Diabetes in New Zealand: Lifestyle and Prevalence

This study aims to investigate the underlying link between lifestyle and prevalence of diabetes in relation to the outcome variables of physical activity status and dietary intake in the concerned population of diabetic individuals belonging to the age group of 35-60 years and residing in New Zealand.

Name of the Student:
Name of the University:
‘Diabetes’-Silent disorder that
causes health damage

Abstract
Background: Consistent with the global health burden, diabetes continues to be a major health challenge
in New Zealand as well. Healthcare infrastructure is undergoing rapid and drastic changes to cope up with
this menace. People belonging to diverse race and ethnicity in the New Zealand context, and of varied age
group are likely to be at risk of harboring this disease thereby necessitating adoption of suitable
interventions for mitigating the condition.
Aim: The prospective study will strive to find out the underlying link between lifestyle and prevalence of
diabetes in relation to the outcome variables of physical activity status and dietary intake in the concerned
population of diabetic individuals belonging to the age group of 35-60 years and residing in New Zealand.
Method: A quantitative and exploratory research design will be employed in course of the study to obtain
relevant information related to the topic of investigation in the concerned population. The primary
outcome variables of the study will be the assessment of the physical activity level and dietary intake of
the individuals. Global Physical Activity Questionnaire and Eating Habits Questionnaire will be chosen
for assessing the physical activity and nutritional consumption of the respondents through survey. A
sample size of 100 Kiwi respondents who fit into the predefined criteria will be recruited in the study. The
diabetic patients will be screened through proper pathological examinations to be included in the study.
Statistical analyses through correlation will be computed for understanding the association among the
outcome variables with the prevalence of diabetes. Understanding about the association will help to
recommend strategies for ameliorating the diabetes condition in the relevant population.
Ethics: The study will conform to all accepted protocols as well as established ethical and legal guidelines
so that the interests of the participants are safeguarded thereby increasing the credibility and acceptance of
research done.

Introduction to Topic
Diabetes is a metabolic syndrome occurring due to insufficiency
or defect of insulin production from the pancreas and
characterized by high levels of glucose in the circulating blood.
Types of Diabetes include:
 Type 1 diabetes in which pancreas produces little or no insulin
 Type 2 diabetes in which defective insulin receptors lead to
insufficient production of insulin (Drummond, 2015)
Global burden of diabetes is a major health concern to
the scientific and healthcare community.

Introduction to Topic
Diabetes increases the risk for other co-morbidities such as
cardiovascular as well other metabolic disorders like obesity.
Prevalence of type2 diabetes is greater in comparison to type1
diabetes accounting for 90-95% of the total diagnosis of
diabetes.
Overall 1 out of 3 individuals are fund to be pre-diabetic in
which the blood level of glucose is high but not sufficient to be
diagnosed as diabetic.
Incidence and prevalence are found to vary depending on the
racial and ethnic diversity (Eldredge, 2016).

Introduction to Topic
Strategies to combat diabetes include:
 Engagement to daily physical activity
 Adoption of a healthy diet plan
 Management of body weight
 Compliance to medicinal therapy (García-Moreno, 2013; Shi
& Hu, 2014)

Diabetes in New Zealand
Diabetes in New Zealand is a vital health disorder
240,000 are detected to be suffering from diabetes (type2
diabetes mainly)
100,000 remains undiagnosed with diabetes despite being
afflicted by the condition
In addition to obesity rates of diabetes are on the rise
Type2 diabetes is the most prominent of the identified
disorders (Health.govt.nz, 2017).

Diabetes in New Zealand
Populations under threat encompass:
 Māori and Pacific Islanders
 South Asian population
7% of the population affected by diabetes
1 out of 5 Kiwis are at risk of harboring diabetes
(Maoridiabetes.co.nz, 2017).

Diabetes in New Zealand
Figure 1: Frequency of diabetes by age
groups in 2007 and 2014

Professional Practice Area
Healthcare industry operates adopting a multidisciplinary
approach where every member play significant roles.
Physician, nurse and allied healthcare workers form the
backbone of the system
Healthcare workers work in conformity with established
guidelines to ensure health and wellbeing of the diseased
population (Grol et al., 2013)

Professional Practice Area
Community Healthcare Workers (CHW)
 Provide basic healthcare and medical service to the
community
 Renders prevention, promotion ad rehabilitation of
care
 Members of the same community in which they work
 Supported by health system
 Receive shorter duration of training than professional
workers
(Who.int, 2017)

Professional Practice Area
Essential roles played by CHW include:
 Giving advice to other healthcare professionals
regarding linguistic issues and the need for abiding by
cultural sensitivity
 Serve as mediator between community and health
professionals
 Intimately associated with services relevant to Public
Health
(Health.govt.nz, 2017).

Professional Practice Area
CHWs are suggested to be undertake community based
participatory research (CBPR) to harbor optimal
outcomes in keeping with the distinct cultural beliefs and
practices of the indigenous communities like that of the
Māori population
Community based interventions may be improvised and
implemented by CHWs to streamline practices that are
capable of mitigating health conditions like that of
diabetes (Stats.govt.nz, 2017)

Literature Review

Key Practice Issues
Prevention and treatment of diabetes may be achieved
through consideration of key practice issues in the
relevant professional practice area that include:
 Health inequalities or Ethnic disparities
 Unwillingness for visiting healthcare services due to
cost
 Lack of awareness
 Lack of trained healthcare professionals

Key Practice Issues
Ethnic disparities or health inequalities
 Māori people represents systematic inconsistencies in
health outcomes, determinants of wellbeing, health
framework responsiveness, and representation in the
healthcare sector division workforce (Hawley &
McGarvey, 2015)
 Poor access to primary healthcare services
Tukuitonga, 2013)

Key Practice Issues
Figure 2: The percentage of adults consuming minimum two
servings of fruits sustained to decline across every ethnic group
(Ministry of Health NZ, 2017)

Key Practice Issues
Unwillingness for visiting healthcare services due to
cost
 Access to primary heath service is impeded by cost
factor (Wilkinson et al., 2014)
 Pacific and Maori community members do not visit
physician because of cost issue (King et al., 2009).

Key Practice Issues
Figure 3: Rate of obesity increased with socioeconomic deprivation (Ministry of
Health NZ, 2017)

Key Practice Issues
Figure 4: Cost can be an obstacle for gaining access to primary health care
(Ministry of Health NZ, 2017)

Key Practice Issues
Lack of awareness
 Poor prognosis of diabetes retinopathy risk factors
(Papali'i-Curtin, & Dalziel, 2013 )
 Unhealthy consumption of food and beverages that
are calorigenic in nature (Metcalf et al., 2014).
 Lack of reluctance to utilize medication as treatment
modality by healthcare professionals (Krebs et al.,
2016).

Key Practice Issues
Lack of skilled manpower who are capable of adopting
appropriate strategies to remedy the issue of diabetes in
the concerned population Chang et al., 2017)

Existing Gaps in Knowledge and Area of further
Investigation
Evidences support that there is dearth of information related to
 Knowledge, practice, and outlook are inter-connected which on
effective learning, updated information, customs and tradition
(Serrano-Gil, & Jacob, 2010).
 Intolerance and non-compliant behaviours of healthcare
professionals (Mortell et al., 2012).
Scope of investigations include:
 Training and education imparted to the healthcare professionals
to combat the community based disorder
 Narrowing of the healthcare discrepancies to establish equality

Research Proposal

Research Question
The basic research questions of the prospective study
may be stated as:
 How far individuals belonging to 35-60 years,
diagnosed as diabetic and residing in New Zealand are
predisposed to be affected by diabetes due to dietary
intake and physical activity level?
 Is there any association between lifestyle of an
individual and onset of diabetes?

Study Aims
The prospected study aims to
 investigate on the nutritional and physical activity
level of the individual who has been suffering and
diagnosed with diabetes condition in which the blood
glucose level is higher than normal to be labeled as
diabetic
 Lifestyle of the vulnerable population of 35-60 years
will be put under scanner to closely understand the
association of lifestyle with the onset of diabetes.

Research Design
Quantitative Research
Exploratory in nature
Supported by rigorous statistical
computations
Derivation of meaningful information from
the retrieved data

Methodology
Survey method to procure information from the
respondents
Sample size comprising of 100 Kiwi subjects
recruited for the study
Inclusion criteria for participants
Belong to the age group of 35-60 years
Biochemical estimation confirms the presence
of diabetes

Methodology
Primary outcome variables that will be measured
Physical activity status on a daily basis
Daily nutritional consumption
Questionnaires to be used to measure the variables
include:
 Global Physical Activity Questionnaire for daily
physical activity status (Kyu et al., 2016)
 Eating habits questionnaire for daily dietary
intake (England et al., 2015)

Significance of the Study
Trends in lifestyle of the inhabitants of New
Zealand
Association between lifestyle and prevalence of
diabetes in the chosen population
Insight on the level of daily physical activity and
nutritional intake status of the concerned
individuals

Ethical Considerations
Informed consent from the
respondents for participation in the
study
Study approved by the
Institutional Review Board

Ethical Considerations
Data maintained in safe custody of the principal
investigator with secured password in laptop
Confidentiality and privacy of data retrieved
from participants maintained in conformity with
Data Protection Act (Streiner, 2015)

Timeframe of Study
Month Activity
May Initiation of work on research
proposal and pilot study
June Submission of research proposal
July Obtaining approvals from ethical
team
August Questionnaire designing and
Medical Tests
September Data Analysis
October Writing data Analysis, Final
conclusion and Recommendation
November Submitting draft of dissertation

Costing
Funding for the project will be sought from the
Ministry of Health, New Zealand to cater to
every aspect of the study.

Costing
Particulars Amount
Meeting with patients $ 1,200
Travel cost $ 1,500
Advertisement for study $ 800
Medical personnel salary $ 7,100
Ethical measures $ 500
Equipment $ 1,600
Stationary $ 600
Total Expenditure $ 13,300

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