Challenges in Diabetes Management: A Dissertation on UK Asians

This dissertation delves into the complexities of diabetes management, specifically focusing on the challenges faced by South Asian individuals living in the United Kingdom. The research begins with an introduction to diabetes, defining key terms and providing background information on the prevalence of the disease within the South Asian community in the UK. It investigates the difficulties encountered by people with diabetes in managing their condition, exploring factors related to understanding of diabetes, socioeconomic status, cultural beliefs, and access to healthcare services. The study also examines the role of healthcare practitioners in improving diabetes outcomes among this population, including their responsibilities in patient education, treatment, and support. The methodology includes a literature review to gather relevant information, and the results highlight the key challenges and potential solutions for improving diabetes management and healthcare delivery within the UK's South Asian community. The dissertation concludes with recommendations for healthcare professionals and policymakers to address these challenges and improve health outcomes for this population. This research offers valuable insights into diabetes management within a specific cultural context, providing a foundation for future studies and interventions.

DISSERTATION

Table of Contents
Chapter 1: Introduction to the Research..........................................................................................4
1.0 Introduction to the chapter................................................................................................4
1.1 Operational definition of terms........................................................................................4
1.2 Background to the problem..............................................................................................4
1.3 Statement of the problem..................................................................................................7
1.4 Research questions...........................................................................................................7
1.5 Justification of the research..............................................................................................7
1.6 Significance of the research..............................................................................................8
1.7 Summary of the chapter....................................................................................................8
Chapter 2: Literature Review...........................................................................................................9
2.0 Introduction to the chapter................................................................................................9
2.1 The basic understanding regarding the concept of diabetes.............................................9
2.2 The factors that create difficulties for people to manage condition of diabetes............11
2.3 The role of care practitioners to improve condition of diabetes among Asian origin people
..............................................................................................................................................12
2.4 Summary of the chapter..................................................................................................13
Chapter 3: Research Methodology.................................................................................................14
3.0 Introduction to the chapter..............................................................................................14
3.1 Philosophical aspects of the research.............................................................................14
3.2 Data Collection...............................................................................................................17
3.3 Data sources....................................................................................................................17
3.4 Search terms...................................................................................................................18
3.5 Inclusion and exclusion criteria......................................................................................18
3.6 Data analysis...................................................................................................................18
3.7 Data summary table of journal articles...........................................................................18
3.8 Research ethics...............................................................................................................19
3.9 Limitations of the research.............................................................................................19
3.10 Summary of the chapter................................................................................................20
Chapter 4: Results..........................................................................................................................21
4.0 Introduction to the chapter..............................................................................................21

4.1 Summary table of results................................................................................................21
4.2 Result for the basic understanding regarding the concept of diabetes...........................21
4.3 Result for the factors that create difficulties for people to manage condition of diabetes22
4.5 Result for the role of care practitioners to improve condition of diabetes among Asian
origin people.........................................................................................................................23
4.6 Summary of the chapter..................................................................................................24
Chapter 5: Discussion....................................................................................................................26
5.1 Introduction to the chapter..............................................................................................26
5.2 The basic understanding regarding the concept of diabetes...........................................26
5.3 The factors that create difficulties for people to manage condition of diabetes.............27
5.4 The role of care practitioners to improve condition of diabetes among Asian origin people
..............................................................................................................................................27
5.5 Summary of the chapter..................................................................................................28
Chapter 6: Conclusions and Recommendations............................................................................29
6.0 Introduction to the chapter..............................................................................................29
6.1 Conclusions....................................................................................................................29
6.2 Recommendations..........................................................................................................29
6.3 Summary of the chapter..................................................................................................30
References......................................................................................................................................31

Chapter 1: Introduction to the Research
1.0 Introduction to the chapter
This chapter will focus on basic overview about diabetes and its related aspects. It consist
the specific definitions of important terms along with proper background of the research.
However, it will focus on the aim of the whole investigation to determine difficulties faced by
people with diabetes to manage their condition (Whitehead and et. al., 2016). Moreover, it
consist specific research objectives and questions along with explaining proper justification of
this study. It consist importance of this research to define about relevant goal and future benefits
in health & social care for improving health status of citizens with diabetes.
1.1 Operational definition of terms
Diabetes: It can be described as a medical condition of an individual when the blood
sugar level get high as compared to normal and create adverse symptoms on human body.
Type 1 Diabetes: This includes condition of very little or no insulin production.
Type 2 Diabetes: When body is not able to conduct proper utilisation of insulin.
Gestational diabetes: The situation of high blood sugar during the period of pregnancy.
1.2 Background to the problem
Diabetes refers to a health problem in which sugar level of blood increased due to
imbalance of insulin hormone in human body. It includes the condition when glucose in blood
becomes too high because it did not get consumed in the body properly. However, it has been
analysed that glucoses can be considered as a mains source of energy which gained by in-taking
different food items. This health problems is known a chronic disease which take place when
pancreas become unable to secrete insulin or body is not capable utilise insulin that produces.
Meanwhile, diabetic people face problem lifelong if they do not take desired precautions in their
daily routine in regards to maintain sugar levels of body (Herre and et. al., 2016). In addition to
this, diabetes can be categorised in three categories such as Diabetes Type 1, Diabetes Type 2
and gestational diabetes that occurs in individuals accordingly.
On the other hand, diabetic people are required to avoid sweet food products and heavy
eatable items in order to maintain their sugar level. It includes different causes in regards to
occurrence of diabetes are genetics, poor diet, lack of nutrients, lifestyle preferences, physical
inactivity, overweight condition and insulin resistance. However, it is very important for diabetic

patient to take effective precautions in their daily routine because negligence may leads to certain
complications. It consist various complexities such as neuropathy, nephropathy, vision loss &
retinopathy, hearing loss, foot damage, skin conditions, depression, dementia and heart attack,
heart disease & stroke. There are various kinds of symptoms that can be observed in diabetic
people like increased thirst & urination, fatigue, blurred vision, tingling or numbness in hands &
feet, sores that do not heal, unexplained weight loss and increased hard.
This investigation will focus on determine problem faced by diabetic people while
managing their condition in South Asian individuals living in United Kingdom. It includes the
criterion of focussing on basic understanding in regards to concept of diabetes which consist
relevant several aspects including causes, symptoms and treatment (Shirazian and et. al., 2016).
However, the potential elements that are responsible for creating issues for individuals with
diabetes in terms of managing their diabetic medical condition are described here. In addition to
this, it consist number of factors that develop difficulties that may relevant to their budget, habits
or care services. Moreover, the evaluation regarding important roles of care practitioners in
respect of boosting up diabetic condition among Asian origin people is given below. It includes
their duties like increasing awareness among people to adopt healthy lifestyle along with
providing appropriate care facilities for their well-being.
Background of the study – The Asian origin can be described as people whose ethnicity is
from one of more of the different nations that are mentioned here. It includes Bangladesh,
Bhutan, India, Maldives, Myanmar, Nepal, Pakistan, Sri Lanka and Afghanistan. Meanwhile, it
has been evaluated that around 4% of UK population belongs to South Asian people but account
for an estimated 8% of all diagnosed cases of diabetes (Manderson and Warren, 2016). However,
it is determined that South Asians are 6 times more likely to develop the problem of diabetes
type 2 whereas 3 % of these individuals with diabetic condition are 3 times more likely to get
suffered from cardiovascular disease. In addition to this, it is observed that people with Asian
origin are mostly at risks of developing various severe health issues as compared other citizens
living in UK. Moreover, it is identified that this group of citizens has more risk of generating
microvascular and macro vascular complications of diabetes which is not much possible in other
people of the country.
In others words, it has been identified that health problem are more risky and complicated
in Asian origin people as compared to other citizens living in UK. It is necessary for government

and care authorities to establish effective health care campaigns in order to improve the health
condition of of his community. However, it is essential to conduct health promotion and provide
information regarding effective precautions in order to avoid severe health issues like diabetes as
well as relevant risks. In addition to this, it is important to boost up awareness among people this
group to adopt healthy lifestyle including balanced diet, physical work out, meditation and so on.
Moreover, the efficient health programmes should be organised by care professionals and make
sure that every individual will get desired care services on time to become well-being.
Furthermore, it is significant to motivate them for accepting healthy habits along with gaining
required medical facilities on time.
The present research is based on several difficulties that are faced by people belongs to
Asian origin living in United Kingdom, they have lots of issues due to which they are not able to
maintain their diabetic conditions in proper manner. However, it consist the criterion of
identifying various factors are are responsible for developing problem for Asian origin people to
maintain their better health condition, it will provide support to understand the cause of this
problem which facilitate to establish more effective as well as efficient strategies in terms of
improving their heath status respectively (Jones and Crowe, 2017). It will includes the basic
understand related diabetes including its symptoms such as frequent urination, blurry vision,
extreme fatigue, sores that don't heal, increased thirst, increased hunger and weight loss. It can be
categorised into different categorise such as Diabetes Type 1, Diabetes Type 2 and Gestational
diabetes which has their own symptoms, cause and treatment methods for making an individual
well being. It includes different types of commonly used insulin treatment and various
medications that provide support to maintain the sugar level on blood. Moreover, it is necessary
to select specific medications according to particular health condition of patient which is suitable
for them to maintain blood sugar levels.
On the other hand, this study will focus on number of elements that are responsible for
developing problem of Asian origin diabetic people in terms of maintaining their health. It
includes lack of education, limited source of income, unemployment, social and cultural factors
including religious ideas of people. However, it is observed that cultural beliefs of people
motivate them to eat unhealthy due to which various health issues takes place. It is necessary to
make people aware about their wrong habits which create challenges for then in managing
diabetic conditions to be avoided. The role of care professionals in regards to improve diabetic

condition of given population is also studied here. It includes roles and responsibilities of
medical professionals in terms of making patient healthy. Meanwhile, it consist their duty to
remain honest and dedicated while dealing with patients and attend them immediately as soon as
possible. It includes role of care practitioners for avoid factor of inequality and provide desired
and appropriate treatment to people for making them disease free. Moreover, it includes to
understand the responsibilities of care professionals in respect of providing proper facilities to
needy people for their welfare.
1.3 Statement of the problem
“To identify the difficulties faced by people in managing diabetes condition. A case study
on south Asian origin people living in the UK”.
Research objectives:
 To develop the basic understanding regarding the concept of diabetes.
 To identify the factors that create difficulties for people to manage condition of diabetes.
 To evaluate the role of care practitioners to improve condition of diabetes among Asian
origin people.
1.4 Research questions
 How to develop the basic understanding regarding the concept of diabetes?
 What are the factors that create difficulties for people to manage condition of diabetes?
 How to evaluate the role of care practitioners to improve condition of diabetes among
Asian origin people?
1.5 Justification of the research
This investigation has a purpose to identify present difficulties which are faced by people
with diabetes in order to solve them. It is necessary to determine actual problem in regards to
solve it which can be done through this research. However, it includes the criterion of analysing
those existing factors which are responsible for developing issues for diabetic people to manage
their condition and remain healthy (Chatterjee and et. al., 2018). In addition to this, it consist the
reason to identify main components die to which case of diabetes get increase day by day among
Asian origin individuals surviving in UK. Meanwhile, it is necessary for the country to make
sure about entire health status to be well-being which impact on economy of the nation.
Moreover, this study is helpful to understand the causes and factors which affect negatively on

management of diabetes. It is favourable to identify such elements in order to make effective
policies and strategies in order to improve their health condition.
1.6 Significance of the research
The investigation for identifying difficulties faced by people with Asian origin in respect
of managing living in UK is important to determine specific problem. It is significant to identify
particular issues can be consider as favourable in order to organise appropriate strategies and
programmes in terms of solving them for improving health status of citizens. However, it is
necessary to determine the problems and their causing factors which should be focussed in
respect of making better policies and techniques for promoting self care management of diabetes
(Tattersall, 2017). It is significant to find out difficulties so that government and care authorities
can take more effective as well as efficient steps for facilitating proper management of diabetic
among Asian origin population of the country. It will provide support to solve their issues and
helps to maintain their appropriate health condition. Moreover, it is important to evaluate the
difficulties to provide appropriate ways of managing diabetic conditions.
1.7 Summary of the chapter
Considering the above chapter, it has been summarised that basic introduction of selected
topic is given in entire overview. It includes the brief description related to diabetes that it is a
kind of chronic illness in which sugar level get increased in blood due to imbalance of insulin
hormone. However, it includes the information about different types of diabetes include
gestational, Type 2 and Type 2 with their specific conditions of occurring the health problem
(Zimmet and et. al, 2016). Meanwhile, it consist the background of Asian origin population
living in UK including data about their risk of gaining health issues. In addition to this, it
includes the fact that Asian origin people are more likely to get easily suffered from various
disease as compared to other citizens of United Kingdom. Moreover, it includes the significance
of the study in regards to identify factors creating difficulties to solve them which make diabetic
patient capable to manage their heath condition in proper manner.

Chapter 2: Literature Review
2.0 Introduction to the chapter
Literature review can be described as a kind of survey that can be done through analysing
views of different authors in regards to specific research topic. It can be considered as part of
second chapter in investigation in which consist current information related to selected title of
the study. Meanwhile, it includes the criterion of analysing opinions given by great authors by
gathering relevant data from scholarly published articles and books. However, it is necessary to
use various related sources of data and collect appropriate information according to selected
topic for carrying out study properly (Vanstone and et. al., 2017). This chapter will focus on on
basic understanding about diabetes along with specific difficulties facing by people for managing
their diabetic condition. It will also includes the literature review in regards to role of care
practitioners for improving diabetic condition between individuals belongs to Asian origin in
country.
2.1 The basic understanding regarding the concept of diabetes
Diabetes refers to a chronic disease when blood sugar get too high due to imbalance of
insulin in human body. It occurs when body become unable to utilise insulin or pancreas is not
longer capable to secrete insulin. As per viewpoint of Stephanie Watson (2019), insulin is known
as a hormone that is produced by pancreas which is helpful key to let the glucose collected from
eaten food pass through the blood stream into cells in human body for producing energy.
Basically, it has been analysed that insulin hormone plays as an important role to balance the
sugar levels in body and imbalance in this hormone is responsible for occurrence of diabetes. In
addition to this, it has been analysed that there are various general symptoms that take place
when a person is suffering from diabetes that consist weight loss, frequent urination, blurry
vision, extreme fatigue, sores that don't heal, increased thirst and increased hunger. Meanwhile,
some of specific signs and relevant test are required to be carrying out in regard to identify the
kind of diabetes. Moreover, diabetic condition takes place due to rising sugar level in blood due
to different cause which should be identified in terms of providing proper treatment for their
well-being.
In other words, diabetes has its different types such as Diabetes Type 1, Diabetes Type 2
and Gestational Diabetes. Initially, diabetes type 1 refers to an autoimmune health issue in which

immune systems attacks and destroy the pancreatic cells due to that insulin secretion get
disrupted. It is observed that around 10 % of diabetic people are suffering from the Diabetes
type 1 problem but the cause of immune system attack is still nor clear properly. It consist
number of symptoms that occurs due to type 1 diabetes including increased thirst, unintentional
weight loss, frequent urination, blurry vision, tiredness and extreme hunger. Meanwhile, this
problem can be transmitted genetically if relevant gene is present in the family. Secondly,
Diabetes type 2 occurs in several conditions like old age, parent or sibling with this problem, are
not active physically, have had gestational diabetes, pre diabetes, high cholesterol, high
triglycerides or high blood pressure and overweight. According to opinion given by Suzanne
Falck (2019), it has been analysed that diabetes type 2 take place when an individual have
African American, Hispanic or Latino American, Alaska Native, Pacific Islander, American
India or Asian American ancestry. Thirdly, Gestational diabetes can occur after the age of 25
years, overweight condition, has gestational diabetes at the of time of past pregnancy, have given
birth to a baby weighing more than 9 pounds, have family history of type 2 diabetes, have
polycystic ovary syndrome (PCOS) and overweight.
Diabetes is a health problem that can be controlled and prevented by taking effective
steps in daily routine. It is observed that if proper precautions will not attempt and ignoring this
problem is responsible for creating extreme complications for people. However, there are
number of other complications are also associated with diabetes which are required to be
prevented through adopting healthy lifestyle and routine. It includes to avoid extra sugars, fats
and oily food by in taking healthy eatable items. Melissa Conrad Stöppler (2019) states that it is
requires for diabetic person to conduct daily physical work out to remain healthy and fit. On the
other hand, it include different types of treatment methods that are utilised for treating different
kinds of diabetes. In context of Type 1 diabetes, four type of insulin are most commonly used by
care practitioners for improving condition of an individual. Basically, rapid acting insulin starts
to work within 15 minutes and its effects last for 3 to 4 hours. Meanwhile, short acting insulin
begin to work within 30 minutes and lasts 6 to 8 hours. Meanwhile, intermediate acting insulin
starts to work within 1 to 2 hours and lasts 12 to 18 hours. Additionally, long acting insulin begin
to perform a few hours after injection and ends 24 hours or longer.
The Type 2 Diabetes includes different treatment options in which mots suitable one can
be applied for welfare of an individual. As per views of Robert Ferry Jr (2019), it includes

different drugs that are helpful to lower the blood sugar level in human body on different ways.
However, it involves Biguanides (metormin), DPP-4 inhibitors (saxagliptin, sitagliptin &
linagliptin), Glucagon like peptides (exenatide, liraglutide & dulaglutide), Meglitinides
(repaglinide & nateglinide), SGL T2 inhibitors (dapagliflozin & canagliflozin), Sufonyluareas
(glipizide, glimepiride & glyburide), Thiazolidinediones (rosiglitazone & pioglitazone) and
Alpha glucosidase inhibitors (Acarbose & miglitol). Gestational pregnancy is required to be
monitored sugar level of blood several times during the period of pregnancy to control the same.
It has been evaluated that 10 to 20 percent of women needs insulin to in order to lower the blood
sugar to maintain their health condition. It is also observed that insulin is safe for the growing
foetus.
2.2 The factors that create difficulties for people to manage condition of diabetes
Diabetes can become a severe health issues if proper precautions and medications will
not taken on time. It is necessary for diabetic people to intake healthy balanced diet and do
physical work out on daily basis. However, it includes different social and economic factors
which are responsible for creating issues for diabetic individuals belongs to Asian origin in
United Kingdom. It consist various elements like in which people born, grow, live, work and
age. According the opinion of Jiageng Chen, Xiyue Jing and Xiaoqian Liu (2019), it has been
analysed that many of people has their culture to look fat because it is considered as symbol of
their wealth and prosperity due to which they adopt habit of taking heavy and oily meals.
Meanwhile, it is essential for such people to understand the value and importance of taking
healthy food which is favourable to maintain better health condition. In context of Asian origin
people, it has been analysed that they are known as largest minority ethnic group in UK. There
are various factors that develop problem of managing diabetic condition in which some of them
are defined here.
Financial problems can be described as issues related to funds due to which Asian people
are not capable to take proper meal and medicine on time. Jimmy Reyes, Toni Tripp-Reimer and
Edith Parker (2017) states that it is responsible for creating complications in diabetic situation
which is not able to control due to lack of funds. However, the financial constraints includes
several components such as low income, unemployment, no medical insurance etc. It is essential
for Asian origin citizens to have much amount of money so that they can afford expensive
medications to manage blood sugar level. Meanwhile, the selected community did not get proper

employment opportunities to gain sufficient amount of compensation which impact negatively
on their diabetic condition. Moreover, it is observed that if they have jobs then their income is
low due to which they have limited options to fulfil their basic needs and they cannot take
dosage of medicine. Furthermore, these type of financial problems create problem of Asian
origin diabetic people in terms of managing their blood sugar level.
Severity of disease can be explained as high BMI (body mass index), complications,
presence of more to two co-morbidities and poor disease control. It includes the negligence or
reasoned ignorance of maintaining regular diet, physical exercise and other precautions which
facilitate the development of extreme complex health condition. A mentioned by Iswarya
Santhanakrishnan, Subitha Lakshminarayanan, and Sitanshu Sekhar Kar (2014), it will facilitate
to make extreme complicated situation which is difficult to control for care practitioners by
different clinical practices and medications. However, it is important for Asian origin diabetic
individuals to take precautions earlier and take medicines on time which is favourable to avoid
complexities along with maintaining sugar levels in blood. In addition to this, Medical facilities
includes the problem of delayed services and a condition in which provided medications are not
working on the patient. It includes the negligence behaviour of nursing staff towards Asian
origin people while dealing with them and issues of drug errors also generate problem for them
then diabetic condition gain complexities. Moreover, it has been identified that when
complications occurred to inappropriate medical atmosphere then it is responsible for developing
problem of patients to manage their diabetic health situation.
Life restrictions refers to various aspects of life restrictions and occupational restrictions
due to which people are not able to put efforts for managing their own health. Ranjit
Unnikrishnan, Viral N. Shah and Viswanathan Mohan (2019) states that it includes the basic
lifestyle of eating heavy and oily food which is harmful for a diabetic patient and it is mandatory
for them to avoid such eating habits immediately. However, when individuals belongs to Asian
origin group avoid intake of healthy diet and other required habits then it will create problems in
managing their health status. Moreover, own occupational and daily life routine should be
modified to improving diabetic situation to remaining disease free.
2.3 The role of care practitioners to improve condition of diabetes among Asian origin people
Care practitioners refers to group of individuals with degree and license in specific
medical field to contribute in well-being of an individuals. It includes various people like nurse,