Evolution is considered to be a process of slow change that can only be evaluated after a large enough amount of time has passed. Although epidemics are considered as being more revolutionary than evolutionary, researchers have witnessed the evolution of type 2 diabetes in less than 25 years.
The epidemics of obesity and type 2 diabetes pose a deadly and continuing extreme effect on individual and public health. Obesity and type 2 diabetes are closely linked, with the epidemic of obesity preceding and setting the conditions for the progress of type 2 diabetes.
Today type 2 diabetes is the prevailing type of diabetes both in adults and adolescents. Recognition of the epidemic of obesity and type 2 diabetes and their multiple harmful effects on lifelong health has moved these diseases of civilization to the first place of health concerns.
This health intervention report is based on a case study of the patient: Emily. Case reports the experience of 32 years old Emily diagnosed with Type 2 diabetes.
This health intervention report attempts to ‘intervene’, that is, propose the type of intervention focused on psychological issues (motivation, problem solving, acquiring skills about type 2 diabetes, emotional adjustment, stress and fear management) and physical issues (regular exercise).
This timely and comprehensive intervention report deals in depth with the benefits of physical activity, lifestyle changes, dietary regimen, and very-low-calorie diets in the treatment of Emily health conditions which are of growing concern. Particularly, the role of physical activity in Type 2 diabetes improvement, drawing on research will be discussed.
2. Type 2 Diabetes
Type 2 diabetes is by far the most frequent form of diabetes accounting for over 95% of diabetes cases throughout the world. The frequency of type 2 diabetes is increasing worldwide and this trend is closely linked to the global increase in obesity prevalence.
Type 2 diabetes is frequently described as non-insulin-dependent diabetes mellitus (NIDDM). The pancreatic beta cells are able to produce insulin but the body’s cells are not responding to insulin.
This is called insulin resistance. In type 2 diabetes, insulin injections are not always indispensable although they are sometimes causing a good result. Type 2 diabetes usually reported in overweight and obese adults. However, this term is inaccurate since a rapid increase of type 2 diabetes in children has been reported (Ehtisham, Barrett, Shaw 867).
What are the effects of insulin resistance? As the cells become insulin insensitive the reaction of liver, muscle and fat cells to insulin is weakened. In the liver, glucose production continues when it should be stopped, that is, following meals.
Besides this inappropriate hepatic glucose production, glucose taking up by muscle and fat cells is decreased with insulin resistance. The result is a rise in blood glucose amount due to both increased production and reduced elimination of glucose (Kopelman 643).
3. The Case Problem
Emily is 32 years old and happens to have being diagnosed with Type 2 diabetes. She is overweight and has a poor diet, which is probably what has led to her becoming ill.
Her GP (General Practitioner, Medical Doctor) sees her frequently to monitor her condition and has recommended she change her diet and exercise more in order to lose weight, if she does this she may be able to manage her diabetes without needing insulin injections.
However, since he (her GP) explained this treatment plan to Emily, he has not noticed any reduction in her weight and he suspects she is not exercising either, though Emily claims she has changed her eating habits and is walking for 30 minutes a day.
4. Type 2 Diabetes: A Global Perspective
The recorded growth in obesity in the USA has been accompanied by an equally well-recorded growth in type 2 diabetes. In 1990, only four states had a prevalence of diabetes – 6% but, by 2000, 20 states had prevalence – 6% (Mokdad, Ford, Bowman 2000).
The World Health Organization (WHO) has reported that in 1995 there were nearly 130 million people with type 2 diabetes universally. These figures became greater to 150 million in 2000, 172 million in 2002, and the prediction is for there to be 300 million people with diabetes by 2025.
Estimates for the year 2000 present a global diabetes prevalence of 2.7% (151 million people) with type 2 diabetes accounting for 97% (147 million) of these cases (British Heart Foundation 2002).
In Asian countries, lifestyles of people have changed rapidly. The result is less physical activity and more fat intake. As an effect, obesity, which is a major risk factor for type 2 diabetes, has extremely increased in adults and children.
The threshold of body mass index (BMI) for the risks of type 2 diabetes is lower in Asian adults than Caucasian adults. This suggests a genetic predisposition to insulin resistance in Asian adults. Loading of these environmental and genetic risk factors for type 2 diabetes in Asian adults is indicated by the high frequent occurrence of type 2 diabetes confirmed by some population-based and hospital-based studies (Kopelman 630).
In the evolutionary process, type 2 diabetes is now affecting gradually younger age groups. No longer can people consider type 2 diabetes as maturity onset diabetes.
In many countries of the world and among certain ethnic groups, the frequency of type 2 diabetes in the children adolescent age groups is now equal to or greater than in adults. Type 2 diabetes is being recognized in children 4-6 years old in the USA and UK (Rosenbloom, Joe, Young, Winter 345).