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Tutorial Overview

• TAKE HOME MESSAGES
• COMMUNITY
  • Community Empowerment
  • What is community?
  • Community Coalitions
  • Diabetes Burden in Your Community
• DIABETES
  • Key Terms
  • Risk Factors for Diabetes
  • Diabetes Complications
  • Costs
  • Prevalence
  • The Good News
  • In Your Community
  • The Public Health Approach
• SUMMARY
• QUICK CHECK
• REFERENCES

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TAKE HOME MESSAGES

After completing this tutorial, you will be familiar with:

• The role of community coalitions
• Key terms related to diabetes
• The burden of diabetes in the United States
• Modifiable and non-modifiable risk factors for diabetes
• The public health approach

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COMMUNITY

Community Empowerment

By knowing the culture and the challenges faced by a specific population, each community can most effectively address their needs from within.

Members of a community are best equipped to meet the needs of people within that community.

What is community?

A group of people with diverse characteristics who are linked by social ties, share common perspectives, and engage in joint action in geographical or virtual locations or settings.

Communities:

• Set norms for their population
• Have the potential to influence the health behavior of individuals
• Provide opportunities for building supportive environments
• Provide opportunities for collaboration

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COMMUNITY cont'd

Community Coalitions

A coalition is an organized group of individuals representing diverse organizations, factions or constituencies who agree to work together in order to achieve a common goal.

Coalitions form in response to an opportunity such as new funding, a threat to the health of community members, or other defined issues or problems. 

Coalitions also form when local organizations come together to augment limited resources – staff, time, talent, equipment, supplies – and influence in order to solve problems

Diabetes Burden in Your Community

Prior to building your community coalition, it is critical that you have a good grasp of the diabetes burden nationally, and in your specific community.

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DIABETES

Key Terms

Here are some key diabetes terms that you might find useful:

• Diabetes- A condition marked by an excessively high level of glucose in the blood stream
• Glucose- Food is broken down into glucose which the body’s cells use for energy
• Insulin- A hormone that is released by beta cells in the pancreas. Insulin is needed to "unlock" cells so that glucose can get into them and be converted into energy
• Insulin resistance- A condition in which there is either not enough insulin, or the body does not use available insulin properly
• Prediabetes- A condition where blood glucose levels are higher than normal but not high enough to be considered type 2 diabetes. Also referred to as Impaired Glucose Tolerance (IGT) or Impaired Fasting Glucose (IFG)

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DIABETES cont'd.

Key Terms cont'd

• Type 1 Diabetes (5-10% of all cases)
  • The body’s immune system destroys beta cells so that the pancreas cannot produce insulin (no insulin produced)
  • Possible causes include autoimmune, genetic, environmental – at this time not preventable
• Type 2 Diabetes (90-95% of all cases)
  • The body does not produce enough insulin or does not use it properly (insulin resistance)
  • Highly associated with obesity and lifestyle; in many cases may be prevented or delayed through lifestyle change
• Gestational Diabetes
  • Develops during pregnancy
  • Generally goes away after birth of baby
  • Increases mother’s risk for type 2 diabetes

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DIABETES cont'd.

Risk Factors for Diabetes

Risk factors are conditions that increase the likelihood that an event or disease will occur. 

There are two types of risk factors for type 2 diabetes: modifiable and non-modifiable.

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DIABETES cont'd.

Diabetes Complications

The following is a list of complications that can occur as a result of having diabetes.

• Heart disease and stroke
• High blood pressure
• Blindness or impaired vision (retinopathy)
• Kidney disease (nephropathy)
• Nerve disease (neuropathy)
• Amputations
• Dental disease
• Complications of pregnancy
• Depression

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DIABETES cont'd.

Costs

Diabetes creates significant economic and social costs. Check out these and other statistics from CDC ( 2011 )

National costs estimate for diabetes in 2007 over $174 billion

Over $200 billion when factored in costs associated with undiagnosed diabetes, prediabetes, and gestational diabetes

Individual medical expenses for someone with diabetes: approximately $12,000 a year

• That’s more than 2 times higher than someone without diabetes

Prevalence

Nearly 26 million people in the United States have diabetes (2011)

• 11.3 % of the U.S. adult population

More than 7 million (1 out of 4) people with diabetes do not know they have the disease

Approximately 1.9 million cases of diabetes were diagnosed in 2010 (age 20+)

CDC projects 1 in 3 adults in the U.S. could have diabetes by 2050 if current trends continue.

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DIABETES cont'd.

The Good News

There is good news…

People are living longer than they used to with diabetes.

Doctors are diagnosing the condition earlier.

Studies have shown that it is possible to prevent or at least delay diabetes in high-risk individuals (Diabetes Prevention Program).

In Your Community

Ask yourself:

• What are risk factors for me and my family?
• What are risks factors in my community?

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DIABETES cont'd.

The Public Health Approach

The public health approach is an evidence-based way of addressing a problem in a community by focusing on the population level, rather than an individual level. It is easy for your coalition to be side tracked by strategies that are more appealing or pertain to a personal experience or preferred audience.  The public health approach asks you to use data to drive your decision making and to consider the larger impact.

The steps in the public health approach are:

• Identify the problem through surveillance data
• Identify risk factors associated with the problem
• Develop and test a community-level intervention to control or prevent the problem
• Implement the research-based intervention
• Monitor the intervention’s progress

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SUMMARY

Diabetes creates a huge social and economic burden in the United States.  Diabetes is associated with a number of modifiable and non-modifiable risk factors, and a myriad of complications.  The public health approach is an evidence-based method to help your coalition address the problem of diabetes in your community.  Addressing risk factors for diabetes can help prevent the disease, but first you need data about your community. 

The next tutorial, Using Data in Planning, will provide you with information on how to find data that will help you understand the burden of diabetes in your community.  You will learn about national and local data sources, and be asked to go on your own community DATA QUEST to better understand the diabetes burden in your community.

But first, a Quick Check…

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QUICK CHECK

Now, let’s check your understanding of the material just covered. Read each question, select the best answer choice.

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REFERENCES

Adapted from:

• Blais, LM (2006). Community Volunteer Leaders: Who are they? What do they look like? How do you engage them?. American Cancer Society Training, Pennsylvania.
• Caldwell, GG (2006).  Introduction to the Public Health Approach.  Accessed on August 8, 2011 at chfs.ky.gov/NR/rdonlyres/C506EA79.../GCCThePHApproach121306.ppt
• Frieden, TR (2010).  A framework for public health action:  The health impact pyramid.  American Journal of Public Health, 100: 590-595.
• Institute of Medicine (2001).  Health and Behavior: The Interplay of Biological, Behavioral, and Societal Influences.  Accessed on August 8, 2011 at http://www.nap.edu/catalog/9838.html
• Wallack, L., Dorfman,L., Jernigan, D. and Themba, M. (1993) Media advocacy and public health: Power for prevention. Newbury Park, CA: Sage.

Well done!

You have completed Tutorial 1: Assessing Diabetes Burden.  Click on Tutorial 2: Using Data in Planning on the left menu to go on to the next tutorial.