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Evaluation of Epidemiological Problem Diabetes

Undeniably, the healthcare sector has undergone numerous remarkable changes recently to eradicate human diseases. Unfortunately, despite these improvements, individuals continue to suffer from a wide range of diseases. In fact, these sufferings are a clear indication that healthcare renovations and technological advancements have not yet created a disease-free environment. The core objective of healthcare, which is to eradicate diseases, does not seem to be achievable in the nearest time. Diseases, for example, diabetes, continue to affect significant groups of individuals globally. In fact, diabetes is considered one of the most significant problems globally (Roglic, 2016). In fact, this disease affects people with different backgrounds despite the campaigns being conducted to educate individuals about risk factors and prevention strategies against the disease. The causative factors and the cure for this disease have not been identified yet. According to World Health Organization (WHO), diabetes subjects individuals to life-long psychological and physical suffering (2017). However, numerous studies are being conducted to determine the appropriate ways, through which patients' health can be improved. This essay elaborates on different factors associated with diabetes, including epidemiology, signs and symptoms, prevalence statistics and current state at the local, national, and global level, surveillance methodologies, screening methods, and suggests a plan to address the malady.

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Background, Description, Prevalence

Diabetes is a condition characterized by the inability of the body to process the energy obtained from food properly. The food is broken down into sugar, or glucose, which can be used by the body for energy obtainment. The pancreas is responsible for making insulin, which is a hormone, that helps glucose get into body cells. When an individual has diabetes, this means that insulin is insufficient in the body. On the other hand, the body could be unable to use its insulin properly. Thus, this causes glucose to build up in the blood, and it is the reason for the common reference to diabetes as sugar (CDC, 2017). Diabetes can affect any individual, and the risks do not depend on a person's background.

The number of individuals living with diabetes has dramatically increased, approximately by 50% (CDC, 2017). For the last ten years, there has been a considerable increase in the number of people living with this disease. Globally, the disease afflicts over 380 million people. According to WHO, by 2030, the number of individuals living with this disease will double. Today, diabetes takes more lives than breast cancer and HIV/AIDS. At least one American dies because of this disease every three minutes. Besides, diabetes is well known for causing kidney failure, stroke, heart disease, which leads to amputations, blindness, and several other complications.

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Diabetes exists in two forms: diabetes type 1 and type 2 (CDC, 2017). Type 1 diabetes is considered an autoimmune condition, whereby the body attacks and eventually destroys the cells producing insulin. Thus, this means that insulin is not produced. For this reason, glucose quickly rises in the blood as it cannot be absorbed by the tissues. The reasons for this type of diabetes are still not completely understood, and science indicates that it has nothing to do with lifestyle or diet. Approximately 10 % of individuals with diabetes suffer from type 1. On the other hand, type 2 diabetes results in malfunctioning of the body due to the inability to make adequate amounts of insulin. As a result, glucose begins to build up in the blood. The primary cause of diabetes type 2 is genetic factors (CDC, 2017). Nearly 58 % of this type of diabetes cases can be prevented by leading a healthy lifestyle. Almost 90 % of all diagnosed cases of diabetes are type 2 of this disease (CDC, 2017). Therefore, diabetes is a global problem, and a significant number of people are suffering from this malady.

Signs and Symptoms

The first symptoms of diabetes are subtle and harmless. However, once the individual experiences any signs and symptoms, which could indicate diabetes, he or she should see a doctor. Among these signs are increased urination, or polyuria, and excessive thirst, also known as polydipsia (Coates & Flannery, 2010). Due to extreme sugar built up in the blood, the kidney works in excess to reabsorb the glucose molecules. When the organs cannot manage the high amount of sugar, it is excreted into the urine. Another symptom of diabetes is fatigue. An individual will experience fatigue due to the inability of the body to function normally. When a person loses a lot of sugar as a result of frequent urination, a reduced amount of energy can be obtained by the body cells, which leads to fatigue (Coates & Flannery, 2010). Diabetes is also accompanied by blurred vision. High levels of blood sugar affect eye lenses, thus making the eyes unable to function correctly. Itchy skin and dry mouth are commonly observed in diabetics, since the body is using fluids for excess urine production, and there is less fluid left for other purposes. The patient gets dehydrated, which explains the dry and itchy feeling in the skin (Coates & Flannery, 2010). Other signs and symptoms of diabetes include extreme hunger, sores that heal at a slow rate, and frequent infections.

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Prevalence and Current State at the Local and National Level

According to prevalence data about diabetes, 9.4% of the American population had diabetes in 2015. Around 1.25 million American adults and children have diabetes type 1. Amongst the 30.3 million living with diabetes, 23.1 million have been diagnosed, whereas 7.2 million are not diagnosed (CDC, 2017). The prevalence amongst seniors is high as well as the percentage of citizens aged above 65 years (25.2%) (CDC, 2017). Precisely, the total number of seniors both diagnosed and undiagnosed with diabetes is estimated to be about 12 million. Every day, new cases of diabetes are reported, and about 1.5 million people are diagnosed with the disease each year. In 2015, approximately 84.1 million Americans aged 18 and above were reported to have prediabetes. Unfortunately, diabetes is ranked number seven amongst the leading causes of death in America as reported in 2015. Fig.1 represents the proportion of patients with diagnosed and undiagnosed diabetes concerning gender.

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Fig.1. Prevalence of diabetes concerning gender

Regarding national statistics, as reported by CDC (2017), 30.3 million individuals are living with diabetes. About 23.1 million people have been diagnosed with the diseases, while 7.2 million have not received a proper diagnosis yet. The current statistics on diabetes show that over 100 million individuals in the US are living with diabetes (CDC, 2017). The reports confirm that the rate, at which the disease is being diagnosed is steady. In fact, diabetes is a health problem that continues to expand every day. In country-level data statistics, some areas have higher rates of diabetes compared to others. Even though these findings reveal excellent progress in the prevention and management of diabetes, a significant number of Americans still suffer from prediabetes and diabetes.

Current Surveillance Methods and Mandated Reporting

Surveillance of diabetes is conducted to provide necessary information on the disease to providers and the community. The primary goals of the surveillance/monitoring are to assist in the estimation of hospitalization, prevalence, and mortality rates associated with diabetes. Monitoring also provides diabetes data to the disease control program, which assists staff in evaluating the effectiveness of the developing strategies (Roglic, 2016). The surveillance also offers technical help and consultation concerning the epidemiology of the disease, preventive measures, risk factors, and other related issues. Surveillance data among the methods, which are useful in estimating the extent of the specific problems. Some data sources and methods for surveillance systems include laboratory examination of specimens, registries, and conduction of surveys (Roglic, 2016). Surveillance methods can be of two types, namely active and passive. In passive surveillance, reports concerning the disease are received from hospitals, laboratories, physicians, or institutions. An example of passive surveillance is the Foods and Drug Administration (FDA). On the other hand, active surveillance uses diverse approaches to convey information to reporting sources. However, this method is costly compared to the passive one.

Descriptive Epidemiology Analysis of the Disease, Financial, and Social Costs

Many people lack unawareness of the causes of diabetes. They may fail to recognize the disease at its early stages. The most accurate way to identify, if the person is suffering from diabetes is the performance of blood tests. In fact, these tests determine the levels of blood sugar in the body (American Diabetes Association, 2017). The causes of diabetes can differ depending on genetic makeup, ethnicity, environmental, health factors, and family history. The primary cause of diabetes type 1 is immune system abnormality. Its excess activation against pancreatic cells leads to their destruction and inability of the body to produce insulin (American Diabetes Association, 2017). As a result, the body lacks adequate insulin supply, which leads to its poor functioning. There is no particular reason for diabetes type 1, however, some triggers might be involved, for instance, bacterial or viral infections of the pancreas, as well as chemical toxins in the food. All these factors can activate the immune system against the pancreatic cells, which experience the effects of the negative factor. Causes of diabetes type 2 are multiple, however, the most overwhelming predictor is family history. Some of the risk factors for diabetes type 2 include pregnancy, high blood pressure, and lack of exercise.

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Undeniably, the costs for individuals living with diabetes are incredibly high. The average medical expenditures for individuals diagnosed with the disease are approximately $130,700 yearly (American Diabetes Association, 2017). The estimated total costs for the management of people living with diabetes in 2012 were $245 billion. About 62.4% of this amount is used to care for diabetics and is given by governmental insurance. On the other hand, 34.4% is covered by private insurance companies (American Diabetes Association, 2017). Individuals with diabetes, who lack health insurance, have fewer visits to physicians. The total per capita expenditure amongst Hispanics is lower compared to the non-Hispanics. Besides, the total per capita among women is higher compared to men. California records the largest population of individuals with diabetes, and they suffer socially. Management of diabetes suggests strict adherence to self-care and monitoring instructions, regular exercising, diet, and glucose testing (American Diabetes Association, 2017). Thus, the disease is rather challenging for diabetics and those taking care of them, hence affecting interpersonal relationships.

Disease Diagnosis, Current National Standards for Screening or Prevention

The diagnosis of diabetes begins after an individual applies for medical help after noticing the first symptoms of the disease. The physician decides if a urine or blood test should be applied to check for glucose levels, as diagnosis of diabetes can be performed with the help of different tests. One of them is the basic blood test. If this test reads 48mmol/mol or higher, the diagnosis is confirmed. Fasting plasma glucose (FPG) is another test for diabetes. In fact, this test measures the level of glucose in an individual's blood. Notably, this is done after one had stayed for at least eight hours without drinking or eating anything apart from plain water (Kabeya, 2014). Another test is an oral glucose tolerance test (Kabeya, 2014). It measures individuals' blood sugar after staying for eight hours without any drink or meal and after two hours of taking a glucose-containing beverage drink (Kabeya, 2014). The last test is the random plasma glucose test, where the physician checks for blood glucose without respect to having a meal by the patient.

Although diabetes is a serious condition, it can still be prevented. Lifestyle factors are significant contributors to type 2 diabetes. Eating low sugar foods, healthy and low-fat diet can be a preventive method against diabetes. Besides, regular exercising can also lower or delay the onset of diabetes, especially type 2. Metformin, an antidiabetic medication delays the progression of the disease. Also, timely detection and treatment of all complications associated with diabetes, such as heart and kidney problems, can be helpful for the achievement of better outcome. Screening for diabetes is highly important, especially for people, who seem to show the signs and symptoms of the disease (Kabeya, 2014). The ideal screening test is FPG since it is cost-effective, fast, and convenient. Children, who are overweight, are also supposed to be screened every two years starting from the age of ten.

Brief Plan to Address Epidemiological Disease in Your Practice

Once I am done with education, I would like to address diabetes during my clinical practice. In my plan, addressing diabetes in my practice will involve taking numerous steps, and I am planning to use three major actions to the best outcome. The plan will include actions that individuals need to partake in every day. The first action is ensuring that patients receive their medicine as prescribed, even when they feel good. Secondly, I will ensure that they have regular meals but control their portion size. Thirdly, I will educate the patients about the importance of regular exercising and monitor for it. I will improve the awareness about the disease in the population, as I will educate people about the symptoms associated with the disease.

Conclusion

Diabetes is a disease that can affect anyone regardless of their background. Diabetes is a killer disease. Undeniably, individuals continue to suffer as a result of this disease. It is even considered one of the most significant problems globally. Despite numerous campaigns to educate people about the disease, the number of those living with diabetes is increasing steadily. Diabetes is associated with insufficient levels of insulin in the body. About 380 million are affected by the disease globally. In 2030, this number is expected to double. Diabetes type 1 and 2 are the major forms of this disease. Most signs and symptoms of diabetes are harmless and are hardly identified by the patient at the initial stages. The common ones are frequent urination, weight loss, and fatigue. In the US, approximately 30.3 million individuals live with diabetes. Persons aged 65 years and higher are especially vulnerable to this disease. The survey is one of the current surveillance methods for the disease. Diabetes can be prevented by leading a healthy lifestyle, consuming food low in sugars, and regular exercising. Overall, the spread of diabetes can be controlled by screening, which allows for its identification at the early stages.

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