Diabetes: The Future of a Chronic Disease

Diabetes: The future of a chronic disease

The number of cases of type II diabetes has seen a dramatic increase in recent years, both in the United States and worldwide. The primary reasons for this increase are generally attributed to increased consumption of high-sugar, high-starch, and highly caloric food and a lack of exercise. The International Diabetes Foundation estimates that "one in 10 of the world's population will have diabetes by 2035" (Greenberg 2013). Diabetes is "the sixth leading cause of death in the United States" alone (Diabetes disparities among racial and ethnic minorities, 2001, AHRQ). Addressing this national and global epidemic is essential given the common, conventional wisdom in public health that "people will make the healthy choice when the healthy choice is the easy choice" (Greenberg 2013). In the developed, developing, and even the minimally developed world, it is increasingly easy to eat foods associated with triggering the disorder and to engage in lifestyle practices that exacerbate risk factors (Greenberg 2013).

Treatments

The goal of all forms of diabetes treatment is to stabilize blood glucose levels, which requires careful monitoring. The types of treatments suggested for patients with type II diabetes vary depending upon the stages of the disorder and the severity of the case. For patients with 'pre-diabetes' or high blood sugar and associated risk factors not deemed to be serious enough to warrant a full diagnosis, changes in eating habits and exercise may be suggested before medication is prescribed.

Insulin remains one of the most common treatments for diabetes. Insulin may be injected or "delivered through a small tube (catheter) that is placed under the skin (usually in the abdomen)" called a pump (Diabetes mellitus treatment, 2013, UCSF Health). A variety of types of insulin may be used, including rapid-acting, short-acting, intermediate-acting, and long-acting (Diabetes mellitus treatment, 2013, UCSF Health). Oral medications may also be prescribed with or instead of insulin which "improve the effectiveness of the body's natural insulin, reduce blood sugar production, increase insulin production and inhibit blood sugar absorption" (Diabetes mellitus treatment, 2013, UCSF Health). New, recent drugs have been approved which operate on areas of the body other than the pancreas and the liver, the main organs associated with diabetes. New medications "focus action on hormones called incretins" and "have an added bonus of promoting weight loss" (Spotlight on new diabetes treatments, 2013, Joslin Diabetes Center). This reflects a new understanding of how glucose is regulated, not merely "as a conversation between a few key players: the pancreas, the liver, muscle and fat" but also through "hormone[s] from the skeleton" which "influence how the body handles sugar" (Schaffer 2013).

Technology

Although diabetes is a growing epidemic with serious health consequences, one 'good' aspect of its ubiquity is that there have been major investments in improving technology to make living with the disorder easier. Noted one diabetic regarding his insulin pump, which maintained a normal blood glucose level for him nearly effortlessly: "I'm wearing and using, in living color, the Tandem T:slim insulin pump, Dexcom G4 Platinum continuous glucose monitor (CGM), and OneTouch VerioIQ meter. All have easy-to-read full-color screens with extra features. They're also rechargeable and use standard USB cables" (Farrell 2013). Given that precise monitoring of glucose levels is essential to minimize the long-term complications of the disorder, this is a positive development. As more and more people use health monitoring devices that connect to smartphones and other portable devices, diabetics can make use of such information to "measure heart rate, exercise intensity and duration, blood pressure, and/or weight" to optimize their health status (Farrell 2013)

Diabetes training and education

Despite these advances in treatments for diabetes, diabetes remains a chronic condition with potentially life-threatening consequences for the individual, including blindness, loss of limbs, and death (Diabetes: Times topics, 2013, The New York Times). Diabetics have higher rates of high blood pressure, heart disease, kidney disease, eye disease, nervous system disease, heart attack, and stroke. Thus, early intervention is considered to be extremely important in stopping the spread of the disorder. Offering nutritional and lifestyle counseling to patients identified as high risk for developing the disorder; promoting healthy environments which encourage physical activity and discourage overeating; and changing the habits of children when they are still young and developing eating preferences, are all the foci of recent public health campaigns. Type II diabetes was once called 'adult onset' diabetes because it primarily occurred in older patients, but now there has been an upsurge in this disorder amongst children. Unlike type I, which is an autoimmune disease with largely genetic causes, lifestyle factors play a major role in the development of the type II form of the disorder.