Introduction<\/p>\n
Diabetes is a health condition that inhibits the body from making insulin or using it efficiently. The disease affects how the body converts food into energy. The body breaks down food into glucose, a form easy to absorb. High blood sugar signals the pancreases to discharge insulin, which converts the sugar into energy. Therefore, with diabetes, the function of insulin is curtailed. When cells cannot react to insulin or the lack of it, sugar concentrates in the bloodstream. With time, elevated blood sugar causes severe health problems like kidney disease, vision loss, and heart disease. <\/p>\n
Diabetes is a chronic condition that is widely prevalent in the world today, especially in developed countries. In part, many would argue that Diabetes is very often a result an outcome of social health determinants. Access to health care, education, and the doors that economic stability opens- better paying jobs, therefore more stable and secure housing, better food, etc.- contribute to healthier lifestyles that often, the research has found, leads to a reduced risk of Diabetes. Those populations who suffer increased risk or prevalence of diabetes are typically of marginalized groups with lower socioeconomic status and therefore limited access to healthcare, healthy food, and who generally live healthier and more active lifestyles.<\/p>\n
A group of particular interest to research is youth because of the lifelong implications of diabetes on one\u2019s health. Families in marginalized or impoverished families are more likely to experience social and economic issues and concerns revolving around equity and access. This translates to higher risk for behaviors and lifestyle factors that make them more prone to develop Diabetes as youth. <\/p>\n
Problem To Be Studied<\/p>\n
The problem to be studied is therefore Diabetes in youth, and the risk factors and contributing social and economic circumstances, as well as the social determinants of health, that make youth more prone to developing Diabetes. By understanding these factors and their impact on the health of these youth, this study can help contribute to the conversation about how to mitigate such risk factors and reduce the lifelong impact of chronic health conditions such as Diabetes. <\/p>\n
The Research Question<\/p>\n
The research question is: What is the impact of diabetes in youth?<\/p>\n
Background<\/p>\n
There is no cure for diabetes, but managing the disease is achieved by avoiding a sedentary lifestyle, eating healthy, and losing weight. Those affected can take prescribed medicine, attend care appointments, and learn self-management to reduce the impact of the disease on quality of life. According to Mendola et al. (2018), millions of American citizens have diabetes. Mendola et al. (2018) also claim that majority are unaware they have the disease. Liu et al. (2017) support the finding by Mendola et al. (2018), mentioning that it is the seventh prominent cause of death in America. Liu et al. (2017) mention that diabetes is the principal cause of adult impaired vision, limb amputations, and kidney disease. However, this review is dedicated to literature about diabetes in youth, citing cause, prevention, complications, and risk factors.<\/p>\n
Review of the Literature<\/p>\n
Diabetes in Youth <\/p>\n
Diabetes mainly develops as either type 1 or type 2. Type 1 manifests as an autoimmune reaction that prevents the body from producing insulin. With type 2, the body cannot use insulin well, which leads to a spike in blood sugar levels. Type 2 takes years to develop and is common among adults. However, young adults, teens, and teens are increasingly diagnosed with type 2 diabetes (Dabelea et al., 2014). Bleil, Spieker, and Booth-LaForce (2021) suggest taking frequent blood sugar tests, especially those at risk. The condition is usually silent, and it may be hard to notice any symptoms. Butler (2017) reiterates the fact that the exact cause of diabetes remains indefinite. However, genetics and family history seem to take centre stage. Other factors include excess weight, particularly belly fat, and also inactivity. What is clear from Eskicioglu et al. (2014) is that youth suffering from diabetes type 2 cannot process blood sugar properly. The result, according to Lawrence et al. (2021), is blood sugar accumulating. Instead of fueling tissue and muscle cells. <\/p>\n
A person\u2019s body derives sugar from the foodstuff they consume. Therefore, when the child\u2019s body resists insulin or when the body cannot produce enough, sugar spikes causing symptoms of elevated blood sugar. Wells (2018) remarks that research has not uncovered why some youth develop diabetes while others do not, despite having analogous risk factors. However, Temneanu, Trandafir, and Purcarea (2016) cite certain risk factors that increase the risk, including being overweight. Weight is a resilient risk factor for diabetes in youth. Temneanu, Trandafir, and Purcarea (2016) found that the fattier the tissues a child had, the higher they were at risk of contracting diabetes. Inactivity was also among the primary concerns cited by Temneanu, Trandafir, and Purcarea (2016). Inactive youths are at a greater risk of having diabetes. Per the work of Temneanu, Trandafir, and Purcarea (2016), youth who are physically active efficiently manage their weight because they use energy. Used up energy helps a child\u2019s cells respond better to insulin. <\/p>\n
Regarding Bleil, Spieker, and Booth-LaForce (2021), a child\u2019s risk of developing diabetes seems to increase when they have a sibling or parent with the disease. In addition, Butler (2017) emphasizes that it is unclear why ethnicity or race seems to play a crucial part in diabetes in youth. Asian Americans, American Indians, Hispanics, and African Americans are more prone to developing diabetes (Lawrence et al., 2021). Age is also a crucial factor when determining the cause of diabetes in youth, as explained by Lawrence et al. (2021). Nadeau et al. (2016) found that most children developed diabetes during the onset of their teens. The study also found that girls were more likely to suffer from diabetes than boys. Siobhan et al. (2008) associated gestational diabetes and low birth weight with a higher likelihood of developing diabetes. Similarly, Ogunwole and Golden (2021) associated diabetes in youth with premature birth. Infants born before 42 weeks were over had a greater risk of developing diabetes. <\/p>\n
Mendola et al. (2018) confirm that diabetes affects virtually all the organs in the body. These organs include kidneys, eyes, nerves, and blood vessels. It is undeniable from Eskicioglu et al. (2014) that enduring complications develop as the child grows into adulthood. Eventually, these complications turn to disable and finally life-threatening. Diabetes-fostered complications in youth include stroke, high cholesterol, liver disease, high blood pressure, blindness, blood vessel and heart disease, amputation, and kidney disease. Dabelea (2018) believes that the only viable way to reduce these complications is keeping blood sugar levels close to optimal all the time. Likewise, Nip et al. (2019) consider maintaining healthy lifestyles to prevent the risk of exposing youth to diabetes. As for children already having diabetes, Nadeau et al. (2016) advocate for lifestyle changes, which reduces the complications associated with the disease and dependence on medication. <\/p>\n
Eskicioglu et al. (2014) talk about peer mentoring and encouraging youth to eat healthy, balanced meals while discouraging too much sugar-laden junk foods. Wells (2018) adds to this approach by pointing parents and guardians focusing on whole grains, vegetables, and fruits. Consistent with Nip et al. (2019), caregivers should offer youth foods low in calories and fat. Caregivers can prevent boredom if they provide their children with a variety of healthy diets. On top of food choices, Nip et al. (2019) ask caregivers to strive for more exercise and physical activity. Parents should encourage their children to take part in an active lifestyle. They can accomplish this by signing them up for dance lessons or sports co-curriculum activities. Perhaps, the best solution, as offered by Bleil, Spieker, and Booth-LaForce (2021), is to find active things to commit to together. <\/p>\n
Summary <\/p>\n
Lawrence et al. (2021) suggest that the best way to combat diabetes in youth is to make it an intimate, family affair. Lifestyle choices that prevent diabetes in adults can help prevent it in childhood. A child\u2019s diet meant to combat or evade diabetes would work best for the entire family. From this study, reiterated by Dabelea (2018), it is apparent that diabetes affects a child in the same way it affects an adult. Sugar will build up in the bloodstream, provided there is not enough insulin in the body. If an individual leaves the condition untreated, it causes severe complications. The risk factors observed in adults are still the same ones witnessed in youth, including genetics, family history, and race. Since diabetes affects a child\u2019s organs, the remedy for prevention and treatment is to keep their blood sugar close to normal. Ogunwole and Golden (2021) find that optimal blood sugar levels reduce the risk of diabetes-related complications like stroke, high blood pressure, kidney damage, and eye damage. For Temneanu, Trandafir, and Purcarea (2016), diabetes prevention is better than cure, more so because there is no known cure for the disease. There is no proven way to prevent diabetes type 1, but it remains an active part of the research on the disease. However, with diabetes type 2, all the sources reviewed in this study, including Nadeau et al. (2016) and Siobhan et al. (2008), support making lifestyle changes the preeminent way to prevent or manage the disease.<\/p>\n
Methods<\/p>\n
I propose an observational study that focuses on observing individuals who meet a threshold for set qualifiers as outlined below. To this end, I believe that a cohort study would serve my purpose best, over a set period of time. The cohort would be selected based on the exposure or risk status of the individuals. In this case, I would choose cohorts made up of family units, so that I could follow the families of the cohort to determine and evaluate them and their ongoing health for the outcome of interests, Diabetes in youth. <\/p>\n
Study Design<\/p>\n
This particular study design was chosen because the needs assessment made clear that for youth, families play a vital role in shaping the lifestyle, habits, and food choices of youth by necessity. Youth live in the homes of their families and their food choices are those of their parents, largely- the parents purchase the food and often take charge of preparing it. The parents also, through their own socioeconomic status, define the opportunities and access of their children to healthcare, educational opportunities, access to recreational activities for exercise and fitness, and perceptions about fitness, health, and diet. <\/p>\n
Location<\/p>\n
The location chosen is urban areas of the state of New York.<\/p>\n
Participant Parameters<\/p>\n
Because of COVID-19, it is appropriate to conduct this study with a selection of sixteen families with youth who meet the following qualifications and are familiar enough with technology to participate in interviews and follow up via digital or online platforms such as Teams or Zoom:<\/p>\n
Lower socioeconomic status- below 120% of state poverty level;<\/p>\n
The family lives in an urban setting within the state of New York;<\/p>\n
Be considered a \u201cfamily\u201d with a least one parent figure;<\/p>\n
All parent figures in the family unit work;<\/p>\n
Have at least one youth- a child under age eighteen;<\/p>\n
All youth in the household participate in the local education system;<\/p>\n
Have at least one youth in the family unit who has been diagnosed with either Type 1 or Type 2 Diabetes in the last six months. <\/p>\n
Purpose of Study<\/p>\n
The purpose of the proposed study is to not only determine whether youth who meet risk factors for developing Diabetes do so, but more importantly for this study what factors contribute to the development of that chronic illness. It is important that social, economic, and health factors are considered as part of a comprehensive whole to assess the true impact of the development of Diabetes but further, how to anticipate those risk factors and thus mitigate the negative health outcome through behavior and social modifications. <\/p>\n
It is important to construct and analyze the life stories of these families in order to understand truly the context in which they live, their choices, and the health behaviors that contribute to their increased risk and potential development of Diabetes. This will allow for consideration of both the impact of Diabetes on the youth themselves, but also on the other potential youth in the family <\/p>\n
Design of Study<\/p>\n
The study itself will consistent of sixteen families who meet the above qualifications and are able to commit to eight monthly individual and group meetings per year. <\/p>\n
Statistics of Study\/Measurements<\/p>\n
The study will focus on these group meetings as opportunities to gather information through discussion and the use of questionnaires\/interviews. The focus of the questions will center on:<\/p>\n
The impact of Diabetes on the family as a whole:<\/p>\n
Expenses<\/p>\n
Lifestyle<\/p>\n
Fitness<\/p>\n
Health insurance\/education<\/p>\n
Diet<\/p>\n
The impact of Diabetes on the youth:<\/p>\n
Body image<\/p>\n
Acceptance of illness<\/p>\n
Denial of illness<\/p>\n
Lifestyle changes<\/p>\n
The methods by which youth have sought to modify behavior after diagnosis:<\/p>\n
Diet<\/p>\n
Education<\/p>\n
Exercise<\/p>\n
Treatment adherence<\/p>\n
Analytic Strategy<\/p>\n
The use of specific questions and ratings scales as administered in the questionnaire will allow for quantifiable data to be gathered on which to base statistical analysis to assess treatment compliance success, lifestyle changes, and diet modifications. The discussion notes and interview questions will allow for anecdotal data to be gathered on which to base general observances and will allow for more in depth analysis of the emotional and physical toll of Diabetes diagnosis on youth.<\/p>\n
References:<\/p>\n
Bleil, M., Spieker, S., & Booth-LaForce, C. (2021, June 3). Targeting parenting quality to reduce early life adversity impacts on lifespan cardiometabolic risk. Frontier Psychology, Retrieved September 14, 2021 from https:\/\/doi.org\/10.3389\/fpsyg.2021.678946<\/p>\n
Butler, A.M. (2017). Social Determinants of Health and Racial\/Ethnic Disparities in Type 2 Diabetes in Youth.\u00a0Current Diabetic Reports,\u00a017(60). Retrieved September 14, 2021 from https:\/\/doi.org\/10.1007\/s11892-017-0885-0<\/p>\n
Dabelea, D. (2018). Diabetes in youth\u2014looking backwards to inform the future: Kelly West Award Lecture 2017.\u00a0Diabetes Care,\u00a041(2), 233-240.<\/p>\n
Liu, Y., Sayam, S., Shao, X., Wang, K., Zheng, S., Li, Y., & Wang, L. (2017). Peer reviewed: prevalence of and trends in diabetes among veterans, United States, 2005\u20132014.\u00a0Preventing chronic disease,\u00a014.<\/p>\n
Dabelea, D., Mayer-Davis, E. J., Saydah, S., Imperatore, G., Linder, B., Divers, J., Bell, R., Badaru, A., Talton, J. W., Crume, T., Liese, A. D., Merchant, A. T., Lawrence, J. M., Reynolds, K., Dolan, L., Liu, L. L., Hamman, R. F. (2014). Prevalence of type 1 and type 2 diabetes among children and adolescents from 2001 to 2009.\u00a0Journal of the American Medical Association,\u00a0311(17), 1778\u20131786. Retrieved September 14, 2021 from https:\/\/doi.org\/10.1001\/jama.2014.3201 <\/p>\n
Eskicioglu, P., Halas, J., S\u00e9n\u00e9chal, M., Wood, L., McKay, E., Villeneuve, S., McGavock, J. (2014, June 01). Peer mentoring for type 2 diabetes prevention in first nations children. Pediatrics, 133(6),\u00a0e1624-e1631. Retrieved September 14, 2021 from DOI: https:\/\/doi.org\/10.1542\/peds.2013-2621<\/p>\n
Lawrence, J. M., Divers, J., Isom, S., Saydah, S., Imperatore, G., Pihoker, C., Marcovina, S. M., Mayer-Davis, E. J., Hamman, R. F., Dolan, L., Dabelea, D., Pettitt, D. J., Liese, A. D., (2021). Trends in Prevalence of Type 1 and Type 2 Diabetes in Children and Adolescents in the US, 2001-2017.\u00a0Journal of American Medical Association,\u00a0326(8), 717\u2013727. Retrieved September 14, 2021 from https:\/\/doi.org\/10.1001\/jama.2021.11165 <\/p>\n
Mendola, N. D., Chen, T. C., Gu, Q., Eberhardt, M. S., & Saydah, S. (2018).\u00a0Prevalence of total, diagnosed, and undiagnosed diabetes among adults: United States, 2013-2016. US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics.<\/p>\n
Nadeau, K., Anderson, B., Berg, E., Chiang, J., Chou, H., Copeland, K., Zeitler, P. (2016). Youth-onset type 2 diabetes consensus report: Current status, challenges, and priorities. Diabetes Care, 39(9), 1635-1642. Retrieved September 14, 2021 from https:\/\/doi.org\/10.2337\/dc16-1066<\/p>\n
Nip, A. S., Reboussin, B. A., Dabelea, D., Bellatorre, A., Mayer-Davis, E. J., Kahkoska, A. R., … & Pihoker, C. (2019). Disordered eating behaviors in youth and young adults with type 1 or type 2 diabetes receiving insulin therapy: The SEARCH for Diabetes in Youth Study.\u00a0Diabetes Care,\u00a042(5), 859-866.<\/p>\n
Ogunwole, S., & Golden, S. (2021, January 01). Social determinants of health and structural inequities-root causes of diabetes disparities. American Diabetes Association. Retrieved September 14, 2021 from https:\/\/doi.org\/10.2337\/dci20-0060<\/p>\n
Siobhan C.\u00a0Maty,\u00a0John W.\u00a0Lynch,\u00a0Trivellore E.\u00a0Raghunathan,\u00a0George A.\u00a0Kaplan. (2008).\u00a0Childhood Socioeconomic Position, Gender, Adult Body Mass Index, and Incidence of Type 2 Diabetes Mellitus Over 34 Years in the Alameda County Study,\u00a0American Journal of Public Health,\u00a098, 1486-1494. Retrieved September 14, 2021 from https:\/\/doi.org\/10.2105\/AJPH.2007.123653<\/p>\n
Temneanu, O. R., Trandafir, L. M., & Purcarea, M. R. (2016). Type 2 diabetes mellitus in children and adolescents: a relatively new clinical problem within pediatric practice.\u00a0Journal of Medicine and Life,\u00a09(3), 235\u2013239. Retrieved September 14, 2021 from https:\/\/pubmed.ncbi.nlm.nih.gov\/27974926\/<\/p>\n
Wells, J.C.K. (2018). The capacity\u2013load model of non-communicable disease risk: understanding the effects of child malnutrition, ethnicity and the social determinants of health.\u00a0European Journal of Clinical Nutrition,\u00a072,\u00a0688\u2013697 (2018). Retrieved September 14, 2021 from https:\/\/doi.org\/10.1038\/s41430-018-0142-x<\/p>\n","protected":false},"excerpt":{"rendered":"
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