Problem Journal 22 For Diabetes Prevention Program

Journal 2 2problem Diabetesprogram Diabetes Prevention Lifestyle Cha

Diabetes is a chronic degenerative and metabolic disease which prevalence continues to increase year after year. In 2014 the estimated population living with diabetes was 9.4%. (CDC 2014). It is currently estimated that a total of 30.3 million Americans are diabetics, however, there is a significant amount of underdiagnosing and approximately 7.2 million people with living with diabetes have not been identified as such, that is, one out of every 4 patients with diabetes are undiagnosed. The African American, Native Americans and Hispanics, who have a lower access to health services are the more affected. (Geiss 2014).

Underdiagnosing brings significant problems to the table. These patients are not treated appropriately, spending years living with a condition that can have devastating consequences that if left untreated, may develop major complications, disability, lower productivity, organ failure, etc. which, can translate into major economical magnitude problems. The American Diabetes Association released new research in 2013 estimating the total costs of diagnosed diabetes have risen to $245 billion in 2012. (ADA 2012). This cost has been steadily rising and, between 2007 and 2012 there was a 41% increase. If we couple that, one of every 4 diabetics are not yet diagnosed, the cost is even of higher magnitude.

Disparity Facts: Even though diabetes affects the entire population, there are indeed important differences when race, education level and socioeconomic level are taken into consideration. The cargo of diabetes is much higher for specific ethnic minorities than for the white population. This may have a genetic influence, however multiple social factors as well as economic factors are known to play a role. Furthermore, some minorities have higher rates of diabetes-associated complications and death. (AHRQ 2001). For example, African American are up to 4 times more likely to develop renal disease, blindness, amputations and death as compared to Whites. (Peek 2007).

This is of major impact for the population well-being and in life in general. Diabetes is more prevalent among American Indians, African American and Hispanics. (CDC 2017). Table 1 and Figure 1 show these statistics graphically. Race/ethnic group Age-adjusted prevalence (%) Non-Hispanic Whites 7.1 Asian-Americans 8.4 Hispanic-Americans overall 11.8 Non-Hispanic Blacks 12.6 Alaska Natives 5.5 Native Americans 33 Table 1. Race/ethnicity and Diabetes prevalence.

Figure 1. Diabetes prevalence and race/ethnicity. Another important disparity is education, diabetes prevalence varies markedly by education level. This is an indicator of socioeconomic status. Specifically, in people with less than high school education, the prevalence is 12.6%, whereas the incidence is 9.5% and 7.2% of those with high school education and more than a high school education respectively. (CDC 2017, Geiss 2014).

Figure 2. Education and death risk of diabetes among same economic group people. Importance of education level. Figure 3. General health and education level.

The effect education has in general health. Similar to diabetes, higher education is positively related to better health. Poverty is a major hurdle for healthcare access, those families with yearly income below Ten thousand dollars make 35.7% of the uninsured people, in contrast with a 7.1 % of those earning more than seventy-five thousand each year. The poverty rate form American Indians is 26%, for African-Americans is 26%, for Hispanics 25%^ and 9% for Whites. If we look at these poverty rates among ethnic groups, we can see that they parallel the prevalence of diabetes in our country.

This is a clear example that economy is a major determinant of health and an important health disparity factor. Diabetes is a chronic disease, it takes years to develop into a full-blown disease. Most patients become prediabetic prior to developing diabetes. This prediabetic state is a metabolic derangement that has multiple health consequences. Prediabetes or metabolic syndrome is known to be the most common cause of heart disease and precedes diabetes in most cases. Approximately 34% of the population are prediabetic. (CDC 2017).

Importantly, 97% of the people with metabolic syndrome are not aware of having the condition. We are failing to address a major epidemic in a proper manner. As a consequence, multiple years go by before adequate therapy is started. For those patients with less access to health services, is not uncommon to have their first encounter with a health provider in an advanced stage when end organ failure is already present. As we can see, diabetes is a major public health problem, it has epidemic behavior and its prevalence has steadily been climbing through the years.

There are clear disparities and efforts as well as funds should be directed towards education and programs to address this important health problem. References Agency for Healthcare Research and Quality (2001). Diabetes Disparities Among Racial and Ethnic Minorities. . Extracted, February 24, 2018. Alliance to Reduce Disparities in Diabetes. (2011).

Paper For Above instruction

Diabetes mellitus remains one of the most pressing public health challenges worldwide, with its prevalence sharply increasing across diverse populations in the United States. The disease's insidious nature, compounded by significant disparities in diagnosis, management, and outcomes among different racial, socioeconomic, and educational groups, underscores the need for targeted prevention and intervention strategies. This essay explores the epidemiology of diabetes, the health disparities impacting vulnerable populations, and the critical role of lifestyle change programs in mitigating this epidemic.

Overview of Diabetes Prevalence and Impact

The prevalence of diabetes in the United States has escalated dramatically over recent decades. According to the CDC (2014), approximately 9.4% of the population was living with diabetes in 2014, with estimates rising to over 30 million individuals. A noteworthy concern is the underdiagnosis of the disease, whereby approximately 7.2 million Americans remain unaware of their diabetic status. This gap in diagnosis is particularly pronounced among racial minorities such as African Americans, Native Americans, and Hispanics, who face barriers to healthcare access (Geiss et al., 2014). The consequences of undiagnosed or poorly managed diabetes are severe, leading to complications like renal failure, blindness, amputations, and increased mortality (CDC, 2017). The economic toll is equally burdensome, with the American Diabetes Association (2012) estimating costs exceeding $245 billion annually, reflecting the substantial societal and healthcare system burden.

Disparities in Diabetes Among Racial and Socioeconomic Groups

The burden of diabetes is unequally distributed, with racial minorities experiencing higher prevalence and worse outcomes. African Americans, for example, are up to four times more likely to develop complications such as kidney disease, blindness, and amputations compared to non-Hispanic whites (Peek et al., 2007). Data from CDC (2017) reveal that Native Americans and Hispanics also have significantly higher prevalence rates—33% among Native Americans and 11.8% among Hispanics—compared to 7.1% in Non-Hispanic whites and 8.4% in Asian Americans (Table 1, Figure 1). Moreover, socioeconomic factors, including education and income levels, greatly influence disease risk. Individuals with less than a high school education have a prevalence of 12.6%, whereas those with higher education levels have significantly lower rates (CDC, 2017; Geiss et al., 2014). Poverty further exacerbates disparities; families with incomes below ten thousand dollars per year comprise a large proportion of uninsured populations and are more vulnerable to developing diabetes and related complications (CDC, 2017).

The Role of Prediabetes and Lifestyle Factors in Disease Progression

Before developing full-blown diabetes, many individuals experience prediabetes—a condition characterized by elevated blood glucose levels that are not yet classified as diabetic. Approximately 34% of the U.S. population is prediabetic, yet 97% of these individuals are unaware of their status (CDC, 2017). This silent progression underscores the importance of early detection and lifestyle interventions. Prediabetes is strongly associated with metabolic syndrome, which significantly increases the risk of cardiovascular disease (Ford et al., 2002). The progression from prediabetes to diabetes can be halted or delayed through lifestyle modifications, including weight management, physical activity, and dietary adjustments.

Prevention and Lifestyle Change Programs

Given the preventable nature of many diabetes cases, lifestyle change programs are vital. These typically include dietary counseling, physical activity promotion, weight loss strategies, and behavioral support. The Diabetes Prevention Program (DPP) study demonstrated that intensive lifestyle interventions reduced the incidence of type 2 diabetes by 58% among high-risk individuals (Knowler et al., 2002). Such programs are most effective when tailored to the cultural and socioeconomic contexts of target populations, ensuring accessibility and adherence. Community-based interventions, especially in underserved areas, can bridge gaps in healthcare access and deliver culturally competent care.

Addressing disparities through a comprehensive approach involves increasing awareness, early screening, and integrating lifestyle interventions within broader public health initiatives. Policy changes that promote affordable access to healthy foods, safe environments for physical activity, and education are essential components. Supporting community health workers and utilizing technology, such as mobile health applications, can enhance outreach and engagement among vulnerable populations.

Conclusion

Diabetes remains a significant public health crisis marked by rising prevalence and stark disparities among racial, socioeconomic, and educational groups. Addressing this epidemic requires multifaceted strategies emphasizing early detection, culturally sensitive lifestyle interventions, and policy measures aimed at reducing social determinants of health. Implementing community-based prevention programs and ensuring equitable access to healthcare resources are critical steps toward mitigating the burden of diabetes and improving health outcomes for all populations.

References

• Agency for Healthcare Research and Quality. (2001). Diabetes Disparities Among Racial and Ethnic Minorities.
• American Diabetes Association. (2012). The cost of Diabetes.
• CDC. (2014). National Diabetes Surveillance System. National diabetes statistics report, 2014.
• CDC. (2017). National Diabetes Statistics Report.
• Ford, E., Giles, W., & Dietz, W. (2002). Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey. JAMA, 287(3), 356–359.
• Geiss, L., Wang, J., Cheng, Y., et al. (2014). Prevalence and incidence trends for diagnosed diabetes among adults aged 20 to 79 years, United States, 1980–2012. JAMA, 312(12), 1218–1226.
• Knowler, W. C., Barrett-Connor, E., Fowler, S. E., et al. (2002). Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. New England Journal of Medicine, 346(6), 393–403.
• Peek, M., Cargill, A., & Huang, E. (2007). Diabetes health disparities. Human Health Services.
• United States Department of Health and Human Services. (2011). About Diabetes Disparities.
• American Diabetes Association. (2012). The cost of Diabetes.