Diabetes Case Study

Diabetes affects nearly 10% of the total population and national cost of more than $200 billion each year in the United States (Center for Diseases Control and Prevention, 2017). Before the patient protection and affordable care act (PPACA), many low-income diabetes patients had no or very limited access of health insurance coverage due to financial disadvantage. PPACA Title II-Role of public programs expanded Medicaid coverage to individuals under 133% of the federal poverty level (Obamacarefacts.com, 2013). Nurses directly interact with low-income diabetes patients to guide, advocate, educate and navigate the complex healthcare system to deliver the best evidenced care (Marquis &

The incidences of diabetes are growing annually, and predicted to increase within the coming decades. The number of cases yearly is not only increasing, but the age of onset for diabetes has decreased. This means more individuals are developing diabetes at an earlier age. Diabetes not only affects individuals and communities but countries as well. The prevalence of diabetes has gathered billions of dollars in healthcare costs. [1]Type 2 diabetes also leads to other serious medical conditions such as heart disease, renal failure, blindness, and tissue damage in extremities that will eventually lead to amputation. These illnesses, as a result, result in further costs in the form of disability and the loss of a portion of our workforce. However, incidences of type 2 diabetes are in higher occurrence amongst Hispanic groups. According to the Hispanic Health and Nutrition Examination Survey, Mexican Americans have an unusually high prevalence of diabetes compared to that of the general population [2]. Hispanic females have the highest lifetime risk of becoming diabetic – 52% [3], compared to that of the average risk of

Hispanics households with low socioeconomic status and low education coupled with low diabetes awareness have high type 2 diabetes prevalence 9. The high prevalence rates of type 2 diabetes can be attributed to a number of reasons such as; the Latinos have a genetic tendency to develop insulin resistance and they face high risks for abdominal obesity. The study emphasized that the strongest predictors of developing type 2 diabetes in Hispanic population are impaired insulin sensitivity, low insulin secretion and and glucose effectiveness 1. In addition, the prevalence rates are high in poor families who have poor nutrition and lifestyle behaviors. Since poor families have low access to education, they tend to have low awareness for diabetes hence these results in high diabetes prevalent rates. The results of the study indicated that incidence of diabetes decreased with rising educational level in Hispanic population

Diabetes  is a serious health condition that is a chronic illness for the African Americans. Diabetes preventions strategies in African American community can be a tricky task to contain and prevent for several reasons I will discuss in this paper.

According to the American Diabetes Association, more Americans die each year from diabetes than from AIDS and breast cancer combined. As a result, researchers have extensively studied the causes, treatments, and interventions for diabetes. Despite efforts to ameliorate its effects, diabetes remains a prevalent danger in society. In 2014, 7% of U.S. adults were living with diagnosed diabetes (Centers for Disease Control and Prevention [CDC], 2016). In Louisiana that number was even higher - 10.4% of adults have been diagnosed with diabetes. Breaking it down by age group, however, in Louisiana 3% of people aged 18 and 44 have been diagnosed, and 15.2% of people 45-64. (Centers for Disease Control and Prevention [CDC], 2015a). Several studies have predicted future rates of diabetes both in the United States and worldwide - nearly all of these studies reached a similar conclusion: rates of diabetes will continue to rise (Boyle et al., 2001).

Based on the United States census, it is estimated that by the year 2050 one in three people living in the United Sates will be of Hispanic/Latino origin which include sub groups like Puerto Rican, Mexican, Cuban, Central Americans, and South Americans (Heart Association, 2014). Within those subgroups, the prevalence varied for people of Mexican descent from as high of 18.3 percent to as low as 10.3 percent for people of South American descent, Dominicans and Puerto Rican descent 18.1 percent, Central American descent and Cubans descent 13.4 percent all living in the United States with diabetes type 2. On another commentary being published in the same issue of Diabetes Care, the author wrote, “the differences in diabetes and obesity prevalence among Latinos subgroups are marked when all individuals are combined into a single group” (Heart Association, 2014). Diabetes in Latino Americans has become more prevalence with aging, by the time they reach the age of 70 years, 44.3 percent of Latino men age 70 years old to 74 years old will have develop diabetes. The same study also indicated that the longer Latino Americans live in the United States the more likely they will develop diabetes, that is according to the education and income level of the person. The study also shows

While only 7.6 percent of non-Hispanic whites and 9 percent of Asian-Americans have diabetes, 12.8 percent of Hispanics have diabetes. Other high-risk ethnic groups are non-Hispanic blacks (13.2 percent) and American Indians/Alaskan Natives (15.9 percent). For Hispanics living in the United States, the prevalence of type 2 diabetes is lower in those coming from Central and South America (8.5 percent) or Cuba (9.3 percent), but higher for those who are Mexican American (13.9 percent) and Puerto Rican (14.8 percent), who comprise the majority of Hispanic immigrants in the U.S. (Valencia, Oropesa-Gonzalez, Hogue & Florez,

Diabetes is a prevalent health disparity among the Latino population. Diabetes is listed as the fifth leading cause of death among the Latino population in the website for Center for Disease Control and Prevention, CDC, in 2009. According to McBean, “the 2001 prevalence among Hispanics was significantly higher than among blacks.” (2317) In other words among the Hispanic or Latino community, there is a higher occurrence of diabetes as compared to other racial/ethnic groups such as Blacks and Native Americans. The prevalence of diabetes among Latinos is attributed to the social determinants of health such as low socioeconomic status and level of education. Further, this becomes an important public health issue when it costs the

Diabetes as describes by health. NY. GOV is a disease in which blood glucose (blood sugar) levels are above normal ("Diabetes Basics," 2007). This can lead to a range of serious health consequences, “including vision loss, nerve damage and numbness, high blood pressure, kidney disease, heart disease and death” (DiNapoli, 2015). Diabetes is a growing epidemic in New York City among all age group but has grown significantly over the years among adults especially African American and other minority groups. In 2007, data report from the New York City Health Department reported that “diabetes was higher in NYC than in the U.S. overall (9.1% vs 7.5%). (NYC health data).

The Hispanic population is constantly growing and we have an estimated 13.7% of Hispanics making up the United States. “The annual percentage of patients with prediabetes in whom overt type 2 diabetes develops is about 5% in the general US population and may reach 15% in the Hispanic American population” (Idrogo & Mazze, 2004, para. 7). This a community health issue because of the percentage of Hispanic individuals that may end up with diabetes. These individuals need to be educated to help the promotion, protection, and maintenance of diabetes in this group. That is why I have created the intervention program for this ethnic group.

The impact of diabetes on African Americans is disproportionate. An estimated four million of African Americans with the age of twenty and above are diabetic. They are more prone to have diabetes as compared to non-Hispanic whites. Once an African American reaches the age of 65,

Native Americans are mainly affected with type 2 diabetes. This is are mainly due education barriers. Not fully understanding the diagnosis usually leads to further problems, like not being able to treat the diagnosis

First, for Latinos, studies have found that the prevalence of total diabetes, diagnosed and undiagnosed, among all Hispanic/Latino groups was roughly 16.9 percent of both men and women, compared to 10.2 percent of non-Hispanic whites. However, when looking at Hispanic/Latino groups individually, it found that prevalence varied from a high of 18.3 percent for those of Mexican descent to a low of 10.2 percent for people of South American descent. The study showed 18.1 percent of people of Dominican and Puerto Rican descent; 17.7 percent of Central American descent; and 13.4 percent of Cuban descent living in the United States had type 2 diabetes (Alexandria, 2014). As people believe, also prevalence rose dramatically with age, reaching more than 50 percent for Hispanic/Latino women by the time they reached age 70 and 44.3 percent for men aged 70-74.

Diabetes is a major medical problem in the US. In the year 2015, it was reported that 86 million Americans are diagnosed with prediabetes (ADA, 2016). Diabetes is the seventh leading cause of death in the United States (CDC, 2016). Research has

According to the Centers for Disease Control and Prevention's National Center for Health Statistics, "[By 1993] death certificates listed diabetes as the fifth leading cause of death for Blacks aged 45 to 64, and the third leading cause of death for those aged 65 and older in 1990.” (Bailey, 2007). These statistics show how serious the problem of diabetes has become in the black community. Epidemiological studies can focus the efforts of the healthcare community to effective interventions aimed at lowering the prevalence and incidence of diabetes among African Americans.