Discuss about the Social Factors for Contribute Diabetes.
Diabetes is an auto-immune disease. It may lead to retinopathy, nephropathy, neuropathy, angiopathy and uncontrollable infections if not controlled. It is a serious health condition and its percentage is expected to rise to 122% by 2025 (Hill, 2013). Current researches indicate that social factors play a key role in developing and treating diabetes. This essay discusses about the case study of Mdm. R with diabetes and the correlation of diabetes with identified social factor.
Mdm. R, 45 year old woman has got admitted in this hospital with chief complaints of fatigue, tiredness, increased thirst and hunger, loss of weight, increased urinary frequency, blurred vision, decreased sensation and numbness with tingling sensation in both feet. She is an obese person with 90 kg and likes to eat more non-vegetarian foods. She consumes alcohol at-least thrice a week. She belongs to a lower middle class family and lives with her husband and three children of ages 12, 10 and 7 years. She has dropped out from school education and has shifted from a small village in Malaysia to Singapore 10 years ago with her husband and his uncle, who had helped for their livelihood. She is a home maker and her husband is a truck driver and is the only source of income for their family. He visits them only once a week and hence, Mdm. R has to individually manage all the household work, outdoor shopping, and take care of their children which push her into greater stress. She is reluctant to visit the healthcare services as she doesn’t believe in modern medicine and doesn’t know English that make her feel uncomfortable to converse with the healthcare professionals as well as fear of cost of healthcare services.
On history collection, she revealed that, she has started feeling tired and lethargic even for simple household work and started losing weight. Due to this, her physical activity has reduced and so feels guilty as she is unable to take care of her kids. She also finds it difficult to control her bladder and is reluctant to discuss it with her GP. She has insomnia due to nocturia. She underwent all the investigations and was diagnosed to have type -2 diabetes mellitus. She doesn’t have any past medical history. But both her parents died of cardiovascular disease and diabetes.
Correlation between Social Factor and Diabetes
Both physical and social factors affect the health equally. Recent studies suggest that chronic illness depends on social conditions where a person is born, grow, learn, work and age. Social factors such as level of income, education, housing facilities and access to nutritious food forms the central for the development as well as progression of Type-2 diabetes which is evident from Mdm. R with poor background, low income status, poor housing facilities, less education and inability to get nutritious foods due to low income (Pilkington, 2010). The incidence of type-2 diabetes is observed to be 2-4 times more in low income and poor educated persons than that of advantaged persons. Low education results in decreased awareness that ultimately results in inadequate management of a disease (Pilacinski, 2014). If the social factors are not addressed sufficiently, they will remain a key barrier in their management. Similarly, though Mdm. R has genetic inheritance, her social factors such as stressful environment, lack of support, lower income, reluctant to visit health care faculties, poor education, etc has contributed to get diabetes at the earliest.
The social factors such as ethnicity, culture, social isolation and illiteracy have influenced her condition. Culture posses a greater influence on her medical condition as it affects the description of illness. The expression of conditions varies from one culture to another. Asian cultured people will report physical rather than emotional symptoms as like Mdm. R has described only her physical but not her emotional issues in the beginning and has expressed her emotional aspects only after good interaction (Tol, 2013). Some cultures supports consuming more alcohol and fatty foods but it may lead to obesity and increasing the risk for diabetes as Mdm. R. She has strict values and belief and hence ignores the advanced medical treatment and prefers traditional practices. This has increased her risk for developing complications.
Chronic stress is found to cause depression and anxiety leading to reduced self-esteem, energy and motivation that amplifies the adaption of self destructive behaviors as alcohol and unhealthy food intake (Mikkonen, 2010). The physical features of chronic stress includes high blood pressure, cortisol level and blood glucose with inability to manage stressors. These reactions have increased the risk of developing obesity and type-2 diabetes as Mdm. R. Diabetes could be controlled by increasing the physical activity, right food intake and following the right treatment regimen. Healthcare professionals should educate the patients and convince them to adhere to their treatment modalities by promising that their cultural and traditional values will be respected. Therefore, diabetes is strongly influenced by social and cultural habits rather than genetic predisposition.
Understanding the social factors that are correlated to the diabetic condition is very important step while planning the interventions as it aids the professionals in managing the illness. Decreasing the barrier between the misconceptions of patients about the illness and practicing healthy lifestyle will increase their adherence to treatment. Successful self- management for any medical condition is possible only when the social factors are addressed properly. In this case, Mdm. R can gain maximum benefit if she is properly educated about her illness and is been convinced to adhere to the treatment regimen and practice healthy lifestyle habits. Nurses are the front line workers and so they can screen the patients for identifying diabetes at the earliest, recognize the care needed and initiate the corrective procedures in case of inadequate treatment modalities, help these patients to set goals for management and achieve them appropriately and assess complications related to diabetes. The nurses should educate regarding the signs and symptoms of complications as neuropathy, nephropathy, retinopathy, infections, etc. Nurses should play an active role in teaching the diabetics about the nature of type-2 diabetes, its progression, importance of treatment and self-managing techniques. Nurses should indulge in alleviating the sufferings, maintaining quality of life and slowing down progression of complications. The nurses should pay attention to diet intake, encourage regular exercise to reduce weight, explain the reason to consume balanced diet, maintain normo-glycaemia, be-aware of cardiac risks, teach foot care and prevent diabetic complications.
Hill, J. (2013). Understanding the Social Factors That Contribute to Diabetes: A Means to Informing Health Care and Social Policies for the Chronically Ill: Perm J. 17(2): 67- 72.
Mikkonen, J. (2010). Social determinants of health: the Canadian facts. Canada: York University School of Health Policy and Management.
Pilacinski, S., & Ziolkiewicz, Z. (2014). Influence of lifestyle on the course of type 1 diabetes mellitus: Arch Med Sci: 124- 134.
Pilkington, F.B. (2010). The experience of living with diabetes for low-income Canadians: Canadian Journal of Diabetes. 34(2): 119–26.
Tol, A., Sharifirad, G., Shojaezadeh, D., Tavasoli, E., & Azadbakht, L. (2013). Socio-economic factors and diabetes consequences among patients with type 2 diabetes: J Educ Health Promot. 2: 12.