Diabetes is one of the four major non-communicable diseases
ABSTRACT
Diabetes is one of the four major non-communicable diseases that cause millions of deaths across the globe. The focus of this paper is on the increased rates of Diabetes among middle-aged individuals in Baltimore, Maryland. In Baltimore, undiagnosed Diabetes has posed a significant public health concern with very costly public health implications among the residence. With this fact, it is crucial to look into the burden as well as risk factors that are associated with Diabetes in Baltimore to inform policy and national programs.
INTRODUCTION
Among middle-aged adults, hypertension is known to accompany type 2 diabetes, although it’s not known how early in life, blood pressure begins among individuals who later develop Diabetes. In Baltimore, the prevalence, as well as incidences of type 2 diabetes, has been on the rise over the years hence rising concerns regarding worsening population health status as well as the ever-rising health care costs. Clinicians, policymakers as well as individuals with Diabetes especially among young adults are increasingly focusing on improving the management of HBP including the attainment of glycemic control, blood levels and lipid, as well as blood pressure targets which have been evident in randomized controlled targets to decrease some diabetic complications (Tao, Shi & Zhao, 2015). In spite of the fact that most of these efforts have been focusing on the improvement of diabetic management performance of physicians as well as other providers, self-management of Diabetes by individuals is critically significant towards attaining diabetes care targets and decreasing complications among middle-aged adults in Baltimore.
BACKGROUND
Diabetes occurs when the individuals’ blood sugar, also known as blood glucose, is too high hence causing health problems over time. Major types of Diabetes include; gestational, type 2 and type one. Diabetes symptoms include; blurred vision, unexplained loss of weight, feeling tired, increased thirst and urination. In the United States, an estimate of 30.3 million has Diabetes which is 9.4% of the country’s population. Those already diagnosed are estimated to be 23.1 million which is 7.2% of the U.S population while those undiagnosed are estimated to be 7.2 million adults aged 18 years and above which is 23.8% of those with Diabetes. As per the American Diabetes Association’s Economic Costs of Diabetes in the U.S, the estimated costs of diagnosed Diabetes in 2017 was $327 billion which includes $237 billion in direct medical cost as well as $90 billion in reduced productivity.
PREVALENCE/INCIDENCE
Diabetes, as well as pre-diabetes, are a prevalent and very serious condition that can result in complications such as kidney disease, amputations, vision loss, stroke, as well as heart disease. In the city of Baltimore, 467,041, which is 10.2% of the middle-aged population, have Diabetes. 10.5% among those without Diabetes have told that they have pre-diabetes. As per the CDC, 9 out of 10 individuals are not aware they have pre-diabetes. A survey conducted in 2014 by the community health indicated that those who reported they had Diabetes were 12%compared to a previous report in 2009 in Baltimore city where those who reported having Diabetes were 14%. Between 2010 and 2014, the rates of hospitalization for Diabetes type two as well as hypertension decreased by over 20%. For diabetes type one there was a slight increase of 5% in the rate of hospitalization between 2010 and 2014.
HISTORICAL CONTEXT OF THE PROBLEM
In Baltimore, smoking and alcoholism and use of hard drugs is a major practice by young adults, and these are major causes of Diabetes. Approximately, 20,000 individuals in Baltimore are active users of heroin with thousands more misusing prescription of opioid, and the prevalence of Diabetes cannot be addressed without addressing opioid and overdose (Rawshani et al., 2018). Moreover, the food we eat turns into sugar which is used by the body for energy. The pancreas makes insulin which allows the sugar in the blood to get into the body cells. Whenever the body cannot use insulin in the right way, the sugar is unable to move into cells but instead stays in the blood hence insulin resistance. The buildup of sugar in the blood, therefore, causes pre-diabetes. Individuals who are overweight are never physically active and have diabetes history in their families are much likely to get pre-diabetes.
SIGNIFICANCE OF THE PROBLEM
In Baltimore, the prevalence of middle adults suffering from Diabetes cannot be understood without understanding the effects of systemic discrimination on the community. As a result of industrialized discrimination, policies, such as the federal housing administration’s “redlining,” Baltimore suffers significant racial as well as economic health disparities. Baltimore also suffers disparities between the predominantly black as well as the predominantly white neighbourhoods within Baltimore city. In Baltimore, the comparison amid areas with the highest life expectancy and those with lower life expectancy shows a staggering 20-years difference.
LITERATURE REVIEW
In the United States, Diabetes is growing at an epidemic rate. As per the Center for Disease Control and Prevention, it is evident that about 30 million Americans suffer Diabetes and face its devastating consequences. On a previous study conducted by the American Diabetes Association, it is notable that an estimate of 623,000 individuals in Maryland or 12% of the population has Diabetes (American Diabetes Association, 2018). Among these, 156,000 of them have Diabetes but are not aware. Moreover, 1,634,000 or a staggering 36.9% of Maryland’s population have pre-diabetes. Over the years, the American Diabetes Association in Baltimore has been committed to educating the public about stopping Diabetes as well as supporting those already affected.
INTERVENTIONS
Diabetes is a major social problem across the globe demands re-education as well as the reorientation of healthcare professionals and healthcare setting preparedness from healthcare professionals and the relevant stakeholders and robust national policies as well as strategies monitored and owned by national authorities. Healthcare promotions should, therefore, include the following strategies.
- Reorient health services,
- Establishment of a healthy public policy,
- Development of personal skills,
- Strengthening of community action,
- Creation of a supportive environment.
Since Diabetes is a serious disease that one cannot be able to treat on his/her own, doctors will often help their patients in a treatment plan that is easily understandable. One might also need other healthcare professions to assist in the treatment plan and may include eye doctor, nutritionist, foot doctor and a diabetes specialist known as an endocrinologist (Kuo et al., 2017). The treatment of Diabetes involves keeping a close watch over blood sugar level, and this is achieved by keeping the blood sugar level at a goal set by the doctor with a combination of diet exercise, as well as medication whenever diabetes patients pay close attention to when and what they eat, it is possible to avoid or reduce the “seesaw effect” of rapidly changing blood sugar levels which may need a quick change of medication dosage especially insulin.
IMPLICATIONS
Social workers have a unique role in facilitating the early intervention services that minimize the impact and burden of Diabetes. Typically, social workers assume the role of counselor, change agents for clients, resource broker, educator, advocate and community change agent in early intervention services. Social workers recommendation for improving early intervention in the treatment of Diabetes include the creation of opportunities that foster the ability to deliver beneficial services to patients, advanced training in medical conditions as well as more experimental-based learning. The role theory framework is applicable in understanding the role of social workers provided one identifies a useful tool for understanding, identifying as well as managing the role demands of social workers in interventions with diabetes patients. Furthermore, the state must help towards achieving affordable healthcare for the general public as well as finance more research on the possible reduction of Diabetes among residence in Baltimore.
DISCUSSION
From the findings above, it is evident that a substantial number of middle-aged as well as other adults in Baltimore suffer Diabetes and have health status challenges that could make it difficult to control. Moreover, some individuals suffer impairments such that some diabetes management interventions like glycemic control at usual targets could have limited benefits (De Boer et al., 2017). In this case therefore, health department as well as social workers ought to undertake early intervention for pre-diabetes individuals so as to avoid the development of type 2 diabetes as well as avoid the development of serious health issues such as kidney failure, heart attack, blindness, as well as stroke, loss of toes, feet or legs. For the purpose of preventing any further complications with pre-diabetes as well as Diabetes, it is recommendable that the Centers for Disease Control and Prevention to establish a National Diabetes Prevention Program.
Ultimately, a National Diabetes Prevention is a program that offers an environment where people are able to learn, try new things, as well as build new habits while improving their health and lowering the risk of type 2diabetes. To achieve a successful group-based program, it is made up of 12 members and consists of six months weekly sessions followed by six monthly sessions led by professional lifestyle coach facilitating this group of individuals with a similar goal. In this group, topics such as losing weight, increasing physical activities as well as eating healthy, are discussed. To maintain progress towards program goals, with a monthly maintenance session, all participants must stay motivated.
References
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Rawshani, A., Sattar, N., Franzén, S., Rawshani, A., Hattersley, A. T., Svensson, A. M., … & Gudbjörnsdottir, S. (2018). Excess mortality and cardiovascular disease in young adults with type 1 diabetes in relation to age at onset: a nationwide, register-based cohort study. The Lancet, 392(10146), 477-486.
American Diabetes Association. (2018). 2. Classification and diagnosis of Diabetes: standards of medical care in diabetes—2018. Diabetes care, 41(Supplement 1), S13-S27.
De Boer, I. H., Bangalore, S., Benetos, A., Davis, A. M., Michos, E. D., Muntner, P., … & Bakris, G. (2017). Diabetes and hypertension: a position statement by the American Diabetes Association. Diabetes Care, 40(9), 1273-1284.
Kuo, C. C., Moon, K. A., Wang, S. L., Silbergeld, E., & Navas-Acien, A. (2017). The association of arsenic metabolism with cancer, cardiovascular disease, and Diabetes: a systematic review of the epidemiological evidence. Environmental health perspectives, 125(8), 087001.