Type 2 Diabetes In Children

Level 1 Research Questions/Writing Prompts
ETHICAL Perspective of Inquiry
What laws govern or pertain to the issue?
What ethical obstacles affect how the medical community addresses the issue?
How do ethical theories apply to the issue?
How do money, power, and control matters relate to the issue and its treatment?
Level 1 Research Questions/Writing Prompts
CULTURAL Perspective of Inquiry
Which cultural values and/or norms influence the issue?
How is the issue addressed differently in varying cultural contexts and situations?
Which cultures or societies are most affected by the issue? Why?
Which cultural traditions affect the treatment(s)?
Your paper must be five pages in length and reference four to six scholarly, peer-reviewed resources. Be sure to follow current APA Style (e.g., spacing, font, headers, titles, abstracts, page numbering).

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Type 2 Diabetes in children and adolescents is an emerging epidemic within the last 20 years. Diabetes is one of the most common chronic diseases in children and adolescents; about 151,000 people below the age of 20 years have diabetes (CDC, 2009). There has been an increase in the amount of younger people, including teenagers that have been diagnosed with type 2 diabetes. According to the CDC website, type 2 diabetes in children and adolescents, although still rare, is being diagnosed more frequently, particularly in American Indians, African Americans, and Latino Americans. Type 2 diabetes is rising in American kids, especially African Americans, Latinos, and Native Americans. Type 2 Diabetes In Children And Young Adults Essay
American Indian populations; 2.3 per 1000 for Canadian First Nation people from Manitoba. The prevalence of diagnosed diabetes in people younger than 20 years of age in the U.S. for 2007 was approximately 186,300 people younger than 20 years have diabetes (type 1 or type 2). This represents 0.2 percent of all people in this age. Type 2 diabetes is still rare in children younger than 10 years old but still does occur in this age group. The most important intervention that nurses can do is to teach parents and children the importance of diet and exercise since studies have shown that being overweight and sedentary lifestyles are linked to the early onset of type 2 diabetes. There are many new programs being advertised for encouragement of exercise and an active lifestyle, such as the NFL movement for an active generation.

Obesity is a condition characterized by body mass index above 30. Diabetes on the other hand refers to elevated blood glucose levels above the normal range. The four common bioethical principals applicable to treatment of other health conditions also apply to obesity and diabetes.
The principle of beneficence requires care givers to consider benefits of a given treatment and risks involved in decision making. Non-maleficence on the other hand refers to avoidance of harm. The two principles are applied together in treatments. Care delivery to children with diabetes and obesity should observe the two principles. Autonomy is also a bioethical principle. In means respecting rights of patients to make decisions. During interventions on obesity and diabetes in children, beneficence and non-maleficence may violate autonomy. This is only recommended if the patient’s decision violates the policies of beneficence and non-maleficence. Children should be consulted on their treatment preferences only if none of the preferences can affect beneficence and non-maleficence.Type 2 Diabetes In Children And Young Adults Essay
Another principle that equally applies to children with obesity is justice. The principle requires that there should be equality and fairness in treatment of patients with different conditions. Policies addressing children with diabetes and obesity should ensure equity and fairness in all dimensions.
This paper focuses on children with obesity and diabetes living in Florida. Children in Florida make up a significant proportion of the state population. According to the 2010 census, population of persons under the age of eighteen years was 4,002,091. 2012 population estimates reveal that population of children living in Florida aged below five years was 5.5% of the total population of the state. On the other hand, population of persons under the age of eighteen years living in the same state was 20.7%. Nationally, the population of children aged below five years was found to be 6.4% according to the estimates. In 2011, there were 1.9 billion children globally. Florida is ranked at position nine based on percentage population growth of children from the year 2000 to 2010. Table 1 shows percentage population growth of children between 2000 to the year 2010.
Obesity is one of the most serious health concerns affecting children in Florida as well as the entire United States. One study found that Children are the fastest growing demographic among the overweight population in the United States (Janssen et al., 2004). According to Baskin, Ard, Franklin, and Allison (2005), data collected from 1999 to 2002 estimates that one in every six children living in the United States is overweight. According to another study by Ogden, MD Carroll, Kit, and Flegal (2012), between the years 2009 to 2010, 16.9% of children and adolescents aged between 2 to 19 years were obese. In Florida, it is estimated that 553,000 out of 1,702,000 children aged between10-17 years are obese as assessed through BMI-for-age standards (Edwards, 2009). This represents a percentage of 32.5%. Children with obesity tend to develop more chronic health complications that their healthy counterparts. A study by Hlaing, Messiah, Lipshultz, and Ludwig (2011) suggests that children who are obese stay longer in hospitals.
Diabetes type 2 is another health problem that affects many children in Florida. It is also a serious health concern in the entire US. According research by CDC (2010), diabetes affects nearly 25.8 million people in the US (CDC, 2010). This represents 8.3% of the entire US population. Of this population, type 2 diabetes accounts for 90-95%. It is the sixth leading cause of death in the US (CDC, 2010). Even though children are less affected than adults, children with obesity are at risk of developing the diabetes given that obesity is one of the risk factors to diabetes type 2. Furthermore, prevalence of diabetes in children has increased over the last few years. In Florida, diabetes hospitalization for children aged between 5-11 years increased consistently from 2009 to 2011.Type 2 Diabetes In Children And Young Adults Essay
Over the last sixty years, several policies on social welfare have been set up in the US. These policies have shown various impacts on children especially those with obesity and type 2 diabetes living in Florida as well as those living in other states. One such policy is Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA), which was introduced in 1996. It made significant adjustments to the welfare system of the United States. This law was designed to serve three main purposes: to move adults permanently into the workforce, to give states more flexibility in drawing programs on public-assistance, and to support stability of families.
The introduction of PRWORA led to replacement of certain federal welfare programs that had been in place with new programs. For instance, Aid to Families with Dependent Children (AFDC) was eliminated and Temporary Assistance for Needy Families (TANF) created in its place. TANF seeks to empower states to be able to provide cash assistance to families. In this case, block grants are given to states to aid in this function. Rules of TANF seek to move more low-income adults into work force. Since its inception, PRWORA has shown various impacts on children welfare. Children with obesity and diabetes have also been affected in all states including Florida. Let us consider some of the impacts of this policy on children with obesity and diabetes.
Since its inception, PRWORA has led to a remarkable increase in the population of women with young children participating in labor force. For instance, the number of employed mothers aged below 18 years with young children increased from forty-seven percent to seventy-one percent between 1975 and 2008 (U.S. Department of Labor, Bureau of Labor Statistics, 2009). The rates of increase in childhood obesity over the last four decades coincide with increased rates of labor force participation of women with young children over the same period (Hoffman & Averett, 2005; U.S. Census Bureau, 2009). This shows that maternal labor force participation influences prevalence of obesity among children.
Mothers who spend adequate time with their children exercise maximum care to them. They prepare the children’s meals as well as those of the family, feed the children, and control their dietary behaviors. In other words, they allocate adequate time to domestic tasks. However, there has been significant decrease in time allocated to domestic tasks by women in the last recent decades. This has partly contributed to rise in prevalence of child obesity.Type 2 Diabetes In Children And Young Adults Essay
PRWORA has also led to many children taking most of their meals from schools. This implies that the children’s nutritional status would depend on the environment of the schools. Ceratin schools sell high calorie foods that predispose the children to obesity. Meals given at child care centers too may also predispose them to obesity.
Rise in child obesity rates has also caused increase in prevalence of diabetes type 2. Pathophysiology of type 2 diabetes links accumulation of triglycerides in the body with reduction of insulin sensitivity of muscle cells. This leads to insulin resistance which eventually causes uncontrolled fluctuations in blood glucose levels. Several children with obesity have developed diabetes type 2 since the inception of this policy.
Some studies report certain positive impacts of PRWORA on children. For instance, one study found out that children performing poorly improve in learning and show greater readiness to school when paced in childcare centers than their counterparts in home-based care (Fuller et al., 2002).
Nursing organizations have played vital roles in advocating for children with diabetes and obesity throughout the United States. Children in Florida have also benefited from efforts of these organizations. These organizations have made their contributions mainly through; educating, advocating, and partnering. In terms of educating, nurses have been given responsibility to educate parents, community members, families, and children about effects of obesity. School nurses also strife to induce culture of health through designing of requirement that teachers should be nutritional role models.
In a bid to advocate for children with obesity and type 2 diabetes, various nursing organizations have used approaches such as supporting such policy recommendations as; funding for wellness programs in schools, setting of federal standards on nutrition, and provision of recreational facilities in underserved areas. Partnering is also another approach that has been explored by various nursing organizations. For instance, American Nurses Association (ANA) has partnered with the White House in promoting an initiative branded “Let’s move”
Full implementation of Affordable Care Act (ACA) will benefit children with obesity and diabetes in Florida and other States. The proposals of the policy seek to address some of the most serious concerns pertaining to children’s welfare.Type 2 Diabetes In Children And Young Adults Essay
First, ACA seeks to expand coverage so that many uninsured patients can benefit. This will definitely help reduce the population of the uninsured by the end of the implementation period. In this sense, children with obesity and diabetes will benefit. Critics have argued that affordability of subsidized coverage in the new insurance exchanges may still make it difficult for many eligible children to benefit. However, if the policy funding is maintained throughout the implementation period, this concern may be addressed.
Secondly, under the policy, both federal and state governments are seeking to enroll many newly eligible individuals. Most of these targeted individuals are adults. This will improve healthcare systems available to parents and also improve their access to healthcare services. This will in turn impact positively on children since improved health of their parents’ bears psychological and emotional effects on them. Children with poor dietary behaviors may benefit as well since their parents act as nutritional role models. Parents will help improve conditions of children with obesity in this sense. In addition, parents will be able to seek more advice pertaining to management of diabetes under this policy.
Thirdly, flexibility of State in design and administration will help keep coverage of children strong. The policy accords States some level of flexibility that will allow them to tailor programs on the basis of their culture, finances, systems of healthcare delivery, and populations. This will ensure that coverage approaches are relevant and sustainable. Children who are genetically predisposed to diabetes for instance may be given more attention. For instance, states that are inhabited by many blacks, who are more predisposed to type 2 diabetes, may tailor implementation of the policy to cater for needs of this population.
Affordable Care Act also requires most insurers to deal with obesity. However, plans on how to do this is upon the insurers themselves. For instance, some insurers may decide to offer counseling services to their patients through telephone. Furthermore, the act requires that screening and counseling for obesity should be covered without patient cost-sharing. These provisions will definitely benefit children with obesity and diabetes.Type 2 Diabetes In Children And Young Adults Essay
Even though much effort has been made to address various healthcare concerns of children with obesity and diabetes type 2 through designing various policies, certain concerns still remain unaddressed. There are majorly three concerns: accessibility, quality, and cost. ACA mainly seeks to address the aspect of accessibility. However, quality still remains the main concern. Medicare patients in particular need to receive quality services just like the rest. However, this has not been addressed. Children in Florida and especially those with chronic illness such as diabetes are the main beneficiaries of ACA. Therefore, such challenges as low quality health being offered to them should be addressed.
Another serious concern is the need to move children from care centers into family homes where they can enjoy family intimacy. Emotional aspects can aggravate condition of children with obesity and diabetes. Many children in the daycare centers lack family love. Adoption can also aid in introducing these children into families so that they can also experience family life and get good parenting. Many policies encourage moving children away from families instead.
Ileana Ros-Lehtinen is currently serving as a US congress representative for Florida. She has served in the congress since 1989. During her tenure, Ros-Lehtinen has voted for and against many bills. For instance, she has supported gay rights despite being a republican. She also sponsored the Every Child Deserves a Family Act which sought to promote adoption of children in the foster care.

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Congress representatives play big roles in supporting various policies and laws governing states as well the federal government. They can also sponsor various bills concerning welfare of residents of the states they represent. It therefore follows that .Ileana Ros-Lehtinen has high capability of advocating for children with obesity and diabetes in Florida. Her support to policy recommendations that concern this population is very crucial hence she is an important personality for children with diabetes and obesity.Type 2 Diabetes In Children And Young Adults Essay

In our society today, the number of people that are diagnosed with diabetes is increasing. Diabetes is caused by many factors like genetics, inactivity, and obesity. With obesity on the rise in our country, so is diabetes especially in young children. With the fattening and unhealthy foods provided by fast food chains and grocery stores, children are the ones that diabetes is affecting the most, by causing them to have higher chances of being diagnosed with diabetes. According to Kim and Lee (2008), the rates of childhood obesity have tripled over the past three decades. Childhood obesity is becoming a problem for many youth in our society, with more youth being overweight and inactive increases the chances for them to be diagnosed with diabetes. The community needs to become active about this topic by having more activities open to the youth in the areas. This would include workshops and sport programs for the youth being available in the community. Hopefully, the North Carolina School Diabetes Act will educate children so that they will learn to make good quality health decision when they are younger and to give them a better chance of not being diagnosed with diabetes.

Point blank, diabetes is a serious disease and causes major effects on people’s daily lives. In a society where food comes in such abundance, people are overeating. Compared to the beginning of the twenty first century when only about five percent of the population had diabetes (Nazarko, 2009), today that number is rising and continuing to do so. This is starting to affect the health of children by being diagnosed with diabetes at a young age.Type 2 Diabetes In Children And Young Adults Essay

Diabetes is a health condition that is developed when sugar level in the blood increases above normal levels. The two major types of diabetes are type 1 diabetes and type 2 diabetes. Type 2 diabetes is more prevalent than type 1 diabetes. This essay discusses some of the most frequently asked questions about type 2 diabetes through a sample dialogue between a patient and a doctor.

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Patient: What is type 2 Diabetes and how is it developed?
Doctor: Type 2 diabetes can be described as a complication in the metabolic processes characterized by a relative shortage of insulin and high levels of glucose in the blood (Barnett, 2011). It differs from type 1 diabetes where there is a complete deficiency of insulin caused by destruction of pancreatic islet cells.

In addition, type 2 diabetes is more common in adults unlike type 1 diabetes which is prevalent amongst young people. The typical symptoms of type 2 diabetes include: recurrent urination, excessive thirst, and persistent hunger (Wilson &Mehra, 1997).Type 2 Diabetes In Children And Young Adults Essay

Type 2 diabetes is caused by a mixture of lifestyle and hereditary factors. Even though some factors, like nutrition and obesity, are under individual control, others like femininity, old age, and genetics are not. Sedentary lifestyle, poor nutrition and stress are the major causes of Type 2 diabetes.

Particularly, excessive consumption of sugar and fats increases the risk of infection. Genetic factors have been linked to this condition. For instance, research indicates that if one identical twin is infected, there is a 90% probability of the other twin getting infected. Nutritional condition of a mother for the period of fetal growth can as well lead to this condition. Inadequate sleep is associated with Type 2 diabetes since it affects the process of metabolism (Hawley & Zierath, 2008).

Patient: How is type 2 Diabetes transmitted?
Doctor: Type 2 diabetes cannot be transmitted from one individual to another, since it is not caused by micro-organisms that can be spread. Instead, it is a health condition where the body is unable to create sufficient insulin to maintain the blood sugar level.

Nevertheless, a child from diabetic parents is likely to develop the complication due to genetic inheritance. According to Hanas & Fox (2007), there are some genes that may result in diabetes. As in 2011, research showed that there are more than thirty-six genes that increase the risk of type 2 diabetes infection.Type 2 Diabetes In Children And Young Adults Essay

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These genes represent 10 per cent of the entire hereditary component of the complication. For instance, a gene referred to as TCF7L2 allele, increases the probability of diabetes occurrence by 1.5 times. It is the greatest threat amongst the genetic invariants. Children from diabetic parents are, therefore, likely to get infected since genes are transferrable from parents to the offspring.

Patient: How is type 2 Diabetes treated?
Doctor: The first step in the treatment of type 2 diabetes is consumption of healthy diet. This involves avoiding excessive consumption of foods that contain sugar and fats as they are likely to increase the levels of sugar in the blood. In addition, getting involved in physical activity and losing excessive weight are also important.

These management practices are recommended because they lower insulin resistance and improve the body cells’ response to insulin. Eating healthy food and physical activity also lower the level of sugar in the blood. There are also pills and other medications that can be injected when these lifestyle changes do not regulate the blood sugar (Roper, 2006).Type 2 Diabetes In Children And Young Adults Essay

Type2 diabetes pills function in different ways. Some pills work by lowering insulin resistance while some raise the level of insulin in the blood or decrease the rate of food digestion. Even though the non-insulin injected medicines for this condition work in complex ways, essentially, they lower the levels of blood glucose after injection.

Insulin injection treatment basically raises the insulin level in the blood. Another treatment for type 2 diabetes is weight loss surgery that is recommended for obese people. This treatment has been proved effective since most of the patients can maintain regular levels of sugar in their blood after surgery (Codario, 2011).

Multiple prescriptions can be applied in controlling the levels of blood sugar. Actually, combination treatment is a popular remedy for Type 2 diabetes. If a single therapy is not sufficient, a health care provider may prescribe two or more different kinds of pills.

For instance, individuals with type 2 diabetes have high fat levels in the blood and high blood pressure. Therefore, doctors can prescribe medicines for treatment of these conditions at the same time. The kind of medication prescribed depends on the health condition of the patient (Ganz, 2005).

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Patient: What are the chances of survival?
Doctor: Diabetes is one of the major causes of deaths in the United States each year. Statistics indicates that it contributes to approximately 100,000 deaths every year. In the United States, there are over 20 million reported cases of diabetes, the majority being Type 2 diabetes. Proper remedy including change of lifestyle and medications is known to improve the health condition of a patient. If properly used together, lifestyle changes and medication can increase the chances of survival of a patient by up to 85 per cent (Rosenthal, 2009). Type 2 Diabetes In Children And Young Adults Essay

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