Public Health in the Prevention of Diabetes Essay

Introduction

Diabetes affects people of all ages around the globe and is a major public health concern in today's society. Diabetes is a disease in which the blood glucose or blood sugar levels are too high or too low. Studies have shown that having diabetes increases one risk of developing depression (Diabetes and Depression). This disease is a huge problem which has put a strain on the healthcare system globally and causing more financial issues. According to Centers for Disease Control and Prevention (CDC) (2017) 30.3 million people or 9.4 percent of the US population have diabetes. 23.1 million People have been diagnosed with diabetes while 7.2 million people with diabetes have not been diagnosed (Centers for Disease Control and Prevention, Para. 2). This problem is a social disaster that can impact the lives of younger children and even adults. Some of the complications of this disease are cardiovascular disease, nerve damage, kidney disease, foot damage, hearing impairment and even Alzheimer disease (Diabetes and Depression). Children and adults are at risk of developing diabetes and complications if they do not take care of their health. Hence, it is very important for everyone to consider the effective public health interventions that do not contradict ethical requirements while taking care of the patients. There are several types of diabetes and several interventions that may include socioeconomic and physical environment and also some ethical concerns that may arise during the implementation stage. Studies indicate that diabetes imposes a huge economic burden to those diagnosed with it due to increased health resource and low productivity as sick people cannot work (Yang, Dall, Halder, Gallo, Kowal, and Hogan). Public health has established several programs and initiatives to reduce diabetes cases using cost scientific and cost-effective strategies. The public health approach to addressing this issue would be more of a population plan of action and not just an individual-based approach.

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Types of Diabetes

There are several different types of diabetes, some of which are more common than others. The most common form of diabetes amongst the given population is the type 2 diabetes. This form of diabetes is normally developed from what is called pre-diabetes. Hence, people who have type 2 diabetes are those people who their body is unable to produce the amount of insulin that is needed to support the body and keep the blood glucose level at a normal level. This kind of diabetes is caused by several contributing factors such as being overweight or obese, consuming too much of drinks or food with sugar and simple carbohydrates, sugar-free foods or drinks and not being physically active (Erica Oberg 18).

Another type of this disease is type 1 diabetes. This form of diabetes is most common amongst young adults and children. It is also known as Juvenile diabetes and this disease invades at any age. Having this kind of diabetes is more serious than all the others because this type of diabetes requires daily insulin injections or infusions. With this form of diabetes, the body does not produce insulin at all. Some of the symptoms that a young child or young adult may experience are using the bathroom regularly, being very thirsty, being very tired, rapid weight loss, loss of feeling in feet, blurry vision and even feeling tired all the time. There is no cure for diabetes type 1 but a healthy lifestyle can help to increase the health of a person.

Public health programs to prevent diabetes

The clinical sector plays an important role in preventing diabetes. It identifies risk status of individuals and refers those at risk of diabetes to community-based lifestyle programs (Bergman 309). It provides the appropriate nutrition counseling to individuals such as sugar food to reduce their chances of diabetes. The sector also prescribes the right medication when required and treat those who have diabetes. Public health, on the other hand, plays a significant role in monitoring the risk of diabetes, organizing partnerships to create diabetes prevention facilities for those at high risk and improving the quality of these programs. Moreover, the public health sector examines public policies that promote diabetes reduction by promoting lifestyle modification and changes to community environments that allow easier practice the healthy behaviors (Bergman, 309).

Public health has come up with several initiatives of preventing or delaying diabetes and decrease the number of people who has the disease. One out of nine people in the United States has diabetes the Congress intervened by authorizing CDC to create and lead the National Diabetes Prevention Program (NDPP) to prevent type 2 diabetes (Albright and Gregg 346). NDPP is a partnership of private and public organizations working to delay or prevent type 2 diabetes. The organizations provides people with or without pre-diabetes to participate in affordable, evidence-based, and high-quality lifestyle change programs to improve their health and minimize their risk of type 2 diabetes. The partners of this program include Healthcare professionals, employers, government agencies, public universities, local and State health departments, private and public insurers that provide affordable insurance to people. The CDC's strategic approach to the NDPP has four core elements and they include recognition, training, health marketing, and lifestyle change program sites and payment model.

Training personnel is one of NDPP strategy to prevent diabetes. A trained workforce delivers lifestyle changes in a cost-effective way which is necessary for public health sector (Albright, and Edward 347). Lay community workers and health professionals offer to counsel on the right lifestyle people should undertake to minimize their risk to diabetes. At Emory University, Diabetes Training and Technical Assistance Center (DTTAC) was established by CDC. It offers complete training services throughout the country to lifestyle coaches to equip them in their job.

Recognition Program

Another key component of the CDC is the Diabetes Prevention Recognition Program (DPRP). Its main goal is to ensure that quality and consistent lifestyle program is disseminated to people who are at risk of diabetes. It provides technical assistance to an organization who take part in lifestyle change program to prevent type 2 diabetes (Albright, and Edward 349).

Lifestyle Change Program and Payment Model

Lifestyle program change is the core element of the NDPP and to reduce the risk of diabetes. This program is offered in many locations across the country. The programs include worksites, community-based associations, and healthcare facilities. One of the lifestyle providers is the United Health Group (UHG). The most prominent core element of the National DPP is delivery of the lifestyle change program. The program is being offered at many locations, including community-based organizations, worksites, and healthcare facilities (Albright, and Edward 350). Several of these sites have recently completed the application process for program recognition. Y and UHG organizations provide a model for the delivery of lifestyle change under the Diabetes Prevention and Control Alliance (DPCA). They provide insurance to self-funded employers and other insurers who buy from DPCA.

Health Marketing

To achieve the intended success, the NDPP markets their lifestyle change programs so that more partners can buy them. The partners increase referrals and participate in lifestyle programs to ensure that all everyone will be sensitized to the disease.

Evidence that lifestyle change prevents or delay diabetes

A study was conducted by Diabetes Prevention Program Research Group to determine whether public health administration of metformin and modification of lifestyle program would prevent or delay the development of diabetes. Data were collected from 3234 participants and they were administered with 850 mg at a lifestyle change that reduced their weight by 7% per week (400). The main age of the subjects was 51 and 45% were members of minority groups (Diabetes Prevention Program Research Group, 400). They were followed up for an average of 2.8 years and the results showed that lifestyle change reduced the risk of diabetes by 58 % and metformin by 31%. Transitional studies and RCTs have proved that diabetes is prevented or delayed in those at high risk through lifestyle modification that focuses on behavior change, nutrition and physical exercise (346).

In conclusion, diabetes cases have been increasing over the years posing a burden to the country. Public health has put up several strategies and programs to prevent or delay the development of diabetes. CDC established NDPP to ensure lifestyle intervention in the country. To reduce the development of type 2 diabetes, NDPP put in components such as training workforce, health marketing, program recognition for quality assurance and program delivery.

Lifestyle changes and treatment with metformin reduces the development of diabetes in persons at high risk but studies show that lifestyle intervention is the most effective.

Works cited

"Diabetes and Depression: What You Need to Know." Healthline, Healthline Media, www.healthline.com/health/type-2-diabetes/depression#outlook.

Diabetes Prevention Program Research Group. "Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin." New England journal of medicine 346.6 (2002): 393-403. Web https://www.nejm.org/doi/full/10.1056/NEJMoa012512#t=articleTop

Albright, Ann L., and Edward W. Gregg. "Preventing type 2 diabetes in communities across the US: the National Diabetes Prevention Program." American journal of preventive medicine 44.4 (2013): S346-S351. Web https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4539613/

Yang W, Dall TM, Halder P, Gallo P, Kowal SL, Hogan PF. Economic costs of diabetes in the U.S. in 2012. Diabetes Care 2013;36(4):1033-1046. Available from http://care.diabetesjournals.org/content/36/4/1033.

Bergman, Michael, et al. "Diabetes prevention: global health policy and perspectives from the ground." Diabetes management (London, England) 2.4 (2012): 309.

Centers for Disease Control and Prevention. National Diabetes Statistics Report, 2017: Estimates of Diabetes and Its Burden in the United States. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2017. Available from https://www.cdc.gov/diabetes/data/statistics/statistics-report.html