Diabetes — Literature Review

It is estimated that nearly five and a half million people, or over a third of the population, have prediabetes in some populations such as the City of New York; diabetes and diabetes-associated cardiovascular diseases have become the leading cause of death in the region accounting for roughly two-thirds of the deaths and the rates of diabetes has lead this trend to be referred to as the diabetes epidemic (Frieden, 2006). The same trends can be found in a greater or lesser extend in most Western nations in the world. Furthermore, there has been a strong correlation between childhood obesity and childhood diseases, such as diabetes, that has now been identified (Dietz & Bellizzi, 1999).

The link between childhood obesity and adult diseases has been the subject of much attention in recent years. Much of the research has considered the programming of adult metabolic processes and disease that have a mechanistic link to the environment in which person develops early in life; it is believed that there is a biological transfer of information that can begin in the postnatal environment (Fernandez-Twinn & Ozanne, 2010). The implications of this are stark for a meaningful intervention to prevent diseases such as type II diabetes. Such research would suggest that prevented measures should really start in pregnancy and some interventions in childhood may be ineffective because they actual begin too late in the process.

Obesity in children can also lead to an increased likelihood of developing comorbidity with other diseases such as an increased risk of developing the metabolic syndrome, cardiovascular disease, and its associated retinal and renal complications, nonalcoholic fatty liver disease, obstructive sleep apnea, polycystic ovarian syndrome, infertility, asthma, orthopedic complications, psychiatric disease, and increased rates of cancer, among others (Kelsey, Zaepfel, Bjornstad, & Nadeau, 2014). Furthermore, diabetes and cardiovascular diseases (CVD) are now identified to be closely correlated: diabetes mellitus (DM) has been closely associated with coronary heart disease, and conversely, many patients with established coronary heart disease suffer from diabetes or its pre-states (Lars & Al., 2007).

Early detection of diabetes II can help mitigate many of the consequences of the disease and improve health outcomes. The evidence-based clinical diagnostic tool that has been researched and adopted in many countries is the HbA1c which is used to identify and diagnose as well as monitor type 2 diabetes. It is often the case that patients often do not have any significant physical change and yet the diabetes continues to develop from low risk to high risk cases with risks of complications. Rather than being a test of glycaemia at a single point in time the advantage of HbA1c is that it indicates the presence of chronic glycaemia. Therefore this characteristic of HbA1c, is most appropriate to diagnose a disease that that is known to have chronic hyperglycaemia and a gradual progression to complications (John, Hillson, & Alberti, 2011).

Most of the interventions that are designed to improve the quality of life for patients with the risks of developing diabetes or who already have developed diabetes are typically focused on early detection, education, and outreach. Early detection may be one of the most critical factors in mitigating the worst symptoms of diabetes. However, there are also many preventative measures that can be taken to prevent or at least stall the onset of diabetes such as diet and exercise. Such interventions are crucial in combatting the risen epidemic of type II diabetes.

References

Dietz, W., & Bellizzi, M. (1999). Introduction: the use of body mass index to assess obesity in children. The American Journal of Clinical Nutrition, 1235-1255.

Fernandez-Twinn, D., & Ozanne, S. (2010). Early life nutrition and metabolic programming. Annals of the New York Academy of Sciences, 78-96.

Frieden, T. (2006). Diabetes in New York City: Public Health Burden and Disparities. Retrieved from New York City Department of Health and Mental Hygiene: http://home2.nyc.gov/html/doh/downloads/pdf/epi/diabetes_chart_book.pdf

John, W., Hillson, R., & Alberti, S. (2011). Use of haemoglobin A1c (HbA1c) in the diagnosis of diabetes mellitus. The implementation of World Health Organisation (WHO) guidance . Practical Diabetes, 12-13.

Kelsey, M., Zaepfel, A., Bjornstad, P., & Nadeau, K. (2014). Age-Related Consequences of Childhood Obesity. Age-Related Consequences of Childhood Obesity, 222-228.

Lars, R., & Al., E. (2007). Guidelines on diabetes, pre-diabetes, and cardiovascular diseases: executive summary. European Heart Journal, 88-136.