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Introduction

Introduction I will be focusing on Type 2 diabetes as it is a major public health issue in the UK. I will briefly mention Type 1 diabetes and diabetes in children. The reason why I will be focusing on Type 2 diabetes is because more people are affected by it compared with Type 1 diabetes. Since 1996 the number diagnosed with the condition has increased with 4 million. Most of these cases are Type 2 diabetes. The number is set to continue to rise as our population is ageing and more people are becoming obese. There also remains up to a million people who have diabetes but aren't yet aware of it. Diabetes is a condition in which the amount of glucose in the blood is too high because the body cannot use it properly. Glucose comes from the digestion of starchy foods such as potatoes, from sugar and other sweet foods and from the liver which produces glucose. Insulin is a hormone produced by the pancreas that helps the glucose to enter the cells. Diabetes put people at higher risk of heart disease, stroke, blindness, kidney disease and amputations. Those with diabetes are five times more likely to suffer heart failure. The main symptoms of diabetes are increased thirst, extreme tiredness, weight loss, genital itching, regular thrush and blurred vision. The NHS spends around five per cent of its budget on diabetes and its effects. This means that up to �3.5 billion a year is spent on the treatment. ...read more.

Middle

Ideally, the program selected should have a team of educators (physician, dietician, nurse, social worker, exercise specialist, etc) who are well-versed in education of children. Standards to look for are paediatric centres with Certified Diabetes Educators on staff and whose programs have met the National Standards for Diabetes Self-Management Education as identified by the American Diabetes Association. Education should include but should not be limited to: self-monitoring of blood glucose, medications and their use, exercise and meal planning. Exercise speeds up calorie expenditure promoting weight loss. It also increases insulin sensitivity at the cellular level. Currently, there are five classes of oral medications approved by the FDA for treatment of type 2 diabetes. It is important to note that few safety and effectiveness studies have been conducted in the paediatric population The most effective way to quickly normalise blood sugar levels is with the use of insulin. Insulin therapy should be started in children with severely elevated blood sugar levels or children with intense thirst and frequent urination. There are a wide variety of insulin regimens that can be used. Once blood sugars are under control, Glucophage can be added while decreasing insulin dosage. It is important to monitor for ketones during this time to rule out type 1 diabetes in a honeymoon period. Primary prevention should involve a public health approach that involves school and community-based programs, directed at improving overall nutrition and physical activity. The population of children with type 2 diabetes is growing perhaps to epidemic proportions. ...read more.

Conclusion

The Government is currently looking at public health initiatives which will include measures to combat obesity and therefore help to prevent diabetes. The recent NHS improvement plan also draws attention to the health and cost benefits of effective Chronic disease management (CDM). The Department of Health has put an increasing focus on CDM stating it as "significant and exciting challenge for the NHS". The UK has developed frameworks which outlines the standards for diabetes care. Primary care trusts are establishing diabetes networks and putting eye screening and diabetes registers in place. Local targets need to be set in order for frameworks to be achieved and the lives of diabetes to be improved. All the diabetes frameworks in the UK emphasise the principle of integrating service delivery to provide systematic care, including a focus on prevention and self management. If implemented effectively the frameworks need to improve people's lives and provide significant cost savings in the long-term as early identification and better treatment decreases the incidence of complications. Diabetes will continue to be a major health challenge in the future and publication of the frameworks is certainly a step in the right direction to meet the challenge. To provide high quality diabetes care across the UK, it is essential that their implementation is as effective as possible. Sources 1. Neil Moonie. Heinemann AS Health and Social Care for Edexcel. 2. Mark Walsh, Paul Stephesn, Richard Chaleoner. Collins AS Health and Social Care. 3. www.bbc.co.uk 4. www.diabetes.org.uk (Graphs) PUBLIC HEALTH UNIT 6 RACHEL LAMPRECHT ?? ?? ?? ?? Rachel Lamprecht Health and Social Care Unit 6 Mr. J Clark 1 ...read more.

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