Introduction

Diabetes (or Diabetes mellitus) is one of the most widely known diseases. However, many people are not well educated on the types, prevention, or the complications associated with diabetes.  The World Health Organization predicts that “diabetes will be the seventh leading cause of death in 2030” (World Health Organization, 2017). This is due to the fact that diabetes causes other chronic complications that can result in fatality. For example, it causes strokes, kidney disease, and heart disease. Educating people on prevention and treatment of diabetes is important because it will decrease its incidence with time. Furthermore, this paper mainly covers basis on major forums of diabetes, who is at risk, and what can be done do decrease its prevalence.

Pathophysiology of Diabetes

This disease affects multiple organs. First of all, when we digest food, it becomes broken down into glucose. The glucose gets into the bloodstream. As soon as this occurs, our blood glucose levels increase. Because of this, the pancreas is signaled by the beta cells to make insulin. In type 1, the beta cells are destroyed and it causes ketones (proteins) to be excreted in the urine. This phenomenon is a characteristic of diabetic ketoacidosis. Diabetic Ketoacidosis. In type 2, it is a combination of inadequate secretion of insulin and insulin resistance caused by the beta cells. If high glucose levels are maintained for an extended period of time due to noncompliance, it can lead to Hyperosmolar Hyperglycemic Nonketotic Syndrome.

 

Prevalence/Incidence

 Diabetes is more prevalent now than in the past because of increased obesity rates and unhealthy eating habits that Americans have. In 2015, “30.3 million Americans, or 9.4% of the population, had diabetes” In Seniors, the “percentage of Americans age 65 and older remains high, at 25.2%, or 12.0 million seniors (diagnosed and undiagnosed).” (National Institute of Diabetes and Digestive and Kidney Diseases, 2017). The incidence of newly diagnosed cases in the U.S. has increased in the past decade. According to the National Diabetes Statistics Report, in 2015, “an estimated 1.5 million new cases of diabetes (6.7 per 1,000 persons) were diagnosed among U.S. adults aged 18 years or older and more than half of these new cases were among adults aged 45 to 64 years, and the numbers were about equal for men and women. At alarming rates, a solution needs to be implemented to combat diabetes head on.”

 

Symptomology

There are two types of diabetes, type 1 and type 2. Type 1 diabetes is an autoimmune disease.  It completely stops your pancreas from making insulin. Type 1 is linked to skinny and younger people where type 2 is linked to obese and older people.  As of right now, there is no cure for type 1 diabetes and people will have to receive insulin daily for the rest of their lives.  With Type 2 diabetes, the pancreas makes insulin insufficiently. Unlike Type 1, it can make insulin but it is not enough insulin for your body to continue functioning efficiently. “Most people with diabetes—9 in 10—have type 2 diabetes” (Centers for Disease and Control Center, 2017).  If you are at risk or have prediabetes, it is important to have glucose testing frequently because Type 2 can be symptomless at first. When symptoms are present they can include frequent urination, blurry vision, sores that slowly heal, numbness in the extremities and weight loss. Genetics can play a role but prevention is definitely key! Losing weight, drinking plenty of water, physical activity and stress reducing activity will help delay or prevent this disease.

 

Social Epidemiology

Diabetes has many factors. Researchers have found that lifestyle choices and genetics are associated with this disease. However, education, ethnic background, and socioeconomic status play a role as well. People who are more educated have access to the tools for preventing diseases such as diabetes.  This explains why people who went to college have the lowest risk of getting diabetes no matter which racial or genetic group that they fall under. Out of all the racial groups, African Americans are more susceptible to diabetes.  Poor diet is a risk factor of diabetes among all racial groups, however, it is more prevalent in African Americans. African Americans often consume foods high in unhealthy fats and sugar. They also have a diet low in vegetables. It is also believed that African Americans have a gene that can cause Diabetes. It is believed that African Americans acquired a gene during American slavery. This gene is believed to have been used for storing fats and sugars that they were deprived of. Although, this gene is now causing African Americans health issues due to excessive storage of fats and sugars. Household income can also predict if a person will get diabetes. “Households with $50,000/year in income had half as much a rate of incidence (5%) as those which have $35,000/year (10%)” (AJMC,2012).  As you age, the risk of diabetes becomes higher. A higher prevalence chronic illness means that bad health becomes associated with old age. “IN the U.S. the leading causes of death among people 65 or over are chronic conditions: heart disease, cancer, chronic respiratory disease, stroke, Alzheimer’s, and diabetes” (Quadagno, 2018). Moreover, the risk of a chronic disease, such as diabetes, rises significantly higher in people that are older than 75 years old. 19 % of people 75 years or older have diabetes, which not that high when compared to other chronic diseases (Quadagno, 2018).  However, this decline is due to the fatalities from diabetes.

Policy Suggestions

Implementing a policy needs to be done to combat diabetes and ensure that people maintain a quality of health. Also, coming up with a policy would eradicate other chronic illness that are caused solely by diabetes. First of all, there needs to be some type of restriction against sugary foods and sugary drinks beginning within the next few years. I propose that the government stops the promotion of foods and drinks loaded with sugar.  “It is well recognized that price promotions are key to increasing sales and this is particularly evident in the Eastern Mediterranean Region where sales of sugar-enriched soft drinks have been increasing rapidly over the past two decades” (World Health Organization 2017). Moreover, price promotions lure the consumers to buy and consume the product. Second of all, diet and exercise promotion programs need to be implemented by 2025. These programs should be offered to all adults no matter what age they are. Moreover, programs that are tailored towards older adults should be implemented as well. Since diabetes is highly prevalent in older adults, prevention programs can be created to improve glucose control and weight control. Since diabetes is also highly prevalent in African Americans, they need to have access to programs and education on prevention.  Last of all, governments need to subsidize healthier foods to make them cheaper and more available to the lower income households. This plan could be implemented by 2030 and would require the government to almost eliminate subsidies on unhealthy foods. The money that the government would use on unhealthy foods will be used on healthier foods.

 

Conclusion

More time and funding needs to be focused on diabetes. More and more American people die of complications from diabetes that otherwise could have be prevented. Data and statistics collected over the past few years further validates that there is an issue with the rate of people being diagnosed with diabetes. Furthermore, implementing a policy to combat diabetes needs to be followed through to improve the populations’ quality of life.