SNGP3011: Community Profiling of Yishun Area, Singapore, Report

This report provides a comprehensive community profile of the Yishun area in Singapore, focusing on the public health concern of diabetes mellitus. It begins with an introduction highlighting the global prevalence of diabetes and its increasing impact in Asia, particularly in Singapore. The report then delves into the aetiology and epidemiology of diabetes mellitus, differentiating between Type 1 and Type 2 diabetes, and discussing associated risk factors like genetics, lifestyle, and obesity. The analysis extends to the Yishun district, presenting data on the burden of diabetes and related risk factors. The core of the report examines the role of nurses in planning interventions, including prevention, screening, early detection, and patient self-management strategies. The report emphasizes the importance of nurses in promoting self-care, providing nutritional guidance, and monitoring patients for effective disease management. The conclusion reiterates the significance of nursing interventions in mitigating the impact of diabetes and promoting a healthier community in Yishun.

Running Head: COMMUNITY PROFILING OF YISHUN AREA, SINGAPORE
COMMUNITY PROFILING OF YISHUN AREA, SINGAPORE
ASSIGNMENT 2

COMMUNITY PROFILING OF YISHUN AREA, SINGAPORE
Table of Contents
Introduction......................................................................................................................................3
Aetiology and epidemiology of the Diabetes Mellitus....................................................................3
Analysis of the public health problem to the district.......................................................................5
Role of nurses in planning interventions.........................................................................................6
Conclusion.......................................................................................................................................7
References........................................................................................................................................8
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COMMUNITY PROFILING OF YISHUN AREA, SINGAPORE
Introduction
The global rates of diabetes mellitus amongst people have quadrupled in the last three
decades (Vasudevan & Levene, 2013). Diabetes mellitus currently ranks as the ninth major cause
for death and an estimated 1 in 11 adults have the disease. Amongst these people, almost 90% of
people suffer from type 2 diabetes mellitus (T2DM). In Asia alone, the disease is emerging as a
global epidemic with increased rates of patients centered in Singapore. Diabetes mellitus is one
of the major cause of public health concern amongst adult as well as children population (Bonds
et al, 2010). The current scope of discussion encompasses the major public health concern of
diabetes mellitus and its widespread in the Yishun district of Singapore with nursing roles to
manage the concern.
Aetiology and epidemiology of the Diabetes Mellitus
Diabetes mellitus is one of the leading causes of ill-health and death amongst the adult
population around the world. The risks associated with the condition increases the chances of co-
morbidities reducing life-span in healthy individuals (Zheng, Ley & Hu, 2018). Research depicts
that genetic predisposition partly determines the susceptibility of an individual to the given
condition. Causes attributed to the disease are associated with an unhealthy diet and sedentary
lifestyles. These factors drive the current global susceptibility leading to the early development
of T2DM.
The Ciba Foundation Colloquium 15th on Endocrinology organised in England in 1963
reviewed information related to the aetiology of diabetes mellitus. The pathogenesis of diabetes
mellitus and its complications with humans were discussed. The aetiology associated with
T2DM arises from several factors that include genes and lifestyle factors (Knip, 2012). Type 1
diabetes takes place when the body’s immune system fights for infection, attacks while
destroying the beta cells produced by the insulin present in the pancreas. The aetiology of type 1
diabetes is caused primarily by environmental factors and genes, which act to trigger the disease.
Type 2 diabetes is primarily caused by factors such as genes and lifestyle. Overweight, physical
inactivity and obesity are the aetiology is a leading factor of type 2 diabetes. Extra weight is
known to the leading factor causing insulin resistance and is found extremely common amongst
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COMMUNITY PROFILING OF YISHUN AREA, SINGAPORE
people with type 2 diabetes (Abbasi et al, 2016). The location of fat within the body also makes
significant different and belly fat has been found associated with insulin resistance.
In type 1 diabetes causation is linked with genetic susceptibility. It has been diagnosed
that environmental factors have a considerable role in the progression from islet autoimmunity as
improvisation in living standards has been considerably linked to reducing microorganism
exposure and in the reduction of autoimmunity. Various research has reflected the close
association of early social mixing, toxins, viral infections and dietary factors to be aetiologies as
well. The onset of type 2 diabetes without acute metabolic disturbance is rather difficult to
determine.
Back in 2005, it has been estimated that approximately 1.5 million new cases of diabetes
were diagnosed. Such trends have changed considerably over time and diabetes mellitus in 2018
has emerged as a major epidemic. Over the past 2 decades, data from Singapore reveals a
growing and huge number associated with the disease. In 2014 alone residents with the condition
was estimated to be at 440,000, who were 18 years and above. This number is estimated to grow
to 1,000,000 in the year 2050. Diabetes was found to be the fourth most common condition of
polyclinic attendance and for hospitalization, it was also one of the fourth-leading cause of
mortality. The incidence of the cost associated with diabetes mellitus has been expected the rise
to approximately $1.8 billion in 2050.
Diabetes has been found to affect many different organ systems and over a period of time
lead to serious complications. The most significant risk factors include high blood pressure,
hyperglycemia and hypercholesterolemia. Improvisation in glycemic control, cholesterol and
blood pressure can considerably reduce risks from complications. A person suffering from
diabetes can reduce individual risk for microvascular complications by 40%.
Medicine can be found to harm the beta cells or in disruption of the manner in which
insulin functions. Some of the medicine includes niacin, which consists of a type of vitamin B3,
certain types of diuretics known as the water pills, psychiatric drugs, and anti-seizure drugs
(Strachan, Reynolds, Frier, Mitchell & Price, 2009). The drugs for treating human
immunodeficiency virus is also often used for treating the condition. Anti-rejection medicines
that are used for stopping the body from the rejection of a transplanted organ and
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COMMUNITY PROFILING OF YISHUN AREA, SINGAPORE
glucocorticoids, comprising of medicines that are used for the treatment of inflammatory
illnesses including asthma.
Analysis of the public health problem to the district
The current aetiology and epidemiology of diabetes mellitus in Yishun district in
Singapore are considerable. The pancreas produces ineffective or little insulin hormone for the
body cells use in blood sugar for the purpose of energy. In Singapore, approximately 400,000
residents from 200,000 residents above 40 years of age are estimated to have diabetes by 2030.
Diabetes has no cure hence it is best to keep it under control. The figure below reveals the
projected burden of diabetes in Singapore according to the year.
Figure 1: Burden of Diabetes in Singapore
The risk factors for the chosen public health problem in Yishun area have been identified
as family history, race and viral infection during childhood for type 1 diabetes.
The risk factors for type 2 diabetes are more diverse. The nonmodifiable risk factors for
type 2 diabetes is race, age, family history, ethnicity, a period of gestational diabetes and low
birth weight (Forouhi & Wareham, 2010). The incidence of diabetes in Singapore as well as
around the world has been seen to increase considerably with age.
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Role of nurses in planning interventions
Self-management roles are seen to be the most essential in diabetes care. With support
from the nursing staff, the condition can be managed in an effective manner and will allow
individuals to stay healthy and prevent further complications. Diabetes Specialist Nurses (DSN)
are most important in providing and promoting self-care management and patient care (Faerch,
Borch-Johnsen, Holst & Vaag, 2009). Nurses can effectively provide prevention advice such as
behavioural change and health coaching techniques. Nursing care for a patient with diabetes
involves the following;
o Prevention, screening and early detection of type 2 diabetes: Nurses roles and
responsibilities include prevention, screening, and early detection of type 2 diabetes.
Patient’s need to know risk factors for type 2 diabetes. The importance of delay or
prevention of the onset of type 2 diabetes needs to be explained. Consciousness regarding
patient's weight control and the role of diet in the prevention or delay in progression
needs to be raised.
o Promotion of self-care: Supporting the patient to self-care in their diabetes by developing
guidance is essential.
o Mental health: Raising awareness on the mental health issue can significantly affect
people with diabetes and assists in the promotion of self-care.
o Nutrition: The patient’s nutritional needs to be assessed and met. The foods and drinks
with high blood sugar content needs to be identified following a nutritional plan for
reporting any related problems. Measuring of waist circumstances, weight and height of
the patient in an accurate manner can enable controlling the disease.
o Urine Monitoring: Regular monitoring of urine and blood glucose monitoring can help in
controlling the disease.
o Blood glucose monitoring: Safe use of blood glucose monitoring needs to be undertaken.
The normal range for glycaemia and reporting of readings in case of outside range has to
be undertaken.
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o Oral therapies: Oral therapy and injectable therapies and identification and treatment of
hypoglycaemia.
o Injectable therapies
o Hypoglycemia: Identifying and relating of hyperglycaemia for stating the normal blood
glucose range and description of the symptoms with signs has to be undertaken. The
accepted range has to be documented correctly. Blood and ketone tests needs to be
undertaken according to local guidelines.
The above nursing intervention strategies along with identifying newer strategies will
enable Yishun area to emerge as a healthier area. This will also enable leading the localities
towards a healthier population.
Conclusion
To conclude, it can be said that diabetes mellitus is a major cause of public health
concern in Yishun district in Singapore. In spite of the income of the population group there
lacks awareness regarding the harmful impact of the disease. Effective nursing intervention
strategies can enable overcoming this epidemic. Nursing strategies can enable to avoid the
possible risk factors associated with the disease in an effective manner such that the community
can become a healthier one.
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References
Abbasi, A., Sahlqvist, A.S., Lotta, L., Brosnan, J.M., Vollenweider, P., Giabbanelli, P., Nunez,
D.J., Waterworth, D., Scott, R.A., Langenberg, C. and Wareham, N.J. (2016). A
systematic review of biomarkers and risk of incident type 2 diabetes: an overview of
epidemiological, prediction and aetiological research literature. PloS one, 11(10),
e0163721. DOI: 10.1371/journal.pone.0163721.
Bonds, D. E., Miller, M. E., Bergenstal, R. M., Buse, J. B., Byington, R. P., Cutler, J. A., ... &
Horowitz, K. R. (2010). The association between symptomatic, severe hypoglycaemia
and mortality in type 2 diabetes: retrospective epidemiological analysis of the ACCORD
study. Bmj, 340, b4909. DOI: 10.1136/bmj.b4909
Faerch, K., Borch-Johnsen, K., Holst, J. J., & Vaag, A. (2009). Pathophysiology and aetiology of
impaired fasting glycaemia and impaired glucose tolerance: does it matter for prevention
and treatment of type 2 diabetes?. Diabetologia, 52(9), 1714-1723. DOI:
10.1007/s00125-009-1443-3.
Forouhi, N. G., & Wareham, N. J. (2010). Epidemiology of diabetes. Medicine, 38(11), 602-606.
DOI: 10.1016/j.mpmed.2010.08.007.
Knip, M. (2012). Descriptive epidemiology of type 1 diabetes—is it still
in?. Diabetologia, 55(5), 1227-1230. DOI: 10.1007/s00125-012-2522-4.
Strachan, M. W., Reynolds, R. M., Frier, B. M., Mitchell, R. J., & Price, J. F. (2009). The role of
metabolic derangements and glucocorticoid excess in the aetiology of cognitive
impairment in type 2 diabetes. Implications for future therapeutic strategies. Diabetes,
Obesity and Metabolism, 11(5), 407-414. DOI: 10.1111/j.1463-1326.2008.00963.x.
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Vasudevan, C., & Levene, M. (2013, August). Epidemiology and aetiology of neonatal seizures.
In Seminars in Fetal and Neonatal Medicine (Vol. 18, No. 4, pp. 185-191). WB
Saunders. DOI: 10.1016/j.siny.2013.05.008.
Zheng, Y., Ley, S. H., & Hu, F. B. (2018). Global aetiology and epidemiology of type 2 diabetes
mellitus and its complications. Nature Reviews Endocrinology, 14(2), 88. DOI:
10.1038/nrendo.2017.151.
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