Healthcare Administration and Diabetes Essay

Pre-diabetes Condition



Burden of disease: disability/morbidity



The word 'pre-diabetes' applies to persons highly susceptible to contracting diabetes mellitus (type 2). Those diagnosed as pre-diabetic have sustained, higher-than-normal blood glucose levels; however, these levels are not sufficiently high to be characterized as diabetes. Pre-diabetics suffer from either IGT (impaired glucose tolerance), or IFG (impaired fasting glucose), or both. The former denotes a condition wherein glucose tolerance levels of individuals after two hours of glucose consumption lie between 140 and 199 milligrams/deciliter whereas the latter refers to a condition wherein fasting blood glucose levels lie between 100 and 125 milligrams/deciliter (when nothing has been consumed throughout the night) (Thomaskutty & Dwivedi, 2011).



After pre-diabetes sets in, beta cells lose their function progressively, resulting in the onset of diabetes. Type 2 diabetics characteristically have by high blood sugar levels, a condition that, with time, damages blood vessels and nerves, thereby giving rise to complications like heart disease, kidney failure, lower-limb amputation, stroke, and blindness, among others. Research has depicted that a majority of pre-diabetics become diabetics in a ten-year span if they fail to alter their existing lifestyle. Lifestyle modifications imply a loss of 5-7% of their current body weight (for instance, between 10 and 14 lbs. for an individual weighing 200 lbs.) by altering their physical activity levels and diet (Prediabetes and Insulin Resistance, 2009).



Current Scenario



Pre-diabetics are increasing at an alarming rate in the U.S., with DHHS (Department of Health and Human Services) figures of the year 2012 claiming that a minimum of 86 million citizens above twenty years were pre-diabetics (Prediabetes and Insulin Resistance, 2009).



On a global scale, pre-diabetes is growing in prevalence, and can set in anywhere between seven and ten years prior to clinical diabetes diagnosis. At this juncture, risk factors typically exist and grow, including higher risks of contracting cardiovascular disease. Similarly, cardiovascular disease onset, particularly CAD (coronary artery disease), cerebrovascular disease, and peripheral vascular disease may transpire as well, which lead to elevated global mortality and morbidity levels (Magalhaes, Cavalcanti & Cavalcanti, 2010).



Several sources have issued pre-diabetes prevalence figures, which depict pre-diabetes levels between 5.8 and 35% in individuals aged 20+. Reported rates differ based on what criteria are utilized for defining pre-diabetes. Nevertheless, the condition has grown in prevalence in the past few decades. 1988-94 and 1999-2010 National Health and Nutrition Examination Survey data comparisons reveal that pre-diabetes grew in prevalence from about 5.8% to 12.4% in these duration. It is predicted that in the absence of intervention, between 15 and 30% of pre-diabetics will contract diabetes (type 2) in five years' time (Endocrine Society, 2015).



Etiology-cause: distribution of disease



Individuals who develop insulin resistance become increasingly prone to developing the condition of pre-diabetes. The condition normally surfaces among individuals with existent insulin resistance. While this is not the only factor leading to pre-diabetes, insulin resistance normally sets the scene for its onset, by greatly taxing insulin-generating beta cells. Beta cells of pre-diabetics stop secreting sufficient insulin for overcoming insulin resistance, thus resulting in slightly elevated blood sugar levels (Prediabetes and Insulin Resistance, 2009).



The condition sets in when an individual's body loses the capacity of properly maintaining normal blood sugar levels. While blood sugar levels are elevated compared to normal figures, they are not sufficiently high to be characterized as diabetes. Whatever one consumes is converted into sugar, and the human body uses up this sugar for energy. Under ordinary conditions, the pancreas secretes insulin, a hormone that facilitates blood sugar entry into the human body's cells. However, when the body cannot utilize insulin properly, glucose fails to move into body cells and remains in the person's blood. This condition is termed as insulin resistance.



Sugar accumulation in an individual's blood results in pre-diabetes. This condition will develop into diabetes mellitus type 2 when sustained elevated levels of blood sugar remain in a person's blood. Furthermore, physically inactive individuals, obese/overweight individuals and those with diabetes running in the family are highly susceptible to pre-diabetes. Lastly, females with gestational diabetes (diabetes during pregnancy) are also a high-risk group (Prediabetes, 2014).



Further, a difference has been observed in pre-diabetes distribution among ethnically different groups of people. A 2005-08 National Health and Nutrition Examination Survey data analysis depicted similar pre-diabetes rates among Non-Hispanic White individuals (35%), Mexican-American (36%) and Non-Hispanic Black individuals (35%). The 2010 National Health and Nutrition Examination Survey data was utilized to conduct a research work, which discovered gender differences based on ethnicity: pre-diabetes rates were consistent across females from different ethnic populations; however, rates were lower in non-Hispanic black men as opposed…