Cushing's syndrome, cortisol excess and testosterone deficiency are also associated with the disease. Often, it is a number of co-dependent conditions that seem to give rise to diabetes (Jack & Boseman, 2004).
Genetics -- There is ample evidence that there is a strong inheritable genetic condition in type-2 diabetes. In addition, there is a genetic mutation to the Islet Amyloid Polypeptide gene that results in early onset diabetes (Lee & Hasim, 2001). There is a stronger inheritance pattern for type-2 diabetes with a significant association between family members. Typically, this is excacerbated by cultural and lifestyle factors that, while not inherited, are culturally shared. Gene expression promoted by a diet of high fats and sugars results in individuals that a prone to insulin resistance (Don't Blame Your Genes, 2009).
Diagnosis- The World Health Organization has formed a global template for type-2 diabetes as a single raised glucose reading with symptoms, otherwise raised values on two occasions of either: fasting plasmal glucose or with a glocose tolerance test, two hours after the dose of plasma glucose as follows:
Condition
2-hour Glucose
Fasting Glucose
Mmol/(mg/dl)
Mmol/(mg/dl)
Normal Ranges
< 7.8 (7.0 (>126)
(World Health Organization, 2006).
At present, there is no academic literature that recommends universal screening for diabetes since there is no evidence that such a program would dramatically improve outcomes. However, screening is recommended by the U.S. Preventative Services Task Force in adults without symptoms that have blood pressure greater than 135/80 or those individuals who show certain symptoms and have high-risk components (Valdez, 2009; U.S. Preventative Services Task Force, 2008). Prevention is clear -- type-2 diabetes can be delayed or prevented through proper nutrition, regular exercise, and attention to body-mass ratio. Intensive lifestyle measurement may reduce the risk by over 50%, and are shown to be far more effective than medications (Rispin, Kang, & Urban, 2009).
Theoretical Basis -- The cost of type-2 diabetes in the United States rose from $44 to $92 billion in just five years. This was the equivalent of 20+ years of aging. Combine this with a reduced ability to work (individuals pay taxes, purchase products, etc. And contribute to the overall welfare of the system), and the fact that most individuals with type II diabetes are not receiving the care necessary and we see that there are massive considerations involved. And, if wealthier countries are unable to handle this burden, how can one expect developing countries, which represent the largest portion of countries with this rising problem? (American Diabetes Association, 2009)
We now know that obesity is one of the major contributors to this problem, but what are the factors that contribute to this rise in obesity -- particularly in developing countries? Ironically, it seems that the process of globalism has a darker side, as does the technological access to the Internet. On one hand, sharing of cultural information, the ability to communicate globally, and the ability to receive goods and services from virtually anywhere in the world is a positive way to bring the world's populations closer together. Of course, one of the basic theories promoting globalism is that countries that actively trade with one another rarely make war. Certainly, as the Third World has had access to media and western goods, their desire for more of these products has increased. Additionally, greater urbanization and a change in the lifestyles of the global workforce contribute to the increase in risk factors as well. There are several factors that are a direct result of modernization and globalization, however, that contribute significantly to the problem:
More women in the workforce combined with a move towards cities causes a population that adopts less healthy eating styles (fast food, etc.).
Since people work more, they tend to eat away from home more; lack of home prepared food puts the population at risk.
Fresh fruits and vegetables are now more expensive than fast food; this trend continues because of fewer rural producers
Lesser quality foods with higher caloric value are cheaper and consumed more because of ease (example, pastries for breakfast, starchy empty caloric foods for lunch, etc.)
More indoor work using more time often translates into less outdoor physical activity.
All these factors have one thing in common -- they actively contribute to obesity and are very much a part of the developing world. These are economic realities, and changes in these macro-paradigms are not only difficult, but require the buy-in of the sociopolitical structure as well as the populace. In developed countries, for instance, many school systems have banned soft drinks and candy from campuses, and First Lady Michelle Obama has announced an initiative fighting childhood obesity. She, too, is calling obesity an epidemic and one of the greatest...
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