The Determinants Of Diabetes Health And Social Care Essay

The Determinants Of Diabetes Health And Social Care EssayDiabetes affects over 3 million adults in Australia alone-of which 90% is type 2 (Baricevic, 2007) non-insulin dependent diabetes mellitus (NIDDM-for the sake of this essay diabetes is referring to type 2 NIDDM). There are numerous biological and socioeconomic determinants of the disease which has substantial into Australias fastest growing chronic disease. Whilst it is often considered a lifestyle disease (Scobie Samaras, 2009) this is a common misunderstanding with numerous other contributing factors such as genetics, the environment and economic circumstances. Whilst much research has gone into the management/treatment of diabetes, work on addressing the upstream determinants has begun. Physiotherapists play a vital role in the streak and treatment of the correct with them often prescribing exercise programs for diabetic patients.Diabetes results from a total or partial insulin deficiency, resulting in hypoglycaemia. Th is deficiency prevents glucose movement between the credit line and cells, creating a build-up of glucose in the bloodstream. As a result of the hypoglycaemia, several call symptoms are present including blurred vision increased healing times undetermined weight gain increased passing of urine thirstiness tiredness and dizziness. In 2010 diabetes accounted for 6.6% of Australias total burdens of disease and has been identified as one of the eight national health priorities (AIHW, 2010). percentage 1Hamdy, Goodyear, Horton (2004) contend that there are three key contributing factors to the bombardment of diabetes. These include genetic predisposition, decreased insulin action and a stigma in the pancreatic cell.However the most well-known biological and behavioural determinants of the condition relate to obesity with the relative attempt being 1.8 for an overweight somebody and a staggering 3.2 for obese people (Marks, Coyne, Pang, 2001). Weight related determinants includ e obesity (morbid and moderate), sedentary lifestyle, poor diet and low aims of physical use (Ramlo-Halsted Edelman, 1999). Hamdy, Goodyear Horton (2004) nominate the primary reason for such societal changes leading to the dramatic rises in the rates of both obesity and more so diabetes is urbanization. They suggest that the recent world-wide urbanisation and increase in technology has created a society where conventional incidental forms of exercise commence been alleviated in favour of technology and the ad trainces that it has facilitated. Ethnic sort outs have oddly been affected by these changes with their traditional forms of life transformed as they too are impacted by globalisation.An example of such a group in Australia is the Indigenous Australians. As with nearly all areas of health, they are severely over represented in the percent suffering from diabetes. __________Other factors contributing to the tone-beginning of the disease include older age,Section 2Desp ite these factors being well documented as some of the primary causes of diabetes, Scobie Samaras (2009) argue that these factors accelerate the onset rather than being the primary cause.-biological/behavioural determinants of healthAgeGenetic background-parental score-groups at particular riskElderlyPeople with a family historyCertain ethnic groups (eg Aboriginal Australians)Low SESSection 2 ( draw back in with single(a) determinants)-Factors such as poverty, poor facts of life, social exclusion, unemployment and lack of or poor quality housing all contribute to health inequalities.-socioeconomic determinants of healthPolicyPA levels in schools, NPAG, educationCommunityaccess to parks/pathsenvironmentalsafety, access to fresh intellectual nourishmentSocietal urbanisation and increase in technology = down incidental exerciseEconomicemployment/occupation, income, wealthSection 3Traditionally treatment of diabetes has focused on the downstream factors, with the focus being at an individual level. Exercise and weight loss are key aspects of the treatment, given that ________. Exercise alone leads to a meaning(a) improvement in insulin sensitivity (Misra, et al., 2008). In line with the topic Physical Activity Guidelines (Department of Health and Ageing, 2010), it is recommended that individuals get in in at least 30 min of walking 5 mean solar days per week. The guidelines highlight four key points for all adults regarding physical activity, with these being particularly important for people with diabetes. They areThink of movement as an opportunity, non an inconvenienceBe active every day in as many ways as you canPut together at least 30 minutes of moderate-intensity physical activity on most, preferably all, daysIf you can, too enjoy some regular, vigorous activity for extra health and fitness (Department of Health and Ageing, 2010)In conjunction with exercise, a healthy diet is essential for the legal treatment of diabetes (DA Victoria, 2002). Th is has been proven to have the single greatest natural impact on blood glucose levels as well as encourageing weight loss and decrease insulin resistance. Foods should non be limited to low GI, with a diet focussed on high protein (such as fish and low fat dairy) high carbohydrates (such as pasta, bread and fruit) and low saturated fat/sugar (Baricevic, 2007).The AIHW (2010) suggests that the most appropriate method of treatment is initially finished diet and exercise, progressing only later to medicine. Diabetes medication primarily acts to help regulate the blood glucose levels. Given that with this condition insulin is unable to effectively function, it becomes important to have a way to regulate blood sugar. The figure range is 3.5-6 mmol/L prior to meals and 3.5-8mmol/L directly afterwards (DA Victoria, 2002). Glucose management is very important to keep the risk of cardiovascular disease down, and without regulation the somebody may suffer from hypo/hyperglycemia. That sa id, Ramlo-Halsted Edelman (1999) point out that the optimal regimen particularly for medication will change for each individual as the condition progresses. There are two different options for medication-tablets or insulin injections. The tablets are taken orally and decrease the release of stored glucose in the liver, keeping blood sugar levels down. In contrast, insulin injections come in the form of a needle (syringe) or a pen and are used when the pancreas is unable to produce the required amounts of insulin (Baricevic, 2007).Diabetes, as with many health conditions, requires a multi-disciplinary team for successful treatment and management. Diabetes Management in General Practise (2009) describes the roles of at least eight different team members in the treatment of diabetes. These includeGeneral practitionerExercise specialist (commonly a physiotherapist)PodiatristOptometristOral health professionalDiabetes educator (nurses etc)DieticianEndocrinologist/diabetologistWhilst not all of these health professionals will necessarily be involved in every individuals treatment, the teams cooperation is vital for long-term treatment.To help with individual treatment of diabetes, the Australian presidency has established the National Diabetes Services Scheme (NDSS). The program has in excess of 900 000 registered people with diabetes and is continuing to grow. There are several key elements of the scheme with subsidised products and information as well as education. Through this program, there are 2200 outlets which supply discounted products for treatment to the registrants.Whilst treatment is very common, alongside it is an extensive management plan. DA Victoria (2002) describes several aspects to proper management. Aside from being physically active and eating well as previously mentioned, it is preferable for a diabetic to link up with a local support team for help, support and to maintain a positive attitude. Additionally testing blood glucose regularly and medicating appropriately as prescribed is also important. Diabetes Management in General Practise (2009) also emphasises the need to quit smoking (if applicable), have less than two standard drinks per day and ensure BMI (body mass index) in less than 25 to achieve general wellbeing.Hawley Zierath (2008) also outline the importance of minimising the risks and effects of complications. They state that this can be achieved through controlling glycaemia, blood pressure and lipid levels in conjunction with regular health checks (focussing on eye, kidney and foot problems).Section 4Prevention of diabetes is an absolute priority especially when over 60% of type 2 cases are preventable. With diabetes being the 7th leading cause of death in Australia (AIHW, 2010), there is no disbelief why the Australian Government has made the condition a national health priority. According to Weeson (2000), upstream treatment by primary health professionals should be the focus of all approaches. These upstream factors include______________.Simple steps can easily help prevent or delay the onset of diabetes (Type 2 Diabetes, 2011) through implementing a healthy lifestyle. Diabetes Australia encourages individuals to maintain a healthy weight, participate in regular physical activity, eat healthy food, manage blood pressure/cholesterol and not smoke, to decrease the onset of the condition (Type 2 Diabetes, 2011). There is a very healthful link between physical activity and diabetes as previously mentioned, up to now it should benoted that participation in a moderate or preferably brisk walking regimen can decrease the incidence of diabetes by 30% (Jeon, Lokken, van Dam, 2007). Furthermore Jeon, Lokken van Dam (2007) describe this strong relationship saying that there is also a link between the amount of physical activity and the reduction of risk-an amazing 58% decrease in the incidence of prediabetes can be achieved through exercise previously stated.Zimmet (2000) emphasises t hat diabetes cannot be stooped by traditional medical approaches. Given the scale and enormity of the issue, he contends that drastic socioeconomic and cultural status changes are required to make progress. Zimmet (2000) says that international diabetes and public health organisation need to lobby and mobilise politicians and non-government agencies. Through this, the issues causing the pandemic (socioeconomic, behavioural, nutritional and public health) can be addressed. A multi-disciplinary task force is suggested to aid in the reversal of the socioeconomic issues, as Zimmet feels that individuals alone acting to change will not make a big enough difference (Zimmet, 2000).The National Evidence Based Guidelines for the Primary Prevention of Type 2 Diabetes (Colagiuri, Girgis, Gomez, Walker, Colagiuri, ODea, 2009) describe four key areas to creating effective preventative action for diabetes. These includeHaving a strong theoretic base for the programDesigning the program with clea r messages, incorporating a multifaceted approach to deliver these messagesEncouraging family involvementIntensive and sustained vex over a long durationThe guidelines also discuss the facets within the broader community that should be targeted for prevention of the condition. One of the central elements to effectively targeting the population is education (Colagiuri, Girgis, Gomez, Walker, Colagiuri, ODea, 2009). Through media, the guidelines propose that the education can change attitudes as well as levels of knowledge. This can have a particularly profound impact on the short term increase in physical activity. This was seen in the Life be in it___________In terms of prevention for individuals, the guidelines also provided several points specifically targeting those in the risk groups. The guidelines (Colagiuri, Girgis, Gomez, Walker, Colagiuri, ODea, 2009) specify individuals at particular risk as having a score greater than or equal to 15 on the AUSDRISK risk assessment tool . There are three levels of action to prevent the onset of diabetes. Initially lifestyle modifications such as weight management, progressing to pharmacological interventions where necessary and in cases with severe risk bariatric surgery may be considered. Furthering the treatment dietary considerations previously mentioned, in order to prevent diabetes sugar-sweetened drinks have been identified with fast food as items that pose the largest threat of inducing diabetes (Hu, van Dam, Liu , 2001). Fish oil and polyunsaturated fats have also been proven to help with the prevention of the condition.Other-conversion from high risk to low risk lifestyle = moderate stylePhysiotherapists play a large role particularly in the treatment, but also the prevention of diabetes. Ozdirenc, Kocak Gutekin (2004) highlighted the importance of physiotherapy in the accurate prescription of exercise. They suggested that any exercise prescribed in the interest of decreasing complication with diabetes o r preventing it should be undertaken at 65-75% of a persons VO max and emphasised the necessity of a professional in such prescription. According to their study, physical exercise can lead to a significant decrease in physical impairment and provide improvements to functional limitations that the person had suffered. In contrast, they determined that low levels of activity caused a decreased cardio respiratory dexterity and hence lessened ability to walk longer distances. These effects of inactivity too have the potential to be improved through the implementation of a physical activity regime (Ozdirenc, Kocak, Gutekin, 2004). Physiotherapists also play an important role in the prevention of diabetes through education and public health promotion. At an individual level such professionals can help their clients who are identified as being at risk (of diabetes) to make behavioural modifications to lessen their personal risks. In addition to this, physiotherapists can help their patie nts with diabetes arm an exercise program to aid in weight loss and improving their future prognosis.At a broader level physiotherapists can be involved in policy development and other awareness campaigns. For example the National Physical Activity Guidelines require experts and other professionals inputs to develop programs with the key elements previously mentioned such as strong theoretical bases.Conclusion-prevention must be a key focus given that -a condition that is passing amenable to primary intervention