Diabetes is a metabolic disorder defined by excessive glucose levels caused by a lack of cellular resistance or insulin production (Arcangelo & Peterson 116). According to the Centers for Disease Control and Prevention (CDC), the number of diabetics in the United States increased from 26 million to 29 million in ten years. People with diabetes are most commonly seen in poor countries. In fact, Asian countries with industrialization, socioeconomic growth, and urbanization account for almost 60% of the world's diabetic population (CDC n.d). These are the key variables contributing to the spread of this disease. In geographical regions, genetic factors like improved living standards, high levels of obesity and other reasons, are the leading cause of diabetes. This paper will reflect on the pathology, epidemiology and the social causes of diabetes as well as the medical and cultural treatment of diabetes.
Catalogues of diabetes
Type 1/Juvenile diabetes
Peterson and Arcangelo (p. 136), state that, type 1 diabetes is an immune condition where the pancreatic beta cells get demolished and can only be restored by insulin. The role of beta cells is to produce insulin which transports glucose from foods eaten to be utilized for energy. The inability of the body in this case to generate insulin leads to complications like coma, ketoacidosis or even death.
Type 11 diabetes
In most cases, this type of diabetes is commonly found to diagnose people because it’s caused by the decrease in the sensitivity of insulin in the muscle cells as well as the decrease of the ability and function of the pancreas to produce insulin for body utilization. Type 11 diabetes, in this case, have higher risks of developing vision loss, cardiovascular disease, and extremity amputations (Pasinetti 209). Therefore type 11 diabetes, in other words, occurs when there are defects in the beta cells and when there is resistance to insulin.
Gestational diabetes
This type of diabetes only occurs during pregnancy because the body becomes intolerant to glucose. The disorder is related to anti-insulin effects that are related to cortisol and progesterone hormones as well as the human placenta. (Gross 165). When a woman is pregnant, it is paramount that she is screened to determine risk factors like family history, obesity, and history of gestational diabetes. It is also vital that gestational diabetes is treated because it usually affects the unborn child.
Epidemiology of diabetes
According to the WHO the Global report on diabetes showed that the number of adults who are diagnosed with this condition has quadrupled to 422 million from the year 1980 (Roglic 4). This dramatic rise is mostly the type 11 diabetes, and the primary factors that drive this cause was obesity and overweight. In 2012, diabetes killed about 1.5 million people. Type 11 diabetes can also lead to complications such as strokes, blindness, heart attack, lower limb amputation and kidney failure. The WHO also estimated that in 2014, the world had over 422 million adults who are above 18 years lived with diabetes (Roglic 7). The largest number, in this case, was estimated to be from the Western Pacific and the South-East Asia regions. In past few decades, the number of people with diabetes increased due to population growth, the rise in the prevalence of diabetes, and the increase of the old people. Worldwide, between the years, 1980 to 2014, people living with diabetes augumented from 108 million to four times by 2014 (Roglic 10). Forty percent of the increase was due to aging and population growth. Twenty-eight percent was from age-specific prevalence while thirty -two percent was from the interaction of the two.
Diabetes in America
In America, it is estimated that type 1 and type 11 diabetes are in existence. In all diabetes cases, type 11 diabetes accounts for 90%. For instance, in West Virginia, the rate of diabetes is fifteen percent. The rest of the 11 states in this case that have a high number of type 2 diabetes are in the south. In the past two decades, the rate of diabetes growth in the U.S amplified rapidly from 5.5% to 9.3% only in 2012 (CDC n.d). Moreover, the estimates also show that 86 million Americans have prediabetes while 29 million have both type one and two diabetes. According to the CDC, one out of three adults will have diabetes by the year 2050. Most likely the senior adults (65 years and above) in this case will be diagnosed with type 2 diabetes.
The CDC also reported that in the United States, diabetes is the leading cause of death accounting for medical bills of about $245 billion each year. Between the years 1997 to 2011, the CDC reported that the average age which people were diagnosed with diabetes was around 54 years. Most of them because of the age factor developed the type 2 diabetes. In 2014, it was estimated that about 4.3 percent of people living in America who were above 20 years had both type 1 and two diabetes (CDC n.d). A Research that was done in 2016 found out that type 2 diabetes was very high in Chinese adults between the ages of 55-74 than those that were between 20-34 years. An estimated 12 out of 100,000 Chinese youth under 20 years were also diagnosed with type 2 diabetes with the symptoms starting at 14 years.
The social, cultural & medical responses to diabetes
According to the American Diabetes Association, the screening age of diabetes is supposed to be after the age of 45 years. However, the period at which a person develops this condition has different factors thus making it hard to predict accurately. Due to the broad mix of lifestyle factors and individual’s health, there are many factors which can influence the progression of diabetes. Most people in this case that have diabetes were diagnosed with diabetes have caused a substantial variation in the onset age and the age of diagnosis. Moreover, estimates have claimed that one-third of people with diabetes don’t even know they have which complicates the forecast
Culture and Diabetes Care Seeking Behaviour
Decisions concerning disease management have a close connection to the available cultural background and resources. The method in which families connect with health care providers and how they access healthcare delivery system gets influenced by cultural factors. A lot of people, as well as communities, do not regard diabetes as being a stigmatized disease yet there is still no active participation towards the prevention, screening, and care programs for diabetes mainly because of cultural beliefs, differing priorities, and limited access to services. Poor outcomes of diabetes care programs are determined by cultural factors such as low health literacy, lack of knowledge in regards to diabetes, lack of knowledge on diabetes services, lack of patient involvement, lack of family and social support, and misconception about diabetes (Gross 172).
Delay in diabetes care to the point that symptom and complications start to appear most of the time is a result of the use of folk medicine because of the misconception that diabetes is part of a divine intervention. A lot of the herbal therapies are hypoglycaemic agents, and when combined with the traditional diabetes treatment it can cause a hypoglycaemic crisis. It is however not been proven if the herbal medicines are useful in the management of type 2 diabetes. People only feel the need to use drugs when diseases and illnesses start to show signs and symptoms. This belief by people is the most significant barrier when it comes to the proper management of diabetes and adherence to treatment.
Most of the times people use the amount of pain, disability, and discomfort that an illness produces to judge its severity. It is also common for diabetes care providers to feel disappointed with their patients because of not making follow-ups of blood sugar monitoring and the early diagnosis and treatment of diabetes complications (Pasinetti 253). Some providers feel that diabetes being a chronic disease makes people from rural areas to not care about the disease or even their health. People most of the time only seek health care when their condition worsens and interferes with activities in their social and personal lives. In order to ensure complete adherence to diabetes care, it is crucial that patients get family and social support. The diabetic patients who have a strong family support tend to follow the recommendations given by care providers.
Medical treatment of diabetes
Type 1 diabetes is utilized by insulin which is a hormone that controls the amount of glucose found in the blood. Buysschaert (p.1822) stated that when insulin is used as medicine when it is genetically made or extracted from pork and beef, it usually replicates the human insulin. Diabetes can also be treated in several ways by use of insulin. Each type, in this case, is categorized on their peak level of taking action, how fast they work, the effect and the time it lasts. To avoid short term and long term complications, diabetes requires proper management and treatment. The short-term complications that occur with improper treatment are diabetic ketoacidosis and hypoglycemia.
When the patient obtains too much insulin that was not planned based on their meal, then they get hypoglycemia. Ketoacidosis, on the other hand, occurs when insulin is not taken enough. This causes urine to increase thus leading to dehydration. When the person has not treated the complications can lead to coma, shock or death (Buysschaert 1829). When type 1 diabetes is not managed and controlled, microvascular complications develop in small blood vessels of the kidneys, nerves, and eyes. It is therefore essential that everyone should monitor for the signs and symptoms of diabetes and insulin therapy so that complications don’t occur.
Conclusion
Diabetes, as elaborated in the essay, is a disease that needs a lot of awareness as the rates at which it is escalating is alarming. According to CDC diabetes accounts for about 5-10 % of world’s death. Insulin, in this case, is required to treat people with diabetes, but they have to be educated on proper administration and preparation of insulin to prevent complications that are brought by underuse or over the use of insulin. Despite the fact that diabetes has spread through the world, if left untreated it can cause a lot of deaths.
Works Cited
Arcangelo, V.P., & Peterson, A.M., (Eds). “Pharmacotherapeutics for advanced
Practice: A practical approach” (3rd). Ambler, PA: Lippincott Williams & Wilkins 2013. pp. 104- 209
Buysschaert, M. “Hyperhomocysteinemia in type 2 diabetes: Relationship to macroangiopathy, nephropathy, and insulin resistance.” Diabetes care 2000; 23: 1816-1822.
Center for Disease Control and Prevention. “Diabetes Latest: More than 29 million Americans have diabetes;” 1in 4 doesn’t know. Retrieved from http://www.cdc.gov/features/diabetesfactsheet/
Gross, J.L. “Diabetic nephropathy: diagnosis, prevention, and treatment. Diabetes Care” 2005; 28:164-186.
Pasinetti, G.M. “Caloric Intake, Dietary Lifestyles, Macronutrient Composition, and Alzheimer' Disease Dementia,” Int J Alzheimers Dis.2011; 11:206-293.
Roglic, Gojka. “WHO Global report on diabetes: A summary.” International Journal of Non-communicable Diseases, vol. 1, no. 1, 2016, pp. 3–10., doi:10.4103/2468-8827.184853.
