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Type 2 Diabetes Research and Analysis Paper: Insight Into Effective Treatment in Merced County

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Type 2 Diabetes Research and Analysis Paper: Insight Into Effective Treatment in Merced County Vol. 6 Issue 1 2014 Type 2 Diabetes Research and Analysis Paper: Insight into Effective Treatment in Merced County Tori Palmberg May 20, 2014 Acknowledgements My friend, Michael, assisted me with proofreading, spelling, clarity, and grammar Authors Contribution: T.P. wrote this manuscript. T.P. certifies that T.P. did not receive any help with the content of this manuscript and has complied with the University of California, Merced Academic Honesty Policy, including not representing the work of others as my own, and plagiarizing/failing to properly acknowledge the intellectual property of others. Introduction able, type 2 diabetes is a very serious issue affecting the residents of Merced County. The purpose of this study is to research Compared to all 58 counties in California, the disease Type 2 Diabetes and to dis- Merced ranks 50th in the number of deaths cover whether it is being effectively treated from this disease, with an age-adjusted and prevented in Merced County, Califor- mortality rate of 26.1 deaths per 100,000 nia. According to the National Institute of the population (2007-2009)4. In com- of Health, Type 2 Diabetes Mellitus is a parison, California's age-adjusted average \chronic disease in which there are high lev- is 19.5 deaths5. However, we find that els of sugar (glucose) in the blood. It is Merced fairs better than the 65.8 deaths also the most common form of diabetes"1. set as the target rate by Healthy People There are many risk and lifestyle factors 20206. In addition, healthypeople.gov has associated with this disease, with the most an overarching goal related to type 2 dia- prevalent being obesity (#1 risk factor), betes and health which is to reduce disease sedentary lifestyle, unhealthy eating habits, and lessen economic burden, while improv- family history and genetics, increased age, ing the quality of life for all persons who high blood pressure and high cholesterol, have, or are at risk for the disease7. They and a history of gestational diabetes2. The hope to achieve this through several mea- long term complications from having type sureable objectives which include: reducing 2 diabetes can include but are not lim- the number of new cases and death rates re- ited to: eye problems (cataracts and glau- lated to diabetes in the population, improv- coma), foot problems (neuropathy/ nerve ing glycemic control for persons with the damage), skin problems (infections), high disease, and increasing prevention for those blood pressure (which raises your risk for at high risk for diabetes with prediabetes8. heart attack, stroke, eye problems and kid- By understanding the risk factors and so- ney disease), hearing loss, oral health is- cial determinants related to those with type sues, mental health issues and early death3. 2 diabetes in Merced County, researchers Based on the quantitative data avail- and other health professionals can hope to 73 Vol. 6 Issue 1 2014 improve the overall health of those with the adoption of the Western diet of processed disease, and slow or prevent others with a and refined foods as well as lack of phys- predisposition to diabetes. ical activity. In addition, Hispanic boys ages 12-19 have shown the most significant increases in obesity among the U.S. pop- Literature Review ulation outpacing African American's and other minorities13. As demonstrated, fac- The overabundance of literature and re- tors such as race/ethnicity, behavior, and search regarding type 2 diabetes reveals lifestyle are all part of a much larger path- a significant relationship between the dis- way or trajectory that encompasses a per- ease and a person's behavioral and lifestyle son over their life course which contributes choices. While researchers do not know to poor health and the development of dis- why some individuals develop diabetes and eases like type 2 diabetes. others do not, what is known is that poor The likelihood of acquiring type 2 di- diet, lack of exercise, weight, family his- abetes can be assessed by analyzing and tory, race, and lack of access to healthcare evaluating the progression of factors and are key factors associated with the disease9. related social determinants related to the According to several recent studies, includ- disease over the course of one's life. Begin- ing a study from the World Health Orga- ning with the socioeconomic status (SES) nization, lifestyle factors, namely poor diet of the parents; it is important to consider and obesity act as a catalyst for the dis- the impact that little or no education, low ease as more and more people are eating income, and unstable occupation can have a calorie-dense diet of processed foods rid- on the health outcome of an unborn child. dle with refined sugars10. This behavior Studies have shown time and again that in- coupled with inactivity from a sedentary dividuals of lower SES are more likely to lifestyle may lead to type 2 diabetes mel- have limited access to resources which in- litus. While behavior and lifestyle factors clude supermarkets, parks and other recre- are closely associated with diabetes, there ation spaces, and quality healthcare14. In are several other significant considerations. addition to SES, maternal health is another While it is often difficult to distinguish social determinant that can have a sub- causal mechanisms related to disease, re- stantial effect on the health of the unborn searchers are able to make very impor- child. The mother's weight (obesity), fam- tant correlations between factors. Along- ily history of diabetes, and genetic predis- side factors such as behavior and lifestyle, position, all play a pivotal role in their con- a person's race and ethnicity is also thought tribution to whether a child will go on to to play a key role in assessing risk fac- develop diabetes in later life.1 Childhood tors related to type 2 diabetes. A study obesity is an important social determinant from the American Journal of Clinical Nu- and one of the fastest growing epidemics in trition examines the relationship that par- the Western hemisphere. According to the ticular races/ethnicities may have when Center for Disease Control and Prevention, it comes to diabetes11. Findings suggest obese adolescents are more likely to have that, in general, African American's were prediabetes; which is a condition in which more likely to report diabetes than Cau- high blood glucose becomes a predictor for casian's especially at older ages and at diabetes16. In addition to childhood obe- higher body mass indexes12. It should sity, studies are revealing that children who also be noted that in recent years, dia- maintain an inactive, sedentary lifestyle, of- betes among Hispanics/Latinos has been ten go on to become obese young adults steadily on the rise, primarily due to the with poor eating habits and lack of phys- 74 Vol. 6 Issue 1 2014 ical activity. The lifetime accumulation of prevalence rate of diabetes. In Merced these social determinants lead to poorer County alone, there are approximately health outcomes than those with a higher 15,000 diagnosed persons with diabetes, SES, who maintain a healthy weight, eat a which is 8.9% of the total population (See proper diet, and exercise on a regular basis. Table 1). Most notably, the obesity rate These social determinants play key roles as in the County stands at 28.7% of the total predictors of whether or not someone is at population, which is significant when con- high risk for a non-communicable disease sidering that obesity is one of the leading such as type 2 diabetes. Discussion social determinants for developing this dis- Recent research about diabetes, its de- ease. In addition, Merced County ranks a th terminants, and who is most at risk, staggering 50 out of 58 counties in the demonstrates the effects that a disease such number of deaths from this disease (See Ta- as this has on a nation, at the state level, ble 1). and in one's own community. In the United Based on known risk factors, social States alone, diabetes affects over 25 mil- determinants, and county demographics, lion people which is approximately 8.3% of Merced County's Hispanic population are the total US population (See Table 1)17. at greater risk for poor health outcomes Of those affected, 18.8 million have been from this disease as they makeup over half diagnosed, leaving over 7 million people of the population and comprise 41.3% of undiagnosed and untreated. According to those diagnosed with prediabetes and dia- many studies and national sources, as pre- betes (See Figure 1). Hispanic's are also at viously mentioned, the attributing factors high risk of developing heart disease, hav- are directly correlated with behavioral and ing a stroke, needing a limb amputation, lifestyle factors, namely diet and lack of acquiring blindness, and dying of an early exercise (obesity), and predominantly af- death from this disease. Research con- fect those with low socioeconomic status. ducted by the University of California, Los Among those diagnosed at the national Angeles Center for Health Policy supports level, we see that African Americans and the underlying data that the obesity rate Hispanics have the highest rates of preva- in Merced County, race, poverty level, and lence at 12.6% and 11.8%18. When eval- even immigration status are major contrib- uating diabetes at the state level, health utors to the rising cases of diabetes21. In data shows that an overwhelming 1 in 7 order to lower incidence rates and slow the Californians has been diagnosed with dia- progression of new cases in Merced over the betes, with that number growing rapidly. next decade, intervention, prevention, and The total number of cases in California has outreach must be accessible to those most reached 13.8 million which comprises 13.8% in at risk and in need.
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