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Adult Onset

Diabetes
C. Jackson, V. Koroma,
V. Kwofi, & F. Taylor

Adult Onset Diabetes


A condition that describes a group of
metabolic diseases in which a
persons blood sugar tends to rise
above normal levels

Adult Onset Diabetes Signs


& Symptoms
Polyuria

frequent passing of urine greater than 2.5 liter to 3

liter over 24 hours


Polydipsia

constant, excessive drinking as a result of thirst.

Polyphagia

excessive hunger or increased appetite

(McCarthy, 2014).

The Burden of the Disease in the United


States of America
There are 8.1 million people who are undiagnosed.
21 million Americans diagnosed in 2014.
Total number of people living with diabetes is 29.1 million or
9.3% of the American population.
The 2009-2012 National Health and Nutrition Examination
Survey revealed that there were more men living with diabetes
than women.
15.5 million Men were diagnosed with diabetes vs. 13.4 million
women.

The Burden of the Disease in the United


States of America
Estimated diabetes costs in the United States, 2012
Total cost (direct and indirect)
$ 245 billion
Direct medical costs
$ 176 billion
Average medical expenditures among people with diagnosed

diabetes were 2.3 times higher than people without diabetes.


Indirect costs
$ 69 billion (disability, work loss, premature death).

Treatment/Managem
ent
Goal of management is to restore normoglycemic control and

prevent target organ damage:


Microvascular: eyes, kidneys
Macrovascular: vessels, heart
Neurovascular: nerve, neuropathy
Metabolic: Electrolytes balance

Treatment/Management
Life style
Monotherapy agent such as metformin (ADA, 2014):

A second agent such as glyburide to be added if unable to achieve


normoglycemic control

Both ADA (2014) and AACE (2014) recommend early

initiation of insulin therapy in complicated diabetes to


prevent target organ dysfunction

Treatment/Management
The client must be involved in the decision making process
Lifestyle modification:

healthy food choices (whole wheat, lean meat, low fat , low salt,
low cholesterol diet), smoking cessation and exercise (3omins/day for 35x/week)

Teaching:

Finger stick glucose monitoring, daily foot examination,


potential side effects medication and insulin therapy .

Annual Physical Examination:

Eye dilation by an ophthalmologist, urine microalbumin,

Follow-Up Visits:

A1c every 3-6 months, self- blood glucose monitoring, routine eye and
foot exam (ADA, 2014).

U.S. Census Baltimore City vs.


Houston
3,000,000

2,800,000

2,600,000
2,500,000
2,170,000

2,210,000

2,240,000

2,260,000

640,064

640,961

640,150

638,091

2005

2006

2007

2008

2,096,798

2,150,000

2,160,000

2,195,914

2,162,000

637,418

621,115

619,493

622,417

622,104

620,961

2009

2010

2011

2012

2013

**2014**

2,000,000

1,500,000

1,000,000
614,004
500,000

0
2004

Baltimore City

Houston, Tx

New cases of adult onset diabetes


Baltimore(city), MD vs. Houston(city), TX
Adult Onset Diabetes
Baltimore City

Houston, TX

30,000
27,213

21,403

25,371

25,193

25,000

23,468
21,769

20,806

20,883
19,474

20,000

18,273

17,273

15,000

10,000
5,520
5,000

0
2004

5,555

2005

5,835

2006

5,835

2007

5,825

2008

5,445

2009

5,613

2010

5,633

2011

4,639

4,226

3,956

2012

2013

2014

Morbidity Rates
Baltimore City vs. Houston
Morbidity Rates
1400
1200
1000
800
600
400
200
0

2004

2005

2006

2007

2008

2009

Baltimore

2010

Houston

2011

2012

2013

2014

References
American Association of Clinical Endocrinologist. (2015). AACE Comprehensive Diabetes Management Algorithm. Retrieved

from https://www.aace.com/publications/algorithm
American Diabetes Association. (2015). Type 2. Retrieved from http://www.diabetes.org/diabetes-basics/type-2/?loc=dbslabnav
Centers for Disease Control and Prevention. (2015).National Diabetes Statistics Report, 2014. Retrieved from
http://www.cdc.gov/diabetes/pubs/statsreport14/national-diabetes-report- web.pdf
Center for Disease Control and Prevention. (2014). Diabetes Surveillance Data [Data file]. Retrieved from
http://www.cdc.gov/diabetes/atlas/countydata/atlas.html
Lobo, P. (2014). New diabetes screening recommendations in the USA. The
Lancet Diabetes & Endocrinology, 2(12), 934. doi:10.1016/s2213-8587(14)70182-2
McCarthy, M. (2014). Nearly one in 10 US residents has diabetes, CDC
reports. BMJ, 348(jun11 10), g3962-g3962. doi:10.1136/bmj.g3962
Sepah, S., Jiang, L., & Peters, A. (2014). Translating the diabetes prevention
program into an online social network: validation against CDC Standards. The Diabetes Educator, 40(4), 435-443.
doi:10.1177/0145721714531339
Texas State Department of Health. (2014). Diabetes Care [Data file]. Retrieved from
http://www.dshs.state.tx.us/diabetes/diabetescare.shtm
Walker, A. (2013, 02-10). Health Disparities in Baltimore. Baltimore Sun. Retrieved from
http://articles.baltimoresun.com/2013-02-10/health/bs-hs-enterprise-zones-follow-20130210_1_health-disparities-health-car
e-reform-health-enterprise-zone
United Stats Census Bureau. (2015). Quick Facts Data [Data file]. Retrieved from http://
quickfacts.census.gov/qfd/states/24/24510.html