Methods and Approaches to Controlling T2DM
Public Health Perspectives and Theories
From the public health perspective, diabetes can be controlled effectively using two public health theories: the “Intersectionality Theory” and the “Health Program Behavior Approach.” The Intersectionality Theory is used to understand how different people’s identities in society can affect their health. Age, sexuality, ethnicity, and different identities can give personal privilege and more access to health care (An Overview, n.d.). This theory can be applied to control diabetes because diabetes development is greatly affected by the environment of the patients. People in low to middle-income countries have less access to health care, low education, and economic instability. This lack of resources can lead to unhealthy food consumption such as processed meat and sugared food due to its comparatively low prices and late detection of the disease. In comparison, many people in developed countries have the privilege of easier access to health care, good education, and economic stability, but live a more sedentary life with high rates of obesity). Understanding these different identities and situations of patients and their effects on health are essential to directing the most effective public health policies towards the right group.
The Health Program Behavior Approach is used to address how different communities behave in different ways, and how this understanding of behaviors can be used to make interventions that can successfully influence the behaviors to work beneficially towards health outcomes (An Overview, n.d.). The implementation of this theory can influence communities to take actions that can lead them to a healthier lifestyle and earlier detection. Such influencing methods include using mass media to educate people on the health consequences of an inactive and unhealthy lifestyle, or conditional cash transfer when getting check-ups for T2DM even if symptoms are not observed.
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Methods of Treatment and Prevention
Different methods are used to prevent, delay, and reverse the development of T2DM. Intensive lifestyle modification is one of the most common methods and includes weight reduction, a healthy, low-calorie diet, reduced alcohol consumptions, encouragement of physical activity, and other personal modifications needed based on each patient (Khunti et al., 2012; Norris et al., 2005; Thomas et al., 2006). According to the study performed by the Diabetes Prevention Program Research Group (2015), at the 3-year and 15-year follow-up, the relative risk reduction [RRR] of the disease from intensive lifestyle modification was 55% and 27%.
The benefits of lifestyle modification are supported by additional studies. According to a meta-analysis, a 1kg weight loss results in a 7.1% decrease in risk of heart failure, and another study found that 40% of patients who maintained an 8-week low-calorie diet resulted in shorter diabetes duration and a glucose concentration below 7 mmol/L, which indicates a significant decrease in diabetic conditions (Steven et al., 2016; Udell et al., 2015). Over 60% of type 2 diabetes patients are obese, so intensive lifestyle modification could be a huge contributor to the decrease in patients when effectively followed (Davies et al., 2015; Wadden et al., 2013). Another prevention plan was a policy passed in Ottawa, Ontario. This policy aimed to increase physical activity during work commutes. It enforced the creation of pedestrian areas on all roads, reduced pedestrian crossing distances, developed cycling connections, and implemented other actions to promote a more active lifestyle. The effects of this policy are planned to be measured in the 10-year time frame, and authorities predict that this implementation will prevent up to 1620 cases of diabetes among 17, 300 physically inactive individuals, which is a great start to decreasing the community-wide prevalence of the disease (Arnason et al., 2019; Transportation Master, 2013).
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