Research Proposal on "Diabetes Prevalence of Diabetes (Diabetes Mellitus)"

Research Proposal 5 pages (1652 words) Sources: 6 Style: APA

[EXCERPT] . . . .

Diabetes [...] prevalence of diabetes (diabetes mellitus) in the urban areas of the United States. Diabetes is a growing healthcare problem in the United States because there are more overweight Americans than ever before, and obesity is a leading cause in the most prevalent type of diabetes, adult onset diabetes, or Type 2 diabetes. Diabetes is especially prevalent in the urban African-American and other ethnic communities, and there are differing opinions about why this is the case.

Diabetes is extremely prevalent in the United States. Two authors note, "Approximately 18.3% (8.6 million) of the U.S. population age 60 and older has diabetes. This population is more likely to experience heart attacks, strokes, hypertension, blindness, end-stage renal disease, and lower-limb amputations than their nondiabetic counterparts (Dabelko & Decoster, 2007). There are two types of diabetes, diabetes Type 1, and diabetes Type 2. Type 1 diabetes is the type of the disease that people are born with or develop early in life, and their bodies do not produce any insulin. Type 2, or "adult onset" diabetes develops over time, and the body gradually develops a resistance to insulin, which is the chemical that keeps diabetes in check. In most Type 1 cases, the patient must take insulin shots throughout their lives. In most Type 2 cases, the disease can often be controlled through managing the diet and weight loss. There is not a cure for diabetes, but it can be managed effectively. Diabetes sufferers must monitor the glucose levels in their blood frequently, and many carry monitors that they can use to test their blood levels throughout the day.

In addition to the health risks diabetes poses for patients, who can suffer from a variety of ailments, from poor blood flow and even amputation, to serious health concerns if their blood sugar goes to high or too low, diabetes is costly for anyone who pays health insurance premiums. The two authors continue, "Annual diabetes health care costs reached $92 billion in 2002 and are expected to increase as the number of older adults and the frequency of diabetes both rise above levels ever experienced in the United States" (Dabelko & Decoster, 2007). Thus, as the country's baby boomers age, a growing number of them will contract Type 2 diabetes, leading to higher health care costs for everyone.

There is a growing prevalence for diabetes to strike lower-income ethnic minorities, like urban African-Americans and Hispanics, although research does not show exactly why this is the case. "The incidence of type 2 diabetes is continuing to increase each year by 6.5%, affecting all socioeconomic classes and both men and women. This type of diabetes particularly afflicts older adults and certain racial ethnic groups including African-Americans, Latinos, Native Americans, and Asian-Americans" (Cox, Carpenter, Bruce, Poole & Gaylord, 2004). There are some theories, however, that are based on income levels, education levels, diet, level of education, and other factor like availability of health insurance that adversely affect low-income inner city populations, and can adversely affect their health, too. For example, one study shows that diabetics manage their blood levels if they have less education. A study found, "Glycemic control was significantly worse for less educated adults than more educated adults with diabetes, and mean systolic blood pressure was significantly higher for less educated than more educated adults with hypertension" (McWilliams, et al., 2009, p. 508). These individuals often have less access to health care due to lack of health insurance or public health insurance, such as Medicare, which may not provide all the health care services they need.

Another issue with lower-income ethnic minorities when it comes to diabetes is their ability to self-manage their disease. Many healthcare professionals advocate creating self-help instructional programs in highly affected inner cities and/or rural areas. Another group of authors notes, "Such interventions are perhaps most needed within low-income communities, where rates of type 2 diabetes are consistently high, and access to medical care for treating diabetes complications is often limited" (Shaw, Gallant, Riley-Jacome & Spokane, 2006). Diabetes is most often managed at home, by the patient and/or their family, so education on the proper use of insulin or glucose tablets, how to blood sugar levels, how to check for circulation problems, and such, can be taught by doctors, nurses, or community programs, but the patients have to know these are available and they are attainable. These authors concluded that self-care education is extremely important, and that it is most successful when it is implemented and followed up by social care organizations and the family. They write, "Beyond this, the current findings suggest the potential importance of family and friends, as well as neighborhood resources, as sources of support for diabetes self-care" (Shaw, Gallant, Riley-Jacome & Spokane, 2006). Often, these neighborhood resources are unattainable in urban neighborhoods, and ethnic minorities either do not know about other resources in other areas, or they have no way to reach them. This can help keep diabetes incidents higher and successful treatment lower. They often have less education, so they have less understanding of the educational materials and instructions necessary for self-care. Another group of authors state, "Low-income individuals may not understand or follow the education provided for diabetes self-management, if that education does not take into account the patient's prior knowledge, understanding, beliefs, attitudes, and barriers (real or perceived)" (Cox, et al., 2004).

Studies show that diabetes and the associated health risks are growing in this ethnic population, while they are lessening in the white population. Another group of authors continue, "However, racial, ethnic, and socioeconomic differences in blood pressure and glycemic control have persisted or widened, suggesting that more focused efforts are needed to improve the quality of care for black, Hispanic, and less educated patients" (McWilliams, et al., 2009, p. 513). This treatment could include the self-help education and support noted above, and it could also include more healthcare options in poor urban neighborhoods, where the prevalence of diabetes is growing the quickest.

Another way to control the problem is to expand insurance options. The author's group continues, "In particular, because black, Hispanic, and less educated adults are much more likely to be uninsured or underinsured, expanding insurance coverage may be especially beneficial for these groups" (McWilliams, et al., 2009, p. 510). Of course, creating nationalized health care could help this segment of the population, and ensure they receive the health care they need, which ultimately could reduce health care costs for all of the insured, because they could result in lower diabetes-related emergency room and hospitalization costs, which would reduce the cost of premiums, eventually.

Studies have confirmed there is a higher incidence of diabetes among Black Americans. Another group of researchers note, "African-American subjects had been diagnosed with diabetes for a longer period than Caucasians (12 years vs. 8 years), […] The earlier onset of diabetes among African-Americans may be due to ethnic differences in diabetes risk and to a higher rate of obesity among this group than among Caucasians" (Cox, et al., 2004). Researchers do know that obesity is one of the risk factors for developing Type 2 diabetes, and that the urban poor tend to be more obese due to lack of variety and availability of healthy foods in their diets. In addition, this population is often difficult to educate about healthy eating, due to educational and monetary restraints.

There is another aspect of this phenomenon of diabetes in the inner city that is especially troubling. Many more children are contracting Type 2 diabetes now, and it used to be confined largely to the adult population. Many of these children are minorities, as well. Another author notes, "Once seen only in adults, type 2 diabetes has been rising steadily in children and teens, especially black, Hispanic and American Indian adolescents, according to government reports from… READ MORE

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