Early Diabetes Screening In Adults Essay

Early Diabetes Screening In Adults Essay

Executive Summary

The early screening of diabetes in adults is extremely significant given that the long-term complications and general patient outcomes from its management will depend on it. Diabetes is characterized by microvascular and macrovascular complications whose course may be altered if early detection and treatment is done. Adults will develop type II diabetes that is lifestyle dependent. For this reason, any adult that leads a sedentary lifestyle, is overweight or obese, and feeds on junk foods must be considered for screening. Actually, the United States Preventive Services Task Force (USPSTF) recommendation on type II diabetes is that each adult between the ages of 35 to 70 years should be screened for the condition. Screening for diabetes is done through the test known as the HbA1c. It is the test that determines the percentage of red blood cells that are glycosylated within a period of the past three months Early Diabetes Screening In Adults Essay.

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Key stakeholders: Providers, patients, federal agencies, payers, policy makers

Target audience: Adults between the ages of 35 to 70 years

Issue Brief: Early Diabetes Screening in Adults

Diabetes is a metabolic condition characterized by an insulin shortage or a poor responsiveness of tissues to the presence of insulin (what is called insulin resistance). Type II diabetes mellitus is a type of diabetes that strikes people later in life rather than while they are young. Type II diabetes is essentially a lifestyle disease or condition that is predisposed to by the presence of lifestyle variables in the setting of genetic susceptibility. Poor food and a low physical activity with no exercise are among the lifestyle variables that contribute to overweight and obesity (Hammer & McPhee, 2018). The HbA1c or glycated hemoglobin test is ordered by the clinician to conclusively identify type II diabetes. The test determines the percentage of erythrocytes that have been coated with glucose in the last two to three months. The purpose of this paper is to present a policy or issue brief concerning the early screening of diabetes in adults Early Diabetes Screening In Adults Essay.

Problem Statement

Type II diabetes has a global prevalence of 6059 cases per 100,000 people. According to worldwide epidemiological figures from 2017, this equates to 6.28 percent of the total global population. In other words, approximately 462 million people worldwide have type II diabetes, which begins in adolescence (Khan et al., 2020). When the stated prevalence is divided by age category, it is as follows: 15-49 years (4.4 percent), 50-69 years (15 percent), and 70 years and older (4.4 percent) (22 percent). According to Khan et al., these are grim numbers (2020). According to the authors, diabetes is responsible for a million deaths per year. They also predict that the global prevalence of type II diabetes would climb to 7079 people per 100,000 by 2030. In 2018, the prevalence of type II diabetes was 6.9 adults per 1,000 people.

Background

A lifestyle of physical inactivity that contributes to overweight and obesity is the ideal environment for the development of insulin resistance and type II diabetes in adults. Typically, the patient consumes very few, if any, fresh fruits and vegetables. They frequently consume a lot of junk food and carbohydrates that are high in calories. Unfortunately, because they do not exercise, calories are absorbed into the body, leading to overweight and obesity. Insulin resistance and obesity coexist with other pathogenic components to form the condition known as metabolic syndrome. According to the World Health Organization (WHO), sedentary living (lack of exercise) is the single most leading cause of disability and death globally. According to Najafipour et al. (2017), a lack of physical exercise and the resulting obesity are to blame for the rising prevalence of type II diabetes in the United States and around the world.

Aim of the Issue Brief

The aim of this brief is to draw the attention of all the stakeholders to the subject of early detection of type II diabetes among the adult population. It also draws their attention and engagement to the current prevailing situation on the same subject. This is to do with current policy and practice amongst other issues Early Diabetes Screening In Adults Essay.

Current Policies

The Patient Protection and Affordable Care Act (ACA 2010) made considerable headway in achieving accessibility and cost-effectiveness for the poor and vulnerable, but much more work remains to be done (Kominski et al., 2017). This is due to the fact that early diagnosis of diabetes through screening will result in lifelong reliance on the healthcare system. The ACA 2010 mandates coverage for pre-existing diseases. Therefore the present policy is advantageous for persons with type II diabetes. The Centers for Medicare and Medicaid Services (CMS) is also assisting, but it is still insufficient, resulting in a high disease burden and death from type II diabetes in the United States. According to Cai et al. (2020), the United States requires a single-payer system.

Evidence-Based Practice Recommendations

The United States Preventive Services Task Force or USPSTF recommendation on type II diabetes is that each and every adult between the ages of 35 and 70 be checked for diabetes. This is especially true if they are obese or overweight (USPSTF, 2021). The rationale is that being overweight or obese is a major risk factor for developing type II diabetes mellitus. The USPSTF also recommends that treatment starts with lifestyle measures first (Rao et al., 2020). That means no drugs and only exercise and diet. Only after these have failed to produce the desired outcomes can oral hypoglycemics be introduced to the regimen.

Advantages and Disadvantages of Proposed Solutions

The advantages of the proposed solutions include that the screening at the ages of 35 to 70 places the timing at the optimum age bracket where type II DM usually commences. The other advantage is that these proposed solutions are evidence-based meaning that they have been tested scientifically and found to be effective. The disadvantages of the proposed solutions include the high cost of healthcare in the US (Sultz & Kroth, 2018), the scarcity of primary care providers at the grassroots level such as nurse practitioners, and the low levels of sensitization of the vulnerable populations to the availability of the options provided.

Recommendation with a Literature Supported Rationale

The recommendation for management as supported by scholarly literature and guidelines include the following:

At least 30 minutes of daily isotonic aerobic exercise, such as walking, six days a week.
Regular eating of fresh fruits and vegetables
Avoidance of fatty and oily foods
Avoidance of sugary sweetened beverages and snacks
Daily blood glucose monitoring with a self-monitoring home device
Dietary advice and guidance from a dietician
Exercise counseling and direction from a physical therapist
Taking antidiabetic medications in conjunction with exercise and diet after lifestyle measures fail to control the condition (Chaudhury et al., 2017; Khan et al., 2020; Najafipour et al., 2017; Rao et al., 2020; USPSTF, 2021)Early Diabetes Screening In Adults Essay.

Annotated Bibliography

Khan, M.A.B., Hashim, M.J., King, J.K., Govender, R.D., Mustafa, H., & Al Kaabi, J. (2020). Epidemiology of type 2 diabetes – Global burden of disease and forecasted trends. Journal of Epidemiology and Global Health, 10(1), 107-111. https://doi.org/10.2991/jegh.k.191028.001

This article provides the statistics about type II diabetes that is the type that affects adults most. It gives the prevalence of the condition and the measures being taken to control the condition from various aspects.

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Najafipour, F., Mobasseri, M., Yavari, A., Nadrian, H., Aliasgarzadeh, A., Abbasi, N.M, Niafar, M., Gharamaleki, J.H., & Sadra, V. (2017). Effect of regular exercise training on changes in HbA1c, BMI and VO₂ max among patients with type 2 diabetes mellitus: An 8-year trial. BMJ Open Diabetes Research & Care, 5(1), 1-8. http://dx.doi.org/10.1136/bmjdrc-2017-000414

This research article provides the facts of a scientific investigation on the effects of exercise on the values of the HbA1c test that is the indicator of progress and status of a patient’s diabetes. It also lays out the benefits of exercise in reducing the body mass index to healthy levels amongst other things.

Rao, A.S., Hegde, S., Pacioretty, L.M., DeBenedetto, J., & Babish, J.G. (2020). Nigella sativa and Trigonella foenum-graecum supplemented chapatis safely improve HbA1c, body weight, waist circumference, blood lipids, and fatty liver in overweight and diabetic subjects: A twelve-week safety and efficacy study. Journal of Medicinal Food. 1-15. https://doi.org/10.1089/jmf.2020.0075

Lastly but not least, this research article tackles the issue of diet and its usefulness in controlling the progression of diabetes. The paper shows that proper diet especially natural supplements work effectively to reduce the HbA1c levels to physiological levels.

References

Cai, C., Runte, J., Ostrer, I., Berry, K., Ponce, N., Rodriguez, M., Bertozzi, S., White, J.S., & Kahn, J.G. (2020). Projected costs of single-payer healthcare financing in the United States: A systematic review of economic analyses. PLOS Medicine, 17(1), 1-18. https://doi.og/10.1371/journal.pmed.1003013

Chaudhury, A., Duvoor, C., Dendi, V.S.R., Kraleti, S., Chada, A., Ravilla, R., Marco, A., Shekhawat, N.S., Montales, M.T., Kuriakose, K., Sasapu, A., Beebe, A., Patil, N., Musham, C.K., Lohani, G.P., & Mirza, W. (2017). Clinical review of antidiabetic drugs: Implications for type II diabetes mellitus management. Frontiers in Endocrinology, 8(6), 1-12. https://doi.org/10.3389/fendo.2017.00006

Hammer, D.G., & McPhee, S.J. (Eds). (2018). Pathophysiology of disease: An introduction to clinical medicine, 8^th ed. McGraw-Hill Education.

Kominski, G.F., Nonzee, N.J. & Sorensen, A. (2017). The Affordable Care Act’s impacts on access to insurance and health care for low-income populations. Annual Review of Public Health, 38. https://doi.org/10.1146/annurev-publhealth-031816-044555

Sultz, H.A., & Kroth, P.J. (2018). Sultz and Young’s health care USA: Understanding its organization and delivery, 9^th ed. Jones & Bartlett Learning.

United States Preventive Services Task Force [USPSTF] (August 24, 2021). Pre-diabetes and type II diabetes: Screening. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/screening-for-prediabetes-and-type-2-diabetes Early Diabetes Screening In Adults Essay