Diabetes

Diabetes Health Initiative in New York Meredith Barlow HCA 415 John D Moore October 24, 2011 Identify and provide description of the health problem. Diabetes is caused by the inability of the body to create insulin or the ineffectiveness of the body to use deficient insulin that it does makes. Insulin is used to assist sugar in food to bind to cells that generate energy. When sugar or glucose does not receive insulin it stays in the cells and energy is not produced. As time passes the blood contains more glucose than is necessary which contributes to health issues (NYSHealthFoundation.org, 2010). Some problems that are caused by diabetes are kidney disease, amputation of extremities, and even blindness. Diabetes is among the leading causes of death in New York and nearly every state. Related illnesses such as stroke and heart disease are direct results of diabetes. Complications with pneumonia and the flu can cause death from these normally treatable illnesses when diabetes is present. There are some misconceptions that diabetes is the result of eating excessive amounts of sugar. However this is only a myth and a physician has to diagnose the presence of diabetes after completing certain tests such as a glucose tolerance test. The growth and spread of diabetes has been increasing year by year. Now reaching epidemic proportions in New York, it affects one twelfth of adults. The number of cases has doubled since the early 1990s and now is expected to double again in less than forty years (Wiley-Rossett, 2010). There has been a million New Yorkers that have been diagnosed with the disease that are known cases. Nearly another half million have the disease but may be unaware of it. The number of children that are contracting the disease is also on the rise according to the Center for Disease Control (NYSHealthFoundation.org, 2010). The statistics state that one third of the children born are likely to develop diabetes during their lives. The number of Hispanic Americans contracting the disease is even higher at one in two. The medical costs of treating diabetes is very high each year. As recent as2006 the cost was reported at $175 billion a year. The costs of diabetes takes one fifth of government Medicare and Medicaid dollars to pay for treatment. The costs is close to $12,000 per person with the disease. Compare that to those without the disease whose medical treatment is much lower at $2,600 a year. A grant was awarded to several locations throughout New York State Health Foundation to the local YMCA Community Centers to implement preventative programs (NYSHealthFoundation.org, 2010). The hope is to collaborate with the state YMCA Foundation and also the New York Health Department Diabetes Control Program. The hope is to reverse the alarming growth rate of Diabetes in the region. The plan is to intervene when those at risk are facing pre-diabetes symptoms and their blood sugar levels are above normal. Those with higher blood sugar levels are at risk of developing Type 2 diabetes which puts them in the path of heart disease and other severe illnesses. This particular grant was designed to assist Long Island including Queens, Buffalo, Middletown, Plattsburgh, New York City, Rochester, Syracuse, and the Capital District (NYSHealthFoundation.org, 2010). The plan has at its core lifestyle habits designed to incorporate healthier diet and exercise as part of a daily routine. There are several programs and research studies that are active in finding ways to impact people that have Type II Diabetes. An organization focused on this issue of diabetes type II is the Queens New York Hospital (NYHQ) which is the location for research of the Action to Control Cardiovascular Risk of Diabetes, known as ACCORD. This research consists of a trial where patients will undergo a very aggressive treatment program designed to reduce risks of strokes and also heart attacks for those with Type II Diabetes (NYHQ, 2010). Trial results were reported in The results were presented at the American College of Cardiology meeting this past weekend and published the New England Medical Journal. The research was started back in ‘99’ and has continued through 2007, since that time more than 10,000 patients were studied including at least 60 from the Queen’s Hospital (Bacon & Levine, 2010). The results were not as hopeful as expected. The treatment involved reducing blood pressure and/or adding a medication that was designed to lower triglyceride levels and increase HDL the good quality cholesterol Those in the study did experience better cardiovascular health that had lower HDL and triglyceride levels that were elevated. Dr. Daniel Lorber, Director at NYHQ reports these findings are useful to the medical field and are a step in the right direction. He says that controlling HDL and LDL levels of cholesterol are the key preventative factors in cardiovascular health. This ACCORD research made it apparent that aggressive treatment is not always the solution for each patient (NYHQ, 2010). Yet another study this time sponsored by the NIH, National Institute Health included the New York Hospital in Queens as part on a trial led by Dr. Phyllis August in the BARI2D study. This study was the Bypass Angioplasty Revascular Investigation of Type II Diabetes (University of Rochester Medical Center, 2010). The findings with this trial was that intensive therapy involving revascularization did not have an effect on Type II diabetics nor did it impact heart disease (Bacon & Levine, 2010). Revascularization involves creating a new path of blood flow into the arteries of the heart. Lastly the NIH is investigating the effects of aspirin derivatives or salicylates, on patients with Diabetes. This research is ongoing across the nation and NYHQ is one of the sites in New York participating. The objective of this study is to administer a drug called salsalate and monitor its effect on Type II Diabetic. Those interested in learning more about what is being done through studies to combat Type II Diabetes should contact their local hospital or NYHQ directly. Some problems or barriers that are posed to those with Type II Diabetes are limited mobility due to urinary incontinence, dialysis, retinal dysfunction (weak vision) or reduced cardiovascular capacity for example. The ability to exercise would increase mobility however due the condition of the patient facing these daily problems, exercise is often very limited (Coonrod, 2010). This further lends itself to exacerbating the disease unfortunately. Finding solutions to barriers is part of the Those facing visual impairment can get equipment and resources to assist with daily activities such as a seeing eye dog, a nurse aid, or even audio and visual aids to diminish their incapacities. Contacting the local hospital, Family Dependent Agencies, Senior Care Facilities, or AARP where information about how to get the help needed is important to improve the quality of life for those with the disease. The stakeholders in the fight against Type II Diabetes beyond the entire population and those currently living with the disease are the economic, medical, and government agencies that distribute funding care and research. While pharmaceutical companies are a stakeholder in Type II Diabetes cares. The industry is not always on the side of patients with recent recalls of Avandia drug that was supposed to control blood sugar levels of those with diabetes was instead reported as causing a 43% higher incident of heart attacks based on a Food and Drug Administration (FDA) review (Asweetlife.org, 2010). With the cost of patients rising significantly each year, government funding has risen, this increases taxes on those who work and those who provide jobs. Though there have been generous contributions by private parties in committing to support from philanthropists such as Eugene M. Lang, who gave $2 million to the development of the NYHQ Lang Center for Research and Education (NYHQ.org, 2007). The cost of treating and care for Type II Diabetes patients has been increasing each year. With corporations having to pay more for medical benefits, they cannot hire as many workers resulting in layoffs and early retirement. The after effect of fewer jobs is a slower economy. Type II Diabetes affects every American and it is important for each of us to find ways to support our community, make smarter choices about diet and exercise, and learn more about its impact on society. References Asweetlife.org. (2010). Avandia Recall Possible: FDA Reviews. Retrieved December 28, 2010 from http://asweetlife.org/a-sweet-life-staff/in-the-news/drugs- treatment/avandia-recall-possible-fda-reviews/8928/ Bacon, C. & Levine, D. (2010). New York Nationally Recognized Diabetes Expert Says Efforts to Reduce Heart Attacks in Diabetes Patients is on the Right Track. Retrieved December 28, 2010 from http://NYHQ.org Coonrod, B.A. (2010). Overcoming Physical Barriers to Diabetes Self-Care. Retrieved December 28, 2010 from http://spectrum.diabetesjournals.org/content/14/1/28.full Morris, S.F. & Wiley-Rossett, J. (2010). Medical Nutrition Therapy: A Key to Diabetes Management and Prevention. Retrieved December 28, 2010 from http://clinical.diabetesjournals.org/content/28/1/12.short'rss=1 NYSHealthFoundation.org. (2010). Awards $375,000 Grant to YMCA to Implement Diabetes Prevention Program in 10 Regions Across NY. Retrieved from December 21, 2010 http://www.nyshealthfoundation.org/content/article/detail/12510 New York Hospital Queens (NYHQ). (2010). ACCORD Trials. Retrieved December 28, 2010 from http://www.nyhq.org/wtn/page.asp'PageID=WTN000208 NYHQ.org. (2007). Eugene & Theresa Lang Contribute $2 Million Gift to NYHQ. Retrieved December 2010 from http://www.nyhq.org/Eugene_Theresa_Lang_Contribute_2_Million_Gift_to_New _York_Hospital_Queens University of Rochester Medical Center. (2010). Strong Heart and Vascular Center: Coronary Revascularization. Retrieved December 28, 2010 from http://www.stronghealth.com/services/surgical/Cardiothoracic/Coronaryrevasc.cf m