Epidemiology of Diabetes Mellitus Type 2

This article discusses the epidemiology, disease burden, risk factors, and preventive approach to Diabetes Mellitus Type 2. It explains how this chronic disease affects the population and how it can be prevented through lifestyle modification and frequent blood sugar screening. The article also highlights the financial, physical, and emotional burden of Diabetes Mellitus Type 2 to the population and the government.

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Running Head: EPIDEMIOLOGY OF CHRONIC DISEASES
Epidemiology of diabetes mellitus type 2
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EPIDEMIOLOGY OF CHRONIC DISEASES
Contents
Diabetes mellitus type 2..............................................................................................................................2
Public health approach................................................................................................................................4
Disease burden for diabetes mellitus type 2...........................................................................................4
Risk factors for diabetes mellitus type 2..................................................................................................5
Arguments supporting the preventive approach to type 2 diabetes mellitus.............................................7
Arguments against the preventive approach to diabetes mellitus type 2...................................................8
Conclusion...................................................................................................................................................9
Works Cited...............................................................................................................................................10

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Diabetes mellitus type 2
Diabetes mellitus type 2 is also referred to as non-insulin dependent, type 2 diabetes
or adult onset of diabetes. It presents with high blood sugar, insulin resistance or lack of insulin
production by the pancreas. Diabetes mellitus type two contributes to 90% of cases of diabetes;
type 1 diabetes contributes to the remaining 10% of the disease burden to the population.
Chances of developing this condition are attributed to obesity, unhealthy lifestyle, and inactivity
which may cause obesity. There has been a positive genetic link to the development of type 2
diabetes mellitus; therefore, the risk to developing this condition is associated with increased
age, obesity, inactivity, unhealthy lifestyle practices and a positive genetic link (1).
Diabetes mellitus present with unexplained weight loss, frequent urination and
increased thirst. Diabetes mellitus type 2 leads to so many complications if not controlled (2).
The complications result from a long-term hyperglycemic state which leads to diabetic
retinopathy resulting to blindness, diabetic nephropathy; leading to kidney failure, and diabetic
neuropathy. In amputations the hyperglycemic state makes it impossible for wounds to heal. A

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state of hyperglycemia results to the alteration of the normal glycemic state and this alteration
may result to a number of complications. Diabetes mellitus type 2 is diagnosed after a series of
random blood sugar check-ups; a random blood sugar is taken to determine the resting blood
sugar levels of a person and fasting blood sugar to determine the patency of the pancreas to
produce enough insulin to breakdown glucose in blood after a meal.
Diabetes mellitus type 2 sets in gradually, such that a person may be predisposed to
the risks, but the condition sets in later in life. The rate of onset of diabetes mellitus has been on
the rise. Typically; diabetes type 2 is mostly described in the old adult, but research shows that
currently the rate of diabetes in young adults has been on the rise. In 2015 392 million people
were diagnosed with diabetes as opposed to 30 million people diagnosed with the same condition
in 1985. The rate of developing diabetes mellitus has been on the rise, diabetes mellitus type 2 is
not only restricted to the old people, but young adults too (3).
Diabetes mellitus type 2 is a preventable chronic condition. It can be prevented
through regular exercise, and eating nutritionally health food, these two factors helps a person
maintain a normal basal mass index; therefore decreasing the chances of developing obesity
which is a major contributory factor to obesity (3). Obesity can be successfully prevented even in
the people who are genetically exposed; however, if a person develops diabetes mellitus type 2
regardless of taking the preventive measures to normalize their blood sugar levels, they are
treated with artificial insulin to help normalize their blood sugar levels (2).

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Public health approach
Diabetes mellitus type 2 is associated with many other morbidities, this has led to
aggressive campaigns promoting the prevention of diabetes. Most of the mortality associated
with diabetes is attributed to its complications and not the high blood sugar state. This implies
that a high blood sugar results in an altered homeostatic state which leads to the complications
associated with diabetes mellitus and the morbidity and mortality that result from high blood
sugar (3). Numerous studies have been conducted about diabetes mellitus type two, its etiology,
risk factors, prevention approach. Prevention of this condition is the best option in preventing the
morbidity and mortality associated with diabetes mellitus type 2 (1).
Disease burden for diabetes mellitus type 2
Type 2 diabetes mellitus has become a major public health burden because of the
increased incidence rate. In Australia type 2 diabetes mellitus is linked to a reduced life
expectancy. Analysis conducted between the year 2009 and 2014 shows an increased rate of
mortality by 10% for people suffering from type 2 diabetes mellitus. This condition is also
attributed to major health concerns because of the increased complication that results from type 2
diabetes mellitus. Diabetic neuropathy, diabetic foot ulcer, amputation of the lower limps and
vision impairments are the major morbidities caused by; diabetes mellitus type 2 in Australia (4).
His condition is a burden which not only affects Australians, but also other regions
of the world; therefore, making it a major public health concern to the whole world because of
the debilitating complications associated with diabetes mellitus type 2. Lower limp amputations
associated with diabetes have resulted to a major health problem because of the disability caused
by the amputations. This creates extra financial burdens to families and the government at large
because the number of disabled people goes high. Such statistics show that there is an increased

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financial burden caused by diabetes mellitus type 2 to the government and increased physical
burden to caregivers.
In Australia; the impact of type 2 diabetes mellitus on kidney disease is on the rise.
Type 2 diabetes mellitus is risk factor for developing chronic kidney disease; same applies to
lower limb amputation whereby 1.7% of the patients with amputated legs are diabetic patients
with more patients suffering from type 2 diabetes mellitus. In Australia the highest number of
insulin consumers and other blood glucose lowering agents are patients suffering from type 2
diabetes mellitus.
According to statistics it shows that, there is an increase in the financial burden,
physical burden, and emotional burden of diabetes mellitus type 2 to the population. Financial
burden is accrued because of the constant insulin medication which diabetic patients have to
purchase. Emotional burden is acquired due to the stigma associated with diabetes and its
complications. Physical burden is mostly experienced by care givers especially family members
and the diabetic person (3). These different forms of burden as a result of diabetes mellitus type 2
are a clear indicator that diabetes is a public health concern because it affects every person
regardless of their age or socioeconomic status; therefore, aggressive campaigns on the
preventive measures, blood sugar screening and risk factors associated with; diabetes mellitus is
an important step in preventing the morbidity and mortality associated with the condition (5).
Risk factors for diabetes mellitus type 2
Age above 45 years, an increase in age predisposes a person to the development of this
condition..

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A positive family history of diabetes mellitus type 2 is another contributing factor to the
development of diabetes mellitus type 2 apart from age.
Race; the racial background of a person determines if the person will get diabetes
mellitus type 2. The race that is most likely to develop diabetes mellitus type 2 is African-
American, Hispanic, Asian-American, Pacific highlanders, Native Hawaiian and American-
Indians.
Low levels of high density lipoproteins (HDLs). Low levels of HDLs leads to
the accumulation of Low density lipoproteins (LDLs), which may result in obesity and obesity is
directly linked to developing diabetes mellitus type 2 (1).
Hypertension; which refers to high blood pressure predisposes a person to the risk of
developing diabetes mellitus type 2 (4).
Gestational diabetes; this is another risk factor for developing this condition. Pregnant
women who experience gestational diabetes which resolves after pregnancy are at a higher risk
of developing diabetes; therefore they are encouraged to go for regular random blood sugar
checks.
The risk factors associated with diabetes are modifiable factors with an exception
of gestational diabetes and genetics or a positive familiar history. Modifiable factors are factors
which can be avoided. It is the duty of the department of public health to create awareness for the
risk factors associated with diabetes mellitus type 2 in order to decrease the number of cases
reported.

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Arguments supporting the preventive approach to type 2
diabetes mellitus
In a randomized study published in the PMC journals, they studied the
treatment and occurrence of diabetes mellitus type 2 in children and young adults. As it is widely
known this condition only affects the old people but recent research indicates otherwise. This put
great emphasis on the primary prevention of non-insulin dependent diabetes mellitus because of
its onset in the young population. Primary prevention implies that lifestyle modification and
blood sugar checks should be started at a young age to minimize the risk of the young population
developing type 2 diabetes mellitus in adulthood or old age (1).
In another study published in the journal for diabetes care about early and late
prevention strategies for diabetes, supported the argument that the adoption of early preventive
measures for diabetes mellitus type 2, helps in the prevention of this disease. The study indicated
that to successfully prevent the occurrence of chronic conditions such as type 2 diabetes mellitus;
the alteration of the modifiable factors that influence the occurrence of chronic diseases should
be the prime preventive strategy for this condition is caused by modifiable factors such as
unhealthy lifestyle which is made up of unhealthy eating habits and lack of exercise which
contributes to the occurrence of obesity (2).
Another study published in the PMC journals also emphasized on the prevention
of this condition because of the increasing incidence rate of the condition and the public health
burden it is imposing on the population. This study led to the recommendation of a healthier
lifestyle and a more active lifestyle which aide with the prevention of such a condition. The
study explored different ways of implementing the preventive strategies and taxation was one of
the strategies. Tax is levied on alcohol and tobacco which are associated with the development of

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hypertension. Hypertension is a risk factor for development of the condition under study; alcohol
and tobacco are known to increase the chances of developing hypertension, which may result in
the development such a disease. eventually. Imposing tax on these items is a strategy to reduce
the consumption of alcohol and tobacco, because increased tax results in increased prices making
alcohol and tobacco expensive (3).
Effective management and prevention of type 2 diabetes mellitus is necessary for the
prevention of morbidity and mortality associated with this disease.
Arguments against the preventive approach to diabetes
mellitus type 2
Most of the studies conducted indicated that there are no arguments against the
preventive approach used for type 2 diabetes mellitus. The lack of arguments is attributed to the
increasing incidence rate of diabetes mellitus type 2 and the increasing financial burden to the
community, the government and the affected individuals. The increasing incidence rate of
diabetes mellitus type 2 has prompted research and epidemiologists to conduct more studies with
the aim of isolating the risk factors, the most effective preventive measures and the treatments
modalities for this illness.
There are no scientifically proven arguments against studies conducted on the risk
factors, preventive measures or treatment modality for diabetes mellitus type 2; however there
are changes in the treatment regimen, where by there are long acting and short acting blood sugar
reducing agents that are used in differently (6).

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Conclusion
Diabetes mellitus type 2 is a global burden that can be prevented through lifestyle
modification, and frequent blood sugar screening (16). There has been an increasing incidence
rate and currently diabetes mellitus type 2 is not restricted to old age because it can affect young
adults and children too; therefore sensitization and aggressive campaigns are required to promote
primary health education about diabetes mellitus type 2.

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Works Cited
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2. M ZSaW. Impact of age, age at diagnosis and duration of diabetes on the risk of macrovascular and
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p. 2465-74.
3. L G. Global estimates of diabetes prevalence for 2013 and projections for 2035. Diabetes research
and clinical practice. 2014 February 1; 103(2): p. 137-49.
4. SE I. Management of hyperglycemia in type 2 diabetes, 2015: a patient-centered approach: update
to a position statement of the American Diabetes Association and the European Association for the
Study of Diabetes. Diabetes care. 2015 January 1; 38(1): p. 140-9.
5. Ö BJaL. Dapagliflozin maintains glycaemic control while reducing weight and body fat mass over 2
years in patients with type 2 diabetes mellitus inadequately controlled on metformin. Diabetes,
Obesity and Metabolism. 2014 February 1; 16(2): p. 159-69.
6. P LRaZ. Economic evaluation of combined diet and physical activity promotion programs to prevent
type 2 diabetes among persons at increased risk: a systematic review for the Community Preventive
Services Task Force. Annals of internal medicine. 2015 September 15; 163(6): p. 452-60.
7. A BEaE. Combined diet and physical activity promotion programs to prevent type 2 diabetes among
persons at increased risk: a systematic review for the Community Preventive Services Task Force.

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Annals of internal medicine. 2015 September 15; 163(6): p. 437-51.
8. JE HLaS. Burden of diabetes in Australia: life expectancy and disability-free life expectancy in adults
with diabetes. Diabetologia. 2016 July 1; 59(7): p. 1437-45.
9. KG ZPaA. Diabetes mellitus statistics on prevalence and mortality: facts and fallacies. Nature
Reviews Endocrinology. 2016 October; 12(10): p. 616.
10. E HT. Wellbeing Among Adults with Diabetes: Results from Diabetes MILES—Australia. Journal of
Happiness Studies. 2016 June 1; 17(3): p. 1205-17.
11. Shah AD LCaRE. Type 2 diabetes and incidence of cardiovascular diseases: a cohort study in 1· 9
million people. The lancet Diabetes & endocrinology. 2015 February 1; 3(2): p. 105-13.
12. H D. Treatment of type 2 diabetes in youth: an argument for randomized controlled studies.
Paediatrics & child health. 1999 May 1; 1(4): p. 265-9.
13. FL GLaB. Primary Prevention of Diabetes Working Group. Primary prevention of type 2 diabetes:
integrative public health and primary care opportunities, challenges and strategies. Family practice.
2012 April 1; 29(1): p. :i13-23.
14. E.H JTaP. Preventing Diabetes: Early Versus Late Preventive Interventions. Diabetes Care. 2016
August; 39(2): p. :S115–S120.
15. Association AD. 7. Approaches to glycemic treatment. Diabetes care. 2016 January 1; 39(1): p. S52-9.
16. CS F. Update on prevention of cardiovascular disease in adults with type 2 diabetes mellitus in light
of recent evidence: a scientific statement from the American Heart Association and the American
Diabetes Association. Circulation. 2015 August 1; 132(8): p. 691-718.
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