This essay will discuss what the public health concern of the accumulative prevalence of diabetes and this essay will also explore the inequalities globally. Frameworks that are available for diabetes patients for guidance and the influence from the care of diabetes, will also be discussed. The examination of the management for diabetes in relation to education provided to the patients and the self-management to patient’s conditions, assessing both the role of both professionals and patients in achieving the best outcome. Public health can be identified as "The science and art of promoting and protecting health and wellbeing, preventing ill health and prolonging life through the organised efforts of society". 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 income, ethnicity, social class or gender through the promotion of healthier lifestyles and protecting them from potential hazards to the health of individuals.
There are three different types of diabetes; the first being type 1 diabetes this occurs when the body cannot produce any insulin, the second type of diabetes is type 2 diabetes this occurs when the body does not produce enough insulin to function properly or when the body cells do not react to insulin. Type 2 diabetes is the most common and accounts for around ninety-five per cent of people with diabetes. The final type of diabetes is gestational diabetes, this type occurs only in women who are pregnant, the complications that can arise from gestational diabetes can increase the chance of preeclampsia, high blood pressure and it can also increase the chance of women having a risk of type 2 diabetes after pregnancy. If diabetes is left untreated both type 1 and type 2 diabetes can lead to further complications which include stroke, heart disease, kidney failure and blindness. Life expectancy can be reduced by up to ten years for patients living with diabetes. In the majority of cases, type 2 diabetes is treated with changes to peoples lifestyles such as weight loss, increasing physical exercise and eating healthier.
There are a variety of explanations for the growth of prevalence for diabetes, two of the main reasons are the modernisation of urbanisation and industrialisation, which has changed individual’s eating and lifestyle habits and caused and escalation in obesity. Diabetes and obesity are closely linked; eighty percent of patients diagnosed with diabetes can be identified as obese during diagnosis. Studies have shown that type 2 diabetes can be linked to genetics, although increased levels are more likely to be attributable to obesity resulting from a decrease in physical exercise and westernised diets. The relations between socioeconomic deprivation and ill health are well recognised. Type 2 diabetes does not affect all social groups equally, it is more prevalent in people over 40, minority ethnic groups, and in low socioeconomic groups. Several studies have established people with type 2 diabetes living in deprive areas suffer higher morbidity and mortality rates than those in more affluent areas. Links between deprivation and type 2 diabetes appear evident in areas that have little access to benefits.
Frameworks and policies exist to give guidance on standards of care, improve the quality of life and life expectancy of people with diabetes and lessen the financial burden on health services. There have been plan set out in guidance for modernising services, raising standards and moving towards patient centred care. There have been different polies that have been outlined and put into effect to help have a standard plan in order to have improved services for people with diabetes, these policies will also help reduce inequalities between the care people are provided not differentiating between wealth and status.
Frameworks are a useful outline for action and set out clear goals and targets, but do not address the social, economic and environmental causes of ill health or take account of available financial and staffing resources. The availability of funding will have been significant in the achievement of one hundred per cent of people with diabetes now being offered this service. There have been policies that have been enforced that has placed frameworks to offer financial rewards to meet other targets set out by government, for instance maintaining practiced based registers of people with diabetes, to enable primary care providers to provide proactive care. Ten years on this framework is still credible and sets the 'gold standard' of care for patients with diabetes which would seem to be an outstanding achievement.
The main reasons for the onset of diabetes and risk of further complications is due to suboptimal health relative behaviours which include little physical activity, high calorie intake and inadequacy to maintain good glucose control and it is said individuals with diabetes play a central role in determining their own health status. The burden relating to care of individuals who have diabetes lies within individuals themselves. Patient education is seen as fundamental in the treatment of diabetes to ensure the best possible health outcomes for individuals. A move away from medical care to encourage individuals to take responsibility for their own health but also places the onus on health care professionals to educate, support and empower people to enable them to effectively care for themselves. Healthcare services only contribute to one third of improvement made to life expectancy stating that a change in lifestyle and removing health inequalities contribute to the remaining two thirds. Giving people the skills, knowledge and tools to take control of their own health logical as people with diabetes. Programmes have been developed to help healthcare professionals move away from a paternal approach to care planning to a more personalised approach for people with chronic long-term conditions. This approach involves both healthcare professionals and patients working together to prioritise individual needs. Personalised approach to care planning which should be holistic and include the person's social circumstances, will empower patients to take a central role in their own healthcare and suggests that nurses and patients should work together to set goals the patient can work towards which would include self-care and the services they will use.
Changing the health-related behaviours of people with diabetes has been proved to be successful in reducing or even eradicating the risk of complications. Many different health promotion models of exist which can help a patient to digest health promotion advise and want to change their health-related behaviours. Health promotion models are useful tools to assist with this process. The Stages of Change health promotion is a frequently used model for weight management as it identifies 6 stages of readiness to change which helps health professionals identify the intervention actions to recommend and support. Standard 3 has also ensured people with diabetes receive regular care. Every person with diabetes should receive the highest standards of individualised care, no matter who delivers it or where or when it is delivered. Access to specialist services should be available when required.
The growing prevalence of diabetes and the drain on current health resources it continues to be a concern globally, in terms of the quality of life and life expectancy of patients. Many health inequalities exist for people with diabetes; there are proven links with obesity and deprivation; and diabetes care provided is not equal for all patients. Patients who are able to attend their GP surgery receive better care than those who are housebound, although this inequality is being addressed and care is improving. There are useful frameworks for healthcare professionals to follow when providing care for people with diabetes. The quality of diabetes care has improved since this framework has been introduced. However, the implementation of some recommendations has been slow. Patient education is paramount to successful diabetes control and there appears no doubt that the key to successfully slowing the onset of diabetes and the recognised associated complications is to engage patients.