Obesity and Diabetes Research Paper Example

Abstract

Obesity and diabetes are some of the conditions that are common in today's society. Both diabetes and obesity have been identified to cause adverse life-threatening co-morbidities and substantial economic costs; thus, perceived as a significant public health concern. It has become a norm in contemporary society to see morbidly obese individuals and to know of individuals with type 2 diabetes (T2DM). The increased levels of type 2 diabetes and obesity and the consequences of the two conditions on the population of United Kingdom inspired the research to focus on the relationship between the two life-threatening conditions. The objectives of the present study include identifying the prevalence of obesity linked to type 2 diabetes in the United Kingdom, assessing the relationship between type 2 diabetes and obesity, and evaluating the interventions available for reducing the impacts of obesity on type 2 diabetes. The review identified behavioral, social, and economic factors as some of the crucial themes that influence the prevalence of obesity and type 2 diabetes. The study reviews various studies to identify the relationship between obesity and type 2 diabetes. The findings indicate that excess weight poses a significant threat to the health of an individual. Exercise and increased physical activity have been recommended to alleviate the problem of obesity in the United Kingdom. Nurses have been recognized to have a crucial role to play in the mitigation of obesity and type 2 diabetes. The nurses are expected to advocate for the promotion of increased physical activity at the governmental level and support efforts to preserve and enhance parks since they provide the suitable environment for physical activities, walking, and bicycle paths.

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Aims and Objectives

The alarming levels of obesity and its health consequences on the population of United Kingdom has inspired this research to focus mainly on the review the relationship between obesity and type 2 diabetes. The above aim will be achieved by meeting these objectives:

• To identify the prevalence of obesity linked to diabetes type 2 in the United Kingdom.
• To assess the relationship between obesity and type 2 diabetes
• To evaluate the interventions available for reducing the impact obesity on type 2 diabetes.

Background StudyObesity and diabetes are emerging pandemics in the 21st century. Both are major public health problems throughout the world and are associated with significant, potentially life-threatening co-morbidities and enormous economic costs. The prevalence of overweight (body mass index (BMI) between 25 and 30 kg/m2) (WHO, 2000) and obesity (BMI of 30 kg/m2 or higher) is increasing rapidly worldwide, especially in developing countries (Aucott, 2008). Similarly, there has also been a steady rise in the incidence and prevalence of type 2 diabetes mellitus. According to Guh (2009), it can be said that many individuals with type 2 diabetes (T2DM) are overweight or obese; however, in examining obese or overweight individuals, it is not always the case that these individuals have T2DM but a significant number will have T2DM (Roelants et al., 2009). This relationship between obesity and T2DM leads to the assumption that the two conditions are interconnected.

Obesity and T2DM are conditions where their cause is directly related to the habits and lifestyle practices of the individual. Obesity and T2DM are largely preventable with a change in lifestyle and avoidance of sedentary habits and over-consumption of energy (De Onis et al., 2009). The excess calorie intake along with the inadequate burning of calories with activities such as exercise leaves the body in a state of positive energy balance. This positive state of energy balance causes the body to retain both fats and sugars.

WHO (2000) defines "obesity" as a BMI equal to or more than 30. BMI, calculated by weight (kg)/height (m2) and adjusted for sex, is used as a measure of weight standards. Although there can be many contributing factors for obesity, including genetics, diet, exercise, underlying medical condition like Hypothyroidism or Cushing's Disease, obesity is more commonly related to irregularities in diet and physical activity. The daily recommended calorie intake for healthy adults is approximately 2000 calories per day for women and 2500 calories per day for men. In the case of an obese individual, the consumption of calories exceeds the recommended amount. In addition to the excess in the calorie intake, there is also a deficit for calories that are burned by physical activity or exercise. These two factors together create a state in the body where there is storage of the excess calories as fat, leading to a gradual increase in body mass. Individuals with obesity, compared to individuals with a body weight that is within healthy range are higher risk for experiencing other serious health disorders that include T2DM, Coronary heart disease, hypertension, and many more disease processed. These individuals have an overall increased rate of mortality.

Diabetes according to the world health organisation (WHO, 2016) is a common metabolic disorder that is defined by chronic hyperglycaemia. The constant state of hyperglycaemia over a period of time will lead to severe damage to vital organs such as the heart, blood vessels, kidney, eyes and nerves added WHO, (2016). Type 2 diabetes (T2DM) is a condition of insulin resistance and relative insulin deficiency, in which hyperglycaemia develops when a person's v-cell function is no longer sufficient to meet their insulin requirement (Stewart, 2005). Insulin resistance is common in people with T2DM and exacerbated by obesity, but individuals with normal weight can develop T2DM if their v-cell function is sufficiently compromised (Fleming et al, 2014). The interplay between the degree of insulin resistance and the level of v-function is likely to contribute to the heterogeneity of T2DM presentation, especially in non-obese individuals (Wilks et al, 2007). The identification of Monogenic causes of Maturity onset diabetes of Youth (MODY), which are unrelated to obesity, has reinforced the notion that 'classical' T2DM is linked to obesity and that all non-obese people may probably have a different diabetes subtype (Roberts, 2015). The perceived relationship between T2DM and obesity, however, has not always been obvious. In the 1970s, when the average weight of the UK population was considerably less than at present, the Whitehall study showed only a small association between obesity and T2DM (Wu et al., 2009). At that time, it was considered that there was no major effect of obesity on the development of T2DM (Naidoo and Wills, 2007). It has since been studied that there is a correlation between Obesity and T2DM. The prevalence and incidence graphs of these 2 conditions have been parallel in its rise over the years.

It has become quite common in our communities to see morbidly obese individuals and also common to know of individuals with type 2 diabetes (T2DM). It is not an unknown phenomenon for the individuals that we encounter with obesity to have T2DM or the individuals with T2DM to be obese. It is also not unknown that the rise in individuals with T2DM and obesity is linked to the poor lifestyle behaviors in dietary choices and physical activity. Statistics of the prevalence and incidence of obesity and diabetes have been on a steady rise over the past years, becoming more of a norm than an abnormality. This paper will discuss the interconnectedness of these two conditions and delve into solutions and strategies that can curb the upward ticking prevalence and incidence. These strategies can assist practitioners to provide the best care for this patient demographic and put pressure on public health policymakers to provide the necessary support. The strategies and solutions will focus on the importance of the role of the nursing staff in mitigating this new epidemic they are facing while managing patients.

Introduction

Diabetes is a chronic multisystem disease all over the world. Diabetes affects more than 180 million people worldwide, and the number of patients diagnosed with diabetes is anticipated to increase to 300 million by 2025 (Mozaffarian et al., 2016). Since we live in a global community with increased migration patterns, we see this projection in influx of diabetic patients will represent a significant increase in the diabetic population of the UK. A series of recent studies have indicated that a rise in T2DM in both developed and developing countries has posed one of the most serious public health challenges of the 21st century (Albright 2007, Chen et al., 2012). The mortality rates of the people that belong to this demographic will increase significantly. Mathers and Loncar (2006), proposed that diabetes will be the seventh prominent cause of death globally by 2030. Along with the increase in mortality rates experienced because of the growing demographic of diabetes we also have increase strain on the finances of the National Health Service system in the UK. Diabetes was estimated to cost the National Health Service (NHS) 9.8 billion, of which 1 billion is spent for type 1 diabetes and 8.8 billion for type 2 (Diabetes,2017). Diabetes care is estimated to account for approximately 5 percent of the total UK healthcare budget and 10 percent of NHS expenses (Nice, 2015).

According to the Public Health England (2017), more than one in five children in reception stage at primary school were overweight or obese between 2015 and 2016. This number had greatly increased to more than one in three children by the time they reached Year 6 with an average age of 10 to 11 years old. The latest National Health Service (NHS) review into obesity in England has revealed 58 percent of women and 68 percent of men are obese (Public Health, 2017). This review puts to light that more than half the population of men and women in England are afflicted with obesity. Compared to the previous year's report, obesity prevalence percentage for women remained the same at 58 percent, whilst the figures for men raised from 65 to 68 percent (Public Health, 2017). The statistics released by NHS Digital in the Statistics on Obesity, Physical Activity, and Diet in England 2017, showed there were 525,000 admissions to NHS hospitals across the country between 2015 and 2016 where obesity was a factor. Obesity has been shown to increase the risk of insulin resistance and type 2 diabetes among many other diseases (Public Health England, 2017).

Diabetes and obesity have placed heavy health and economic burdens on individuals and on health systems across the world. The interconnection between the incidence of insulin resistance and the presence of obesity is found in all ethnic groups, and across all ages in both men and women (Kodama et al., 2012, Abuyassin and Laher 2015). About 90% of adults with type 2 diabetes are overweight or obese (Diabetes UK 2016). Several studies suggest that the risk of type 2 diabetes and likelihood of insulin resistance rise as body fat content increases. This implies that the absolute amount of body fat is positively correlated with increase of insulin sensitivity (Man et al 2016). It is well established that individuals who develop type 2 diabetes have a higher body weight, either being overweight or obese when compared to individuals of control population that do not have T2DM (Bugianesi et al., 2010). These strong associations between obesity and the development of diabetes lend to the importance of weight management if both the case of treating and preventing diabetes and obesity.

Intervention studies in which modest weight loss has been achieved...