Diabetes in the Elderly: Causes, Symptoms, and Treatment

Background 

Population health approach emphasizes on improving and maintaining the health status of a group of people in the society. The main aim is to reduce the inequities that reveal themselves in many instances by moving beyond the conventional health sector approaches to improving health. By applying this to the elderly population with the type 2 diabetes, it can be possible to assess the interventions perceive and how the current situation is for this group. By focusing on the determinants of health, we can check on the interrelated factors that contribute to the prevalence of type 2 diabetes among the elderly over the course of life. This can lead to the formation and implementation of policies that improve the health and well-being of the older population. 

Determinants of Health 

The health determinants refer to the environmental, economic, social, and personal factors that influence the status of the well-being of a population or a person. 

Access to Healthcare 

Diabetes is one chronic condition that claims the lives of thousands of people per year while giving the ones living with it the financial and health burden. It can lead to other conditions such as stroke, heart attack, and other microvascular complications. Access to quality healthcare is one determinant of type 2 diabetes. This factor addresses the diagnosis and management. It has been found that half of the number of people with the condition does not know they have it. Diabetes has no known cure but early diagnosis can help in the management of symptoms and prevent complications that may arise. One of the daunting facts in this determinant is the lack of insurance coverage among the elderly ( Zhang et al., 2012) . Without this, a person is less likely to go for screening. When the diagnosis is positive, the family that lacks coverage may find it extremely difficult to afford the checkups and pharmaceutical therapy. Lack of access to health can lead to the reduction of the quality of a diabetes patient. In addition, it is difficult for the individual to participate in preventive care ( Zhang et al., 2012) . 

Individual Behavior 

Apparently, the behavior is the most impactful health determinant of type 2, diabetes, both before and after diagnosis. There is ample evidence that links obesity or being overweight as the biggest risk of developing type 2, diabetes, which mostly occurs at a young age. The body weight of an individual compared to their height is one of the means through which the diagnosis of diabetes occurs. Being overweight or obese comes from poor behavioral factors including dietary, sedentariness, sleep, exercise, and stress ( Hornick & Aron, 2008) . Unhealthy eating habits include frequent intake of foods containing high sugar level, low fibre, and high level of fat. A sedentary lifestyle includes sitting or lying for long while engaging in activities like reading, or watching a screen. All of these can lead to weight gain, which is a contributing factor to diabetes. 

A change in lifestyle can have a huge impact on the prevention or management of diabetes ( Tuomilehto et al., 2001 ). Treating the condition is similar across population groups, and it involves the modification of lifestyle alongside pharmaceutical therapy. Refraining from changing the way of life after a diagnosis may lead to complications that are common with type 2 diabetes (cardiovascular disease, retinopathy, neuropathy, and atherosclerosis). Individual behavior as a determinant of health comes to play when a person follows the recommendations of lifestyle change and the guidelines set by the doctors. 

Social Environment 

Social and physical factors of health emphasize on the influence that the environment in which people are born, brought up, learn, work, and age has on the development and occurrence of a disease. These elements affect a wide range of health, functionality, and outcomes. The culture of individual and other social factors makes an important determinant of health in type 2 diabetes. This category of determinants of health contains elements such as social norms and attitudes, quality education, socioeconomic conditions, and availability of resources for meeting daily needs such as job opportunities, healthful foods, and living wages. The elderly in most cases are retired and living off retirement pension cuts. This makes them vulnerable to the type 2 diabetes, as they cannot afford the basic cost of medication ( Hornick & Aron, 2008 ). 

The average cost of taking care of a person with diabetes is estimated at 13,700 dollars per year ( American Diabetes Association, 2013) ). This leaves a huge hole in the average retiree’s income. If the family is coming from a low-income community, it means that the elderly cannot afford the necessary medication. There are some instances where people have taken obesity as a norm and making sense that type 2, diabetes is hereditary and thus inevitable. This means that when individuals are raised in such an environment, they willingly accept diabetes as part of life. The same notion will go on until they become elderly and thus increasing the epidemiology. Apart from the attitudes and finances, the support system is another important factor in the elderly. The presence of a system that guarantees support from family may lead to the better management of type 2 diabetes. 

Physical Environment 

There is a connection between toxins in the air and the development of type 2 diabetes. Frequent exposure to some organic pollutants can lead to a diagnosis of the condition ( Thayer et al., 2012) . Particulate matter in the air is known to be the leading cause of cardiovascular events that increase more emergency room visits, mortality, and high hospitalization of patients with type 2 diabetes. Pesticides influence the development and management of the condition as it increases the chances of complications ( Thayer et al., 2012) . 

The immune system of the elderly is known to be weakened by age and thus susceptible to the small allergens. For the adults in the nursing homes, it is crucial to train the caregivers in the management of the environment of the patient to ensure positive outcomes and reduce complications. Adverse environmental conditions can also be a crucial factor in the access to healthcare. The zones that are prone to earthquakes and hurricanes may have the elderly locked out of access to vital care. 

Genetics 

There is a strong connection between genetics and the development of type 2 diabetes. Studies have confirmed that a person with a first-degree relative having diabetes has a three times chance of developing the condition as compared to those without ( Barroso, 2005) . Family history is one of the diagnostic factors of the condition. It is possible that the elderly person with diabetes got it by virtue of having a member of the family with the condition. This also means that they continue the diabetic history of the family. 

Another genetic determinant of health is the ethnicity of the elderly person ( Barroso, 2005) . There is also the connection that the people with a minority race decent are more susceptible to the disease than the one from majority race. The knowledge of how genetics affects the development of type 2 diabetes can help with early screening as soon as signs start showing. This leads to a proper management of the condition. 

The factors that I consider the most important include individual behavior, access to health, and social environment. This is because the social changes and cultural influence play an important role in the design of mitigation strategies. 

Epidemiology data is important in the management of type 2 diabetes. The availability of statistics reveals that the issue has reached the level of an epidemic and thus calls for drastic containment measures. Apart from focusing on the elderly population, epidemiology data shows the increasing trend in the development of diabetes in children, adolescents, and young adults ( Kirkman et al., 2012 ). This means the whole population is in danger of the disease and its complications. The dataset also reveals the group that is highly susceptible and why, which makes the interventions to be curved around preventive measures because diabetes is incurable. 

The epidemiology data on diabetes is important in making the management and treatment policies that are customized for every population. Previously, guidelines for treatment were based on clinical studies in middle-aged people, while giving the same recommendations for everyone. Old age is attributed to the risk of obesity, lowered physical activity, reduced beta-cell function, and loss of muscle mass. All the factors are important in the development of policies to tackle the condition in an individualized manner. One of the benefits of the data is in designing for the management of hyperglycemia and its symptoms and help patients manage themselves. 

In conclusion, type 2 diabetes has reached the level of an epidemic and pandemic. It, therefore, calls for the approach of population health to find out how it evolves in different groups and how to address the prevalence. The health determinants that influence the occurrence of the condition are important in determining the cause of spread, and the reason why it is underdiagnosed. These determinants can help in designing mitigation procedures and policy that target the specific group instead of having a one-size-fits-all approach. 

References 

American Diabetes Association. (2013). Economic costs of diabetes in the US in 2012:  Diabetes care , DC_122625. 

Barroso, I. (2005). Genetics of type 2 diabetes:  Diabetic Medicine ,  22 (5), 517-535. 

Hornick, T., & Aron, D. C. (2008). Managing diabetes in the elderly: go easy, individualize:  Cleveland Clinic journal of medicine ,  75 (1), 70-78. 

Kirkman, M. S., Briscoe, V. J., Clark, N., Florez, H., Haas, L. B., Halter, J. B., ... & Pratley, R. E. (2012). Diabetes in older adults  Diabetes care ,  35 (12): 2650-2664. 

Thayer, K. A., Heindel, J. J., Bucher, J. R., & Gallo, M. A. (2012). Role of environmental chemicals in diabetes and obesity: a National Toxicology Program workshop review:  Environmental health perspectives ,  120 (6), and 779. 

Tuomilehto, J., Lindström, J., Eriksson, J. G., Valle, T. T., Hämäläinen, H., Ilanne-Parikka, P., ... & Salminen, V. (2001). Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance:  New England Journal of Medicine ,  344 (18), 1343-1350. 

Zhang, X., Bullard, K. M., Gregg, E. W., Beckles, G. L., Williams, D. E., Barker, L. E., ... & Imperatore, G. (2012). Access to health care and control of ABCs of diabetes:  Diabetes Care , DC_120081.