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Diabetes: The Rise and Potential Fall of a Non-Communicable Disease

One major global health issue that many researchers link to improper diet and lack of exercise is diabetes. Diabetes is a non-communicable disease that affects approximately 9% of adults around the world (World Health Organization, 2015). In the U.S. alone, 20 million people are diagnosed with either Type 1 or Type 2 diabetes (though there is a third form -- gestational diabetes -- that can affect women during pregnancy) (National Diabetes Statistics Report, 2014). According to the International Diabetes Federation, in the entire world 387 million people are impacted by the disease, and over the next twenty years that number is expected to climb to nearly 600 million (IDF Key Findings, 2014). But what is diabetes and why is it so deadly?

Of the two main forms of diabetes mellitus (DM), Type 2 is by far the most common. Type 1 DM occurs when the body fails to produce adequate amounts of insulin. Type 2, on the other hand, occurs when cells fail to respond to insulin. This type sets in later in life, typically around middle age, though it can occur earlier. 90% of all diabetes cases are Type 2. The result in either case is characterized by high glucose levels (blood sugar) in the body. Insulin (a pancreatic hormone) is what normally regulates glucose levels. In effect, insulin reduces the level of blood glucose by assisting tissue in the absorption of that glucose, which it uses for energy. When a sugary substance is introduced into the body (for example, a milk shake, chocolate bar, or simply any kind of food), the pancreas releases insulin which acts to keep the blood's sugar content in check. However, when insulin is either not produced or ineffective in regulating the blood sugar levels, diabetes is the result: a metabolic disease that can do much damage to the body's organs and nervous system. This happens when the glucose produced by the liver as a result of consuming food is unable to be absorbed by tissues; the tissues naturally use the glucose for energy but if they cannot absorb it, they begin to break down fat and protein, which gathers along with the glucose in the blood, harming the body (What is Diabetes Mellitus, 2015)

A number of causes can affect the production of insulin in the pancreas, such as cancer, malnutrition or infection -- however, it is typically regarded by researchers that obesity is one of the main causes of the failure of tissues to react to insulin and absorb glucose (as exercise helps tissues to absorb blood sugar) (Davis, 2008).

Because of the belief among researchers that dietary and exercise issues are the root cause of Type 2 diabetes, and because so many people are affected by it, it stands to reason that diabetes is a non-communicable disease (NCD) that demands attention in both developed and developing countries -- and that with the proper attention, a positive resolution can be achieved that will stem the rising tide of this NCD.

Globally

Though obesity is a major problem in many developed countries like the United States, the issue of diabetes is not limited to American borders. Tabish (2007) states that diabetes "is approaching epidemic proportions globally" (p. 5). Part of the reason for this world-wide systemic shock to the earth's population's health can be found in the fact that the American consumerist culture has been exported to many societies that wish to follow in the footsteps of one of the most powerful industrialized forces on the planet. Industrialization has facilitated globalization and globalization has facilitated the spread of various modern customs and practices that in turn affect the lifestyles and habits of individuals. Lifestyle changes can lead to health issues, as can be seen across the globe (Tabish, 2007). In Jamaica, for instance, in just 35 years, diabetes rose tremendously in adults, following a transformation of the island's populace. Indeed, the latter half of the 20th century shows that "the majority of immigrants to Jamaica have come from Commonwealth countries," a fact which suggests that a change in social structure and environment is related to the change in the country's health (Glennie, Chappell, 2010). Following in the footsteps of the developed world comes with certain risks: obesity, improper dieting, and a lack of exercise are some of the effects, which can lead directly to diabetes. This much is evident in the developing nation of Jamaica.

In a Developing Country: Jamaica

Jamaica is still a developing country and here diabetes accounts for 11% of the nation's deaths, a percentage equal to that of several other NCDs combined. 24% of the population suffers from obesity, most significantly among Jamaican women, while males are found to consume far more alcohol (World Health Organization -- Non-Communicable Diseases Country Profiles, 2014). Moreover, since the 1960s, the rate of diabetes onset in Jamaican adults has risen dramatically from 1.3% to nearly 18% by 1995 (Ferguson, Tulloch-Reid, Wilks, 2010). This increase can be, moreover, directly linked to the arrival of "junk foods" in Jamaica following the increased manufacturing and importing of these products as well as the American fast food chains that have popped up ubiquitously around the world (Gilchrist, 2012).

Jamaica is an example of where a shift in cultural cues and social dynamic has affected the lifestyles of the nation's inhabitants. Essentially, the island has adopted Western habits and allowed itself to become a kind of outpost for fast food chain mentalities, corporations and unhealthy consumerism. This is most likely due to the fact that Jamaica has long been a resort destination for citizens of the developed world, who want both the exotic island experience of a place like Jamaica with the comforts of their home cuisine styles too.

So while diabetes is technically a non-communicable disease, it might be argued in one sense that diabetes can be communicated indirectly via social and economic changes in a nation's culture. Just as a sexually-transmitted disease is not communicated unless sexual contact is made, diabetes could be said to be a cultural disease that is not communicated from one nation to another unless there is cultural contact and the spread of the lifestyles and habits of the carrier country where diabetes is a problem to the host country where diabetes is not yet a problem occurs. This exchange can clearly be seen in Jamaica where prior to the 1960s, obesity and unhealthy dietary habits were not issues that were exacerbated by an influx of Americanized culture. Since then, however, Jamaica has adopted the economic and social habits of its Big Brother leader, America, and is thus at serious risk of developing the same diseases, namely, diabetes. If one considers diabetes in this sense, as an effect of a culture that is affected by luxury and excess, the outcome in terms of health is apparent: diabetes is the expression of one particular aspect of that outcome, which is, in short, poor health.

The study by Cunningham-Myrie et al. (2015) suggests that neighborhoods in Jamaica play a significant role in the rise of diabetes, which further supports the notion that while diabetes is an NCD, the social aspect of the disease is such that the lifestyle habits conditioned by neighborhoods in Jamaica are responsible for facilitating the risk factors that lead to diabetes. These factors include diet, (lack of) exercise, weight gain, and social acceptance or tolerance of habits that are detrimental to one's health. In Jamaica, these factors are prevalent (Cunningham-Myrie, 2015).

At the same time, researchers also note that "developing countries have few effective strategies to manage the prevention of diabetes," which indicates that while the rise of the disease has a social/lifestyle/dietary root, the lack of preventative measures by health associations and government agencies is also a contributing factor in so far as awareness and deterrence are concerned (Liu et al., 2013, p. 729).

How the Developed Country -- America -- is Handling the Disease

In the developed world, diabetes is virtually raging. Yet, various studies have been instrumental in showing that with the right lifestyle, diabetes can be prevented (Davis, 2008). One attempt by the Diabetes Wellness Program, an American-based non-profit organization, to curb the sort of diabetes skyrocketing and plaguing Jamaica has had successful results in another island community: the Marshall Islands (Davis, 2008). This program was designed to educate the Marshallese and implement a dietary program consistent with what the Islanders consumed prior to their exposure to modernized cultures, imported foods, and high glucose consumption. The dietary program consisted of "100% plant based" products, a minimal amount of sugars and starches, high fiber, low fat foods. The program also consisted of pro-active exercises in which the Islanders were "taught how to grow their own vegetables," a habit they had relinquished over the years due to their exposure to easy access to manufactured food items, which were in turn causing them to develop diabetes (Davis, 2008, p. 24). The result of the program was that the incidences… [END OF PREVIEW]

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