Health Determinants Of Type 2 Diabetes Health And Social Care Essay
The likelihood of an adolescent developing type 2 diabetes is influenced by several factors, or health determinants. These health determinants can be categorized into five themes: behavior, genetics, social and physical environment, and healthcare. The determinants interact with each other to increase or decrease the likelihood of developing a disease, such as diabetes, as well as affect the ease or difficulty of disease management and relief.
Behavior is arguably the most influential health determinant, both prior to and after a diagnosis of type 2 diabetes. There is a significant amount of evidence noting that being overweight or obese is the biggest risk in developing type 2 diabetes, especially at a young age (Reinehr, 2005; Tamasan, Velea, Paul, & Popa, 2010; Wilson, 2013). An individual’s body weight compared to height is one of the criteria physicians use for a diabetes diagnosis (Tamasan et al., 2010). A sedentary lifestyle and unhealthy eating habits cause weight gain, so a change of lifestyle can have a great impact on preventing a diabetes diagnosis and management of diabetes.
Treating diabetes in children is very similar to adult treatment, which includes lifestyle modification and pharmacological therapy (Reinehr, 2005; Tamasan et al., 2010). Not following lifestyle and pharmacological recommendations can result in complications common with type 2 diabetes, such as neuropathy, retinopathy, and atherosclerotic cardiovascular disease (Tamasan et al., 2010). In terms of behavior as a health determinant, following nutrition and physical activity guidelines set by the adolescent’s doctors is important for proper treatment of type 2 diabetes. Adhering to the pharmacological regimen prescribed to the adolescent is also key in ensuring successful treatment.
There is also a strong genetic component linking family history to type 2 diabetes (Reinehr, 2005; Wilson, 2013). Adolescents who have a family member with type 2 diabetes have a greatly elevated risk of developing diabetes themselves. In fact, Reinehr noted in his research, "Of the patients, 74–100% have a first- or second- degree relative with [type 2 diabetes]" (2005, p. S106). This is a very important connection to realize because adolescents who continue to have diabetes into adulthood leave their children with a similar risk of developing diabetes.
Another genetic, non-modifiable connection is the adolescent’s ethnicity. Multiple reports note a higher risk of children and adolescents developing type 2 diabetes if the child is from a minority ethnic group, including African Americans, Hispanics, and American Indians (Gavin & Wright, 2007; Reinehr, 2005; Society for Endocrinology, 2012). Gavin and Wright further note that African Americans are at a 1.8 times higher risk of developing type 2 diabetes when compared to other ethnicities (2007). It is important for families to understand how their genetic predisposition can affect their likelihood of developing diseases such as diabetes to ensure that screening begins as soon as signs and symptoms begin appearing.
African American culture and other factors of an adolescent’s social environment play a role in determining the development and outcome of type 2 diabetes. According to Gavin and Wright, "African Americans have a strong sense of living in the present, willingly accept obesity as the norm, and express the view that [type 2 diabetes] is hereditary and therefore cannot be prevented" (2007, p. S15). This viewpoint could cause families to not seek medical advice when their adolescent begins to show symptoms of type 2 diabetes, or they may choose not to follow a doctor’s lifestyle and pharmacological orders if already diagnosed.
The adolescent’s family income and social support are also important factors in diagnosing and treating diabetes. The average medical cost for an individual diagnosed with diabetes to be $13,700 annually, and African Americans top all other ethnicities in hospital inpatient costs and total healthcare expenditures (American Diabetes Association, 2013). If the family has a low income, they may not be able to afford the best diabetes treatment. In addition to finances, the support system of an adolescent with diabetes has been shown to be important for aiding in disease management (Brouwer et al., 2012). Having a system where the adolescent feels support from friends and family encourages the adolescent to follow the recommended regimen and get relief from diabetes-related symptoms.
Studies have shown that toxins in the environment have been linked to the development of type 2 diabetes (Tamasan et al., 2010; Thayer, Heindel, Bucher, & Gallo, 2012). Thayer, Heindel, Bucher, and Gallo (2012) found exposure to certain organic pollutants that were positively associated with diabetes diagnoses, as well as a link to pesticides affecting the development and management of diabetes and inducing complications, such as hyperglycemia.
An additional environment that can affect the management of type 2 diabetes in adolescents is the adolescent’s school. Diabetes must be managed throughout the entire day, and with adolescents spending at least seven hours of their day in school, it is crucial that schools are properly trained in assisting with managing type 2 diabetes. The American Diabetes Association outlines in their "Safe at School" campaign that it is important that certain staff members be trained for proper diabetes management to avoid blood glucose levels from dropping (American Diabetes Association, 2011). If the school does not have a staffed nurse or nobody with knowledge of diabetes management, the adolescent could be at risk of experiencing diabetes-related complications.
Quality and accessibility of healthcare are significant determinants of type 2 diabetes diagnoses and management. It is recommended that adolescents who have a higher risk of developing diabetes be screened every two years for a diabetes diagnosis (Society for Endocrinology, 2012; Tamasan et al., 2010). However, the Centers for Disease Control and Prevention reported in 2011 that 18.8% of African Americans were without health insurance coverage (Centers for Disease Control and Prevention, 2011). Without insurance coverage, screening for diabetes is less likely to occur, and if diagnosed with type 2 diabetes, families without insurance coverage will have an extremely difficult time affording checkups and pharmaceutical therapy. The American Diabetes Association reported individuals diagnosed with diabetes who do not have health insurance to have 79% less physician visits and 68% fewer prescriptions for pharmaceutical diabetes management (2013). Adolescents with type 2 diabetes who are not receiving adequate care are at a higher risk of experiencing complications and further reducing their quality of life.