Diabetes Needs Assessment in a Community with Identified Areas

Running Head: DIABETES MELLITUS DIABETES MELLITUS 10 10 DIABETES MELLITUS Name of the Student Name of the University Author’s Note Introduction This report will summarize the health needs assessment that is needed in an identified population through an interview of a patient and it will include the description of the population with identified areas for the needs assessment, the epidemiology of diabetes in this community and the prevalence of diabetes in Singapore that will include the high risk groups

Running Head: DIABETES MELLITUS
DIABETES MELLITUS
Name of the Student
Name of the University
Author’s Note

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Introduction
This report will summarize the health needs assessment that is needed in an identified
population through an interview of a patient and it will include the description of the population
with identified areas for the needs assessment, the epidemiology of diabetes in this community
and the prevalence of diabetes in Singapore that will include the high risk groups, the services
and interventions that is already existing for the care of this disease, identification of unmet
needs and the proposal plan that will be designed to combat this issue (Zimmet et al., 2014).
Interview for health assessment
The health needs will be identified of a patient who is named Mr. A and he is a 60 year
old man of the Chinese origin. He was diagnosed of diabetes mellitus around 3 years back and
he is under the medication known as metformin 850 mg thrice daily to control and prevent
further complications due to diabetes. The prevalence of diabetes is common in Singapore and
the patient is from the same community, which makes it necessary for the healthcare sectors to
work in collaboration to find a solution for such issues. Mr. A has been trying medical
interventions, therapeutic diet and physical activities to maintain his blood glucose levels. He
was unaware of the consequences of this disease because initially he thought it is a flu and it will
be treated through medications. After a long time he realized what diabetes is and he needed to
live with it his whole life through lifestyle maintenance. This shows the unawareness of people
who are not educated about the chronic diseases and its consequences to their health (Zheng, Ley
& Hu, 2018).
Diabetes is a chronic lifestyle disorder that occurs when the blood glucose levels are not
under control due to the low secretion or no secretion of insulin hormones and when the body

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becomes insensitive to the action of insulin. When there is an excess amount of glucose in the
blood, it can lead to severe issues such as cardiovascular diseases, diabetic neuropathy, kidney
disease, stroke and cataract (Papatheodorou et al., 2016). The global prevalence of diabetes has
risen from 4.7% to 8.5% in the time span of 1980-2014 amongst adults above the age of 18. This
is an alarming rate and is threat to the global public health as well as the healthcare sectors.
Diabetes is divided into three categories according to its pathophysiology such diabetes type 1,
diabetes type 2 and gestational diabetes. The most common type of diabetes is diabetes mellitus
type 2 as the reason for its prevalence is unhealthy lifestyle that includes alcohol, trans-fat, diet
rich in refined food, smoking and a sedentary lifestyle. This paper will be discussing about
diabetes mellitus type 2.
Epidemiology in Singapore
Singapore has a changing demography of diabetes mellitus and the prevalence keeps
rising almost every year. From 1975 to 1984, the rate increased from 2% to 4.7%, in 1992 the
rate was 8.6% and 9% in adults between the ages of 18-69 years in 1998. The most risked groups
are Malay with 14.3%, Indian women with 14.9% and Indian men with 16.7%. The reason for
such alarming incidence rate is due to the fact that it is an affluent country with a fast growing
population including the deterioration of the quality of lifestyle with a rise in sedentary lifestyle,
which is eventually leading to fast ageing in the population (Phan et al., 2014). A population
15% in Singapore has been have the issue of impaired glucose tolerance (IGT). Diabetes is the
reason for 39.7% of strokes in the country and the reason for 9.3% of deaths in the country. The
6th leading cause of death in Singapore is Diabetes Mellitus as the children is also diagnosed with
type 2 diabetes mellitus, which is due to obesity (Kove et al., 2017). The prevalence of obesity is
highest in Malay community with 16.2%Indian communities with 12.2%, and Chinese

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community with 3.8%. This can be controlled by decreasing childhood obesity, stopping the
consumption of alcohol and tobacco, and promoting physical activity amongst adults. The global
statistic shows that the prevalence of diabetes in the age group of 20-79 years is 463 million and
it is predicted that it will increase 700 million till the year 2045 according to the International
Diabetes Federation. The majority of the diabetic patients are found in the middle and low
income countries and that consists of 79%. Approximately, every 1 in 5 individual is a diabetic
and every 1 person in 2 individuals are not diagnosed. A total of 4.2 million deaths have been
reported due to diabetes and the loss of monetary gains is predicted to be 760 billion dollars only
in the healthcare sectors (Ng et al., 2014). It is also being predicted that around 374 million
people are susceptible to being diagnosed with diabetes mellitus type 2. The incidence rate of
diabetes in Singapore is higher than the global rate, which is 12.8% and 10.8%, respectively
(Guariguata et al., 2014).
Existing Services and Interventions
Singapore Ministry of Health has been implementing action plans and policies for
controlling the epidemic of diabetes in the country. In the year of 2016, a set up was created
known as National Diabetes Prevention and Care Task Force to eradicate and control the issue of
diabetes mellitus. It was done to improve the quality of public health in Singapore and reduce the
incidence of diabetes as it is becoming a matter of national concern. The mission of this
framework was to make people live without the trauma of diabetes and if they are diagnosed
with the disease then they should know how to manage (Ting et al., 2016). The strategic
framework of this initiative was to prevent the prevalence of this disease through safe living,
detecting it in the early stages and prevention, and enhancing ways for disease control. The name
of this campaign was War on Diabetes and it published a report that suggested that different

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ways and methods are being implemented for the citizens of Singapore, which included safe
alternatives. The government of Singapore also planned interventions to provide healthy food in
schools to encourage healthy living and prevention of childhood obesity, this would help in
promoting healthier habits in every generation. The Department of Education and the Early
Childhood Development organizations have been collaborating with the government to increase
physical activity in children through the medium of educational institutes. This is for every age
group in the country so that everyone will be aware about the importance of healthy diet and
physical activity to reduce the issue of chronic lifestyle diseases. In the year of 2017, the
Ministry of Health started a fund known as Screen for Life (SFL) and it supported the plan to
increase screening surveillance activity regarding the prevalence of diabetes. In the year of 2019,
the ministry of health started a diabetes no-screening tests, which will help the citizens of the
country to feel more flexible about the initiative. The healthcare sectors that includes clinics of
general practitioners will have an extensive team for the people suffering from diabetes mellitus
and the coordination between the interdisciplinary team will be more efficient in maintaining a
smooth flow of work. The Singapore Integrated Diabetic Retinopathy Program (SiDRP) started
offering a screening system, which was standardized for all the polyclinics, so that it would
diagnose issues in the eyes of diabetic patients and chronic renal diseases (Gupta et al., 2017).
This initiative was planned to systematically reduce the prevalence of chronic kidney failure in
April, 2017. Another initiative was started by the National Foot Working group and it focused on
the complication of Diabetic foot, which occurs in diabetic patients. It planned strategies to
control diabetic related amputations, and promoted health campaigns and risk management
interventions through healthcare sectors for diabetic foot screening. A hospital in Singapore
started interventions for tele-medical facilities for improving Patient Relationship Management

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(PRM) through the health management unit. The strategy included training the patients regarding
a healthy diet therapy, hypoglycemic treatment, smoking prevention, diabetes education, lifestyle
improvement plans and learning sessions regarding treatment of co-morbidities (Ley et al.,
2017). The program also included techniques for self-management such as self-monitoring,
monitoring the clinical indicators, collaborating the health teams to resolve issues. The use of
multidisciplinary teams in the healthcare industries is needed for the control of diabetes and it
improves the health management through aids such as tele-health services. All these
interventions have been utilized for the prevention of diabetes. However, it can be successful
only if it is maintained for a longer period and if it is valid for every culture and communities
that also includes high risk groups. The situation of the country regarding the issue of diabetes is
sensitive and it needs such services and interventions for the betterment of the country (Png et
al., 2016). The sustainability of these programs have been showing results in the enhancement of
public health but it still needs more attention towards the incidence rate because people are
unaware about the management and control.
Identification of unmet needs
The unmet needs of these population will be evaluated with the help of the patient and his
interview, which gives a picture about the requirements that is extremely necessary for the
betterment of public health. Mr. A has a tendency of eating junk food and snacks, which is the
cause of his obesity. It could be said that his prevalence of diabetes might be due to his obesity
because it is one of the risk factors that causes diabetes during adulthood (Lin et al., 2017). When
he was diagnosed with diabetes, he was in consultation with a dietician and he was advised to
lose weight. He was told to maintain his required BMI, which was between the ranges of 18.5 to
22.9kg / m2. He was given this advice because he was also susceptible to cardiovascular diseases

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and he is already diabetic. The diet recommended for him was a balanced diet that consisted of
all food groups in moderate amounts including carbohydrate or starchy food, fiber rich meals,
and including healthy options such as herbs and spices in every meal so that he could reduce his
glucose production (Esposito et al., 2017). Another dietary advice given to him was that he
needed to have every meal in short intervals so that his blood glucose levels do not fluctuate. He
used to follow the protocol of foot and eye screening every year to reduce the chances of diabetic
neuropathy and diabetic foot (Zhang et al., 2017).
After going through the interview, the unmet need was becoming clear and it was noted
that it was the less amount of family support. Mr. A. expressed that his family was not
encouraging or supportive about his health condition and this was a matter of concern because it
would not lead to a positive health outcome. His family was not aware about the interventions
needed for a diabetic patient and they did not understand the concept of pre-meal and post-meal,
which is necessary for managing the medications. Diabetes patients need dependency on others
regarding the huge amount of information about the maintenance and prevention of high blood
glucose levels (Baig et al., 2015). His family needed to be more responsive about his needs and
concerns so that he could increase the rate of his recovery.
Action Plan
The action plan is to help Mr. A in reducing his emotional dilemma as he feels left out
when his family does not understand his issues and his medical complications. He will be
advised to talk to his family privately and explain them his condition and his requirements. He
can guide them about the strategies and protocols the government is implementing for the
betterment of diabetic patients. The ministry of health can be used as an example while
explaining it to his family members. Mr. A should also take the important members of his family

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to the medical counselling for diabetes so that they can understand his prescriptions and dietary
modifications. His wife should visit the dietician with him so that it becomes easy for her to
understand what should be given to him for his meals (Twito, Frankel & Nabriski, 2015).
It is necessary for the family members to look after the health needs of their fellow
members and especially when they are old and cannot look after themselves such as following
the doses of medication and dietary intervention.
Conclusion
In conclusion to this paper, it is important to summarize the prevalence of diabetes in
Singapore and how a large population is suffering from this chronic disease as seen from the
incidence rate. The global incidence of this disease is lower than Singapore, which is alarming.
The country has been implementing services and implementation to reduce the prevalence of this
disease.

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