Diabetes: The Silent Disorder and Its Association with Lifestyle Factors in New Zealand

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This presentation discusses the prevalence of diabetes in New Zealand and its association with lifestyle factors. It introduces a prospective study that aims to investigate the link between lifestyle and diabetes in the 35-60 age group. The study will employ a quantitative and exploratory research design and will assess physical activity and dietary intake through survey questionnaires. The study aims to provide insights into the underlying mechanisms related to lifestyle and diabetes and recommend strategies for mitigating the condition.

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Background or literature review
Serious Medical condition
According to the Diabetes Research & Wellness Foundation (DRWF) diabetes is a disorder that occurs in the
body’s ability to change glucose or sugar into energy. Glucose is considered to be the primary fuel of the
body which is transferred from the blood into cell by insulin. When an individual suffers from the disorder
his or her body is unable to produce the necessary quantity of insulin (Blackwell, 2014). The Type 1
diabetes is the case when the insulin that is produced is defective in nature since it is ineffective to move
glucose to cells. The Type 2 diabetes occurs when the quantity of insulin produced is not sufficient or it is
defective so it fails to move glucose into cells.
Facts on Diabetes - WHO and DRWF
The World Health Organization (WHO) keeps on updating on diabetes since it is a silent disorder that
affects millions of people worldwide. As per 2016 statistics, the people that have diabetes have almost
quadrupled since the 1980s (http://www.who.int). Different types of diabetes cause complications in the
body and increase the risk of causing a premature death. As per DRWF, currently there is no cure for
either types of diabetes but there are numerous ways to keep the condition under control. The Type 1
diabetes requires insulin while the Type 2 diabetes treatment depends on the level of blood sugar of an
individual (Drummond, 2015). Lifestyle modifications have been recognized as the choicest interventions
capable of mitigating conditions like that of diabetes. Hence, performance of daily physical activities
alongside management of dietary intake is suitable for combating the ill effects of diabetes and harboring
positive outcomes in the affected individuals (Shi & Hu, 2014).
Statistics of diabetes
According to the Centers for Disease Control and Prevention (CDC) the Type 2 diabetes is responsible for
about 90 to 95 percent of all the diagnosed diabetes cases in adults. It also states that 1 out of 3
individuals have pre-diabetic conditions. Certain racial and ethical groups are prone to the disease
(Eldredge, 2016).
One in four New Zealander is estimated to have pre-diabetes. In 2013 the highest rate of diabetes was
observed in the Indian ethic section (11 %) followed by Pacific nations (9.6 %). Pacific Islanders and Māori
population apart from the South Asians in New Zealand have been reportedly to be under the threat of
developing the disease more in comparison to others ethnic and racial groups (Health.govt.nz, 2017).
Need to keep a tab on Diabetes
Diabetes is a condition that can be controlled if necessary measures are followed by an individual.
According to Diabetes New Zealand, an individual’s risk of having Type 2 diabetes from the pre-diabetes
stage can be almost reduced to half if certain steps are taken such as losing weight, adopting a healthy
diet plan, exercising daily, include medical treatment, etc (García-Moreno, 2013).
Thus different sources show that diabetes is a condition that can be life threatening in certain cases and
lead to further health complications if it is not effectively controlled. Since the disorder is on the rise, it is
vital to keep a tab on it and understand how it causes other health conditions in the patients.(García-
Moreno, 2013)
Research design
The prospective study will resort to a quantitative research design for harboring
meaningful results through conduct of a survey and employing suitable statistical
analyses subsequently to account for proper interpretation of the pertinent derived
data from the survey. Respondents will be selected in accordance with the
inclusion criteria by virtue of simple random sampling. Survey through adoption of
suitable questionnaire will be carried out to retrieve the responses from the
respondents and gain an insight on the issue. Further, an exploratory research
design will be essentially pursued so that clarification may be gained for the
nature of the problem related to the study (Creswell, 2013). Hence, satisfactory
evaluation of the cause and effect relationship between the independent and
dependent variables will be understood so that novel ideas may be generated.
Introduction
Diabetes is a throbbing health concern of recent times that is essentially
considered as a metabolic syndrome increasing co-morbidities and
mortalities for significant health disorders. In the context of New Zealand,
data reveals that over 240,000 people are afflicted by diabetes (mainly
type2). However there are another 100,000 who have the disease but remain
undiagnosed. It has been found that Māori and Pacific Islanders are more
likely to harbor the disease, precisely three times more in comparison to
other New Zealanders in addition to the South Asian population. Statistics
suggest that both forms of diabetes are increasing with obesity related type2
diabetes being more prominent (Health.govt.nz, 2017). Another report
through research based evidences suggests that 7% of the population is
suffering from diabetes while 1 out of 5 individuals are at risk of
encountering it (Maoridiabetes.co.nz, 2017). On 14th November 2016 the
World Diabetes Day was held with the theme “Eyes on Diabetes” since
diabetes is one of the major causes of blindness and visual impairment. WHO
used the occasion to call different governments, healthcare professionals,
and researchers to make significant contribution towards enhancing the
outcome for people who suffer from diabetes. In New Zealand, it is the
largest and fastest growing health condition that together with heart
ailments causes more deaths than smoking (Health.govt.nz, 2017).
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?
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.
Study Aim
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.
Diabetes: The silent disorder that causes health damage
Methodology
Subjects for the study will be chosen in a manner so that they fit into the inclusion
criteria of the research. Around 100 respondents, who are citizens of New Zealand,
diagnosed to be diabetic and belonging to the age group of 35-60 years will be selected
for the study. Familiarization trial will be conducted with the research participants to
allay all their apprehensions and study will be carried out in compliance with the
established ethical and legal guidelines. Accepted pathological tests will be performed
to screen the subjects who are diabetic. In order to procure relevant information
pertaining to the topic of investigation, questionnaire will be given to the subjects to
respond to. Information relevant to the physical activity level of the concerned
individuals will be derived by adopting the universally accepted ‘Global Physical Activity
Questionnaire’ (GPAQ) (Kyu et al., 2016). Moreover, data related to the daily nutritional
consumption of the chosen population will be obtained from another credible
questionnaire termed as ‘Eating habits questionnaire’ (England et al., 2015). Besides
assessment of these outcome variables, additional information related to the smoking
and drinking habits of the respondents will also be taken into account considering the
fact that these two exert a discernible influence on the health status of a person through
close ended questions. The results obtained from the survey questionnaires will be
subjected to rigorous statistical analyses to arrive at definite conclusion and
transforming the data obtained into meaningful forms. Correlation will be performed for
understanding the association of physical activity and dietary intake on the prevalence
of diabetes. Thus, the underlying mechanisms related to lifestyle of a person will be
highlighted in course of the study by focusing on the variables of physical activity and
nutritional intake of the concerned population. The link between the lifestyle of a person
and the risk of developing diabetes will thus be known from the study.
Significance of study
Outcomes derived from this study are of paramount importance considering
the fact that diabetes persists to be a major health concern for a bulk of the
population worldwide. New Zealand is a nation that is thwarted by the
adverse impacts of diabetes and incurs a considerable health burden on its
population. As a consequence to this trend, healthcare expenditure has also
accentuated in the country thereby appearing as a major area calling for
prompt intervention. This prospective study is expected to provide an insight
on the physical activity and nutritional consumption of the chosen population
that have been identified as crucial determinants of metabolic syndrome like
diabetes (American Diabetes Association, 2014). Succinct comprehension of
the topic of research will account for recommending strategies that might be
effective in alleviating the symptoms of diabetes. Thus, abatement of serious
health complications due to diabetes will be possible by emphasizing on the
lifestyle related components consisting of level of physical activity together
with the dietary intake of the individuals. The trends of the Kiwi population on
matter related to lifestyle will thus be of particular importance to mitigate the
diabetes related health concerns. Moreover, population based interventions
may be streamlined through identification of the primary issues in course of
the study.
Ethical considerations
Before the initiation of the research activity, all the necessary ethical
approvals would be taken since the research activity involves medical
conditions of people. The ethical aspects are crucial for the study since the
focus is on the human factors and their medical conditions and lifestyle.
Since medical details are considered to be confidential, a strict ethical
model would be followed so that the respondents would not sense any form
of insecurity. The family members of the respondents would be intimated
about the particular research study. Confidentiality of data will be
preserved and under no circumstances data will be leaked to any
unauthorized person thereby ensuring safety (Streiner, 2015).
Timeframes
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
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
Funding for the project will be sought from the Ministry of Health,
New Zealand to cater to every aspect of the study.
References
A, B. (2014). Research methods in health: investigating health and health services. . McGraw-Hill Education (UK).
American Diabetes Association. (2014). Standards of medical care in diabetes—2014. Diabetes care, 37(Supplement 1), S14-S80.
Blackwell, D. L. (2014). Summary health statistics for US adults: national health interview survey, 2012. Vital and health statistics. Series 10. Data from the National Health Survey,.
Boulware, L. E. (2016). Race and trust in the health care system. Public Health Reports.
Creswell, J. W. (2013). Research design: Qualitative, quantitative, and mixed methods approaches. Sage publications.
Drummond, M. F. (2015). Methods for the economic evaluation of health care programmes. . Oxford university press.
Eldredge, L. K. (2016). Planning health promotion programs: an intervention mapping approach. . John Wiley & Sons.
England, C. Y., Andrews, R. C., Jago, R., & Thompson, J. L. (2015). A systematic review of brief dietary questionnaires suitable for clinical use in the prevention and management of obesity, cardiovascular disease and type 2
diabetes. European journal of clinical nutrition, 69(9), 977.
Furrow, B. R. (2013). Health Law: Materials and Problems.
García-Moreno, C. P. (2013). Global and regional estimates of violence against women: prevalence and health effects of intimate partner violence and non-partner sexual violence. . World Health Organisation.
Health.govt.nz. (2017). Diabetes. Ministry of Health NZ. Retrieved 14 August 2017, from http://www.health.govt.nz/your-health/conditions-and-treatments/diseases-and-illnesses/diabetes
Kyu, H. H., Bachman, V. F., Alexander, L. T., Mumford, J. E., Afshin, A., Estep, K., ... & Cercy, K. (2016). Physical activity and risk of breast cancer, colon cancer, diabetes, ischemic heart disease, and ischemic stroke events: systematic
review and dose-response meta-analysis for the Global Burden of Disease Study 2013. bmj, 354, i3857.
Larson, L. K. (2015). Employee Health--AIDS Discrimination (Vol. 10). Larson on Employment Discrimination.
Maoridiabetes.co.nz. (2017). Diabetes rates rising - one in five Kiwis at risk » Maoridiabetes. Maoridiabetes.co.nz. Retrieved 14 August 2017, from http://www.maoridiabetes.co.nz/about-diabetes/what-is-diabetes-prediabetes-video/
diabetes-rates-rising/
Shi, Y., & Hu, F. B. (2014). The global implications of diabetes and cancer. The lancet, 383(9933), 1947.
Statistics, N. C. (n.d.). Health, United States, 2015: with special feature on racial and ethnic health disparities. 2016.
Streiner, D. L. (2015). Health measurement scales: a practical guide to their development and use. . Oxford University Press, USA.

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