In order to correct or avoid a medical condition, especially one that is preventable, a person has to have a good understanding of what is causing that condition and how to prevent (or reverse) it in order to promote optimum health. However, one cannot work on preventing a condition without examining the literature on it, in an effort to determine what actually works and what does not. There are many "cures" and "remedies" for a number of conditions, and a significant number of those remedies and cures are not helpful. Some may actually be dangerous, so it is very important to understand the true nature of what is being offered to a person or a community when it comes to remaining (or becoming) healthy. Here, type II diabetes will be discussed in order to determine how to use the literature review and other data so it can be applied to community-based healthcare settings and county hospitals.
The conclusions and insight that are derived from the analyses will provide guidance for a program of disease management and assist in the decision-making process when it comes to allocating healthcare resources. In turn, that can help the county address challenges and confront concerns that are related to the prevention of type II diabetes within the confines of the community. How successful this turns out to be will depend on the community and the county, as all of them are different. However, in areas where there are a number of people who have type II diabetes or who are at risk for developing it, it is clear that more must be done. While rates of type II diabetes have risen in step with obesity rates since the 1960s, it is also important to note that there are other health issues that can cause diabetes -- and that some cases do not seem to have a specific cause (Boussageon, et al., 2011; Ripsin, Kang, & Urban, 2009; Zanuso, et al., 2010). It is also important to note that type II diabetes may not be preventable in every single case, but that the illness is still considered a preventable one in that the majority of cases can be prevented if risk factors are caught in time (Farmer, et al., 2012; Fasanmade, Odeniyi, & Ogbera, 2008).
Diabetes (both type I and type II) are caused by high blood sugar. Insulin is supposed to work in the body in order to keep blood sugar relatively stable and at the proper levels, but it is not always successful in doing so (Shoback, 2011). Because of that, some people's blood sugar rises too high, and when that happens consistently they are diagnosed with diabetes. Type I diabetes occurred when the body either does not produce insulin or does not produce enough insulin for the person to function properly and safely (Zanuso, et al., 2010). This generally occurs in childhood, and many people are born with this condition. While it is treatable, there is no cure and no way to prevent it. However, type II diabetes -- often also called adult-onset diabetes -- is very treatable and generally preventable in most people (Ripsin, Kang, & Urban, 2009). For these individuals, the body is making enough insulin but it is not being used properly in order to keep blood sugar levels low. When people visit their doctor and their blood sugar is elevated, this is investigated further in order to determine if it was an isolated incident or a pattern. There are two issues to consider.
First, the person's blood sugar should not be too high as a baseline number. If the person has fasted before the appointment, a better, more accurate blood sugar reading can be obtained (Boussageon, et al., 2011). Second, if the person has not fasted it is possible that his or her blood sugar is elevated because of something he or she recently ate or drank. That can raise the number, but there are still limits to how high it should go. If eating something sugary sends a person's blood sugar soaring, that could still indicate a problem, since a properly working body that is handling insulin correctly will not allow blood sugar spikes that are severe (Zanuso, et al., 2010). More insulin will be released when something sugary is consumed, and that will help bring the blood sugar back in line with normal limits. A person's fasting blood sugar number should generally be between 90 and 120, and it can rise higher after a meal (Vijan, 2010). There is also a condition called pre-diabetes, where blood sugar is only slightly (but consistently) elevated.
It is the people in the pre-diabetic range who are most in need of treatment. These people are not yet diabetic, but if they continue on their present path they could become diabetic in months or years. When a person is discovered to have pre-diabetes, it must be stressed to him or her that diabetes is on its way, but that it can usually be prevented if the person is willing to make changes. Some people will not take this seriously. They will avoid their doctor's advice and continue to do as they please -- and many of them will develop diabetes as a result. If they do not take that seriously, they will end up taking medication for the rest of their lives. Even with medication, there can still be complications that arise from diabetes, and many of those are very unpleasant. For those who do not take their health seriously, serious complications are sometimes required before they begin to make changes in their life. By then, the damage is already done, and it can be significant. The best time to catch and prevent diabetes is before it ever starts, and working with people who are non-diabetic and pre-diabetic is a good way to help prevent the disease (Boussageon, et al., 2011; Farmer, et al., 2012).
People who are pre-diabetic have elevated blood sugar when they are fasting, but not elevated enough to technically be considered diabetic. They may also have poor blood sugar control over time, in that eating something sugary can cause their blood sugar to rise excessively and/or return to normal much more slowly than someone who does not have the disease (Vijan, 2010). These people generally have a few things in common. First, they are often overweight or obese. Being overweight does not cause diabetes in every person, as there are overweight people who do not have the disease. Additionally, there are some thin people who develop pre-diabetes, but it is less common. Generally, people who carry around extra weight have a more difficult time with blood sugar control, so more of them are likely to be pre-diabetic (Zanuso, et al., 2010). The best way for them to avoid becoming diabetic is to lose weight.
Second, these people generally do not get much exercise. That is not to say that a very active person cannot develop pre-diabetes, because it can and does happen. However, those who are active have a lower risk of the disease than those who are very sedentary (Zanuso, et al., 2010). Often, a lack of exercise correlates with being overweight or obese, but that is not always the case. Some overweight people are very active, and some thin people are highly sedentary. People who are not active and who are diagnosed as being pre-diabetic can benefit from starting an exercise program -- with their doctor's approval -- and making sure they stick to that program so they can have a higher chance of avoiding becoming diabetic in the future. Pre-diabetes is a warning, and it gives the person being warned a chance to change habits and other factors in order to lower his or her risk of actually developing a chronic illness that could cause serious impairment and even an early death.
Third, people who are pre-diabetic generally have poor diets. They are more likely to eat processed foods and fast food, and they also drink more soft drinks. They may consume more carbohydrates, which are turned into sugar in the body, and they may also eat more candy, pastries, and other sweet foods (Kumar, et al., 2005). That is not to say that people should never have any of these things. Many people can and do consume these foods in moderation without harm to their health. For those who are pre-diabetic, though, these foods may be off limits or severely restricted. When someone is pre-diabetic, it is important that he or she learns to eat healthier. Consumption of proteins and vegetables is emphasized, with fruits in moderation because of their high sugar content (Zanuso, et al., 2010). Many doctors will recommend that people who are pre-diabetic drastically reduce the number of carbohydrates they eat, and that they avoid or significantly reduce their intake of sugar from sodas and candy. People who follow their doctor's advice may be able to avoid becoming diabetic.