Type 2 Diabetes: A whole person-centered intervention is mandatory.

Diabetes is a complex, and seriously increasing chronic disease around the world. Statistics collected from World Health Organization depicts that, in 2014, 422 million people had diabetes where most of them were suffering from type 2 diabetes (When the body cannot use the insulin it produces properly). The fact sheet provided by this organization claimed that 1.6 million people died globally in 2015, directly caused by diabetes. While considering England, 3.8 million people were anticipated to have both types of diabetics, however, among them, around 90% of diabetes issues have been found is type 2 diabetes mellitus. It is quite surprising that in 2016,6030 people died directly because of diabetes. Moreover, The current trend suggests that 2.9 million people will have diabetes by 2035 even if only type 2 diabetes costs the NHS ￡8.8 billion each year, however, Jenifer Smith, NHS Diabetes Prevention Programme Director( Healthier You) mentioned that type 2 diabetes is largely preventable through small changes in lifestyle while type 1 is not preventable as it is not related to life style, and NHS England found that 3.4 million people have type 2 diabetes, furthermore, 1 in 10 will develop type 2 diabetes by 2034.

If this disease is not prevented and managed properly and timely, several serious health issues can evolve which may cause even death. According to NHS choices (2016), it can cause many complications such as Heart diseases, Kidney disease, Nerve damage, Diabetic retinopathy, Miscarriage, and Stillbirth.

Walker et al. (2014) conducted a cross-sectional study to investigate the effect of socioeconomic and psychological social determinants in type 2 diabetes, and found that these determinants have a strong association. This study recruited 615 adults, and self-efficiency and perceived stress found to be most often associated with diabetes and quality of life. Besides socioeconomic and psychological factors, spiritual or religious influences have a significant relationship with eating behavior and coping with health. A qualitative research concluded after having interviews with 70 southern African-American women with type 2 diabetes, that, spirituality is an important factor in general health, disease adjustment and coping. A theme emerged about the impact of diabetes manifested in feelings of dietary deprivation, tiredness, worry, and fear of complications for diabetes.

Moreover, an association between depression and type 2 diabetes has been found where it causes poor health outcome and increased risk of complications. A study recruited 50 patients with recurrent depressive disorder and diabetes mellitus, and after one year of observation, they have found that 30% of patients had developed new complications. Even if it doesn’t mean that those new complications evolved due to the association between diabetes and depression, but still another research on Mexican American revealed the prevalence of diabetes and depression after conducting three follow-up interviews, and only 2.8% patients had diabetes without having any depressive symptoms, but rest had different levels of depression.

Patient-centered diabetes management programs have been implemented successfully around the world. A holistic intervention aimed at empowering the individual to take care of their diabetes and achieve the desired health outcome has been conducted in Nigeria through education programme in communities involving religious leaders and traditional healers. Even in the United States, after one year of diabetes education engagement program, the percentage of T2DM patients increased who achieved the goal of recommended HbA1c, BP, and lipid level. Similarly, a nationwide disease management program for DM was developed to promote adherence to treatment goal and self-management in Germany and after 4 years of follow up, compared to usual care, they have found the overall mortality for patients, drug and hospital costs were significantly reduced to those who participated in the program. These all suggest that changing lifestyle considering the individual social, emotional and spiritual needs can change the behavior towards diabetes positively.

If it is the prevention and management of this problem we are looking at, a whole person-centered intervention necessarily crucial to develop. The pieces of evidence evaluated above illustrate the severity of type 2 diabetes, and how important is it to reduce this burden to establish a healthier life. Therefore, a holistic approach of intervention will be developed considering the individual involvement of the local community where faith-based person-centered education will be given about healthy lifestyle and behavior with the aim of prevention and management of Type 2 diabetes.

References

• World Health Organization (2016) GLOBAL REPORT ON DIABETES [online] Geneva. available from <https://apps.who.int/iris/bitstream/10665/204871/1/9789241565257_eng.pdf?ua=1>
• World Health Organization (2017) Diabetes [online] available from <https://www.who.int/mediacentre/factsheets/fs312/en/>
• NHS England (2016) Thousands To Benefit As First Wave Of NHS Diabetes Prevention Programme National Rollout Is Announced [online] available from <https://www.england.nhs.uk/2016/03/nhsdpp/>
• Walker, R., Gebregziabher, M., Martin-Harris, B. and Egede, L. (2014) ‘Independent Effects Of Socioeconomic And Psychological Social Determinants Of Health On Self-Care And Outcomes In Type 2 Diabetes’. General Hospital Psychiatry 
• Samuel-Hodge, C., Headen, S., Skelly, A., Ingram, A., Keyserling, T., Jackson, E., Ammerman, A. and Elasy, T. (2000) ‘Influences On Day-To-Day Self-Management Of Type 2 Diabetes Among African-American Women: Spirituality, The Multi-Caregiver Role, And Other Social Context Factors’. Diabetes Care 
• Krupkin, A., Molodetskikh, A., Maximkina, V. and Slavgorodskiy, Y. (2015) ‘Exacerbation Of Depression As A Predictor Of Chronic Complications Of Type 2 Diabetes Mellitus’. European Psychiatry
• Black, S., Markides, K. and Ray, L. (2003) ‘Depression Predicts Increased Incidence Of Adverse Health Outcomes In Older Mexican Americans With Type 2 Diabetes’. Diabetes Care