Diabetes: Public Health Issue, Management, Strategies, and Prevention

This report addresses diabetes as a significant public health issue, defining it as a metabolic disorder with various types, including Type 1, Type 2, and gestational diabetes. It highlights the prevalence of diabetes in the UK, emphasizing the impact of lifestyle factors and the economic burden associated with the disease. The report explores approaches to address diabetes, such as national diabetes plans, clinical management strategies, and patient-centered care. It also examines the role of organizations like the EU Diabetes Working Group in advocating for diabetes-related policies and research funding. Furthermore, the report presents a case study of Ashton, Leigh, and Wigan, detailing their efforts to implement lifestyle and behavioral changes through health services and trainers to prevent diabetes. The findings suggest that lifestyle interventions can reduce the risk of Type 2 diabetes, emphasizing the importance of self-care and monitoring for effective disease management. The report concludes by highlighting the need for comprehensive strategies to reduce the occurrence of diabetes through a combination of individual and societal efforts.

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DIABETES
Diabetes: A Public Health Issue
World Health Organization (WHO) defines the term Diabetes mellitus as a metabolic
disorder which is a result of defect in insulin secretion or insulin action or both, characterized
by damage, dysfunction or failure of organs. The term Diabetes mellitus is coined from the
Greek words meaning “a siphon of sweet”.
Based on the aetiology, Diabetes can be classified into three types; namely, Type 1 diabetes
which is characterized by an absence of insulin production, hence, also known as Insulin
Dependent Diabetes mellitus (IDDM), Type 2 diabetes is characterized by ineffectiveness of
the produced insulin, hence, also known as Non-Insulin Dependent Diabetes mellitus
(NIDDM), and Gestational diabetes which is present by birth. Type 1 diabetes is particularly
found mostly in adults whereas Type 2 is a result of physical inactivity and obesity (WHO,
1997).
Statistics from the Public Health England (PHE, 2015) has shown that in UK approximately
3.8 million people (9% of the total adult population) suffer from diabetes. It has been
estimated that 90% of the affected are suffering from Type 2 Diabetes. The importance of
lifestyle changes has to be estimated as Type 2 Diabetes is an aftermath of unhealthy habits,
obesity etc. among the others. A recent survey has brought to light the fact that of the
population that is affected, nearly 1 million people are ignorant of their condition. Tackling
the disorder is of prime importance to any society as each year £8.8 billion is spent in
diabetes health services (New diabetes prevalence figures for England - Diabetes UK, 2017).
A population suffering from diabetes can have far-reaching impacts on its economy. A person
who has diabetes exhibits more chances of developing depression, cardiovascular diseases
etc. among the others. Moreover, a disorder such as diabetes impacts an individual at various

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levels.These disorders will in turn have a negative impact on a person’s income. For instance,
in Ireland about 66% of men and 42% of women were found to be less likely to work (LSE
Diabetes Report, 2012). Diabetes treatment is a costly affair and the burden of treatment and
management will invariably fall on families, leading them into poverty. Long-term therapy
becomes an issue for the elderly and socially backward communities. The social and mental
impact of the disorder can lead to poor quality of life for an individual. As for a nation, young
individuals suffering from and dying due to such a disorder leads to economic implications.
The poor health of the labour power causes loss of productivity (Tolet al., 2013). Although,
Europe has the world’s leading healthcare it is difficult to gather data of management and
costs in many states.
Approaches to address Diabetes
The European Union has put in place National Diabetes Plan whose main objectives are to
understand prevention and treatment of diabetes in the population. These policies try to target
Type 1, Type 2 and gestational diabetes. The whole plan is patient-centred, wherein the
patient is consulted to understand his/her need to develop a plan. These policies try to include
a wide range of ethnicities, socio-economic groups in order to ensure impartial access to all.
NDPs work towards prevention, care and education across countries. One of the key elements
of NDP is risk-profiling where they identify risk groups and provide them with care, nutrition
and education to prevent the onset of the disease. The monitoring and evaluation of the
implemented policies is annually carried out in England, Netherlands and Slovakia among
other countries (National Diabetes Plans in Europe: Policy Brief - 2016).
Clinical management strategiesare yet another strategy that involves evidence based
probability of an individual to develop the disorder. For instance, a physician can predict the
chances of an individual to develop diabetes by looking at the patients’ lifestyle and

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pharmacotherapy (Diabetes Care, 2014). Another strategy that can be adopted at individual
level is Patient-centred care wherein a patient and the family is exposed to diabetes mellitus
management education. This is an initiative adopted for self-care. The education introduces
the disease process, diet plans, treatment strategies, prescriptions, monitoring and knowledge
of complications to the patient. Lifestyle interventions are another way to control the
development of the disorder (Buren and Tibbs, 2014). The advantages and shortcomings of
such evidence-based management systems have to be considered on based individual
characteristics (Ofori and Unachukwu, 2014).
The EUDWG also known as the EU Diabetes Working Group is a group dedicated towards
putting diabetes on the national agenda. The aims of the group include the following: To
recognize diabetes as a national health urgency and support legislation that supports the fight
against diabetes. These play a role in increasing the funding from the European Public Health
Programme. The group also aims at securing funds for diabetes related research in the nation.
Due to their efforts, the European research association receives substantial funding from the
Research Framework Programme. They also work towards consumer protection by ensuring
that value added products are received by the patients, with a clear understanding of the
nutritional value. They work towards making life easier for diabetic people, for instance, by
encouraging the amendment of driving regulations to reduce restrictions placed on such
people. The role of such groups is also to ensurethat people living with the disorder get their
rights and safety (IDF Europe - EU Diabetes Working Group, 2015).
A lack of research data collection from these high-end policies have limited the gathering of
evidence-based decisions in the contemplation of the working of regional and national
programmes (Yates et al., 2012).
Setting an example- Ashton, Leigh and Wigan

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Ashton, Leigh and Wigan have a larger percentage of diabetics as compared to the rest of
UK. In order to overcome their situation, the CLAHRC supported the NHS in the region in
implementing the existing systems for the treatment and prevention of diabetes. The role was
to bring about a lifestyle and behavioural change in the masses. To bring about this change
they made the use of the existing health services in the region, due to the previous success of
the same strategy at Greater Manchester. An initiative called “Choosing Life” was founded to
support the people with higher chances of developing cardiovascular diseases. The whole
initiative was aided by Health trainers, who are people with intensive training meant for
motivating people in the path of a behavioural change. These health trainers worked in
collaboration with primary care and community health centres. The programme is scheduled
for over a period of 6 months with free counselling over time and as need arises. During the
intervention, trainers help the clients in setting achievable goals.
Evaluation of the programme was based on quantitative and qualitative elements. Qualitative
elements include the number if patients that enrolled during the period, the change in BMI of
these patients, nutritional habits etc. among the others. The quantitative elements include
feedback of the staff and clients in the form of questionnaires and interviews. For the purpose
of evaluation, before and after weights of clients were recorded and a drop in the mean BMI
was observed. By the end of the intervention, evident changes in physical exercise were
observed. Results obtained from this study helps us to infer that change in lifestyle and
behaviour can decrease the chances of developing Type 2 Diabetes. The clients who partook
in the programme have rated it positively, which means the set targets are achievable.
Another observation is that each person should be registered under the IGT registry to ensure
efficient monitoring. Although, the complete eradication of the disease is not yet possible, a
society can contribute to reducing the occurrence of the disease by paying attention to self-
care (Betzlbacher, 2013).

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References
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2017].
Buren, D. J. V. & Tibbs, T. L. 2014. Lifestyle Interventions to Reduce Diabetes and
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IDF Europe - EU Diabetes Working Group 2015. International Diabetes Federation.
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LSE Diabetes Report 26Jan2012.pdf 2012. Available at:
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