Interventions for Diabetes, Essay Example

Introduction

In today’s fast-paced society, many individuals do not have or take the time to consume healthy foods and to participate in sufficient levels of exercise to maintain positive health and wellbeing. Over time, these behaviors contribute to less than desirable health concerns and higher levels of risk for more complex conditions such as chronic disease. Prior research evidence suggests that a high level of risk may contribute to the formation of chronic diseases such as type 2 diabetes (American Diabetes Association, 2007). Under these conditions, it is important to identify methods that may be utilized to reduce some of the risks associated with type 2 diabetes and to determine how lifestyle modifications and improved behaviors will support prevention of the disease in many population groups.

The effectiveness of evidence-based research is instrumental in supporting an agenda to promote the prevention of type 2 diabetes in adults and in determining how to best approach this practice to have the greatest possible impact on the communities that are served (Community Preventive Services Task Force, 2014). Therefore, nurses and other healthcare providers must provide their knowledge and expertise in the promotion of lifestyle modifications through improved nutrition and expanded physical activity in order to prevent new cases of type 2 diabetes. The following discussion will address programs that are specifically designed to promote greater awareness and prevention of type 2 diabetes in adults, using diet and physical activity promotional activities and an effectiveness model to promote success within these endeavors. It is important to identify the specific tools and resources that are required and available to conduct lifestyle interventions, and these reflect the importance of an organized strategy to promote community-based prevention and a greater focus on positive health and wellbeing for those facing a higher risk of the disease.

Analysis

It is widely known that lifestyle behaviors play a significant role in risk of many health concerns, including chronic diseases such as type 2 diabetes, and obesity is one of the primary causes: “Recent decades have seen a dramatic rise in the incidence and prevalence of childhood and adult obesity, physical inactivity, glucose intolerance, metabolic syndrome, and type 2 diabetes mellitus (DM2) throughout the world. It is predicted that by 2030 almost 10% of the world’s population will have diabetes mellitus (DM)” (Glauber, 2013, p. 74). The high prevalence of obesity across many cultures, races, and population groups demonstrate that type 2 diabetes does not discriminate and that it has a lasting and often permanent impact on body organs and systems (Glauber, 2013). Addressing the nature and prevalence of the disease, however, contributes to many complex issues and challenges that impact people in communities throughout the world (Glauber, 2013). The availability of resources to educate citizens regarding type 2 diabetes is limited in some areas and abundant in others; therefore, it is important to develop strategies that will have a lasting impact on residents in communities with varying levels of risk (Glauber, 2013).

The ability to prevent type 2 diabetes is largely individualistic in that each person has his or her own set of risk factors to contend with, such as genetic makeup, behavioral concerns, mental and psychological status, motivation, and other characteristics (Glauber, 2013). Therefore, it is important to identify some of these factors and to determine the best possible approaches to manage the risks associated with type 2 diabetes in order to promote a high level of prevention and a greater focus on achieving positive health outcomes (Glauber, 2013). One of the most important strategies to consider is to conduct lifestyle interventions that will encourage individuals to examine their current health-related behaviors and to consider whether or not modifications are required and if so, how to address these changes to ensure that they become a permanent and lasting part of the daily routine (Glauber, 2013). In many ways, the prevention of type 2 diabetes depends on lifestyle interventions that will impact health and wellbeing in a manner that is consistent with improved diet and physical activity to feel better and to reduce the risk of chronic diseases (Glauber, 2013).

According to the Diabetes Prevention Program Research Group (2002), “Since current methods of treating diabetes remain inadequate, prevention is preferable. The hypothesis that type 2 diabetes is preventable is supported by observational studies and two clinical trials of diet, exercise, or both in persons at high risk for the disease but not by studies of drugs used to treat diabetes.”  In this context, it is observed that a lifestyle intervention is likely the most feasible method of preventing new cases of type 2 diabetes in at-risk populations, thereby creating an environment in which there are significant opportunities for improvements in eating habits and levels of physical activity (Diabetes Prevention Program Research Group, 2002). It has been suggested that medication administration may also play a role in the prevention of type 2 diabetes (Diabetes Prevention Program Research Group, 2002), but lifestyle interventions are a primary focus for many researchers and educators because of their organic approach rather than through pharmacological means. It is likely that when an individual elects to modify his or her behaviors accordingly, there will be improvements in patient care outcomes for this individual and his or her own wellbeing, both now and in the future (Diabetes Prevention Program Research Group, 2002).

In the community setting, it is necessary to evaluate the conditions under which persons at risk of type 2 diabetes might overcome adversity and seek to develop new approaches to improve their own health. Lifestyle interventions may fill this void and create an environment in which patients will favorably respond to these recommendations (Satterfield et.al, 2003). In this capacity, interventions must be able to demonstrate that even small behavioral modifications may go a long way in advancing personal decision-making and habits towards improving health and the prevention of type 2 diabetes through these actions (Satterfield et.al, 2003). The establishment of a support system to accompany the intervention is likely to have important benefits for the group, and it also engages participants in the steps required to accomplish their goals and to complete their journey in preventing the disease (Satterfield et.al, 2003). In this context, it is important to identify the methods by which individuals might be able to take action to improve their behaviors, even in small ways, such as the reduction of sugar in the diet or limited consumption of soda. These issues are likely to have a significant impact on patient outcomes and in ensuring that patients receive the level of care and attention that is necessary to reduce their type 2 diabetes risk at a significant level (Satterfield et.al, 2003).

A primary prevention effort to alleviate the risk of type 2 diabetes requires a significant approach that will support prevention and a greater focus on healthcare outcomes for the designated population (Schmittdiel et.al, 2013).  The use of techniques such as health coaching have become increasingly relevant for some employers, particularly as they aim to provide a level of care and treatment that is aimed towards prevention; therefore, these practices support interventions that will contribute to effective patient outcomes and the prevention of disease for high risk patients (Schmittdiel et.al, 2013). In this context, it is important to identify specific tools and resources that will be used to prevent disease and to promote lifestyle modifications and to encourage individuals to make changes in their lives that will positively contribute to their health over time (Schmittdiel et.al, 2013). This process demonstrates the importance of developing methods to improve outcomes and to be proactive in changing behaviors to prevent type 2 diabetes, with a particular focus on nutritional habits and increased physical activity (Schmittdiel et.al, 2013). It is known that “Given the large numbers of people at increased risk for these conditions, efficient approaches are needed to identify and support patients and providers in effecting lifestyle changes. Evaluating these approaches will be useful to policy makers dealing with questions of benefit designs and to public health officials seeking to understand the roles that health systems and employers can play in preventing chronic disease” (Schmittdiel et.al, 2013). As a result, it is important to identify resources that will capitalize on the needs of those at the highest risk of developing type 2 diabetes and emphasize the role of lifestyle improvements in expanding knowledge and resources for individual patients (Schmittdiel et.al, 2013). The impact of these interventions must be identified, but it is likely that with a strong and focused effort from healthcare providers, there will be significant attention paid to lifestyle choices and behaviors as they impact patient care and wellbeing (Schmittdiel et.al, 2013).

Any intervention method used to prevent type 2 diabetes requires a cost-effective approach so that the effort is sustainable and appropriate for application on a long-term basis. This process requires organizations to utilize their existing resources wisely and to recognize the value of lifestyle interventions in advancing behavioral modifications for patients who face these risks (Smith et.al, 2010). In this capacity, patients must be evaluated in accordance with their level of risk in order to determine how to make the strategy as cost effective as possible so that it may have far-reaching implications for patients (Smith et.al, 2010). There are considerable efforts required to ensure that type 2 diabetes prevention is managed appropriately and that it supports a long-term lifestyle intervention to improve behaviors (Smith et.al, 2010). The ability to prevent type 2 diabetes through personal changes in behavior is likely to go a long way in supporting individual health and wellbeing, particularly if patients take these roles seriously and are enthusiastic regarding improving their nutrition and physical activity (Smith et.al, 2010). In addition, it is important to develop new ideas and approaches to encourage patients to evaluate their own behaviors and to determine where they might be able to improve in order to accomplish the chosen objectives (Smith et.al, 2010).

In accordance with established community-based interventions, it is necessary to develop strategies that will encourage the growth of lifestyle approaches in order to prevent new cases of type 2 diabetes in patients. From a research-based perspective, it is known that “Observational studies have provided firm evidence that multiple lifestyle-related factors either increase or decrease the risk of type 2 diabetes. Thus, in type 2 diabetes prevention, it is important to pay attention not only to one single factor such as obesity but also to several factors simultaneously” (Tuomilehto, Schwarz, & Lindstrom, 2011). These findings suggest that lifestyle interventions are likely to have a positive impact on patients when they realize their own risks associated with type 2 diabetes and aim to prevent the disease and to live life on their own terms (Tuomilehto et.al, 2011). The lack of control over one’s health that is observed when patients have diabetes is largely responsible for a potential decline in health-related quality of life; therefore, it is important to examine individual behaviors in order to determine where changes might be made in this arena (Tuomilehto et.al, 2011). Diet and exercise are the obvious choices, as they represent lifestyle behaviors that may be readily modified when the motivation and focus are in place to do so (Tuomilehto et.al, 2011). It is also important for patients to be educated regarding how individual decisions to consume certain foods or to limit their exercise by choice may be detrimental to their health and may dramatically increase their risk of diabetes in some ways (Tuomilehto et.al, 2011). It is likely that when patients receive the proper education regarding type 2 diabetes and evaluate their own level of risk, there is a much greater potential to modify behaviors (Tuomilehto et.al, 2011). As a result, patients will respond to these risks more effectively if they realize that their own behaviors contribute to these levels of risk in different ways that impact their lives (Tuomilehto et.al, 2011).

Most importantly, any lifestyle intervention that is selected for implementation within a community must support a greater focus on patient care and in the development of new ideas and approaches to improve outcomes and support permanent lifestyle changes. These practices are elusive to some patients because they may not seek to modify their behaviors because their perception of individual risk is distorted. In light of these considerations, lifestyle intervention programs must be aligned with specific community-based needs and modified accordingly to accommodate patients across different population groups. In this context, it is likely that organizations will be proactive in developing lifestyle interventions that will have a cross-cultural impact and that will determine the best possible approaches to treating patients in accordance with existing requirements. Nurses and other experts in the healthcare field must be able to provide participants with specific behavioral guidance that will support individual outcomes effectively and without delays. In order to address the scope of the intervention, however, a risk assessment must be conducted that will accommodate the need for each individual to recognize his or her own level of risk. This process will also require a high level of understanding and acceptance of the changes needed to improve personal decision-making regarding behaviors so that interventions are beneficial rather than derogatory. Patients who make a concerted effort to adjust their lifestyles to the extent that they consume healthier foods and exercise regularly are likely to achieve healthier outcomes as they learn how to adjust their behaviors accordingly.

Methodology

In order to address lifestyle changes in patients, the proposed methodology must incorporate a lifestyle intervention for a selected group of patients who qualify under the established criteria. The intervention will be conducted by the researcher through an approved dietary plan and exercise regimen to determine its level of effectiveness in promoting weight loss and a reduced risk of diabetes. The intervention will measure blood glucose levels and weight at the onset of the intervention and will examine these criteria at various intervals throughout specified period to determine if the intervention is successful in supporting weight loss and stable blood glucose levels.

Conclusion

The prevention of type 2 diabetes in many adult populations requires a high level of attention and focus on different areas, including lifestyle interventions. The effectiveness of these interventions must be examined in order to establish a framework to improve dietary and physical activity habits in adults, particularly those who face a high risk of developing type 2 diabetes due to personal risk factors. This practice requires a high level of attention and focus from healthcare providers, including nurses, to ensure that these interventions are in accordance with established guidelines and principles that have been deemed effective at the community level. It is important to identify the specific areas whereby lifestyle interventions might be successful so that the appropriate steps are taken to ensure that patient care outcomes are appropriate and timely in reaching the desired population groups across different cultures and ethnicities.

Educating the public regarding type 2 diabetes prevention is critical in enabling individuals to improve their own diets and to increase their physical activities. In order to achieve these outcomes, therefore, individuals must be motivated to modify their behaviors and to improve their own health by accepting the challenge set forth through a targeted intervention. It is expected that these efforts will be successful once participants have faith and confidence in their abilities to modify their own behaviors and to act in accordance with the recommendations that are given. This will encourage individuals to recognize that they have control over their own health and must act accordingly to preserve their quality of life for as long as possible. In addition, it will enable healthcare providers to focus on other areas if there are fewer diagnosed cases of type 2 diabetes in the coming years.

References

American Diabetes Association.  (2007). Interventions for diabetes: A position statement of the American Diabetes Association.  Diabetes Care, 30, S48-S65.  Retrieved from http://care.diabetesjournals.org/content/30/suppl_1/S48.full

Community Preventive Services Task Force (2014). Systematic review methods. Retrieved from http://www.thecommunityguide.org/about/methods.html

Diabetes Prevention Program Research Group.  (2002). Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin.  The New England Journal of Medicine, 346(6), 393-403.  Retrieved from http://www.nejm.org/doi/full/10.1056/NEJMoa012512#t=articleBackground

Elkeles, R.  Fibrates: Old drugs with a new role in type 2 diabetes prevention?  British Journal of Diabetes and Vascular Disease, 11(1), 4-9. Retrieved from http://www.medscape.com/viewarticle/740565_1

Glauber, H.  (2013). Preventing type 2 diabetes mellitus: A call for personalized intervention. The Permanente Journal, 17(3), 74-79. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3783068/

Satterfield, D., Volansky, M., Caspersen, C., Engelgau, M., Bowman, B., Gregg, E., Geiss, L., Hosey, G., May, J., & Vinicor, F.  (2003). Community-based lifestyle interventions to prevent type 2 diabetes.  Diabetes Care, 26(9), 2643-2652.  Retrieved from http://care.diabetesjournals.org/content/26/9/2643.long

Schmittdiel, J., Brown, S., Neugebauer, R., Adams, S., Adams, A., Wiley, D., & Ferrara, A. (2013). Health-plan and employer-based wellness programs to reduce diabetes risk: The Kaiser permanente northern California next-d study.  Preventing Chronic Disease, 10, 1-4. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3562174/

Smith, K., Bryce, C., Hsu, H., Roberts, M., Kramer, K., Orchard, T., Piatt, G., Seidel, M., & Zgibor, J.  (2010). Cost –effectiveness analysis of efforts to reduce risk of type 2 diabetes and cardiovascular disease in southwestern Pennsylvania, 2005-2007.  Preventing Chronic Disease, 7(5), 1-5.  Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2938403/

Tuomilehto, J., Schwarz, P., & Lindstrom, J.  (2011). Long-term benefits from lifestyle interventions for type 2 diabetes prevention.  Diabetes Care, 34, S210-S214.  Retrieved from http://care.diabetesjournals.org/content/34/Supplement_2/S210.full