individual sit down can be essential in preventing type 2 diabetes. Individuals should, therefore, engage in physical exercises like running and improve their diet.
Dietary factors and type 2 diabetes
In the recent past, the relationship between diet and the development of type 2 diabetes have received much attention from healthcare leaders and other professionals in the healthcare field. High-calorie intake increases a person’s chances of suffering from type 2 diabetes due to increased body weight, which increases insulin sensitivity. For instance, refined carbohydrates rich in fructose can increase the risk of type 2 diabetes by increasing insulin resistance. Also, individuals who consume large amounts of sweetened beverages are at higher risk of suffering from the condition due to increased body weight, which interferes with glucose metabolism and insulin sensitivity (Tan et al., 2018). Therefore, one can realize that there are significant relationships between dietary interventions and type 2 diabetes prevention. For instance, consuming whole grain-rich foods, legumes, and vegetables can protect an individual from chronic diseases like diabetes.
Recent emerging risk factors
Decreased sleep
Apart from poor eating habits and inactivity among individuals, short sleep duration can also cause type 2 diabetes. Sleep deprivation has detrimental effects on glucose tolerance and insulin sensitivity. Sleep deprivation raises ghrelin levels, a hunger hormone, and decreases leptin levels, making individuals feel full. For individuals to compensate for reduced energy levels, individuals who experience sleep deprivation have high chances of seeking relief in foods that raise blood sugar and put them at a risk of obesity, which is a risk factor for diabetes (Tan et al., 2018). Individuals and especially adults who have type 2 diabetes who experience disturbed sleep, also have high chances of failing to follow other standards for diabetes self-care such as engaging in physical exercises and closely monitoring blood glucose levels. Deprived sleep can also have long term effects on individuals who have type 2 diabetes. Those who experience sleeping problems have a higher likelihood of suffering from stress, especially psychological distress, and cognitive decline.
Environmental pollutants
The contemporary world is experiencing industrialization, which has led to massive gases being emitted into the atmosphere. For instance, it has been realized that there is a strong connection between serum concentrations of chlorinated persistent organic pollutants with diabetes. Also, there exists a pivotal relationship between brominated flame – retardants and type 2 diabetes. “According to healthcare leaders, the accumulation of environmental toxins may accumulate in adipose tissue and act as doctrine disruptors leading to dysregulation of glucose and lipid metabolism.”
Low birth weight and fetal malnutrition
There is a dire need for expectant mothers to ensure that they feed on a balanced diet to prevent maternal undernutrition. Expectant mothers who do not access a balanced diet have a higher likelihood of giving birth to underweight children who have a higher probability of suffering from type 2 diabetes. However, individuals should also realize that children born of women suffering from obesity and those who have type 2 diabetes also have a higher likelihood of suffering from the same condition (Tan et al., 2018). There is a dire need for professionals in the environment to develop measures that can reduce environmental pollution. The number of individuals who have diabetes can be reduced for the greater good of society.
Drug-induced metabolic changes
It has been realized that some of the commonly used medications in different parts of the world can increase people’s chances of suffering from diabetes. The contemporary world is faced with a myriad of infections that poses a threat to people across all walks of life. To curb the spread of HIV/ AIDS, there has been an increase in highly active antiretroviral therapy, which has significantly reduced the mortality of individuals who have HIV (Whittemore et al., 2019). However, protease inhibitors have been found to increase insulin resistance and lipid metabolism. Therefore, an individual can conclude that an increase in the use of such medications will likely have a substantial impact on the epidemiology of type 2 diabetes in an area with many individuals who have HIV/AIDS.
Regional and ethnic patterns of type 2 diabetes in the world
As seen above, the prevalence of type 2 diabetes varies in different parts of the world. When developing an APN, there is a dire need for healthcare professionals to understand how they can identify the causes of the illness and develop ways of dealing with the disease. Different regions in the Africa continent record different numbers of individuals who have type 2 diabetes. For instance, most individuals who suffer from a chronic illness come from urban areas compared to those who live in rural areas. The African continent’s northern parts record higher cases of type 2 diabetes compared to other parts of the continent. According to a study conducted in 2010, 3.8% of Africans were suffering from type 2 diabetes numbers, which were projected to increase to 4.7% by 2030 (Tan et al., 2018). Lifestyle among individuals living in African urban areas is associated with the disease’s prevalence in the urban areas. The majority of individuals living in urban areas have adopted westernized ways of living, which exposes them to obesity and eventually increase their likelihood of suffering from type 2 diabetes.
Diabetes is one of the significant and leading causes of morbidity in America.
The number of individuals suffering from chronic disease varies based on age, race, and gender. People’s biological living standards and their neighborhoods play an essential role in treating chronic illness. In the US, black people and especially adults, have higher chances of suffering from type2 diabetes than their white counterparts. Using analytical analysis can make it possible for individuals to realize how biological, neighborhood, socioeconomic, and behavioral risk factors can contribute to the risk of diabetes. One can recognize that biological risk factors can contribute to most health disparities between these two racial groups. For instance, a combination of body mass index, waist measurement, and blood pressure is higher among black people, which increases their chances of suffering from diabetes (Tan et al., 2018). Also, most black people live in poor neighborhoods, making it hard for them to access quality healthcare services. As a result, they get little or no medical attention when affected by diabetes, thus the prevalence of the illness. Besides, most blacks in the country do not engage in physical exercises, which leads to obesity and eventually type 2 diabetes.
Studies also show that most older individuals who have type two diabetes in the US are men compared to women. This is because the amounts of viscera fat are approximately two kilograms among men and 1 kilogram among women. The sex difference in visceral fat mass can increase the risk of later type 2 diabetes development among men. The given fat can play an essential role in becoming obese and eventually suffering from type 2 diabetes.
Other people at increased risk of suffering from type 2 diabetes in America are Native American Indian communities. According to studies, approximately 50% of Pima Indians suffer from diabetes (Whittemore et al., 2019). The prevalence of chronic illness among these individuals and especially among the young people is associated with adopting secular trends for the last four decades. Such statistics have made researchers predict that the number of individuals with type 2 diabetes is likely to rise from 11 million in 2000 to 29 million in 2050 (Esposito et al., 2014) However, most of the individuals affected by the illness will be people of color due to demographic composition changes and a secular rise in prevalence rates.
Number of people with diabetes in 2010 and 2030 in the 20-79 age group
| rank |
country |
Persons(2010) |
rank |
country |
Persons(2030) |
| 1 |
India |
50.2 |
1 |
India |
87.0 |
| 2 |
china |
43.2 |
2 |
china |
62.6 |
| 3 |
USA |
26.8 |
3 |
USA |
36.0 |
| 4 |
Russia |
9.6 |
4 |
Pakistan |
13.8 |
| 5 |
Brazil |
7.6 |
5 |
Brazil |
12.7 |
Relationship between neighborhood environment and T2DM
Although individual-level risk factors like obesity and poor diet play an essential role in the spread of type 2 diabetes, environmental factors like features of neighborhood environments can impact the prevalence of chronic illness. Neighborhood features can affect the prevalence of diabetes through the limited availability of healthy foods, physical activity resources, and accessibility to quality healthcare services. Also, neighborhood social cohesion and violence can lead to the spread of T2DM through stress and lack of social support.
Although the United States of America is a first-world country, racism is still a contentious issue. Individuals in the country are segregated by race, which exposes the minority groups and especially people of color to more adverse neighborhood environments than white individuals (Birkeland et al., 2017). For instance, people of color find it hard to access quality healthcare services. When it comes to matters related to education and employment opportunities, black people are also disadvantaged. Lack of quality education means that people lack the required skills to enter the job market, which leaves the majority of the black people jobless. Lack of financial capacity implies that black people cannot afford healthy foods like fruits and vegetables and rely on junk foods (Birkeland et al., 2017). Junk foods increase people’s chances of becoming obese and eventually suffer from type two diabetes. Lack of financial capacity also exposes people to stressors due to their incapacity to afford things like quality housing also exposes the black community to type 2 diabetes.
Poor black neighborhoods also suffer from a lack of facilities that can be used for physical exercises. For instance, there are no parks and stadia where individuals can play football and make a morning and evening run. As a result, individuals tend to be inactive and spend much of their time sitting down. Sitting down for long hours exposes individuals to obesity, which, if not controlled, can cause type 2 diabetes among people (Birkeland et al., 2017). There is a dire need for the relevant authorities to understand the relationship between neighborhood social and physical environments and type 2 diabetes to develop policies essential in controlling the disease’s prevalence among people of color.
For instance, in collaboration with healthcare leaders, the relevant authorities can empower the people economically through which they can afford a healthy living. For example, individuals with financial capacity can secure Medicare and Medicaid overs to seek medical assistance whenever need be (Birkeland et al., 2017). Financially able individuals can also afford healthy foods and do not necessarily have to feed on junk foods, leading to obesity and type 2 diabetes.
Impacts of type 2 diabetes
The prevalence of type 2 diabetes has had major impacts on both individuals and societies at large. Apart from the high costs associated with the condition’s treatment, the disease is associated with a myriad of health complications ranging from stroke to blindness. According to healthcare professionals, approximately 3.8 million individuals succumbed to the illness in 2007 (Whittemore et al., 2019). However, what individuals should realize is that most people die of cardiovascular diseases and especially stroke. With the prevalence of type 2 diabetes, most individuals, especially those who have adopted the western way of life, are at a higher risk of suffering from stroke and other heart-related diseases. Below are the impacts of type 2 diabetes.
Mortality and morbidity
According to recent studies, type 2 diabetes has been a major cause of death among individuals in different parts of the world. The studies also show that 4 million individuals between 20 and 79 died of the illness in 2010. Although individuals can argue that developed countries are the most affected by this disease, what an individual should realize is that two-thirds of the given deaths occurred in low and middle-income countries. The majority of individuals die of cardiovascular diseases, particularly stroke. There exists a substantial relationship between type 2 diabetes and stroke (Birkeland et al., 2017). Much of the food consumed by human beings are broken down into glucose to give the body energy. Upon entering the bloodstream, the glucose travels to different cells in the body once the food is digested. The pancreas has the role of producing the right amount of insulin for the amount of glucose present. Individuals who have type 2 diabetes have a pancreas that lacks the capacity to produce enough insulin necessary in the body, making it hard for the fat to use insulin in the right way. As a result, individuals with type 2 diabetes end up with a lot of sugar in their bodies. The blood clots can, in turn, block vessels in the brain. As a result, the blood supply can be cut off, preventing blood from reaching the brain, leading to a stroke.
Healthcare burden and economic costs
The spread of type 2 diabetes in different parts of the world is likely to lead to an increase in healthcare costs. In the united states of America, the amount of money spent on the treatment of diabetes was $ 174 in 2007. The majority of this money was spent on hospital inpatient and medical supplies. The burden associated with diabetes affects all sectors of life. Due to the high cost of treatment of the disease, patients can be left in abject poverty, especially if they do not have personal insurance covers (Garza, Dols & Gillespie, 2017). Diabetes affects not only the patients but also their families. Families of the affected individuals are likely to suffer psychologically and emotionally upon seeing one of them experiencing pain due to type 2 diabetes. For instance, children can be deeply affected and start performing poorly at school if one of the parents is suffering from the disease.
The amount of money spent by the government in the treatment of diabetes can be used to fund other projects like improving the quality of education and the state of roads in the country.
Primary prevention of type 2 diabetes
There is a dire need for all individuals to collaborate and develop ways of controlling the prevalence of this disease for the greater good of the community. For instance, individuals can develop methods of reducing calorie intake and increased physical activity among individuals. Effective management is essential when it comes to the prevention and control of premature mortality to diabetes. Primary care aims at controlling the spread of a pandemic rather than treating it. In a nutshell, primary care aims at treating the root cause of an illness (Garza, Dols & Gillespie, 2017). When developing an APN for the treatment of type 2 diabetes, there is a dire need for an individual to realize the role that physical exercise plays in controlling and treating the condition. Engaging in physical exercises ensures that individuals experience modest weight loss, which reduces the risk of suffering from type 2 diabetes.
Healthcare leaders should encourage individuals to engage in physical exercise to avoid becoming obese, which can eventually lead to type 2 diabetes. For instance, individuals should take morning or evening walks, play football, and go jogging. Through this, they can burn a significant amount of calories and save themselves the burden of seeking medical treatment because of diabetes.
Poor eating habits are another cause of type 2 diabetes. While developing an APN, it is essential to understand the importance of healthy foods like fruits and vegetables in an individual’s life. Individuals should reduce the number of junk and beverages they consume. Taking too much junks and beverages can expose individuals to the risk of type 2 diabetes (Cheng, Wu, Dawkes, Lim & Wang, 2019). Junks can lead to obesity, which is a leading cause of diabetes. People should, therefore, concentrate on taking healthy foods through which they can reduce the risks of suffering from type 2 diabetes.
As previously seen, there is a relationship between stroke and diabetes. There is a dire need for relevant stakeholders to develop a combination of medical and public health developments like improved treatments for diabetes. For instance, they can come up with provisions that can lead to a reduction in tobacco reduction (Spurr, Bally, Bullin & Trinder, 2017). Controlling the amount of tobacco that individuals consume can ensure that cardiovascular diseases are reduced. Reducing these diseases ensures that the prevalence of type 2 diabetes is controlled, thus saving the government the amount of money spent in treating the disease.
All individuals, despite their racial affiliations, are the same. The American government needs to ensure that the minority groups in the country, like the people of color, can access quality healthcare. They should also ensure that people are economically empowered by providing quality education and equal employment opportunities. Provision of quality education in black neighborhoods can ensure that the people of color get the required skills. As a result, they can secure employment opportunities through which the overall quality of life can substantially improve.
Establishing a patient-centered healthcare system is pivotal in the control of the prevalence of type 2 diabetes. This kind of care can ensure that people’s needs, decisions, and values are taken care of. The healthy relationship established between the care provider and the patient can make it possible for the care provider to realize what is ailing the patients and remedies to the given problem. Patient-centered care can ensure that risks are identified and individuals referred to proven community-based prevention (Spurr, Bally, Bullin & Trinder, 2017). Patients can be encouraged to adhere to practice guidelines through which they can get better. For instance, they can be advised to take individual meals and avoid some. They can also be encouraged to engage in physical exercises for them to get better. Strictly adhering to the rules can lead to improved results.
In conclusion, there has been a rapid increase in the spread of type 2 diabetes in the recent past. Several factors have played a substantial role in increasing the condition, which is a worrying trend. People’s living styles are connected to the prevalence of diabetes in the US and other countries in the world. In the contemporary world, most people no longer engage in physical exercises, which increases their chances of becoming obese. Obesity can lead to diabetes due to insulin resistance in the body. The government spends a significant amount of money on the treatment of individuals suffering from obesity. The disease also exposes individuals to increased poverty due to rising healthcare costs. There is a dire need for healthcare professionals to come up with primary care to remedy the situation. Individuals should be advised to feed on healthy foods like fruits and vegetables and avoid junk. Also, primary care can lead to the establishment of a healthy relationship between care providers and patients. Through this, confidence can be created between the two parties, making it possible for them to share confidential information with care providers, which can aid in treatment. On the other hand, care providers can respect the decisions made by the patients through which better results can be achieved.
References
Birkeland, K. I., Jørgensen, M. E., Carstensen, B., Persson, F., Gulseth, H. L., Thuresson, M., … & Bodegård, J. (2017). Cardiovascular mortality and morbidity in patients with type 2 diabetes following initiation of sodium-glucose co-transporter-2 inhibitors versus other glucose-lowering drugs (CVD-REAL Nordic): a multinational observational analysis. The lancet Diabetes & endocrinology, 5(9), 709-717.
Cheng, L. J., Wu, V. X., Dawkes, S., Lim, S. T., & Wang, W. (2019). Factors influencing diet barriers among outpatients with poorly‐controlled type 2 diabetes: A descriptive correlational study. Nursing & health sciences, 21(1), 102-111.
Esposito, K., Chiodini, P., Maiorino, M. I., Bellastella, G., Panagiotakos, D., & Giugliano, D. (2014). Which diet for prevention of type 2 diabetes? A meta-analysis of prospective studies.
Garza, L., Dols, J., & Gillespie, M. (2017). An initiative to improve primary prevention of cardiovascular disease in adults with type II diabetes based on the ACC/AHA (2013) and ADA (2016) guidelines. Journal of the American Association of Nurse Practitioners, 29(10), 606-611.
Khan, M. A. B., Hashim, M. J., King, J. K., Govender, R. D., Mustafa, H., & Al Kaabi, J. (2020). Epidemiology of type 2 diabetes–global burden of disease and forecasted trends. Journal of epidemiology and global health, 10(1), 107.
Spurr, S., Bally, J., Bullin, C., & Trinder, K. (2017). Type 2 diabetes in Canadian aboriginal adolescents: risk factors and prevalence. Journal of pediatric nursing, 36, 111-117.
Tan, C. C. L., Cheng, K. K. F., Sum, C. F., Shew, J. S. H., Holydard, E., & Wenru, W. A. N. G. (2018). Perceptions of diabetes self-care management among older Singaporeans with type 2 diabetes: A qualitative study. Journal of Nursing Research, 26(4), 242-249.
Whittemore, R., Vilar-Compte, M., De La Cerda, S., Marron, D., Conover, R., Delvy, R., … & Pérez-Escamilla, R. (2019). Challenges to diabetes self-management for adults with type 2 diabetes in low-resource settings in Mexico City: a qualitative descriptive study. International journal for equity in health, 18(1), 133.
Epidemiology of Diabetes
- PAPER: Descriptive Epidemiology of Health Event* and Implications for Program Development
The goal of this assignment is to describe a health event epidemiologically and then to determine how this information can be used by advanced practice nurses to guide research projects and in program development.
Expectations/Grading Criteria**
- Identify a health condition that is relevant to your clinical practice or a clinical population of interest. Please follow the timeline located in the syllabus.
- Provide a “definition” (i.e. defining characteristics) for this health event. That is, how is it decided that a person has this condition). (5 points)
- Using morbidity and mortality rates or other appropriate statistics, describe the health condition overall and by all the following characteristics where appropriate: person characteristics (age, sex, marital status, ethnicity/race, socioeconomic status, religion); time (secular and cyclic); place and any other risk factors that describe the distribution of this health event. Tables and graphics can also be included but should follow APA guidelines. (50 points)
- Based on your analysis of the above information and/or the literature, develop a research question that could be studied by an APN using the following format:
What is the relationship of “a risk factor” to “your health event” in a specific subpopulation? For example, What is the relationship of high sodium diet to hypertension in African American males. What explanations are given in the literature for this potential relationship. (10 points)
- Describe a research study using an observational study design that could be used by an APN to study the above research question. Be specific in describing the research study.(10 points)
- Describe how the APN could design and develop an evidenced based program (a program that has been shown to be effective) focusing on primary or secondary prevention of the risk factor. State if your focus is primary or secondary prevention. Provide a reference for the evidence-based program. (15 points)
- Organization, clarity and use of APA format (including tables and figures)*** (10 points)
- Maximum of 15 pages
- Due the last date of class ( please check the syllabus)
