Diabetes is a global problem that has become prevalent in various parts of the world. This condition can be described as a metabolic disease where an individual has high blood sugar level. This can be due to limited insulin production or poor response of the body cells to the insulin produced. Insulin is regarded as a very critical hormone in the absorption of sugars into the blood cells. There are two types of diabetes. This includes the type I and type II forms of diabetes. For the first form of the condition, the body does not produce the insulin hormone. On the other hand, in type II diabetes, the body fails to properly use the insulin produced. Type II diabetes is very common than type I diabetes. Essentially, it is claimed that 90 per cent of diabetic patients suffer from type II diabetes whereas the rest suffer from type I diabetes. Those in the nursing profession should take diabetes seriously as this condition has no cure, but can only be managed.
The United States has a high prevalence of diabetes. Over 25 million people, accounting for about 8 per cent of the US population are suffering from diabetes (Gakidou et al. 2011). In the UK, there are over 2.6 million individuals who are suffering from diabetes. This figure is expected to grow to about 4 million by the year 2025. It is estimated that 4 per cent of the UK population is suffering from diabetes (Radia, 2009). Factors such as ethnicity, age, race, gender, and socio-economic status affect the prevalence of diabetes.
Nursing research study in the USA
Zhanga, Q., Wang, Y. and Huang, E.S. (2009). Changes in racial/ethnic disparities in the prevalence of Type 2 diabetes by obesity level among US adults. Ethnicity & Health, 14(5): 439-457.
This study aimed at analyzing the relationship between ethnic minority status and obesity affected type II diabetes among adults in the United States. This was facilitated through the establishment of the weight status of the adult population in the United States. The participants in the study included 49,574 adults between 20 years and 74 years old. The participants were drawn from different racial groups including Whites, Blacks, and Mexican Americans. Data was collected through surveys that had been conducted by the National Health and Nutritional Examination Surveys (NHANES) between the years 1974 and 2004. In this respect, surveys I (1971-1975), II (1976-1980), and III (1988-1994) and (1999-2004) were used for the study. In this study, an intervention was not tested (Zhanga, Wang and Huang, 2009).
This study established critical findings regarding the research topic. In the findings, it was established that trends in ethnic disparities in respect to the prevalence of type II diabetes were notable among the various categories of the participants. Among the overweight group, the disparities were significantly pronounced. In this respect, the prevalence of diabetes increased by 33 per cent among the Whites, 60 per cent in Black, and 227.3 per cent among the Mexican Americans (Zhanga, Wang and Huang, 2009).
Despite the successes of this study, there were several limitations that could be identified. Essentially, there has been changes significant change in the diagnosis of diabetes over the years. Notably, the self-reported diabetes could have been underestimated in the earlier surveys carried out by the NHANES. Nonetheless, the change in the definitions over time could not have an impact on the aspect of disparity in the prevalence of diabetes. Also, this study failed to account for the demographic and clinical changes within the population in the analysis. In addition, in the cross-sectional design that was adopted, the testing of the statistical significance was a great challenge. Also, this study concentrated on the BMI values leaving other factors that affect diabetes out. Nonetheless, it has been suggested that future research is necessary that will include other aspects related to diabetes (Zhanga, Wang and Huang, 2009).
Nursing Research Study from Scotland
Hamer, M., Kengne, A.P., Batty, G.D., Cooke, D. and Stamatakis, E. (2011). Short Report: Epidemiology Temporal trends in diabetes prevalence and key diabetes risk factors in Scotland, 2003–2008. Diabetic Medicine, 28: 595-598.
This study aimed at assessing temporal trends in diabetes prevalence and critical risk factors of the disease in a span of five years. The risk factors include obesity, physical activity and smoking. Those who participated in the study included 7229 from 2003 and 6313 from 2008 national surveys. Participants were drawn from the Scottish Health Surveys. Survey methodology was used in collecting data. In this case, the method adopted used surveys conducted in 2003 and 2008 (Hamer, Kengne, Batty, Cooke and Stamatakis, 2011).
There were notable findings that were drawn from this study. It was noted that there have been increases in the prevalence of diabetes between the years 2003 and 2008. The increase was significant among those aged 65 and above. Essentially, it was noted that the prevalence of diabetes increased from 5.2 to 9.4 per cent between the years 2003 and 2008. On the other hand, the prevalence of the diabetes risk was noted as 2.9 per cent in 2003 and 12.4 per cent in 2008. An increase in diabetic risk factors was also noted, but they were not influential in determining the trends in diabetes (Hamer, Kengne, Batty, Cooke and Stamatakis, 2011).
It can be appreciated that this study used diabetes prevalence figures that were derived from a subsample of participants with known HbA1c data. However, it can be noted that the figures were reflective of the overall sample population. This study was also associated with some limitations. It has to be noted that the assessment of measures related to physical activity and smoking was done through self-report. Therefore, this could compromise the objectivity as compared to if significantly objective measures were adopted (Hamer, Kengne, Batty, Cooke and Stamatakis, 2011).
Notably, the study used the HbA1c data. This was critical in identifying prevalent and undiagnosed incidences that could have been missed out if self reports were used. Nonetheless, the actual prevalence of diabetes might have been underestimated since the HbA1c is known to underestimate the prevalence of diabetes compared to other measures (Hamer, Kengne, Batty, Cooke and Stamatakis, 2011). It is important to conduct further research that would address the weaknesses that have been identified.
Nursing Research Study from the USA
Oza-Frank, R. and Narayan, K.M.V. (2010). Overweight and Diabetes Prevalence among US Immigrants. American Journal of Public Health, 100(4): 661-668.
This study’s purpose was to articulate the prevalence of overweight and diabetes among the immigrant population in the US by region of origin. There were 34456 participants who participated in the study. The participants were drawn from a nationwide interview survey that had been carried out between the years 1997 and 2005. Survey method was used for data collection. In this respect, the participants were drawn from the National Health Interview Survey covering the years between 1997 and 2005. The NHIS conducts continuous surveys among adults in the US. These surveys employ a multistage probability sampling design (Oza-Frank and Narayan, 2010).
This study came up with various findings regarding the subject of study. Immigrants from the Indian subcontinent were at risk of having diabetes compared to those from Europe without a corresponding increased risk of being overweight. Also, the immigrants from Mexico, Central America, and the Caribbean were at great risk of being overweight and diabetic compared to those from Europe (Oza-Frank and Narayan, 2010).
This study can be hailed for having used a large sample that is nationally representative. Also, the study made a comprehensive comparison of the cases of diabetes among the various migrant groups. On the other hand, there were notable limitations to the study. Notably, it can be asserted that reliance on self-reported data may have hampered the reliability of the findings. Also, it can be noted that the NHIS did not differentiate between types I and II diabetes and the researchers based on estimates from the self-reported data. It was estimated that between 90 and 95 per cent of the self-reported cases had type II diabetes. Another limitation is that the study did not have information on other factors that might affect prevalence of diabetes (Oza-Frank and Narayan, 2010). From the challenges and findings established in this research study, further research is highly recommended on the issue.
Nursing Research Study from Sweden
Taloyan, M., et al. (2010). Poor self-rated health in adult patients with type 2 diabetes in the town of Södertälje: A cross-sectional study. Scandinavian Journal of Primary Health Care, 28: 216–220.
This study aimed at investigating the relationship between ethnicity and poor self-rated health among individuals with type II diabetes. The study also aimed at determining whether the relationship between the two aspects remained intact even after adjustments in probable confounders such as age, gender, employment status and education among others. A total of 354 individuals of Swedish and Assyrian origin participated in the study. In this respect, participants of Assyrian origin were 173 whereas those of Swedish origin were 181. The participants were drawn from four primary health care centers located in the town of Södertälje. The study employed a cross-section study design in collecting data. In this regard, the cross-section design was based on the patient population sampled from the town of Södertälje. Also, there was the use of unconditional logistic regression in estimating the odds rations and 95 per cent confidence intervals (Taloyan, et al, 2010).
The research study came up with various findings on the subjects. The Assyrian participants had a high score in poor self-rated health compared to the Swedish in a crude model. Particularly, the Assyrian participants with type II diabetes had an odds ratio of 4.5 more than that of the Swedish participants. The unemployed and retired also had a high score in poor self-rated health compared to those in employment. In essence, the unemployed and the retired participants had an odd ratio of 5.4 times more than the employed participants. Also, the women scored high in poor, self-rated health compared to men. In this respect, it was noted that women scored 1.8 times more than men in odds ratio. This was in respect to reporting poor self-rated health (Taloyan, et al, 2010).
The study’s strength can be noted in the fact that this was the first study investigating the ethnicity aspect of individuals from the Middle East. This study based on self-identification of ethnicity, as opposed to affiliation based on geographical setting. It lays the ground for further research among homogeneous ethnic groups. Apart from the strengths, this study was noted to be having some limitations. The sample population of the Assyrians was obtained from one town. Therefore, the findings cannot be generalized to other people of Assyrian origin living in other parts of Sweden (Taloyan, et al, 2010).
Another limitation can be noted in the methodology in which case the cross-sectional nature and the small sample used in the study means that extensive causal conclusions are precluded. Also, the study included unexplained confounders within the logistic regression approaches. In addition, there are other aspects related to lifestyle and a risk of type 2 errors in the study that requires to be studied comprehensively. Despite the shortcomings, it can be concluded that the study is critical as it provides important information regarding the poor rating of the Assyrian immigrants in relation to self-rated health on diabetes (Taloyan, et al, 2010). This study gives way for further study to be conducted on the issues raised.
All the research studies used in the analysis did not have an intervention group. Most of the research studied adopted the survey methodology, which is appropriate in the study of trends in diseases. Notably, diabetes is a disease that is affected by various factors such as ethnicity, age, race, gender and socio-economic status among others. This aspect has been noted in the findings of various studies that focused on the element of ethnicity and race.
Gakidou, E, et al. (2011). Management of diabetes and associated cardiovascular risk factors in seven countries: a comparison of data from national health examination surveys. Bulletin of the World Health Organization, 89(3): 172-183.
Radia, H. (2009). Prevalence and incidence of diabetes increased in the UK over 10 years. Journal of Epidemiology and Community Health. 15:24