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Research Topic Type 1 Diabetes

by Sonia Donaires

Public Health Domains

Epidemiology (risk factors and distribution of disease in the population)

Biostatistics

Biomedical basis

Environmental factors

Social and Behavioral factors

Policy (what the government is doing and what it should do)

Epidemiology of Type 1 Diabetes (T1D)

T1D is one of the most common chronic diseases in children and adolescents affecting millions around the world.

Studies worldwide indicate that the incidence of T1D has been increasing by 2% to 5%

The prevalence of T1D in U.S. is 1.7 per 1000 in residents aged 0-19 years.

The risk factors for T1D might be genetic and environmental.

T1D is an active area of research that investigates the complex causes, clinical care, prevention, and cure of the diseases.

Biostatistics of T1D

The incidence of childhood T1D varies upon geography, age, gender, family history, and ethnicity.

Biomedical Basis of Type 1 Diabetes

T1D is an autoimmune disease characterized by the destruction of the B-cells of the islets of Langerhans in the pancreas.

In T1D the pancreatic B-cells lose the ability to produce insulin, resulting in high blood glucose levels and other complications in the body.

Insulin is a hormone the body needs to maintain proper blood sugar levels.

When the pancreas does not produce insulin hyperglycemia results. It means that the level of glucose in the blood is high.

Biomedical Basis of T1D

Biomedical Basis of T1D (Cont.)

T1D is not curable; there are ongoing projects to discover the cure and develop strategies to prevent it.

Treatment for T1D includes daily insulin injections, self-monitoring of blood glucose, prescribed meal plans, and regular exercise.

Symptoms of T1D

Environmental Factors of Type 1 Diabetes

T1D is a genetic disease not well understood; there are multiple hypothesis in regard to environmental risk factors, including:

prenatal influence

seasonal effects

viruses

genetic susceptibility to cow’s milk

early nutritional factors

deficiencies of vitamin D

Social and Behavioral Factors

The purpose of this domain is to develop theories of why people behave as they do and how they can be influenced to change their behavior.

The two psychological model of health behavior that are:

1. The Health Belief Model

2. The Ecological Model

Psychological problems arise when patients do not controlled their illness well and do not have family and peer support.

The Health Belief Model

This model has four stages:

- Perceived susceptibility- patients feel vulnerable to the threat of the disease: “My diabetes could be worse if I did nothing about it”.

- Perceived severity- patients experience the severity of the symptoms: “my diabetes causes me to be sick a lot”.

The Health Believe Model (cont.)

- Perceived barrier to taking action- patients acknowledge the importance of following treatment and doctor’s advice: “I would have to change many habits and respect my prescription even though it interferes with my normal daily activities”.

- Perceived benefits- patients perceived the effectiveness of taking action over their illness: “I believe I can control my diabetes and my medicine would make me feel better”.

The Ecological Model

This model has 5 stages:

- Intrapersonal Factors- T1D is a children’s disease that impacts the child’s live and the lives of those closest to him or her.

- Interpersonal Factors- T1D impacts their peers, teachers, administrators at the school or coworkers at the workplace.

- Institutional Factors- to help school personnel, the National Diabetes Education Program (NDEP) developed a guidebook.

Treatment and Control of T1D

The Ecological Model(cont.)

- Juvenal Diabetes Research Foundation (JDRF) works with researchers, industry, and authorities to ensure a positive impact on the lives of people with T1D now and in the future.

- Public Policy and parliamentarians regulate and limit research funding for the disease to ensure that regulations and limitations impact behaviors of people with T1D.

T1D and the Future

T1D is not curable; possible treatments as a future prospects could be:

Replacing Beta-cells by whole pancreas or islet cell transplantation.

New technologies will ensure to accelerate the investigations to find the cure and ways to prevent it.

Stem cell therapies (very controversial topic).

Genetic engineering in the form of gene therapy.

Xenotransplantation where cells are obtained from another species.

References

Atkinson, M. (2014) Future Prospects. Retrieved, August 17, 2014 from http://www.diapedia.org/type-1-diabetes-mellitus/future-prospects

Center for Disease and Control and Prevention. National Diabetes Statistics Report (2014). Retrieved August 17, 2014 from http://www.cdc.gov/diabetes/pubs/estimates14.htm

Noah Health Tips (2014) General Recommendations for Individual with Diabetes. Retrieves, August 17, 2014 fromhttp://www.noahhealth.org/general-recommendations-for-individuals-with-diabetes/#sal

Scientific American (2012). Diabetes Mystery: Why are Type 1 Cases Surging? Retrieved August 17, 2014 from http://www.scientificamerican.com/article/a-diabetes-cliffhanger/

Spark People (2013) Exercising Safely with Type 1 Diabetes. Retrieved August 17, 2014 from http://www.sparkpeople.com/resource/fitness_articles.asp?id=1497