Diabetes
The Global Prevalence of Diabetes
Diabetes, a medical condition resulting from elevated levels of high blood sugar (hyperglycemia), has become a major worldwide health problem and is only getting worse; in 2010, diabetes affected 6.4% (285 million) individuals worldwide, and this total is expected to increase to 7.7% over the next 20 years (Shaw, Sicree, Zimmet, 2010). By 2025, it is estimated that a total of 380 million people will suffer from diabetes (Dieren, et al.). There are myriad reasons for the explosion in diabetic prevalence, and a number of measures must be enacted in order to combat this growing problem. These measures will not only involve science (nursing, scientific education) but also overhauling cultural lifestyles. This paper begins by describing the effects of diabetes and then discusses a number of the initiatives that must take place in order to combat the issue.
Diabetes is difficult to combat because it has a number of manifestations and its effects on the body are multifaceted and sometimes disguised. A far greater number of people die from diabetes than was previously suspected; in many cases, a person may ostensibly die from an unrelated cause that was in fact precipitated by the person’s diabetes. There is also a stigma associated with diabetes whereby it is assumed that diabetics are those who have not taken adequate care of their bodies and have become overweight or obese as a result. While obesity is a contributing factor to the worldwide prevalence of diabetes, the affliction has become increasingly popular within the developing world as well. There has been a 69% increase in adults with diabetes in developing countries, compared to a 20% increase in developed countries (Shaw, Sicree, Zimmett, 2010). Diabetes is not just a result of a person failing to get the requisite amount of exercise and eating improperly; rather, it refers to the body’s inability to properly metabolise food. Consequently, one of the foremost causes of diabetes is a person’s genetic makeup; if one’s family history contains a high proportion of diabetics, then a person is significantly more likely to develop diabetes. In general, diabetes can be viewed as resulting from the combination between people’s genetic predisposition in conjunction with the manner in which they take care of their body.
It is precisely the multifaceted nature of diabetes, manifesting through both internal (genetic) and external (lifestyle) causes that makes diabetes a worldwide epidemic. In the United States, diabetes has gained prominence in large part because of the lifestyle endorsed by American culture. Specifically, the average person gets very little exercise, and people do not receive the proper nutrition needed to maintain a healthy metabolism. The lack of exercise is largely due to the prevalence of automobile transportation; it is no coincidence that the dependence on the automobile has grown stronger since the 1980s, when obesity first became a pervasive issue in American culture. Certainly, it is true that there is no direct correlation between obesity and diabetes; however, if one is obese than it is significantly more difficult to manage and prevent diabetes. People have no necessity to exercise on a daily basis, and in many demographics (particularly rural or suburban landscapes, in which one must drive everywhere) exercise is not needed to accomplish everyday tasks such as purchasing groceries.
Treating diabetes is an additional complication; because diabetes is characterized by the body’s inability to properly metabolize nutrients, diabetics run the risk of having low blood sugar if they do not eat consistently throughout the day. However, this can pose major challenges to someone on a weight loss program. Accordingly, a diabetic attempting to lose weight should restrict themselves to high-fiber foods (which are significantly easier for the body to metabolize), low-fat foods, and large amounts of water. All foods that can lead to high blood pressure should be avoided; accordingly, the patient should avoid foods with high amounts of cholesterol and saturated fat, and alcohol should be discarded altogether.
Around the world, there exist many misconceptions regarding nutrition. Accordingly, scientific literature is integral in educating the population about how to take care of their body and eat in a way that aids successful processing of nutrients. Moreover, nursing is a crucial component in relieving the problems associated with diabetes. The nurse-patient relationship provides the diabetic with an interpersonal dynamic that can provide the patient with the needed motivation to improve their condition. Nurses can also assist to make sure that the patient is taking their required doses of insulin and regulating their blood sugar level at all times. However, it should be noted that just because a diabetic takes insulin, this does not allow them to indulge in foods with high sugar or saturated fat; insulin should be viewed as a supplementary tool, not as a preventive measure.
In American culture, poor nutrition and a sedentary lifestyle are incredibly popular and are a product of the culture as a whole. Accordingly, adequately combating diabetes in the United States requires not only the assistance of scientific literature and proper nursing care but also a modification to the way in which culture operates. The reliance on the automobile must decrease, and the manufacturing of foods with little to no nutritional value must cease. People will make poor choices if given the opportunity to do so, and culture not only enables irresponsible lifestyle choices but promotes them. Diabetics do not live in a vacuum, and it is time for society to actively combat the epidemic.
Fighting diabetes in the developing world is perhaps more difficult than in the developed countries. Specifically, nursing care is much harder to obtain, and it is difficult for underprivileged families to receive the proper medical care. One additional complication is that around the world, different populations have diverse body make-ups. Specifically, people from Asian or Latin American cultures tend to have slower metabolisms and therefore may be more at risk of contracting diabetes. It may also be difficult for people living in the developing world to obtain the proper nutrition needed to regulate the disease. A diabetic must eat consistently and at the same time each day in order to keep their blood sugar from decreasing, and if someone does not possess the proper amount of food, they will suffer. In India, which has more diabetics than any other nation worldwide, one of the main problems is that the cultural diet is extremely high in calories (naan and white rice being prime examples in this regard), which, compounded with a predominantly sedentary lifestyle, significantly increases risk of diabetes. Additionally, East Indians appear to be genetically predisposed to insulin resistance, resulting in vitamin deficiencies and susceptibility to high body fat (James, 2008). Additionally, in such countries many people may not possess the leisure time needed to receive the proper exercise.
The effects of diabetes are drastic and result in premature mortality; roughly one-half of those suffering from type 2 diabetes die prematurely. The fact that fewer preventive measures are being taken in the developing world will continue to negatively affect the efforts made by people to counteract and prevent the disease. In many cases, moderating one’s diabetes is a result of a cultural lifestyle, and scientific literature and proper nursing care will be integral in fighting the growing worldwide diabetes epidemic.
References
Dieren, S.V. (2010). The global burden of diabetes and its complications: An emerging pandemic. European Journal of Preventive Cardiology, 17(1), s3-s8.
James, W.P.T. (April 2008). The epidemiology of obesity: The size of the problem. Journal of Internal Medicine, 263(4), 336-352.
Shaw, J.E., Sicree, R.A., & Zimmet, P.Z. (2010). Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes research and clinical practice, 87(1), 4-14.
