Prevalence and Risk Factors of Diabetes Mellitus

Background Information

Diabetes mellitus could be a cluster of metabolic diseases characterized by chronic hyperglycemia lead to from defects in hypoglycemia agent secretion, hypoglycemia agent or both. Metabolic abnormalities in carbohydrates, lipids, and proteins result from the importance of hypoglycemic agent as an anabolic hormone. Low levels of hypoglycemic agent to attain adequate response and/or hypoglycemic agent resistance of target tissues, in the main skeletal muscles, fat, and to a lesser extent, liver, at the amount of hypoglycemic agent receptors, signal transduction system, and/or effector enzymes or genes are accountable for this metabolic abnormalities. The severity of symptoms is because of the kind and period of polygenic disorder a number of the (diabetic/ polygenic disorder/ polygenic sickness) patients are well particularly those with sort two diabetes throughout the first year of disease, others with marked hyperglycemia and particularly youngster with absolute hypoglycemic agent deficiency might suffer from renal disorder, polydipsia, polyphagia, weight loss and blurred vision. uncontrolled polygenic disorder might result in stupor, coma and if untreated death, because of acidosis or rare from nonketotic hyperosmolar syndrome. Though classification of polygenic disorder is vital and has implications for the treatment methods, this can be not a simple task and plenty of patients don’t simply work into one category particularly younger adults and tenth of these at classified might need revision.

Although classification of diabetes is important and has implications for the treatment strategies, this is not an easy task and many patients do not easily fit into a single class especially younger adults and 10% of those initially classified may require revision. The classical classification of diabetes as proposed by the ADA in 1997 as type 1, type 2, other types, and GDM is still the most accepted classification and adopted by ADA. Wilkin proposed the accelerator hypothesis that argues “type 1 and type 2 diabetes are the same disorder of insulin resistance set against different genetic backgrounds”. The difference between the two types relies on the tempo, the faster tempo reflecting the more susceptible genotype and earlier presentation in which obesity, and therefore, insulin resistance, is the center of the hypothesis. Other predictors of type 1 diabetes include increased height growth velocity and impaired glucose sensitivity of β cells. The implications of increased free radicals, oxidative stress, and many metabolic stressors in the development, pathogenesis and complications of diabetes mellitus are very strong and well documented despite the inconsistency of the clinical trials using antioxidants in the treatment regimens of diabetes. The female hormone 17-β estradiol acting through the estrogen receptor-α (ER-α) is essential for the development and preservation of pancreatic β cell function since it was clearly demonstrated that induced oxidative stress leads to β-cell destruction in ER-α knockout mouse. The ER-α receptor activity protects pancreatic islets against glucolipotoxicity and therefore prevents β-cell dysfunction (The epidemic of the century. World J Diabetes 2015)

Literature Review

The number of people with diabetes is rises due to population growth especially in urban, aging, increases the prevalence of obesity and physical inactivity. Apprising the prevalence of the diabetes mellitus and the number of the people affected by that disease, This is the important for the government to plan the national budget and allocation of resource.

The global prevalence of diabetes was around to be 9.0% among adults in 2014. About 1.5 million deaths were caused by diabetes; and more than 80% of the deaths occurred in developing countries (WHO, 2014). Additional detestably, it is projected that by 2030, diabetes will be the seventh most leading cause of death (Mathers et al., 2006). IN spite of that, around to be over 175 million peoples living with diabetes mellitus are unknown (IDF, 2013).

The prevalence of diabetes mellitus in Africa was estimated to be around over 7.1% in 2014. It was expected to increase from 19.8 million in 2013 to 41.5 million people in 2035. Unknown diabetes mellitus was calculable to be high as 50% (Peer et al., 2014; WHO, 2016). They estimated to calculable to extend in sub-Saharan Africa is around to be 98%; expected to rise from 12.1 million in 2010 to 23.9 million in 2030; Impaired glucose tolerance of the peoples in sub-Saharan Africa is predicted to will increase by 75.8%, from 26.9 million in 2010 to 47.3 million in 2030 (Mbanya et al., 2010).

In 2012, the prevalence of diabetes mellitus was estimated to be 9.1% in Tanzania. It was absolutely was calculable to be over 1.7 million peoples with diabetes mellitus and about 1.3 million peoples were calculable living unknown (WHO, 2012; IDF, 2013). The prevalence was higher among the people living in urban cores dent, over 5.0% more than the people’ living in rural correlative who accounts to be 2.0% (Mayige et al., 2012).

Problem Statement

The prevalence of diabetes mellitus is increase fast in the country, and the increase of disease in developing country is due to the peoples live modernization life (western way of life) so that would change the dietary habits and lifestyle from traditional to sedentary life, peoples eats food with a lot amount of fats and do not involved in exercise which causes the increases in breathing and heart rate so that the peoples can be overweight and obese. As the matter of fact, the high blood sugar can affect a various cells and organ in the body so that increases the people dying with heart disease or stroke by 50%.The overall risk of dying among people with diabetes is double to the risk of their peers without diabetes; it is among the leading to dialysis, eye damage which could result blindness, kidney failure, chronic conditions like neuropathy (nerve damage), gastro paresis(issues with stomach emptying) and emergency limb amputation. People with diabetes require at least two to three times health-care resources compared to people who do not have diabetes. The economic burden is generally higher for people with relatively lower household incomes, who lack health insurance coverage. Inspite of the increasing the prevalence of diabetes mellitus, most of the researcher studies have able to address the insue of the disease and directed in both rural and urban areas ; but in Tanzania none has focused exclusively on public workers.

Rationale

Despite the initiatives which have already taken by the government to address the risk of lifestyle-related non-communicable diseases, recently the prevalence of diabetic mellitus is continue to be terribly high in worldwide around at 9.1%, the prevalence of diabetes mellitus and was calculable to be over 80% for the peoples unknown with diabetes mellitus. Diabetes mellitus occur among the peoples below 60 years old work age population is high and have negative impact on the workforce of the health, the productivity additionally decreases and have the effect of economic of the state of the nation and comprising the social and welfare of the family. Assessment of prevalence and risk factors for diabetes mellitus is vital it facilitates the government to grasp the magnitude of sickness and to use efforts on the strategies and interventional measures for the rapid increases of diabetes mellitus.

Background Diabetes mellitus is the cluster of metabolic sickness characterized by hyper glycaemia result from defect in hypoglycemic agent secretion, hypoglycemic agent action, or both. The chronic hypoglycemic of pyogenic disorder is related to long harm, pathology and failure of distinction organs, particularly the eyes, kidneys, nerves, heart and blood vessels. In 2012, the prevalence of diabetes was calculable to be 9.1% in African nation. It absolutely was calculable to own over 1.9million of peoples with diabetes mellitus and concerning 1.3 million of peoples were calculable living unknown according to (UN agency,2012; IDF, 2013).

Objective: During this analysis that I will be able to conduct, I will be able to asses the prevalence and risk factors of diabetes mellitus among the patients of Temeke referral in Dar-es-salaam region of Tanzania.

Methods: A descriptive cross sectional study are going to worn out at Temeke referral hospital in Dar es salaam region of Tanzania for a period of two month from July 2019 to September 2019.The research will be expected to include one hundred (100) subjects of age 18 years old and above. Randomized sampling technique will be used to get representative. Moral clearance and consent before enrollment with in the study will be obtained. Data will be collected through face to face interview using structured questionnaires. Anthropometric measurement will be taken. The subject will be screened for RBG and peoples with values of≥5.6mmol/l and ≤11.1mmol/l will be scheduled for fasting blood glucose, and those above 7.0mmol/l, will be confirmed to be diabetic patients. The collected data entry will be analyzed using Epi-info. The budget will be used for conduct research approximately 590,000/=Tsh.