The United States has become known as a fast food society so it is no wonder that the increase of incidences related to chronic diseases have increased. Most Americans spend their time working longer hours and spend less time working out. Healthy People 2020 identify health issues and create health objectives associated with health issues. Diabetes is also referred to as Diabetes Mellitus and has three types: Type one, Type two, and gestational diabetes. Diabetes impacts an enormous portion of the population as well as having detrimental effects on health.
Federal, state, and local governments continually assess how to address this growing health issue. “Diabetes affects an estimated 23.6 million people in the United States and is the seventh leading cause of death” (U.S. Department of Health and Human Services, 2013). The prevalence of diabetes is expected to continue to rise so creating goals, objectives, and educational forums that are easily accessible to the diabetic populations is critical for reducing the incidence.
What is Diabetes?Diabetes “occurs when the body cannot produce or respond appropriately to insulin. Insulin is a hormone that the body needs to absorb and use glucose (sugar) as fuel for the body’s cells” (U.S. Department of Health and Human Services, 2013). When blood glucose levels elevate and remain elevated then other body systems are adversely affected. Type one diabetes is when the body cannot produce insulin resulting in life-long insulin injections.
Type two diabetes is when the body becomes resistant or loses the ability to produce insulin. Gestational diabetes occurs in pregnancy and can be a precursor to type two diabetes later in life.Prevalence and Cost of DiabetesAccording to the American Diabetes Association, there are 18.8 million people diagnosed with diabetes, seven million undiagnosed, 79 million patients that are prediabetic, and one point nine million new cases of diabetes diagnosed in people under twenty years old. “Average medical expenditures among people with diagnosed diabetes were two point three times higher than what expenditures would be in the absence of diabetes” (American Diabetes Association, 2013).
Local, State, and Federal Management of DiabetesThe Tacoma Pierce County Health Department (TPCD) is a local community source for information obtained regarding diabetes. “Diabetes exacts a large and growing toll on the people of Pierce County. About 38,000 adults are currently estimated to be diagnosed with diabetes and about 18,000 more have type 2 diabetes but don’t know it”. TPCD monitors and analyzes diabetes as well as the population affected by the disease.
In Pierce County, there is no specific portion of the population affected by this disease it is found to affect the entire population. “Although diabetes care is costly, there is little evidence that economic barriers play a major role in disease management”. Goals for diabetic education are primary prevention, early detection and treatment, and prevention of complications related to diabetes. Primary prevention is described as optimal weight management and other lifestyle modifications that are beneficial.
Early detection and treatment is a challenge at times because symptoms can be vague or similar to other medical diagnoses.Prevention of diabetic complications includes education about retinopathy, neuropathy, and nephropathy. Public Health is managed and addressed through the coordination of local, state and federal levels. Federal levels include national associations that regulate and govern public health to assist with disease management as well as setting goals and objectives. According to Landrum, Beitsch, Turnoch, & Handler (2008), The National Public Health Performance Standards (NPHPS) program is a CDC-led partnership of national public health organizations (NACCHO, ASTHO, the National Association of Local Boards of Health—NALBOH, the Public Health Foundation, the American Public Health Association, and the National Network of Public Health Institutes) to improve public health systems through the development and application of local and state-based performance standards. According to WHO, they aim to stimulate and support the adoption of effective measures for the surveillance, prevention and control of diabetes and its complications.
Models Used to Determine and Analyze DiabetesThe Mobilizing for Action through Planning and Partnerships (MAPP) “model supports the identification of strategic community health issues by the findings of four assessments: the community health status assessment, a forces of change assessment, a community themes and strengths assessment, and a local public health systems assessment”. MAPP is a planned process that is community focused on community health. This strategic model emphasizes public health issues and available resources in the community. Some measures in the community focus on prevention in the strategic model.
Prevention of diabetes can be “simple lifestyle measures that have been shown to be effective in preventing or delaying the onset of type two diabetes” (WHO, 2013). Community and Targeted Population with DiabetesThere is no population that is excluded from diabetes, this disease affects the old to the young, has no ethnic, gender, race, or intellectual biases. Each community has a department of social and health services providing education, medical resources, and many supplementary services associated with kids and health as well as food assistance. Education is the key when providing individuals in communities about diabetes and the potential consequences of diabetes. Public health awareness needs to improve its campaign for increasing physical activity and increase healthy living.
Diabetics exist in all communities, so by doing broad-spectrum education about improving health will thereby have a positive effect on all diabetics. Epidemiology Tools and Surveillance of Diabetes“Epidemiology is the branch of medical science that investigates all the factors that determine the presence or absence of diseases and disorders” (NIH, 2010). Diabetes has existed as a serious disease that epidemiologists have been able to evaluate the incidence, prevalence, burden of disease, as well as the cost. Surveillance is used as an epidemiology tools because “surveillance can directly measure what is going on in the population, it is useful both for measuring the need for interventions and for directly measuring the effects of interventions”. Surveillance provides evidence enabling public health leaders to manage and make effective decisions. “The WHO Global strategy on diet, physical activity and health complements WHO’s diabetes work by focusing on population-wide approaches to promote healthy diet and regular physical activity, thereby reducing the growing global problem of overweight and obesity” (WHO, 2013).
Obesity is global problem and is linked to increased incidence of diabetes or glucose intolerance.Conclusion“Diabetes is a chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces” (WHO, 2013). Increased education and research has created a greater awareness of diabetes and has improved methods to control the disease. Although further education will be necessary to reduce the incidence of the diabetes, there is a longer life span associated with diabetes as a result of improvements in medications. Epidemiologists continue to research diabetes in hopes of finding better methods to control this disease.
Healthy People 2020 continue to identify various medical issues that need to be addressed with associated goals and objectives. In addition to Healthy People 2020 there are legislative actions in place to improve the education about diabetes and other major disease that are have become an epidemic across the country. The trend for diabetes is continually increasing but with increased public awareness and education this disease can be altered causing a downward shift in diagnosis. We as health care professionals are responsible for ensuring optimal health education and encouragement for better lifestyle choices so patients can make necessary adjustments for optimal health.
