Chapter 5—promoting Diabetes Prevention And Control
Performance audit reports This report presents the results of a performance audit conducted by the Office of the Auditor General of Canada under the authority of the Auditor General Act. A performance audit is an independent, objective, and systematic assessment of how well government is managing its activities, responsibilities, and resources. Audit topics are selected based on their significance. While the Office may comment on policy implementation in a performance audit, it does not comment on the merits of a policy. Performance audits are planned, performed, and reported in accordance with professional auditing standards and Office policies. They are conducted by qualified auditors who establish audit objectives and criteria for the assessment of performance; gather the evidence necessary to assess performance against the criteria; report both positive and negative findings; conclude against the established audit objectives; and make recommendations for improvement when there are significant differences between criteria and assessed performance. Performance audits contribute to a public service that is ethical and effective and a government that is accountable to Parliament and Canadians. Type 1 diabetes Includes about 5 to 10 percent of those with diabetes An autoimmune disease that typically arises in people under age 40 No known prevention Type 2 diabetes Includes about 90 to 95 percent of those with diabetes Higher risk for those who are overweight or obese, physically inactive, or members of certain ethnic populations Modifiable risk factors: weight, eating, smoking Non-modifiable risk factors: age, ethnicity, family history Gestational diabetes Detected in about 3 to 5 percent of all pregnancies that result in live birth Occurs when hyperglycemia develops dur Continue reading >>
A New Approach To Tackling Type 2 Diabetes Is A Step Forward For Prevention
As waistlines continue to expand across the country (62% of adults are overweight or obese), diagnoses of Type 2 diabetes are also rising. The cost of treating diabetes, and associated complications such as heart disease and stroke, is costing the NHS around £10bn every year. Trends are only going one way – with one in ten adults expected to be diagnosed with Type 2 diabetes by 2034. And we know the risks – those who are overweight, physically inactive or have a family history of diabetes are at increased risk of developing the condition, as are people of South Asian, African, and African-Caribbean descent and less affluent individuals and populations. With 5 million people in England at high risk of developing Type 2 diabetes, we urgently need to see a major drive towards diabetes prevention in the UK, and the launch of Healthier You: the NHS Diabetes Prevention Programme represents an important step forward. The programme aims to identify those at high risk and refer them into evidence-based behavioural interventions to help them reduce that risk through achieving and/or maintaining a healthy weight, recommended levels of activity and a healthy, balanced diet. It’s an important part of a wider range of work to tackle a disease that is already a huge burden on the NHS, by shrinking the numbers of people living with Type 2 diabetes in the future. An evidence-based solution We published a systematic review in August last year that examined the effectiveness of ‘real-world’ interventions for the prevention of Type 2 diabetes in high risk populations. The review looked closely at the following areas: The effectiveness of diabetes prevention programmes on reducing cases of Type 2 diabetes and reducing weight in high risk populations The population groups that see Continue reading >>
Ways Of Promoting Health To Patients With Diabetes And Chronic Kidney Disease From A Nursing Perspective In Vietnam: A Phenomenographic Study
Health promotion plays an important role in the management of diabetes and chronic kidney disease, especially when the prevalence of the disease is rising in Vietnam. Nurses have been identified to be the front figure in health promotion; however, little is written about how nurses in Vietnam work with these issues. Therefore, the aim of this study was to describe nurses’ conceptions about how health is promoted, with special focus on physically activity, for patients with type 2 diabetes (T2DM) and/or end-stage renal disease (ESRD). Individual interviews were done with 25 nurses working at two major hospitals in Hanoi, Vietnam. A phenomenographic approach was used to analyse the interviews. Nurses described how creating positive relationships and supporting patients to take part in their social context promoted health. Health was also promoted by educating patients and relatives about health and disease and by supporting patients to be physically active. The findings indicate that the Vietnamese nursing knowledge about health promotion needs to be gathered, and health promotion needs to be further integrated in the education. Further research is necessary to examine patients’ knowledge and attitudes about health and the efficiency of various health-promoting strategies in the Vietnamese context. Continue reading >>
Overview
The importance of both diabetes and these comorbidities will continue to increase as the population ages. Therapies that have proven to reduce microvascular and macrovascular complications will need to be assessed in light of the newly identified comorbidities. Lifestyle change has been proven effective in preventing or delaying the onset of type 2 diabetes in high-risk individuals. Based on this, new public health approaches are emerging that may deserve monitoring at the national level. For example, the Diabetes Prevention Program research trial demonstrated that lifestyle intervention had its greatest impact in older adults and was effective in all racial and ethnic groups. Translational studies of this work have also shown that delivery of the lifestyle intervention in group settings at the community level are also effective at reducing type 2 diabetes risk. The National Diabetes Prevention Program has now been established to implement the lifestyle intervention nationwide. Another emerging issue is the effect on public health of new laboratory based criteria, such as introducing the use of A1c for diagnosis of type 2 diabetes or for recognizing high risk for type 2 diabetes. These changes may impact the number of individuals with undiagnosed diabetes and facilitate the introduction of type 2 diabetes prevention at a public health level. Several studies have suggested that process indicators such as foot exams, eye exams, and measurement of A1c may not be sensitive enough to capture all aspects of quality of care that ultimately result in reduced morbidity. New diabetes quality-of-care indicators are currently under development and may help determine whether appropriate, timely, evidence-based care is linked to risk factor reduction. In addition, the scientific evid Continue reading >>
Where To Find Evidence-based Methods And Interventions
Printable Version Evidence-based health or public health methods and interventions are practices, procedures, programs, or policies that have been proven effective. The effects are clearly linked to the activities, themselves, not to outside, unrelated events. Evidence of effectiveness is demonstrated by: 1) inclusion in federal registries of evidence-based interventions; 2) reports in peer-reviewed journals; 3) documentation in other reputable sources of information; or 4) the consensus of opinion among informed experts. Evidence-based methods and interventions for any given health or public health problem can be found using the resources listed below. This list includes resources covering broad topics. PubMed (see below under Other Resources) is recommended for finding the newest methods and interventions related to specific problems or diseases. Key Resources Guide to Community Preventive Services The official collection of all Community Preventive Services Task Force findings and the systematic reviews on which they are based. Answers questions such as: What interventions have and have not worked? In which populations and settings has the intervention worked or not worked? What might the intervention cost? What should I expect for my investment? Does the intervention lead to any other benefits or harms? What interventions need more research before we know if they work? Healthy People 2020 Evidence-Based Resource Tool A new database that allows searches for interventions by Healthy People 2020 topic areas and objectives; race and ethnicity; sex; age; population group; setting; intervention agent; resource type; intervention type; and desired outcome. Some of the search categories are not yet functional (as of August, 2014), as the tool is still in progress. Healthy P Continue reading >>
Patient Education: Diabetes, Prevention
Young, Smart, Attractive, DIABETIC? Why college students should care about diabetes — and how to prevent it Tell me what diabetes is and what it has to do with me. Diabetes means that your blood glucose (sugar) is too high. The health choices you make as a college student can determine whether or not you will have to deal with serious complications — such as blindness, nerve damage and heart disease — that can come with having diabetes. But no one in my family has ever had it! Did you know that you can develop type 2 diabetes without having any genetic predisposition to it? Recent studies show more and more college-age students starting their after-college lives with type 2 diabetes or prediabetes as a result of poor diet and/or physical fitness while at school. Risk factors for type 2 diabetes/prediabetes include: High Body Mass Index (BMI) Little or no physical activity Family history of diabetes Race/ethnicity (African American, Hispanic/Latino, American Indian, Asian, Pacific Islander) Prediabetes? Never heard of it. Prediabetes means your blood glucose is higher than normal but lower than the diabetes range. It also means you’re at risk for type 2 diabetes; however, you can reduce your risk of getting diabetes and even return to normal blood glucose levels with modest weight loss and moderate physical activity. How would I know if I have diabetes? Some signs of diabetes include being very thirsty or hungry, feeling very tired, blurry vision, tingling in the hands or feet, and sores that are slow to heal. But I don’t feel sick, and my weight is totally fine. Skinny is good, right? Skinny does not always equal healthy. While the association between having a high BMI and diabetes or prediabetes is well-established, weight alone is not the only thing that can Continue reading >>
Diabetes : Strategies For Prevention
Report of the Chief Medical Officer of Health Table of Contents Message from Ontario's Chief Medical Officer of Health Diabetes : A Public Health Challenge What is Diabetes? Why is Diabetes Such an Important Public Health Issue? The Economic Impact of Diabetes A Dangerous Lack of Awareness How Can We Identify People at Risk and Prevent Diabetes and Its Complications? Risk Factors for Diabetes Type 1 Diabetes Type 2 Diabetes Strategies for Prevention Changing Risk Factors Early Identification and Effective Management Rehabilitation Age Socio-Economic Issues Ethnic and Cultural Groups Aboriginal People An Agenda for Action : Recommendations For Individuals and Families For Communities For Health Care Providers For Federal and Provincial Governments Conclusion Acknowledgements Appendix A : Types of Diabetes Appendix B : Symptoms of Diabetes Appendix C : Long-Term Complications of Diabetes Appendix D : Are You at Risk for Diabetes? Appendix E : Canadian Guidelines for Healthy Weights Appendix F : Ontario Diabetes Initiatives in Progress Northern Diabetes Health Network Southern Ontario Aboriginal Diabetes Initiative (SOADI) Seniors and Diabetes Initiative Diabetes Complication Prevention Strategy Evaluation Non-Governmental Organizations Everyone in Ontario needs to understand the seriousness of this disease because all of us are susceptible to diabetes and its resultant impact on health. The prevalence of diabetes is alarmingly high and is expected to increase over the next century. In Ontario, over 600,000 people have been diagnosed with diabetes; at least another 300,000 people don't know they have it. Four out of 10 people with diabetes will develop debilitating and long-term complications. Diabetes is a major cause of premature death, blindness, kidney disease, heart d Continue reading >>
Community-based Lifestyle Interventions To Prevent Type 2 Diabetes
Abstract OBJECTIVE—To conduct a literature review of community-based interventions intended to prevent or delay type 2 diabetes. RESEARCH DESIGN AND METHODS—Recently published findings about the potential to prevent or delay type 2 diabetes with intensive lifestyle interventions prompted a literature search for community-based diabetes prevention interventions. The literature review design was a search of databases for publications in 1990–2001 that identified reports on community-based interventions designed to prevent or modify risk factors for type 2 diabetes. RESULTS—The search revealed 16 published interventions, 8 of which were conducted in the U.S. and involved populations disproportionately burdened by diabetes (e.g., American Indians, Native Hawaiians, Mexican Americans, and African Americans). Of the studies reporting results among youth, there were posttest improvements in intervention groups in knowledge, preventive behaviors, and self-esteem. Among studies reporting results among adults, most reported improvements in intervention groups in knowledge or adoption of regular physical activity. Several investigators offered important reflections about the process of engaging communities and sharing decision making in participatory research approaches, as well as insights about the expectations and limitations of community-based diabetes prevention research. Many of the studies reported limitations in their design, including the lack of control or comparison groups, low response rates or lack of information on nonresponders, or brief intervention periods. CONCLUSIONS—There is a critical need to conduct and publish reports on well-designed community-based diabetes prevention research and share information on the process, results, and lessons learned. Ar Continue reading >>
1. Strategies For Improving Care
A patient-centered communication style that incorporates patient preferences, assesses literacy and numeracy, and addresses cultural barriers to care should be used. B Treatment decisions should be timely and based on evidence-based guidelines that are tailored to individual patient preferences, prognoses, and comorbidities. B Care should be aligned with components of the Chronic Care Model to ensure productive interactions between a prepared proactive practice team and an informed activated patient. A When feasible, care systems should support team-based care, community involvement, patient registries, and decision support tools to meet patient needs. B Diabetes Care Concepts In the following sections, different components of the clinical management of patients with (or at risk for) diabetes are reviewed. Clinical practice guidelines are key to improving population health; however, for optimal outcomes, diabetes care must be individualized for each patient. The American Diabetes Association highlights the following three themes that clinicians, policymakers, and advocates should keep in mind: Patient-Centeredness: Practice recommendations, whether based on evidence or expert opinion, are intended to guide an overall approach to care. The science and art of medicine come together when the clinician is faced with making treatment recommendations for a patient who would not have met eligibility criteria for the studies on which guidelines were based. Recognizing that one size does not fit all, these Standards provide guidance for when and how to adapt recommendations. Because patients with diabetes have greatly increased risk for cardiovascular disease, a patient-centered approach should include a comprehensive plan to reduce cardiovascular risk by addressing blood pressu Continue reading >>
Diabetes Prevention Toolkit
Type 2 diabetes is largely preventable by taking several simple steps: keeping weight under control, exercising more, eating a healthy diet, and not smoking. Yet it is clear that the burden of behavior change cannot fall entirely on individuals. Families, schools, worksites, healthcare providers, communities, media, the food industry, and government must work together to make healthy choices easy choices. This toolkit offers links to dozens of resources to do just that. Among them are evidence-based guidelines and action plans; research reports and surveillance data; tools for families, schools, healthcare providers, employers, and public health policymakers; case studies that showcase local and state efforts to promote healthy eating and active living; and more. Many of these resources focus on food- and physical activity-related policy changes that can promote healthy environments, encourage healthy behaviors, and ultimately, help turn around the diabetes epidemic. For more information on diabetes prevention, read The Nutrition Source article Simple Steps to Preventing Diabetes. Download the complete Diabetes Prevention Toolkit or jump to a specific section: Healthy Eating & Drinking Physical Activity & Inactivity Smoking Cessation and Prevention National Cancer Institute, Tobacco Control Research Branch. Smokefree.gov. The Campaign for Tobacco-Free Kids. Tobaccofreekids.org. Families & Homes American Academy of Pediatrics. Prevention and Treatment of Childhood Overweight and Obesity: Families Portal. Blue Cross Blue Shield of Massachusetts. Jump Up & Go! Harvard Prevention Research Center on Nutrition and Physical Activity. Food and Fun After School. National Heart, Lung and Blood Institute, National Institutes of Health. We Can! New York City Dept. of Health and Men Continue reading >>
Preventing Type 2 Diabetes: Exercise, Eating And Evidence
Let’s get a couple of things straight at the start. We don’t know what causes type 1 diabetes or how to prevent it. We do know that type 2 diabetes is largely preventable. We’re too fat, too sedentary and too many of us now have type 2 diabetes. Now for a bit of detail. The first World Health Organization (WHO) Global report on diabetes, published this week ahead of World Health Day, makes no bones about the scale of the problem (422 million adults living with diabetes, four times as many as in 1980) or that the skyrocketing numbers of people who are overweight or obese is a significant factor behind this alarming increase, much of it in developing countries. The report reminds us that type 2 diabetes “comprises the majority of people with diabetes around the world, and is largely the result of excess body weight and physical inactivity”. Increasingly, this includes children. The WHO report highlights the need to address gaps in the diabetes knowledge base. Systematic reviews are a great way to bring together the best available evidence from primary research so we can see what is known to help us make decisions about health and where important gaps remain. WHO advice on preventing type 2 diabetes The WHO says that “simple lifestyle measures have been shown to be effective in preventing or delaying the onset of type 2 diabetes. To help prevent type 2 diabetes and its complications, people should: achieve and maintain healthy body weight; be physically active – at least 30 minutes of regular, moderate-intensity activity on most days. More activity is required for weight control; eat a healthy diet, avoiding sugar and saturated fats intake; and avoid tobacco use – smoking increases the risk of diabetes and cardiovascular diseases.” Diet and exercise: bett Continue reading >>
Primary Prevention Of Type 2 Diabetes: Integrative Public Health And Primary Care Opportunities, Challenges And Strategies
Go to: Why primary prevention and integration of primary care with public health? Effective management is essential for reducing morbidity and premature mortality related to diabetes and the tools for treating diabetes are stronger than ever before.3–6 Primary prevention, however, is highly attractive as a complementary and integrated strategy for Type 2 diabetes for several reasons (Fig. 1). Firstly, the immense public health burden imposed by diabetes justifies action at the population level. Secondly, currently available treatments, while valuable, are costly, convey risks of harmful side effects (e.g. hypoglycemia), still have limited efficacy and are less likely to be effective for persons who have problems accessing medical care or adhering to self-care regimens. Thirdly, prevention of Type 2 diabetes by lifestyle modification is likely to produce beneficial other effects (e.g. reduction in risk of hypertension, hyperlipidemia, heart disease and certain cancers). Fourthly, most of the determinants of caloric intake, weight management and physical activity are beyond the reach or influence of medical care practitioners by themselves and are likely to be more amenable to public health efforts. Fifthly, since racial/ethnic and socio-economic disparities are the result of several factors, it is logical to suggest that integration of primary care and public health interventions will be needed to address these disparities.7 Finally, a variety of primary prevention strategies, including both lifestyle modification and pharmacotherapy for those at high risk, have been rigorously tested in randomized controlled trials (RCTs) and proven efficacious.8 Translation studies have been conducted in a variety of settings to provide guidance on cost-effective implementation of pr Continue reading >>
- Mutual Involvement in Families With Type 2 Diabetes Through Web-Based Health Care Solutions: Quantitative Survey Study of Family Preferences, Challenges, and Potentials
- The Natural History of Type 2 Diabetes: Practical Points to Consider in Developing Prevention and Treatment Strategies
- Mental Health Care in Pediatric Diabetes: Overcoming Challenges and Barriers
Public Health Issue: Diabetes Mellitus
Disclaimer: This essay has been submitted by a student. This is not an example of the work written by our professional essay writers. Any opinions, findings, conclusions or recommendations expressed in this material are those of the authors and do not necessarily reflect the views of UK Essays. This assignment will address the public health issue of the increasing prevalence of diabetes mellitus (diabetes) and explore links with health inequalities both nationally and locally. It will discuss the frameworks available which give guidance for standards of care for diabetes patients and their influence on diabetes care. It will then critically discuss the issue of diabetes management in relation to patient education and the ability of patients to self-manage their chronic long-term condition, evaluating both the role of both healthcare professionals and individuals in achieving the best possible healthy outcomes. It will then discuss whether all people get the same level of diabetes care, in particular focusing on people who are not able to attend GP surgeries. Public health is defined as "The science and art of promoting and protecting health and wellbeing, preventing ill health and prolonging life through the organised efforts of society" (Faculty of Public Health 2008). Health equality is a key element of social justice and as such justifies the government and other health agencies to work in collaboration to develop health policies which improve the public's health regardless of social class, income, gender or ethnicity through promoting healthier lifestyles and protecting them from infectious diseases and environmental hazards (Griffiths & Hunter 2007). Yet many health inequalities still exist in the UK, some of which will be discussed in this paper. There are predomi Continue reading >>
How A Health Promotion Model Reduces Disabling Complications Of Diabetes
The incidence of diabetes is increasing worldwide, and in England 1.3 million people - 2 to 3% - have the condition (DH, 2001a). Diabetes affects physical and psychological well-being, as well as lifestyle, relationships, income and life expectancy, and the financial implications are significant: 5% of the total NHS budget and 10% of acute-sector resources are spent on diabetes. Full, instant access to all stories Customised email alerts straight to your inbox 5,000+ practice articles in our clinical archive Online learning units on fundamental aspects of nursing care Speak with a member of the team about providing Nursing Times for your whole team Already have an account? Sign in Continue reading >>
The Canadian Diabetes Strategy: History, Evolution, Moving Forward
Diabetes is a chronic condition that affects almost 2 and a half million Canadians. There are three main types of diabetes: Type 2, Type 1, and gestational diabetes. Type 2 diabetes is the most common form, accounting for 90 to 95 percent of all diabetes in Canada. Preventing Type 2 diabetes is a public health priority that relies on supporting Canadians in adopting and maintaining healthy lifestyles, particularly healthy weights. In Canada, two in three adults and one in three children are overweight or obese, and this is driving the increasing rates of type 2 diabetes across the country. Type 1 diabetes (also called juvenile diabetes) accounts for 5 to 10 percent of all cases of diabetes in Canada. It is not preventable and there is no cure. Gestational diabetes is a temporary condition affecting about 4 percent of all pregnancies, which carries an increased risk of future diabetes for both mother and child. The First Phase of the Canadian Diabetes Strategy: 1999 to 2005 In 1999, the Government of Canada committed $115 million over five years to develop a national diabetes strategy. At that time, the Aboriginal Diabetes Initiative was included in the Canadian Diabetes Strategy (CDS), which focused on increasing awareness of diabetes among First Nations, Inuit and Metis in order to reduce the prevalence and incidence of diabetes in these high-risk communities. During the first phase of the CDS, stakeholders worked together to build a framework that would guide priorities -Building a national diabetes strategy: a strategic framework - PDF document. This phase also saw the development of the National Diabetes Surveillance System, which became the basis for the Chronic Disease Surveillance System (CDSS). The CDSS now provides provincial, territorial, and national data on Continue reading >>
