The World Health Organization describes diabetes mellitus (DM) as a chronic disorder where the patient has unhealthy glucose levels in the blood. It occurs when a patient's immune system fights and destroys insulin-producing cells. Without insulin, the body has trouble regulating glucose levels in the blood. Diabetes mellitus comes in three forms: gestational diabetes, type 1 and type 2 diabetes. Type 1 diabetes is caused by the failure of the pancreas to produce insulin and type 2 occurs when the body does not respond to insulin action as it should (WHO, 2018). Gestational diabetes first progresses during the prenatal period. The level of glucose in the blood returns to regular after delivery. The mother and child are at higher danger of developing type 2 diabetes later in life too. Diabetes mellitus in the society is shaped by cultural patterns, cultural standards, technology, and social inequality (Macionis and Gerber). This paper will be based on Macionis and Gerber text book chapter 21 "Health and Medicine" to show social determinants of DM, and theoretical views on how it is perceived by the society
In Canada, the Aboriginals, people of Hispanic, Asian or African descents are more prone to getting diabetes than the Caucasian population. Diabetes prevalence among the Aboriginal population was reported to be three times more than in the overall populace (Diabetes Report, 2005). Unhealthy lifestyles, obesity, poverty, age, and genetic inheritance are some of the causes of diabetes mellitus. Women are at a higher risk of getting diabetes than men in marginalized populations in Canada (Diabetes Report, 2005). When compared worldwide, diabetes prevalence is lower in Canada than in low and middle-income countries, but high when compared with her peers (first world countries). In Ontario, diabetes prevalence had exceeded the predicted global rate in 2030 by 2005. This upsurge in incidences is contributed to by the growing speed and decreasing mortality rate (Lipscombe and Hux 2007).
diabetes mellitus should concern everybody involved. According to Public Health Agency of Canada (2011), 6.8% of Canada citizens are diabetes victims. The trends indicated that diabetes rates had almost doubled over the past decade and one person in three living would be living with diabetes going at that rate. With the cost of diabetes anticipated to grow to $16 billion in 2020 from $11.7 billion in 2010, urgent attention ought to be given to it (Diabetes Report, 2005). the growing burden calls for immediate action on diabetes to prevent collapsing of the Canadian healthcare system.
Diabetes not only affects the health of people living but also the populace as a whole. The cost of curing the disease is on upward escalation and this burden falls squarely on the shoulders of the Canadian citizens. To understand why diabetes should be classified national hazard, one needs to see its economic implications, other ailments relatable to diabetes and its effect on families, especially those in the low-income side of the equilibrium.
Complications Associated with DM
Diabetes complications are divided into micro-vascular and macro-vascular complications (WHO, 2018). Micro-vascular problems include eyes impairment that leads to blindness, kidney damage that leads to renal failure and nerves damage leading to impotence and diabetic foot disorders. Macro-vascular complications are more lethal, that is, they can lead to death or have life lasting effects. They include heart attacks, stroke, and insufficient blood flow to the legs.
Combating these complications is draining to the patient and his family and to the Canada Healthcare system. The lead cause of blindness in Canada is diabetes, an unfortunate scenario. Eighty percent of Canadians with diabetes die from stroke or heart attacks. Of all non-traumatic limp amputations recorded, diabetes is solely responsible for over 70% of them (Canadian diabetes, 2005). This is not to mention the shortened life expectancy of diabetes patients.
Depression and schizophrenia are two psychological diseases that are more common among persons with diabetes than among those without. Complications such as loss of sexual impotence will most definitely lead to feelings of low esteem and depression. Diabetes patients are stigmatized and judged because of their conditions, and this causes more depression (Canadian Diabetes Association, 2005).The risks of suicide get higher when people lose their will to live. The negative effects of diabetes cannot be ignored anymore. To mitigate these losses, it is imperative that the disease is given more attention.
Economic Burdens of DM
The economic costs of a disease are grouped into direct and indirect costs. Costs incurred by individuals and their families or insurance firms are classified under direct costs (Public Health Agency of Canada, 2011). Indirect costs are the non-health care charges that negatively affect the economy, for example, when output lost due to illness, disability, or passing of a person in their prime.
The treatment and service costs are determined by relating the amounts of incidence or use to the number of people with diabetes by age and sex over time. Directs costs in healthcare expenditures include direct hospitalization costs, cardiovascular diseases costs, general practitioner costs, specialist costs and diabetes medication costs. The net difference between outlays of a diabetes patient and non-diabetic people represents the extra costs attributable to MD (Canadian Diabetes, 2009). Other costs that attributed to diabetes include long-term care costs, public health spending and capital spending by the healthcare sector, and the direct costs associated with third-party support such as family caregivers or volunteer healthcare activity.
Diabetes increases the cost of living for its patients. Affordability and availability diabetes drugs, devices and supplies differ reliant on your location in Canada, and the public programs and services available. While some locations have increased support for diabetes victims, costs continue to be the main hindrance to better living standards.
Nationally, the economic burden of diabetes mellitus was estimated to be $12.2 billion in 2010. The cost of the disease is projected to reach $15.36 billion by 2020 (Anja and Laura, 2017). This is about 3.5% of the Canadian expenditure being used to fight diabetes. The sustainability of the Canadian health care system and of the economic progression is threatened by this additional burden.
Groups Vulnerable to Diabetes
The risk of diabetes mellitus and cardiovascular diseases increases in certain conditions. One of the conditions is the metabolic syndrome. Symptoms of metabolic syndrome are elevated waist lengths, elevated triglycerides, blood pressure, and fasting plasma glucose. Its risk factors include age, family hereditary, obesity, and physical inactivity.
Women are prone to developing gestational diabetes. Female suffering from obesity, with hereditary genes, history of glycemic metabolism, or belonging to an ethnic group with high prevalence of diabetes has bigger risks of suffering DM. Age is also a determinant of whether a woman is at risk of getting diabetes mellitus. Women diagnosed with gestational diabetes are at greater risk of pre-diabetes and type 2 diabetes in the first five to ten years following the birth of their baby.
Some ethnic groups are more risks of getting diabetes than other ethnic groups. People of South Asian, Hispanic American, Chinese, and African lineage have a greater risk of developing type 2 diabetes than those of European descent. This is attributed to the different dietary habits of the ethnic groups. For example, the Caucasians tend to eat more vegetables and fruits than people from China and Philippines do.
Immigrants to Canada from non-European nations are known to have higher rates of diabetes than immigrants of European descent. The age, education, income, and place of origin of immigrants means the risk of diabetes among the immigrants vary (Assaris et al. 2017). There is evidence that newly immigrated aliens have low incomes and limited access to health services than the common Canadian citizens. This makes these segments of the population vulnerable to diabetes mellitus.
Prevention and Cure of Diabetes Mellitus
It is critical that necessary action is taken to prevent diabetes from getting any worse. Prevention at the personal and community level is critical. Minimizing the occurrences of obesity greatly reduces the risks of developing diabetes and other relatable complications. Actions recommended are inclusive of improved surveillance, healthy eating, and increased physical activity, and form diabetes prevention and management programs. Actions taken early enough will enhance and save lives and at the same time improve our economic health and the future prosperity of Canada.
Maintenance of body weight, partaking in physical activities, and healthy eating is the principal objectives of public health intervention intended for preventing diabetes mellitus. In order to achieve these objectives, there is need to decipher the intended patients' ability to adopt healthy habits. Most of the unhealthy habits are influenced by factors above the patients' control such as income, education, employment, food security, and access to medical care. Only after understanding the conditions that the individuals are living through can you be able to advocate for appropriate healthy behaviors and choices.
Physical activities are influenced by personal and interpersonal attitude and motivation. However, access to walking pathways increases the chances of individual citizens taking up physical activities of one sort or another. The presence of urban sprawls demotivates people from taking physical activities. As such, it is recommendable that the government of Canada makes considerable investments in the facilities like pathways, cycling lanes and generally encourages physical activities.
Other health promotional techniques, which should be adopted in institutions as well, includes increasing the time for physical activity in schools, providing access to community recreational facilities, starting educational campaigns, teach future generations on healthy eating and sponsoring walking clubs in the locals. Prevention and health promotion strategies should be tailored to address the needs of the targeted population segment's needs. The level of health literacy of the target populace should be considered. Health literacy is a person's ability to understand, and use written information.
Active public-health intermediations for people living with diabetes are needed. Further, more resources should be allocated to help manage the ever-increasing number of diabetes patients. By adequately fighting diabetes, the efforts will help not only at-risk individuals and their families, but also enable the Canada economy to grow by reducing the burden of DM (Lipscombe and Hux 2007).
Anja, B., and Laura, R. (2017). The cost of diabetes in Canada over 10 years: applying attributable health care costs to a diabetes incidence prediction model. Health Promot Chronic Dis Prev Can, vol. 32, issue 2. Pp. 49-53
Assari, S., Lankarani M.M., Piette, J.D., and Aikens J.E. (2017). Socioeconomic Status and Glycemic Control in Type 2 Diabetes; Race by Gender Differences. Healthcare
Canadian Diabetes Association (2005). Diabetes: Canada at the tipping point, charting a new path. Diabetes Quebec.
Cheng, A. Y. (2013). Canadian Diabetes Association 2013 clinical practice guidelines for the prevention and management of diabetes in Canada. Introduction. Canadian Journal of Diabetes, 37, S1-3.
Lipscombe, L. L., & Hux, J. E. (2007). Trends...
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