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Researchers used this information, and designed it in such a way that it fit in with the lifestyle that this population was accustomed to (Acton, Shields, Rith-Najarian, Tolbert, Kelly, Moore, Valdez, Skipper, & Gohdes, 2001). This allowed the researchers not only to study the population more closely, but also to achieve a major degree of success that might not have been possible in a standard intervention program. The study found that many of those who completed the intervention program had lowered blood pressure, lowered weight, and lowered blood sugar levels (Acton, Shields, Rith-Najarian, Tolbert, Kelly, Moore, Valdez, Skipper, & Gohdes, 2001). While this was encouraging, the researchers were also careful to note that the only way the Native American population will actually decrease in their levels of diabetes is to continue the changes made during the intervention program over the course of their lives.
Another study detailing the importance of intervention programs was performed by nurses who realized the significance of remaining in a culture for some time before a true understanding of that culture's ideals was apparent (Costacou, Levin, & Mayer-Davis, 2000). These nurses found that, while there was a lot of literature and information on diabetes and the American population, it was not really sufficient for the work that they wanted to perform. They note in their research that spending an extended period of time immersed in the culture that they were studying was extremely useful in furthering their research.
Among some of the desires of the nurses were training some of the Native Americans to be caregivers, respecting the ideals of the culture, and conducting research that met the needs of the Native Americans while being careful not to make them feel as though they were being experimented on (Costacou, Levin, & Mayer-Davis, 2000). The project was funded for three years, and during that time the researchers note that they were able to learn a great deal by spending time with the Native Americans and learning about their values. Researchers found that when they respected of the values of the people and made a sincere effort to be accepted, they learned much that was of value and were able to do much more toward helping them avoid diabetes (Costacou, Levin, & Mayer-Davis, 2000).
The Diabetes Quality Improvement Project, which has been around for several years, was modified slightly for use with the Native American population, but it can be used with any population that is found to be at risk. Primarily, glucose control and blood pressure were examined. Since the original project had such small ranges of measurement for these items, many of these were omitted or changed because they were simply not practical. Even though the original project was modified slightly, and therefore this also affected the results, it was still a very useful tool in determining the prevalence of diabetes in the Native American population. Since there was no original, established baseline, it took several years of study before the data could really be compared against previous data. Even though this was a complication, the researchers still found the original project to be a useful tool that, when modified, greatly assisted their examination into the causes and complications of Type II diabetes.
Diabetes and Diet
One of the main concerns for Americans when it comes to diabetes is diet (Kramer, 1992). More and more Americans are overweight or obese, and this is a large contributing factor to the prevalence of diabetes in the population. In order for Americans to lessen the frequency with which diabetes occurs, the need to be informed about correct dietary choices and implementation of the correct dietary choices must also be established (Kramer, 1992). The United States Department of Agriculture, as well as the American Diabetes Association, have set out guidelines dealing with proper nutrition and weight management that are instrumental in helping those with diabetes.
In addition, other countries are also seeing their citizens gain weight at an alarming rate because of the western influence that a lot of them are getting. With that being the case, the prevalence of diabetes is beginning to rise in those countries, as well, and steps must be taken to educate these individuals about the foods that they are eating and how this could be causing much of the problem.
Living With Diabetes - Medication and Treatment
Because so many people are living with diabetes (either Type I or Type II) today, treating it has become something of a problem for some doctors. It is not that the disease cannot be treated, but simply that there are so many people to treat (Gilliland, Azen, Perez, & Carter, 2002). For Type I diabetes, insulin shots are the standard treatment. How much insulin must be injected into the body and how often depend on the person's resistance to insulin, what they eat, and how well-controlled their diabetes is. For some people, there is little problem other than some inconvenience.
For other people, controlling their blood sugar becomes seriously difficult, and they can end up having an insulin pump. This is a device that is permanently attached to them, and it monitors their blood sugar and gives them insulin as they need it. They must not take it off or go without it, and it becomes very inconvenient for many individuals who feel that their diabetes has damaged their quality of life (Gilliland, Azen, Perez, & Carter, 2002). For these Type I diabetics, diet is important but will not control the insulin problems that they are facing on a daily basis.
For those with Type II diabetes, lifestyle changes such as exercising and losing weight, coupled with a proper diet, are sometimes enough to control their problems. If not, they can take what is commonly called a 'sugar pill,' but is not actually sugar. These medications are designed to help people with Type II diabetes control their blood sugar without the need for insulin shots, by helping them process the insulin that their body is making more efficiently. They do not need the extra insulin that the shots would give them, they only need to convince their bodies to use their current insulin levels (Gilliland, Azen, Perez, & Carter, 2002). For these individuals diet is very important, as it can help to control their disease very well in many people, and this is especially true of younger people who are just developing Type II diabetes or are at risk for developing it because they are overweight and have a sedentary lifestyle. If they can be addressed and their lifestyles changed, this could also help the next generation avoid diabetes.
Through interviewing a large group of Americans, researchers discovered that many Americans were not eating the type of diet suggested for those who either have diabetes, or are at risk for diabetes (Kramer, 1992). There was a lack of fruits and vegetables, for example, in the typical American diet. Fat intake was also rather high. Researchers concluded that many Americans were not following proper dietary guidelines, and this was, in part, the cause of the high rate of diabetes among the population.
The prevalence of Type II diabetes in the American population, while cause for concern, is not entirely surprising when the research into the subject is examined. For example, many studies mention obesity as an issue for many Americans. The correlation between obesity and diabetes has been well documented in other research. Research does seem to indicate, however, that those with Native American blood have a greater propensity to develop Type II diabetes when other risk factors such as obesity or smoking are placed into the equation. Not only do these studies indicate that Type II diabetes is a problem for many Americans, but there is also an indication that Type II, or adult onset, diabetes is occurring at younger ages. Researchers find this particularly troubling, as it shows a disease that is developing much more rapidly than anyone would hope for.
Acton, Kelly J., Shields, Ray, Rith-Najarian, Stephen, Tolbert, Bernadine, Kelly, Jane, Moore, Kelly, Valdez, Lorraine, Skipper, Betty, and Gohdes, Dorothy. 2001 Jan. Applying the Diabetes Quality Improvement Project Indicators in the Indian Health Service Primary Care Setting. Diabetes Care, v24 i1 p22.
Costacou, Tina, Levin, Sarah, and Mayer-Davis, Elizabeth J. 2000 July. Dietary patterns among members of the Catawba Indian nation. Journal of the American Dietetic Association, v100 i7 p833.
Gilliland, Susan S., Azen, Stanley P., Perez, Georgia E., and Carter, Janette S. 2002 Jan. Strong in body and spirit: Lifestyle intervention for native American adults with diabetes in New Mexico. Diabetes Care, v25 i1 p78-83.
Gilliland, Susan S., Carter, Janette S., Skipper, Betty, and Acton, Kelly J. 2002 Dec. [hba.sub.1c] levels among American Indian/Alaska Native adults. Diabetes Care, v25 i12 p2178-2184.
Jacobson, Sharol F., Booton-Hiser, Deborah, Moore, John H., Edwards, Karethy a., Pryor, Sue,…[continue]
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