In the following essay, I will be talking about type 2 diabetes. Diabetes is on the increase and is now a very prominent public health issue. I have a great interest in metabolic disease as both my maternal and paternal grandparents suffered from it. Type 2 diabetes is very prevalent within my family and if the disease is hereditary both my parents and I may be at risk of it. Diabetes is more like a way of life to many Asian people as they feel they are more than likely to get it. I hope to prove diabetes is down to an individual lifestyle and dietary choices. Diabetes affects 2.8 million people in the UK. It is thought that a further one million people have the condition but are not aware of it. There are two different types of diabetes ‘Type 1’ and ‘Type 2’.
With type 1 diabetes the signs and symptoms are usually very obvious and develop very quickly, typically over a few weeks. The symptoms are quickly relieved once the diabetes is treated and under control. With type 2 diabetes the signs and symptoms may not be so obvious, as the condition develops slowly over a period of years and may only be picked up in a routine medical check-up. Symptoms are quickly relieved once diabetes is treated and under control. Type 2 diabetes can occur at any age. People from African Caribbean and South Asian communities are advised to get tested for diabetes if they are over 25 and have any of the risk factors. White people are advised to get tested for diabetes after the age of 40.
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Type 2 diabetes is caused by a complicated interplay of genes, environment, insulin abnormalities, increased glucose production in the liver, increased fat breakdown, and possibly defective hormonal secretions in the intestine. The recent dramatic increase indicates that lifestyle factors (obesity and inactive lifestyle) may be particularly important in triggering the genetic elements that cause this type of diabetes. Type 2 diabetes usually begins gradually and progresses slowly. Symptoms in adults include the following:
- Excessive thirst.
- Increased urination.
- Blurred vision.
- Weight loss.
- In women, vaginal yeast infections or fungal infections under the breasts or in the groin.
- Severe gum problems.
- Impotence in men.
- Unusual sensations, such as tingling or burning, in the extremities.
Symptoms in children are often different:
- Most children are obese or overweight.
- Increased urination is mild or even absent.
- Many develop a skin problem called acanthosis, which is characterized by velvety, dark-coloured patches of skin.
For many people who are diagnosed with type 2 diabetes, the first approach to treatment will be making changes to their lifestyle. These include taking regular exercise, eating a healthy diet and losing weight if you are overweight or obese. Doing this may be enough to keep your blood glucose at a safe and healthy level, without the need for other treatment. Type 2 diabetes usually gets worse over time. Even if they work at first, diet and exercise may not be enough to control your blood glucose levels. Type 2 diabetes can usually be controlled with the right diet and tablets. If you keep a close eye on the disease and your blood glucose levels, you can greatly minimize the risk of further complications. As the disease progresses, many people need insulin injections.
Because diabetes increases the likelihood of complications such as hardening of the arteries and heart disease, it’s important to try and reduce your risk. Controlling blood pressure and lowering cholesterol levels with drugs known as statins significantly improves the long-term outlook for everyone with diabetes. The prevalence of diabetes is increasing rapidly. More than 220 million people worldwide have diabetes. The World Health Organization (2011) has predicted that diabetes deaths will double between 2005-2030. The chart below shows the incidence of the disease:
- Number of People
- England 5.4 percent 2,338,813
- Northern Ireland 3.7 percent 68,980
- Scotland 4.1 percent 223,943
- Wales 4.9 percent 153,175
- UK average = 4.26 per cent
Therefore the known diagnosed population is now 2.8 million people. (http://www.diabetes.org.uk/Professionals/Publications-reports-and-resources/Reports-statistics-and-case-studies/Reports/Diabetes-prevalence-2010/) What are common consequences of diabetes? Over time, diabetes can damage the heart, blood vessels, eyes, kidneys, and nerves.
- Diabetes increases the risk of heart disease and stroke. 50% of people with diabetes die of cardiovascular disease (primarily heart disease and stroke).
- Combined with reduced blood flow, neuropathy in the feet increases the chance of foot ulcers and eventual limb amputation.
- Diabetic retinopathy is an important cause of blindness and occurs as a result of long-term accumulated damage to the small blood vessels in the retina. After 15 years of diabetes, approximately 2% of people become blind, and about 10% develop severe visual impairment.
- Diabetes is among the leading causes of kidney failure. 10-20% of people with diabetes die of kidney failure.
- Diabetic neuropathy is damage to the nerves as a result of diabetes and affects up to 50% of people with diabetes. Although many different problems can occur as a result of diabetic neuropathy, common symptoms are tingling, pain, numbness, or weakness in the feet and hands.
- The overall risk of dying among people with diabetes is at least double the risk of their peers without diabetes.
Long-term complications of untreated diabetes include damage to the eyes, kidneys, liver, and nervous system, along with many other problems. The complications take years to develop in most cases, but many of them are irreversible, although most of them can be stopped from progressing once treatment is begun. Overall, untreated diabetes greatly shortens life expectancy and can seriously affect the quality of life in later years even in those who survive.
Heart disease and stroke. If you have diabetes, you are up to five times more likely to suffer heart disease and stroke compared with people without diabetes. Prolonged, poorly controlled blood glucose levels increase the likelihood of atherosclerosis (furring up and narrowing of the blood vessels). This may result in poor blood supply to the heart, causing angina. It also increases the chance that a blood vessel in your heart or brain will become completely blocked, causing a heart attack or stroke.
Nerve damage. High blood glucose levels can damage the tiny blood vessels of your nerves. This can lead to a tingling or burning pain that spreads from your fingers and toes up through your limbs. If the nerves in your digestive system are affected, you may experience nausea, vomiting, diarrhea or constipation. Retinopathy (damage to the retina at the back of the eye) Blood vessels in the retina of your eye can become blocked, leaky or grow haphazardly. This prevents the light from fully passing through to your retina. If left untreated, it can damage your vision.
Kidney disease. If the small blood vessels of your kidney become blocked and leaky, your kidneys will work less efficiently. In rare, severe cases this can lead to kidney failure and the need for a kidney transplant. Foot problems. Damage to the nerves of the foot can mean that small nicks and cuts are not noticed, leading to the development of a foot ulcer. About one in 10 people with diabetes get foot ulcers, which can cause serious infections. Check your feet every day and report any changes to your doctor, nurse or podiatrist. Look out for sores and cuts that do not heal, puffiness, or swelling, and skin that feels hot to the touch. You should also have a foot examination at least once a year.
Miscarriage and stillbirth. Pregnant women with diabetes have an increased risk of miscarriage and stillbirth. If their blood sugar level is not carefully controlled in the early stages of pregnancy, there is also an increased risk of the baby developing a serious birth defect. Pregnant women with diabetes will usually have their antenatal check-ups in a hospital or in a diabetic clinic, where healthcare professionals can keep a close eye on their blood sugar levels and control their insulin dosage more easily. Method of Collection. I used many different sources of information. To collect the statistical data I used the internet, I went on the World Health Organization (WHO) website. The data was both reliable and up to date, the information was refreshed in January 2011.
I also went to the library and borrowed the book Diabetes: the ultimate teen guide By Katherine J. Moran, Lisa P. Merriman. The book was published in 2004 and was aimed to help teenagers suffering from diabetes understand the disease. It had many subheadings such as ‘Can my diabetes change?’, ‘What can I eat? ‘and ‘Diabetes and Adolescences’. The book was published over 6 years ago so it was not a completely reliable source but it was very informative and insightful. Unfortunately, I was unable to read the whole book due to time constraints for the assignment but I read a few chapters.
I also picked up a leaflet from my G.P.’s office on diabetes. The leaflet was called Diabetes Complications and How to Prevent Them. The leaflet was very informative on the long-term effects of diabetes and ways to help you avoid causing damage to yourself. I watched a documentary about diabetes called ‘Diabetes: The Silent Killer’. The documentary is about type 1 diabetes. Although I am looking into type 2 diabetes the documentary was very insightful on how diabetes affects the whole family and not only the individual. Type 1 and type 2 diabetes are quiet similar but are different in the fact that type 1 diabetes is usually in younger children and type 2 often develops in adulthood.
Social, Environmental and Lifestyle Factors. Exercise and Balanced Diet. By choosing to eat a healthy balanced diet you’ll already have started to manage diabetes by helping to control your blood glucose levels, blood fats and blood pressure. It will also help to regulate your weight. If you’re overweight it’s especially important to try and achieve and maintain a lower weight. Even small weight losses lead to surprisingly big reductions in the risk of diabetes and will also reduce your risk of heart disease, high blood pressure and stroke. Finding the balance between the number of carbohydrates and fat is important.
Cut down on the amount of fat you eat – particularly saturated fats, as this type of fat is linked to heart disease. Choose monounsaturated fats, e.g. olive oil and rapeseed oil. Aim to eat a portion of oily fish at least twice a week. Where possible, choose wholegrain carbohydrates, these are high in fibre and will help you to control your blood glucose levels. People with diabetes should try to maintain a healthy weight and eat a diet that is:
- low in fat (particularly saturated fat)
- low in sugar
- low in salt
- high in fruit and vegetables (at least five portions a day)
- high in starchy carbohydrate foods, such as bread, chapatti, rice, pasta and yams (these should form the base of meals) – choose wholegrain varieties when you can (http://www.eatwell.gov.uk/healthissues/diabetes/)
Alcohol. If you have diabetes you should drink alcohol in moderation. With the disease, you should spread your drinking throughout the week and avoid binge drinking. Alcohol contains calories so if you are trying to lose weight you should keep your drinking to a minimum. If you’re taking tablets to help control your blood sugars, alcohol can make hypoglycemia (low blood sugars) more likely to occur, so never drink on an empty stomach. Exercise. Whatever your weight, being fit and active reduces your risk of diabetes. Physical activity, when combined with a healthy balanced diet, will help you to manage your diabetes and prevent long-term complications.
Smoking. People with diabetes are at an increased risk of cardiovascular disease. Stopping smoking will help to decrease your risk of cardiovascular disease and minimize the chance of developing other complications of diabetes. Stress. Stress causes the body to make energy available that’s been stored as glucose and fat to help it ‘escape from danger’. With diabetes, this stress response does not work so well, because insulin is not always available to allow extra energy into the body’s cells, and glucose can build up in the bloodstream. It has been discovered that both mental and physical stress can cause blood sugar levels to rise in people with Type 2 diabetes.
Environmental Factors. Food Quality. 1 in 4 people in the UK lives in poverty. With low income, a family may find it hard to buy organic or fresh produce as it is more expensive and they don’t have any disposable income. Diabetic food is rather more expensive where a dairy milk chocolate bar (50g) would cost 50p, the boots range of diabetic chocolate-coated wafers (30g) costs 70p. Having a healthy diet is of paramount importance as it can help you avoid heart and kidney disease and nerve damage etc. With a low income, it can be almost impossible to buy nutritious food to feed yourself for a week.
Air Quality. Recent studies have shown type 2 diabetes may also be linked to air quality. A study carried out in America showed there was a strong link between air pollution and diabetes. Scientists are still trying to find the exact link but are still unsure. Access to Employment. It is illegal for an employer to deny you a job because you have diabetes. Diabetes can limit your choices when looking for a job as it may have to fit around when the person may need to take their medication or insulin shot. It would be hard for someone who develops diabetes in later life as they may have to quit their lifelong profession, for example, if someone has been a bus driver all their life and partially loses their eye sight it could end their career and all they’ve known.
Social Factors. Family & Friends. Family and friends are very important to both emotionally and physically support the person. I read a few people’s stories and experiences when being diagnosed and all of them say it felt like they were physically disabled and it was with the support of family and friends that helped them. Socialization. When out with friends or family it can be hard as you have to watch what you eat and if all your friends order fish and chips you may order the same thing so you fit in but it could affect you in the long term. Type 2 diabetes is now becoming widespread amongst teenagers. The disease is seen as the norm and very accepted especially amongst the south Asian and African – Caribbean communities.
Social Class. A common perception of people who suffer from type 2 diabetes is that they are from the lower class but this conception may in fact be true. A new study finds women who grow up in a lower social class are more likely to develop insulin resistance than those who grow up in a higher class, regardless if they change classes in adulthood. I believe this may be due to an unhealthy diet as they may live on a very basis income meaning they eat what they can afford.
Access to Health Services. The NHS approximately spends ½10 million annually on treatment for diabetes. If you have diabetes you have to visit the doctor quite often to get an overall health check-up and visit the hospital every 6 months for a thorough check-up which includes scans and weighing. The majority of the people who suffer from type 2 diabetes are either overweight or clinically obese. If you are overweight you also visit a dietician every 3months.
Conclusion. Type 2 diabetes is becoming very prevalent in Britain, especially amongst the poorest communities. Research by the charity Diabetes UK and the All-Party Parliamentary Group for Diabetes has shown Britain’s poorest communities are 2.5 times more likely to develop Type 2 diabetes than the general population. They are also 3.5 times more likely to develop serious complications of diabetes, including heart disease. To help tackle this, the NHS now provides free health checkups so everyone can get checked regardless of their social class or financial situation. By doing this they also hope to prevent heart disease, stroke and kidney disease.
The NHS now also has an online test, you simply answer a number of questions and it then tells you whether you are likely to have the disease or not. A new report suggests the NHS spent ï¿½1million an hour, 10% of its yearly budget, treating diabetes and its complications. The report also revealed one in 10 people in hospitals in the UK have diabetes and 60% of inpatients with diabetes have been admitted as emergencies. The total cost to the NHS equates to ½9bn-a-year. New research has found that a vaccine may stop an individual from getting diabetes, if this is true it will substantially reduce the amount of time and money spent on diabetes medication.
The NHS spends a lot of money on leaflets and other forms of advertisement to make the public aware of diabetes. But as type 2 diabetes is becoming more prevalent amongst teenagers I believe that money should be invested to start teaching children about the dangers of diabetes and how it can cause serious problems. Healthy eating and exercising are the best way to help avoid type 2 diabetes. Healthy eating campaigns have been in schools for many years now. I think the NHS should add diabetes to the campaign so it shows how healthy eating can help prevent diabetes. If you are overweight, you’re at an increased risk of type 2 diabetes. Diabetes and weight are very closely linked I think if this was emphasized more and people could visually see the link between the two it may cause them to question what they eat and how much they exercise.
Type 2 diabetes is also rife amongst the African -the Caribbean and South Asian communities I think this is because their traditional food very salty and a lot of it is fried. I believe more should be done to educate them on how they could prevent getting diabetes. a social gathering where you give recipes on how to make healthy meals and reduce the number of salts and sugars may encourage them to start eating healthier. Type 2 diabetes is a widespread problem that is on the increase. There is no cure and many of the side effects are irreversible. The NHS is providing free health check up’s, this may entice people to get a check-up and it could also save the NHS millions of pounds.
As the check-up is free anyone can get it done, diabetes is very common among the lower classes and as many of them have no extra disposable income it is a excellent way to get them to get check over. Many people now have access to the internet either at home, school, work or an internet caf ½. The online test takes no longer than 5 minutes as it is a multiple-choice questionnaire. This is an excellent way for people to check whether they might be at risk of diabetes. I believe the website should be more advertised as it is private and no one has to know.