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Diabetes in American Society

Everyone knows that American society is challenged by a variety of diseases. Some of them could be predicted, controlled, and treated, and some illnesses remain incurable because even the most advanced technologies are not effective and helpless. Diabetes is one of such public health concerns, with no particular cure. People should live with this disease, and researchers find it necessary to investigate this field, make contributions, and follow recent studies and events to clarify if there are any positive changes. To get prepared for diabetes, it is important to learn diabetes triggers, causes, complications, and other characteristics. Besides, one must know that low-income communities are under threat of having diabetes and suffer from its outcomes.

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In this presentation, an understanding of diabetes is one of the initial tasks. It is not only a chronic disease that is frequently observed among US citizens, as well as around the whole globe. Diabetes changes many lives and appears without warning in patients of different ages, races, and ethniticies. Its main characteristics include a high level of sugar (glucose) in the blood.

At this moment, about 30 million Americans are diagnosed with diabetes, and about 24% of diabetics are not diagnosed due to poor care management, the lack of resources, and poor awareness of its complications (Chow et al., 2018; Cohen et al., 2017). Sugar enters the bloodstream with food people take, the stomach makes insulin to control the amount of glucose. Diabetes is when the body lacks insulin, and glucose does not reach the cells, which causes health problems.

Topic Problem

There are many reasons why the prevalence of diabetes among low-income communities is chosen as a topic problem for this project. First, diabetes is one of the diseases with no specific cure to be offered to patients. Therefore, the healthcare system (including organizations and individuals), as well as the government, are involved in developing care plans and diagnostic tools. Second, patients are in need of treatment, health experts’ recommendations, and care management. However, not all American communities have equal access to effective treatment, and many people are not able to control this disease. Finally, self-management is an obligatory step for diabetic patients, and low-income communities are not always ready for it.

Low-Income Communities

Financial inequality remains a serious problem for many people worldwide. In the United States, there are many low-income communities due to a variety of reasons. These people are more likely to stay undiagnosed and unaware of diabetes threats, thus contributing to the development of complications and morbidity rates. When this disease is revealed in a low-income person, it is usually hard to manage it. The problems among the chosen group of people depend on such factors as the level of education, weak access to healthy food, and poor knowledge about diabetes.

Diabetes Triggers

Although it is impossible to cure diabetes, there is always an opportunity to predict it and maintain a healthy lifestyle. For example, much attention is paid to learning the triggers of this disease. Cohen et al. (2017) and Gittelson and Trude (2017) consider obesity (or excess weight) as one of the potential threats for people. As a result, it is recommended to manage dietary habits and control the quality of food. Similar concerns are developed around such triggers as the environment. Besides, if there is diabetes in a family, such a history is also a risk factor for the population. Finally, the presence of high blood pressure may be a cause of the pre-diabetic condition and the reason for regular assessments.

Food-Related Issues

The choice of food predicts the development of diabetes in low-income communities. To avoid obesity-related problems, people should use healthy food and deal with existing feeding barriers. Unfortunately, the representatives of underserved communities do not have access to the resources with healthy food (Gittelson & Trude, 2017). They are obliged to change their food shopping behaviors in relation to their geographical locations, abilities, and other financial and social factors (Cohen et al., 2017). In addition, in low-income communities, people suffer from poor quality of stores where they can buy food products. Therefore, researchers underline the importance of changing living conditions and the quality of food for poor people to predict diabetes.

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Drugs for Patients

The absence of a cure does not mean the absence of drugs that may be used by patients to control their health conditions. In their study, Chow et al. (2018) discuss the basic medications for diabetes. They include (Chow et al., 2018):

Metformin belongs to a group of biguanides, the goal of which is to control the level of sugar produced by the liver and decrease it to the normal limits.

Insulin is probably the most well-known drug people remember when they hear about diabetes because its purpose is to replace its lack in the body.

Sulfonylureas introduce one of the oldest group of medications to help patients and stimulate pancreas for more insulin production.

Sodiumglucose cotransporter-2 inhibitors are not always cheap, but their property is to remove glucose from the body.

Meglitinides belong to a group of drugs, the cost of which is prohibitive in some countries, but its ability to release insulin is unique.

Lack of Medications

Lack of Medications

The prevalence of diabetes among low-income populations can also be explained by the lack of medications for people. Multiple studies aim at investigating the availability of medications for populations, regardless of their social statuses or education levels (Chow et al., 2018). Unfortunately, financial affordability cannot be ignored, and physical, as well as social factors, must be determined. There is an extensive gap between accesses to medications in low- and high-income communities.

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Chow et al. (2018) share statistical data about the most evident differences: if 100% of high-income communities can allow metformin to control diabetes, only 64% of low-income families can afford the same drug. A more serious situation is observed with insulin: 93% for high-income people, and only 10% for low-income communities (Chow et al., 2018). Such a lack of medications turns out to be a critical public problem.

Risks for Pregnant Women

In low-income communities, pregnant women’s predisposition towards diabetes is another topic for discussion in this presentation. McGuire et al. (2015) identify several critical risk factors for the chosen group of people, including economic instability, poor knowledge about the disease, nutrition problems, and stresses. Poverty is a synonym for the unstable economic and financial situation in a family, and when a woman gets pregnant, a number of questions about how to protect the baby financially occur. In addition, women want to know as much as possible about diabetes but lack credible resources and professional support. Finally, nutritional and psychological problems determine women’s behaviors and contribute to diabetes. In general, these risks can be divided into three main groups: economic, psychological, and personal factors.

Economic Problems

One of the current problems many pregnant women face when they discover their pregnancy is the necessity to deal with economic challenges. Their social instability, temporary unemployment, the possible economic crisis in the country, and unexpected financial concerns influence the condition of a woman and changes in the organism. Thoughts about the required baby products and food show that they may become unable to allow regular examinations and a chance to diagnose the disease at its early stage (Yee et al., 2015). As a result, these problems lead to difficulties in buying medications and controlling the development of the disease during pregnancy.

Psychological Factors

When a woman is expecting a baby, she has to be ready for a number of changes in her behavior and mood. However, in the majority of cases, it is impossible to get prepared for this condition. In addition, such women face increased responsibilities in their families and in society. It is expected that pregnant women take care of their health and avoid unfavorable environments. However, in low-income communities, the quality of life and working conditions do not usually meet all the health standards. Therefore, the necessity to follow healthy eating plans and finding a balance between preferences and recommendations provoke new stresses, which contribute to diabetes in some way (Yee et al., 2015). To find help, women address different sources but find insufficient motivation because of differences between their financial opportunities.

Personal Concerns

The burden of diabetes management among pregnant women may take different forms. However, female self-efficacy is harmed due to a variety of questions that occur in the woman’s head. For example, there is the fear of the unknown and the necessity to know as much as possible about possible diseases and potential threats (Yee et al., 2015). Self-management is an obligation to take care of everything, but pregnant women face barriers to be properly motivated and accommodated. Food habits provoke body changes and poor control of glucose in the body. Diabetes can easily progress due to female personal concerns and illogical thoughts. Finally, diabetes management requires control, but pregnancy is a period where the characteristics of control are underestimated.

Effects of Interventions

The prevalence of diabetes in low-income communities contributes to the creation of new areas of interest for researchers. The analysis of interventions that can be available to all people is developed, proving that professional help is necessary. Berg et al. (2016) and Nelson et al. (2017) focus on support programs to relieve diabetes burden. Mayberry et al. (2016) introduce the worth of mHealth applications for disadvantaged adults in the form of FAMs (phone coaching to support self-care). Nelson et al. (2017) investigate the quality of help offered by community health workers (CHWs). The enhancement of self-rated health is observed if people with low incomes choose at least one of the interventions, cooperate with health experts, and report about their problems.

Communication & Cooperation

Treatment and disease management are usually characterized by increased cooperation between doctors, patients, and their families. Mayberry et al. (2016) underline the importance of communication for diabetic patients due to several reasons. First, talks about diabetes serve as a positive factor in understanding the burden. Second, doctors improve patients’ knowledge about the disease and its risks. Finally, it is always possible for patients to learn and identify diabetes symptoms and choose a treatment plan. At the same time, cooperation between patients and doctors is effective in diabetes treatment because professional support is offered, complications are controlled and prevented, and interventions are introduced and analyzed.


Taking into consideration the information from the studies, diabetes remains a serious problem for the global population, but people are able to recognize this threat. Low-income communities are at risk of having this disease, but they learn what they can do to predict its development. People cooperate with doctors and other healthcare employees to improve their knowledge and manage diabetes on their terms. There are many interventions to relieve diabetes burden, and families with low incomes could have access to some of them. It is always possible for all people to control their health and manage diabetes.

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Despite the intention to help patients with diabetes, there are many obstacles and barriers to low-income communities that must be solved. Weight-related risks due to the lack of healthy food access increase people’s chances of becoming diabetic. Financial problems reduce their opportunities to buy necessary medications and manage diabetes in the most appropriate way. Finally, even if doctors and professional organizations are involved in the discussion of diabetes interventions, people from low-income communities are not always interested in improving their knowledge about disease management due to the existence of other social, personal, or economic problems.


In general, diabetes is one of the most complex and unpredictable diseases. Its prevalence among low-income communities continues growing and challenge millions of people around the globe. In this presentation, special attention was paid to several issues, including the essence of the disease, its triggers, and problems poor people face when they are diagnosed with diabetes. Many interventions are developed to manage diabetes at different levels, and families with low incomes should use their chance. They may improve their awareness of diabetes, predict complications, and manage their health independently. At the same time, such risks as the lack of motivation, money, or knowledge cannot be neglected in today’s world.


Chow, C. K., Ramasundarahettige, C., Hu, W., AlHabib, K. F., Avezum, A., Cheng, X., Chifamba, J., Dagenais, G., Dans, A. Egbujie, B. A., Gupta, R., Iqbal, R., Ismail, N., Keskinler, M. V., Khatib, R., Kruger, L., Kumar, R., Lanas, F., Lear, S…. Yusuf, S. (2018). Availability and affordability of essential medicines for diabetes across high-income, middle-income, and low-income countries: A prospective epidemiological study. The Lancet Diabetes & Endocrinology, 6(10), 798-808. Web.

Cohen, A. J., Richardson, C. R., Heisler, M., Sen, A., Murphy, E. C., Hesterman, O. B., Davis, M. M., & Zick, S. M. (2017). Increasing use of a healthy food incentive: A waiting room intervention among low-income patients. American Journal of Preventive Medicine, 52(2), 154–162. Web.

Gittelsohn, J., & Trude, A. (2017). Diabetes and obesity prevention: Changing the food environment in low-income settings. Nutrition Reviews, 75(Suppl. 1), 62–69. Web.

Mayberry, L. S., Berg, C. A., Harper, K. J., & Osborn, C. Y. (2016). The design, usability, and feasibility of a family-focused diabetes self-care support mHealth intervention for diverse, low-income adults with type 2 diabetes. Journal of Diabetes Research, 2016, 1–13. Web.

Nelson, K., Taylor, L., Silverman, J., Kiefer, M., Hebert, P., Lessler, D., & Krieger, J. (2017). Randomized controlled trial of a community health worker self-management support intervention among low-income adults with diabetes, Seattle, Washington, 2010–2014. Preventing Chronic Disease, 14. Web.

Yee, L. M., McGuire, J. M., Taylor, S. M., Niznik, C. M., & Simon, M. A. (2015). “I was tired of all the sticking and poking”: Identifying barriers to diabetes self-care among low-income pregnant women. Journal of Health Care for the Poor and Underserved, 26(3), 926–940. Web.

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