In the past few years, diabetes mellitus has emerged as a common endemic in the Phoenix, Arizona population. The pancreas, an organ that lies near the stomach, produces a hormone called insulin to help glucose, or sugar that human bodies use for energy, get into the body’s cells. Diabetes is a disease that occurs when the body either does not produce enough insulin or cannot use its own insulin as well as it should. Diabetes can cause serious health implications such as heart disease, blindness, kidney failure, and lower-extremity amputations. It is the seventh leading cause of death in the United States. In Arizona, the Arizona Diabetes Prevention and Control Program has been established to assist with the prevention of diabetes, and provide education and other community resources to effectively combat and educate the public about the disease. This paper will discuss diabetes, how it is acquired, communicated and the primary effects to the individual. It will also discuss the effects diabetes has on the family and the community, as well the social and economic implications of the disease, focusing on the Phoenix, Arizona population. It will conclude with a discussion of the methods in which nurses in this setting can address diabetes, in addition to the use of other community resources.
Causes of Diabetes
There are different types of diabetes mellitus; Type 1 diabetes, Type 2 diabetes, and Gestational diabetes. Type 1 diabetes was previously called insulin-dependant diabetes mellitus or juvenile-onset diabetes. Type 1 diabetes may account for 5% to 10% of all diagnosed cases of diabetes (Centers for Disease Control and Prevention, 1997). Type 1 diabetes follows exposure to an environmental trigger, such as an unidentified virus, stimulating an immune attack against the beta cells of the pancreas in some genetically predisposed people (Centers fro Disease Control and Prevention, 1997). Type 2 diabetes was previously called non-insulin dependant diabetes mellitus or adult onset diabetes. Type 2 diabetes accounts for about 90% to 95% of all diagnosed cases of diabetes (Centers fro Disease Control and Prevention, 1997). Risk factors for Type 2 diabetes include older age, obesity, family history of diabetes, prior history of glucose intolerance, physical inactivity, and race or ethnicity. African-Americans, Hispanics, American Indians, and some Asians and Pacific Islanders are at particularly high risk for Type 2 diabetes.
Gestational diabetes develops in 2% to 5% of all pregnancies but usually disappears when a pregnancy is over (Centers for Disease Control and Prevention, 1997). Gestational diabetes occurs more frequently in African-Americans, Hispanics, American Indians and people with a family history of diabetes. Research indicates that nearly 40% of women with a history of gestational diabetes developed diabetes in the future (Centers for Disease Control and Prevention). Other types of diabetes result form specific genetic syndromes, surgery, drugs, malnutrition, infections, and other illnesses, accounting for 1% to 2% of all diagnosed cases of diabetes (Centers for Disease Control and Prevention, 1997). Diabetes is usually treated by keeping blood sugar levels normal at all time, and training in self-management so that one knows how to maintain the disease. Self-management programs are planned by a qualified medical professional.
Primary Effects on the Individual and the Family
The warning signs and symptoms of diabetes usually develop slowly, and consist of unusual fatigue, frequent urination, occasional blurry vision, cuts or sores that won’t heal, extreme thirst or hunger, numb or tingling hands and feet, and unexplained weight loss. Persons with diabetes are at risk for complications such as amputations, heart attacks, strokes, blindness, kidney failure and gum disease (Arizona Department of Health Services, 2006). The Arizona Department of Health (2006) notes several activities that the individual and their family can follow to manage and prevent diabetes. For example, practicing a basic health regimen can reduce the risk of developing diabetes as well as preventing the complications once the disease is present. Family members should note that eating regular healthy meals is necessary, and complications can be prevented by recording blood sugar levels daily, exercise, and taking medication as prescribed.
Social and Economic Implications of Diabetes
There are many social and economic implications of diabetes in the Phoenix, Arizona population. The Centers for Disease Control and Prevention is currently working with the Arizona Diabetes Prevention and Control Program to assist with the prevention of diabetes and develop the state’s capacity to reduce the incidence and severity of primary and secondary complications related to diabetes. The program also coordinates educational and training opportunities that involve state leadership, health professionals and communities. The social implications of diabetes noted by the Centers for Disease Control and Prevention are that the new diagnostic criteria will help find asymptomatic people with undiagnosed diabetes because of the utility and ease of obtaining fasting measurements. The number of people who shift from undiagnosed to diagnosed diabetes may potentially increase the total of 8 million to 10 million people diagnosed with diabetes. The economic implications are that a higher proportion of people will be diagnosed with diabetes and this will result in an increase in diabetes spending. However, over a lifetime, the cost may decrease because to care for people with diabetes will be diagnosed at an earlier stage and the complications may be easier to prevent (Centers for Disease Control and Prevention, 1997).
Nurses in Diabetes Setting & Utilization of Community Resources
The nurse in this setting addresses the issue of diabetes usually as a means of instruction and maintenance of the disease. For example, the nurse may discuss with family members the importance of following a regimen to prevent complications of the disease. In response to the growing health burden of diabetes mellitus, the diabetes community has three choices: prevent diabetes, cure diabetes, and take better care of people with diabetes to prevent devastating complications (Georgia Home Medical, 2004). Public health challenges include addressing issues for newly diagnosed people, and issues for the health care system. Community resources that could be utilized are support groups for those diagnosed with diabetes, or those taking care of a family member with diabetes. These support groups could meet, headed by medical personnel, to learn more about how to treat the disease and prevention further complications once diagnosed. Other individual and community issues involve patient anxiety, personal economic impact, insurability and employability.
Therefore, diabetes mellitus is an endemic in the Phoenix, Arizona population, but can be controlled and prevented with the right knowledge and community resources.
Arizona Department of Health Services. (2006). AZ Diabetes Prevention and Control
Program. Retrieved February 23, 2007, at http://www.azdhs.gov/phs/oncdps/diabetes/igns.htm
Centers for Disease Control and Prevention. (1997). National Diabetes Fact Sheet:
National estimates and general information on diabetes in the United States. Atlanta,
GA: U.S. Department of Health and Human Services.
Georgia Home Medical. (2004). Diabetes Education. Retrieved February 23, 2007, at http://www.ghmed.com.
Narayan, V. (1997). Diabetes Mellitus in Native Americans: The Problem and its
Implications. Springer Netherlands.