Medical Essay on Type 2 Diabetes

Type 2 diabetes is a progressive health condition that develops when the body becomes resistant to the effects of the hormone insulin or when the pancreases lose its capacity to produce insulin. The initial cause of the condition is unknown but, it is associated with modifiable risk factors (Diabetes Australia, 2017). Type 2 diabetes is diagnosed once the pancreases stop producing insulin or produce insufficient amount to meet the bodys needs, or when the produced insulin is adequate but does not work effectively, and also when the cells of the body do not respond to insulin effectively; a condition which is also known as insulin resistance. Type 2 diabetes represents between 85-95% of all the diabetes cases worldwide (American Diabetes Association,2014). The condition mostly develops among adults who are 45 years or older, but today, it is increasingly occurring among the young population including children, adolescents, and young adults.

The lay interpretation of the condition

Type 2 diabetes is a condition that develops over a long period, and during this time, the insulin that is produced becomes less effective. When this happens, the level of sugar in the blood increases, thus causing the pancreases, the organ responsible for insulin production, to produce more insulin to regulate the extra amounts of blood sugar, hence causing the cells of the pancreas to wear out, so that by the time one is diagnosed with type 2 diabetes, the pancreas has lost about 50-70% of the cells that produce pancreas.

Risk factors associated with type 2 diabetes

Type 2 diabetes is associated with modifiable risk factors. Some of these factors according to Bi et al., (2012):

Diet: Diet plays a crucial role in the development of type 2 diabetes. The higher dietary glycemic load and also the trans-fat intake is highly associated with the increased risk of developing the condition. Consumption of highly processed food with added sugar is associated with weight gain and also increased the risk of developing the disease.

Sedentary behavior: sedentary behaviors such as working in offices, driving, sewing, watching TV, among other lifestyles that involve minimal physical activity increase the risk of developing the disease. Individuals exercise less hence reducing energy expenditure. Also, watching TV is associated with unhealthy eating patterns, despite the low physical activity involved.

Smocking and alcohol consumption: Studies indicate that active smocking is associated with increased risk of type 2 diabetes compared to non-smokers. Quitting smoking is associated with weight gain, which is strongly associated with type 2 diabetes. Alcohol also plays a crucial role in the development of type 2 diabetes. While moderate intake improves insulin sensitivity, heavy consumption is associated with increased chances of becoming obese, impairing liver faction and can lead to pancreatitis hence increasing risks of developing the condition.

External environment: a compound found in the environment known as bisphenol A (BPA, 2,2-bis (4-hydroxyphenyl) propane) is one of the known environmental endocrine disruptors. It is used in the manufacture of products such as baby bottles, beverage containers, dental sealants and fillings, protective coatings among others. BPA leaches from these products and is consumed via inhalation, ingestion or dermal absorption. The BPA binds with membrane estrogen receptor hence causing pancreatic beta cells to be overstimulated, inducing glucose intolerance and resistance, hence increasing risks of developing type 2 diabetes.

Genetic risk factors: Genetics is one of the risk factors for type 2 diabetes. Studies indicate that some parts of DNA strands are associated with disruption of the normal function of the pancreas. In addition, people who have relatives with this defective DNA strand are likely to pass it to their children (American Diabetes Association, 2014).

Age: Age is a risk factor for type 2 diabetes. The condition is highly likely to develop among adults with over 45 years, among the whites, and 25 years among the blacks, Hispanics, and Asians (American Diabetes Association, 2014).

Statistics-General and target population

Diabetes is a common chronic condition among children, and there has been a considerable increase in the incidence of both types of diabetes over the last twenty years. According to American Diabetes Association, type 2 diabetes is an emerging disorder among children, and possess unique challenges in the field of research and clinical care (Office of Surveillance, Evaluation, and Research Health Promotion and Chronic Disease Prevention Section, 2013). The disease has the disproportionate impact on children from ethnic/racial minorities. It occurs mainly in environments with complex sociocultural structures challenges adherence to durable lifestyle changes, hence making adherence to medical recommendations a big struggle. In addition, these complexities are known to hinder successful recruitment and completion of research programs hence leaving gaps in pathophysiology and treatment optimization (Office of Surveillance, Evaluation, and Research Health Promotion and Chronic Disease Prevention Section, 2013).

In the United States, type 2 diabetes among children and youth has increased dramatically over the last 20 years, and the estimates are as high as 5,000 new cases annually (Office of Surveillance, Evaluation, and Research Health Promotion and Chronic Disease Prevention Section, 2013). The prevalence increases with age, tripling from 10-14 years to 15-18 years. Adolescent boys have a prevalence rate of 40% compared to girls whose prevalence rate is at 60%. The reasons behind this difference remain unclear (Texas Department of State Health Services, 2017). Children of the indigenous groups such as Native Americans bear the greatest burden of the condition. Reports from Texas Department of State Health Services indicates that 20% of severely overweight children regardless their ethnicity have impaired glucose tolerance (Texas Department of State Health Services, 2017).

Studies indicate that type 2 diabetes is continuing to escalate among children and also adolescents and by 2050, the number of children and adolescents with the condition would increase by 8,431 in Texas (Office of Surveillance, Evaluation, and Research Health Promotion and Chronic Disease Prevention Section, 2013). The growing incidence is linked to the rising prevalence of obesity in this population. In 2015, the prevalence of the condition in Texas was 11.4% up from 10.2% in 2011according to statistics from Texas Department of State Health Services (Texas Department of State Health Services, 2017). Between 2002 to 2005, a study by CDC and NIH revealed that 3,600 youth were newly diagnosed with type 2 diabetes annually. Among the youth aged less than 10 years, the rate of new cases diagnosed with type 2 diabetes was 0.4 per 100,000, and 8.5 per 100,000 among youth above 10 years (Office of Surveillance, Evaluation, and Research Health Promotion and Chronic Disease Prevention Section, 2013).

A survey in 2010, indicated that 14,000 children and youth had been diagnosed with either type 1 or type 2 diabetes, representing 0.2% of this age group. Diabetes prevalence did not differ significantly between boys and girls and also among race/ethnicities from 2007 to 2010. In 2010, estimated 9.7% of Texas adults were diagnosed with diabetes translating to about 1.8 million individuals (Office of Surveillance, Evaluation, and Research Health Promotion and Chronic Disease Prevention Section, 2013). Prevalence of diagnosed diabetes among boys was 0.5% compared to 0.3% among girls. The White, non-Hispanic youth population had a prevalence of 0.4%, the Black, non-Hispanic had a prevalence of 1.0%, and the Hispanics had a prevalence of 0.3%. With regards to gender, men had a higher prevalence of 12.3% compared to women who had 10.6% in 2015 (Texas Department of State Health Services, 2017). This indicates that the prevalence of diabetes among the male population is significantly higher than their female counterparts. With regards to race and ethnicity in 2015, the percentage of the White population with diabetes was 10.2%, the Black population was 17.0%, the Hispanics was 12.2%, and the others had 7.1% (Texas Department of State Health Services, 2017).

Hospital discharge rates is also an important measure of prevalence in healthcare. The rate of hospital discharge as a result of type 2 diabetes in Texas is 12.0 per 10,000 people according to data from 2014. Some counties have as high as 30.4 per 10,000 people, while some counties do not have sufficient (Texas Department of State Health Services, 2017). The report also shows that the number of people discharged out of the hospital as a result of type 2 diabetes significantly dropped from 12.7 per 10,000 people in 2010 to 12.0 per 10,000 people. This is a great indicator of a growing challenge in healthcare service provision. Also, data indicate that the number of males discharged from the hospital is significantly higher at 14.0 per 10,000 compared to 10.2 among female population (Texas Department of State Health Services, 2017). Regarding hospital discharge by race/ethnicity, the Blacks lead by 21.8, then Hispanics at 15.1, followed by other races/ethnicities at 14.8 and Whites at 8.5 per 10,000 people according to Texas Department of State Health Services, (2017).

Regarding mortality, Diabetes is ranked the sixth leading cause of death from 2002 to 2007, and it is believed to be under-reported as both a condition and a cause of death. The overall mortality from diabetes in Texas is 21.8 per 100,000 people with some counties reporting up to 64.4 per 100,000 (Texas Department of State Health Services, 2017). Statistics also indicate that mortality fell from 22.2 per 100,000 people in 2011, to 21.5 per 100,000 in 2015. The mortality rates are higher among men at 24.6 compared to women at 19.3 per 100,000 people. Additionally, more Blacks die from the condition at 36.3 per 100,000 compared to Whites at 16.7 per 100,000. The Hispanics rate is at 32.3 per 100,000 (Texas Department of State Health Services, 2017).

Preventive and management strategies

There is need to take an immediate action to reduce the burden of the disease in Texas and the United States in general. Some of the strategies that can be taken include:

Development of diabetes action plans: there is a need for coordination among state players to utilize the limited funds, and other resources channeled towards addressing the diabetes epidemic effectively (Center for Health, Law and Policy Innovation of Harvard Law School, 2016). The Diabetes Action Plans promotes collaboration and communication among stakeholders in the development of statewide strategies and setting priorities for resource allocation, for prevention, treatment, and management of type 2 diabetes.

There is also need to close the health insurance coverage gap by expanding Medicaid or adopt an alternative strategy for complete healthcare coverage (Center for Health, Law and Policy Innovation of Harvard Law School, 2016). A majority of individuals that do not have medical cover are less likely to seek healthcare services including preventive care for chronic illnesses including type 2 diabetes. States should ensure that individuals with low income receive healthcare insurance by expanding Medicaid or develop other alternatives to cover these populations.

There is also need to amend the scope of practice laws and also regulations to ensure non-physician providers such as nurses, physician assistants, pharmacists provide primary care hence increases access to primary care (Center for Health, Law and Policy Innovation of Har...