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by Dr. Gleen Anciro

Diabetes Mellitus

As global populations grow older, changes in population health constitute a major public health issue. Insight into health-status trends in older populations may help with estimating future health care needs and setting priorities for improving population health. Vital indicators for health in old age are prevalence of chronic diseases as well as disability. The rise of this condition was not only attributable to aging of the population also age-group-specific prevalence rates has increased.

Accordingly, the International Diabetes Federation stated that Diabetes Mellitus (DM) is one of the most common chronic diseases that place a sizeable burden on patients, health care systems, and society. In general, World Health Organization (WHO) defined it as a chronic disease wherein the pancreatic system does not create enough insulin for body consumption. On the contrary, it is also a condition wherein the body cannot utilize the insulin it produces. That can result to hyperglycemia, an elevation of concentrated glucose in the blood that leads to serious damage to the body's organ systems, especially the nerves and blood vessels. There are three common types of DM and these are the following:

1.) Type 1 diabetes (insulin-dependent diabetes (IDD) or childhood-onset diabetes) is characterized by a lack of insulin production.

2.) Type 2 diabetes (non-insulin-dependent diabetes (NIDD) or adult-onset diabetes) is caused by the body’s ineffective use of insulin. It often results from over weight and physical inactivity

3.) Gestational diabetes is manifested during pregnancy.

Furthermore, according to WHO, there are more than 180 million individuals worldwide who are living with diabetes. By 2030, it was predicted that this number would be doubled without immediate resolution. In 2005, it was estimated that 1.1 million will die from diabetes, almost 80% of the occurrence are among low and middle-income countries, and half of the individuals affected are under the age of 70 years old and more likely 55% of women affected will have a fatal outcome.

At present, the commitment to promoting equity in health is derived from the notion that all human beings have the right to the best attainable health. Global programs initiated by WHO in collaboration with IDF promotion and guidelines of early diabetes awareness, care and prevention as the theme of World Diabetes Day (September 14). In addition, advocacy on healthy diet, regular physical activity, maintaining a normal body weight and avoiding tobacco use can prevent or delay the onset of type 2 diabetes.

WHO declared that there is a need for the coordination efforts on diabetes across the nation by supporting the development of comprehensive national non- communicable diseases plans with the collaboration amongst all parties involved which includes governmental and nongovernmental institutions, HMOs, other social and health organizations and patient representatives. Enable to close the existing gap in health outcomes and in order to build, continue the existing accomplishments. In the same context, the action plan that has formulated is aimed at allocating managerial, staff and financial resources to populations at risk. Hoping that these actions will result in a substantial reduction in disparities over the coming years.

Moreover, improved medical knowledge and health services utilization lead to more detection of disease even though the actual disease prevalence remains the same. For some diseases, such as diabetes people are now being diagnosed earlier and are receiving better treatment than before. These advancements in detection and treatment lead to longer periods of known morbidity and thus, to higher estimates of disease prevalence but with improved functional status. These trends would result in stable or decreasing prevalence of activity limitations and disabilities.. With this given, Putt, Deegs, Hoeymans, Nusselder & Shellevis concluded that diseases have become less disabling over time. For different chronic diseases, the possibility of different underlying developments can occur, that can lead to different trends in the disabling impact of the disease.

Note: As child obesity rate has increased, our public/ private schools contribute to our young generation’s condition. As a parent, we should be aware on what we serve on our table during our mealtime. Being aware and educated on proper child nutrition can enhance the right eating habit of our kids.

Reference:

Hoeymans, N., Wong, A. H. & Nusselder, W. J. (2012). The Disabling Effect of Diseases: A Study on Trends in Diseases, Activity Limitations, and Their Interrelationships. American Journal Of Public Health, 102(1), 163-170. doi:10.2105/AJPH.2011.300296

International Diabetes Federation: Diabetes Atlas. (2006). Brussels, International Diabetes Federation.

Jagger, C., Matthews, R.J., Matthews, F.E., et al.(2007). Medical Research Council Cognitive Function and Ageing Study (MRC-CFAS). Cohort differences in disease and disability in the young-old: findings from the MRC Cognitive Function and Ageing Study (MRC-CFAS). BMC Public Health,7:156.

Murabito, J.M., Pencina, M.J., Zhu, L., Kelly-Hayes, M., Shrader, P., D’Agostino, R.B.(2008). Temporal trends in self reported functional limitations and physical disability among the community-dwelling elderly population: the Framingham Heart Study. Am J Public Health, 98(7):1256-1262



Puts, M.T., Deeg, D.J., Hoeymans, N., Nusselder, W.J. & Schellevis, F.G.(2008). Changes in the prevalence of chronic disease and the association with disability in the older Dutch population between 1987 and 2001. Age Ageing,37(2):193.

Schoeni, R.F., Freedman, V.A. & Martin, L.G.(2008). Why is late life disability declining? Milbank Q ,86(1):47-89.

Wilf-Miron, R., Peled, R., Yaari, E., Shem-Tov, O., Weinner, V., Porath, A., & Kokia, E. (2010). Disparities in diabetes care: role of the patient's socio-demographic characteristics. BMC Public Health, 10729.

World Health Organization (WHO). (2006, March).Diabetes. Retrieved February 6, 2012 from http://www.who.int/diabetes/en/.

About the author

Doctor Gleen B. Anciro have been practicing for more than 15 years in the field of Physical therapy, mostly in an in depth out patient setting. I have seen and experienced patients from 10 to 92 years of age undergo a trauma or injury that can result to pain and limitation of function. As a physical therapist, I know how it can be overwhelming and can be a hurdle in our everyday task. As we live by our saying "LIVE FREE. PAIN FREE." I will give you an individualized approach of therapy that can help and guide you alleviate the pain and restore your normal function.

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