Module 7050SOH Assessment Brief and Guidance

1. Introduction

Type-2 diabetes is one of the most common diseases in the world even though it has been observed that the cases of type-2 diabetes are also increasing in China. In this essay, the globalization factors and the role of health agencies to prevent the cases of type-2 diabetes in China will be discussed in detail.

2. Identifying and describing FOUR globalization factors to clarify the impact of factors on global emergence and prevalence of type-2 diabetes

It may be opined that type-2 diabetes is extremely common in China even though it has been observed that cases of type-2 diabetes are increasing significantly in that country. On a broader note, it may be implied that type-2 diabetes is one of the leading health issues of China while the government is extremely concerned to fight against diabetes. Moreover, it may be mentioned that 318 million adults in China have a major risk of developing type-2 diabetes in the upcoming days, however, China has recorded the most number of type-2 diabetes cases and ranked one (Hu and Jia, 2018). In type-2 diabetes, a human body is not able to produce enough insulin or resist insulin which affects the blood sugar level of a human. Considering the case study, it may be defined that more than 30 years ago the total cases of type-2 diabetes was near about 1% while it has been increasing rapidly and currently 11% of Chinese adults are suffering from type-2 diabetes. Moreover, it may be argued that the effects of modernization and the impact of western lifestyle are the prime factors that influence the development of type 2 diabetes although China has the highest number of diabetic people in the world (Diabetes. 2021). Considering the case study, it has been found that overweight, lack of exercise, excessive smoking and genetic history of Chinese people are the main reasons for increasing type-2 diabetes in the country.

Overweight

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It may be derived that obesity is one of the main factors which influence the development of type-2 diabetes in the human body even though it has been mentioned that major Chinese people have suffered from obesity which helps to develop type-2 diabetes in China. On the contrary, it may be implied that high Body Mass Index (BMI) has a positive relationship with the increasing cases of type-2 diabetes in China which resisted the flow of insulin in the human body (Zhao et al., 2017). Furthermore, it may be derived that the cases of obesity are also rising significantly in China as well as it has been observed that a major population of Chains is suffering from obesity which influences the development of type-2 disabilities in the body of obsessed people. Considering the case study, it may be derived that the Chinese people are getting richer these days while the consumption of fast foods and soft drinks is increasing.

Along with that, the soft drink consists of high amounts of sugar which is the main factor for increasing obesity and type-2 diabetes in the country. In addition to that, more than 10.9% of Chinese adults are suffering from type-2 diabetes even though diabetes is the 8th main reason for permanent disability and death cases in China since 2017 (Fan et al., 2017). Moreover, it may be defined that the number of obsessed people is increasing day by day in China while waist circumference is directly related and increases the risk of type-2 diabetes in that country. Additionally, it may be implied that Beijing is the most obsessed city in China while it has been observed that China has recorded more than 20% obesity and 59% abdominal obesity which influences the major spread of type-2 diabetes (Hemmingsson, 2021).

Module 7050SOH Assessment Brief and Guidance

Figure 1: Changes in BMI and waist circumference in China

(Source: Hemmingsson, 2021)

Lack of exercise

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It may be implied that due to the effect of modernization and we4teb culture the people of China have consumed lots of prepared food which increases the case of type-2 diabetes in that country. On a broader note, it may be stated that regular exercise is extremely important to prevent type-2 diabetes although it has been observed that the trends of regular exercise are decreasing day by day which influences the prevalence of type-2 diabetes in that country. Moreover, it may be noted that regular exercise is extremely essential as well as it helps to increase the metabolism in the body which cuts down the extra fat from the human body. In addition, lack of exercise is extremely dangerous and influences the widespread of type-2 diabetes in China even though increasing weight or obesity is one of the main reasons for type-2 diabetes.

Considering the WHO report, it may be derived that type-2 diabetes is extremely common in China while excessive obesity and physical inactivity is the main factor for type-2 diabetes (Who.int. 2021). Furthermore, it may be mentioned that in 1980 the case of type-2 diabetes in China was 5% while currently, 10% of people in China suffer from type-2 diabetes and the numbers of cases may significantly increase by 2040 (Who.int. 2021). Additionally, it may be defined that due to lack of exercise or physical inactivity the rate of obesity is increasing day by day in China while one-third of Chinese adults are overweight and 7% of the Chinese population is obese (Who.int. 2021). Additionally, it may be stated that the rural population of the country is more physically active than the urban population while the number of most type-2 diabetes cases have been found in urban areas of China.

Excessive smoking

It may be derived that excessive smoking is one of the prime factors for the wider spread of type-2 diabetes in China even though it has been mentioned that the number of excessive smoking is increasing day by day in that country. On the contrary, it may be defined that excessive smoking may increase the risk factors of developing type-2 diabetes in a human body even if daily smoking may increase the risk factors of type-2 diabetes by 30-40% (Centers for Disease Control and Prevention. 2021). Considering the case study, it has been found that one-third of the Chinese population are smokers, as well as half of the Chinese population, are addicted to regular smoking. On a broader note, it may be derived that type-2 diabetes increases the possibility of severe heart disease and blood circulation problems while excessive cigarette smoking may influence the risk factors and cause premature death.

Additionally, it may be implied that especially smoking is one of the main reasons for insulin resistance which is prevalent in type-2 diabetes while half of the Chinese population is fond of excessive smoking, for that reason the case of type-2 diabetes is increasing in that country. Furthermore, it may be stated that there is an intimate relationship between cigarette smoking and type-2 diabetes even though excessive smoking has increased the risk factors of type-2 diabetes among both women and men (Yuan and Larsson, 2019). Additionally, it may be envisioned that the consumption of tobacco smoking is rising significantly in China which is influencing the wider spread of type-2 diabetes as well as the death cases of type-2 diabetes is also growing for that reason in that country (Our World in Data. 2021).

Module 7050SOH Assessment Brief and Guidance

Figure 2: Increase in smoking in China

(Source: Our World in Data. 2021)

Genetic history

It may be opined that family history or genetic history is responsible for the prevalence of type-2 diabetes in China even though it has been proved that there is a generic link influencing the spread of type-2 diabetes. Considering the case study, it may be derived that currently there are 116 million diabetic patients in China while 20 years ago the number was less than 25 million which indicates the increasing number of type-2 diabetes patients in China. On the other hand, it may be defined that family history plays a vital role in the prevalence of type-2 diabetes in China even though it has been observed that if a member of a family had diabetes then there is a major possibility that the next generation of the family may be affected by type-2 diabetes. Furthermore, it may be derived that heredity is one of the main reasons for the prevalence of  type-2 diabetes in China as well as the genetic variant having a link in developing type-2 diabetes in that country (Mambiya et al., 2019).

It may be implied that some specific diabetic chromosomes such as 12q, 4q and 22 are also responsible which establishes a genetic link and increased risk of developing type 2 diabetes (Mambiya et al., 2019). However, it may be stated that consumption of healthy foods and regular exercise may help to prevent the increasing cases of type-2 diabetes in that country. Apart from that, if the father or mother or both of a family have suffered from type-2 diabetes then there is a chance that the next generation of the family may be addicted to this disease as well as many genetic factors such as mitochondrial DNA mutations, and environmental components have increased maternal transmission of type 2 diabetes (Papazafiropoulou et al., 2017).

3. Identifying the role of FOUR categories of agencies involved in activities for the prevention, control and management of type-2 diabetes

It may be implied that the government of China has taken many precautions which are extremely impactful to prevent the prevalence of type-2 diabetes in that country. Considering the case study it has been observed that the number of health insurance is increasing in China while most Chinese people are spending so much money to buy health insurance plans. Moreover, it may be implied that the insurance of the government is also not covering the proper treatment of diabetes which may create many problems in the country. Furthermore, it may be derived that the Chinese government needs to invest in finding the proper medicines to mitigate the cases of type-2 diabetes in the country while screening and monitoring is extremely important to prevent the wider spread of type-2 diabetes in China. Considering the case study, the main role of four categories of agencies which is involved in preventing and controlling type-2 diabetes in China are as below:-

Building a primary care structure

It may be implied that the Government of China needs to provide an effective primary care structure that will be extremely impactful for the prevention and control of type-2 diabetes in that country. On the contrary, it may be argued that the Central government of China has launched a health plan to prevent and control type-2 diabetes and other severe diseases which consist of regular monitoring and self-management (Luo et al., 2020). Moreover, it may be derived that the Government of China has implemented a short term strategy that will improve the coordination between all governmental agencies and may create a beneficial impact to prevent and control type-2 diabetes in the country. Along with that, the primary care structure may play a crucial role to implement the dietary changes, restrained uses of tobacco and physician activity through promoting education and self-management which creates a beneficial impact in preventing type-2 diabetes in China. Additionally, it may be asserted that the Government of China also decided to launch a campaign plan which will help to increase public awareness and may be effective in identifying the high risk people who are affected by type-2 diabetes (World diabetes foundation. 2021).

Finding doctors and effective medical scheme

It may be implied that the government of china and health agency of China needs to build more medical colleges which will help to create more doctors who may play a crucial role in preventing and controlling type-2 diabetes in China, On a contradictory note, it may be argued that it is extremely important for the Chinese government to find doctors who are willing to work as a medical practitioner. In addition to that, the government of China has also launched a new health scheme that is extremely effective in expanding the risk pool and mitigating administrative costs (Commonwealthfund.org. 2021). Moreover, it has been mentioned that The National Health Commission is the primary health agency of china which play a crucial role to create a health scheme for the people of China while the main approach of the new health plans is to improve the public health and medical care which may help to prevent the prevalence of type-2 diabetes.

Providing better incentives for general practitioners

It may be implied that it is the responsibility of the government of China to provide better incentives for general practitioners which may help to control and prevent the increasing cases of type-2 diabetes in China. Considering the case study, it may be implied that the Chinese government needs to provide better income and incentives to promote preventive measures in controlling type-2 diabetes in that country. In addition to that, the government of China needs to provide more health facilities in rural areas which will help to prevent disease cases in the rural side. Moreover, it has been observed that in 2018 the country had 308,740 licensed and assistant general practitioners which was 8.6% of total general practitioners in China (Commonwealthfund.org. 2021).

Promote preventive measures

The Government of China also planned to promote preventive measures which include a healthy diet and regular exercise even though it has been observed that some NGOs of China have promoted the benefit of healthy diets which will be extremely impactful to prevent the prevalence of type-2 diabetes in that country. Healthy diets may increase the metabolism rate of the human body and increase the risk factors of type-2 diabetes although regular exercise is also important to cut down the extra fat from a human body. Additionally, it may be asserted that the general practitioners of the country also need to promote healthy lifestyles which will be extremely effective to control the wider spread of type-2 diabetes in that country.

  1. The challenges facing specific agencies in performing the role more effectively to reduce the global burden of type-2 diabetes

The main challenge faced by the National Centre for Biotechnology Information in reducing the burden of type-2 diabetes all over the world is related to the geographical variation as the prevalence of diabetes in the rural and urban areas varies. On the other hand, it may be argued that the people in the rural areas do not have enough awareness of the illness as a result of which preventing diabetes in the rural areas is difficult (NCBI. 2021). The people in the rural areas lack awareness about the disease as a result of which it remains mostly undetected and no effective effort is made to reduce it. A major challenge for the healthcare workers in preventing diabetes is related to the comorbidities associated with it because the management of comorbidities is immensely difficult (Sartorius, 2018). However, the disease remains undetected even in the urban areas since many rural workers migrate to the cities in search of jobs. On a broader note, it may be mentioned that the epidemiologic transition is another cause that makes reducing type 2 diabetes difficult because it results in complex changes in the health and disease patterns of the public. Additionally, it may be stated that the changes in the health and disease patterns is also responsible for altering the demographics, social determinants and consequences of type 2 diabetes (Mattei, 2017).

It may be demonstrated that a challenge in reducing the burden of type 2 diabetes all over the world requires enabling changes in the management of people. On the other hand, it may be argued that it is difficult to encourage people to undertake self-management of type 2 diabetes as it is essential to switch to a healthy lifestyle in order to reduce type 2 diabetes. Moreover, it may be noted that the NCBI has witnessed several disparities in the effectiveness of the healthcare strategies for curing type 2 diabetes as the plans are dependent on the local governments. Dietary factors are an important element that enables the curing of type 2 diabetes because diet is a significant contributor of mortality and morbidity all over the world (Forouhi et al., 2018). NCBI focuses on extending health promotion campaigns revolving around the detection and prevention of diabetes as it will help in overcoming the challenge of curing type 2 diabetes all over the world. The agency has been making significant efforts in making people include high-quality staple food in their diets as it may help in preventing type 2 diabetes, however, the challenge is to identify and promote the culturally-acceptable staple food. The availability of safe and effective therapies is required as it helps in reducing morbidity as well as mortality by either reducing or delaying the complications (Chatterjee et al., 2017).

World Diabetes Forum (WDF) has been dedicated towards promoting public awareness about type 2 diabetes as it helps in the process of reducing the issue of diabetes all over the world. The organisation has been attempting to make people understand the importance of preventive measures as it will encourage people to bring a change in their lifestyle. On a broader note, it may be asserted that the organisation has developed strategies targeted towards people who are at high risk of developing diabetes and people who have undetected diabetes. The problem of implementing the strategies needs to be overcome as the strategies are capable of bringing a positive impact on the entire population of China. A strategy of the WDF is dedicated towards enabling the early detection of the diseases as it makes the management or prevention of the disease easier. On the other hand, it may be argued that the strategy is facing a challenge of providing systematic health check-ups at regular intervals along with the establishment of health care facilities committed towards the cause. People with type 2 diabetes have been identified to contract the Covid-19 pandemic as a result of which the patients with type 2 diabetes need to be extra careful (Barron et al., 2020).

A lack of coordination between the health strategies of the central and state governments is a major challenge as the strategies do not align creating more problems instead of providing solutions. The medical insurances offered to the public are financed through premiums that are fixed annually because the contributions of the patients are bare minimum and it is the government subsidies that contribute towards the premiums. The government faces a challenge in the areas which are not so developed in terms of economic status as the share of subsidies is high in those areas. The permanent foreign residents are given the same benefits in terms of health insurance, however, the undocumented immigrants in China fail to enjoy the benefits related to the healthcare system in the country. On a broader note, it may be implied that the commercial insurance companies also provide private insurances to a number of residents of the country for which there is no proper documented statistics. Insulin resistance is an abnormality associated with type 2 diabetes because it creates an imbalance between the intake of energy and the exhaustion of energy favouring the pathways for the storage of nutrients (Roden and Shulman, 2019).

The need for curing type 2 diabetes all over the world has become a necessity because even the young generation are becoming the victims of the disease. The prevalence of type 2 diabetes in young people is a matter of concern as it leads to various complications including cardio-vascular diseases and even premature deaths. On a contradictory note, it may be mentioned that the curing of type 2 diabetes particularly in the Asian countries is a challenge because of the unhealthy lifestyle. It may be implied that people with unhealthy lifestyles such as having too much stress or eating too much junk food are responsible for causing type 2 diabetes as a result of which various other complications occur. A major challenge that has been identified for curing type 2 diabetes is economic constraints because of which people back away from taking proper medications and undergoing effective treatment.

It may be implied that the health agencies and the government of China have faced many challenges in the way to prevent and control the wider spread of type-2 diabetes in that country. On a broader note, it may be derived that type-2 diabetes patients have a distrust of young medical practitioners while it has been observed that due to the issue of mistrust the prevention of the process of controlling type-2 diabetes has faced many critical challenges. Moreover, it may be envisioned that the number of type-2 diabetes cases is increasing day by day in China which consist of elder patients, however, the growth of type-2 diabetes patients may create extra pressure or additional challenges in the healthcare of China (Papagianni and Tziomalos, 2018). Furthermore, it may be opined that China has the highest population in the world and the cases of type-2 diabetes are increasing day by day while the number of hospitals needs to be increased by the government of China or else it may create major challenges in providing the treatment for type-2 diabetes patients.

It is important that the government of China needs to further improve the health infrastructure of the country or else it will not be sufficient to provide proper treatment for type-2 diabetes patients. On the other hand, it may be asserted that it is one of the biggest challenges for the health agencies of the country to improve the health infrastructure, however, the lower number of general practitioners is another challenge for the health agency and the government of the county. Additionally, it may be implied that it is one of the biggest challenges for McKinsey & Company to create a low cost health policy for type-2 diabetes patients by 2020 (Mckinsey.com. 2021). However, it may be argued that insufficient funding in health infrastructure is one of the major challenges for the health agency of China while the Chinese government needs to invest more funds otherwise the current health infrastructure will not be able to properly treat type-2 diabetes patients. One of the biggest problems for the health agencies is that the national health insurance is not covering the proper treatment of type-2 diabetes while after doing health insurance a type-2 diabetes patient may suffer. Additionally, it may be implied that it is the responsibility of the Government to make proper health insurance that will cover all treatments cost of type-2 diabetes.

The health agencies are promoting the benefits of eating healthy foods and regular exercise while the urban change population is not properly maintaining the diet plans which increases the cases of type-2 diabetes which is another challenge for the health agencies to prevent the increasing case of type-2 diabetes in China.

5. Conclusion

From the above discussion, it may be concluded that the cases of type 2 diabetes are increasing day by day in China and many other countries of the world. On a broader note, it may be stated that some factors are reasons for the prevalence of type-2 diabetes in the world such as obesity is one of the reasons for increasing cases of type-2 diabetes. Moreover, it may be derived that family history or generic link is also responsible for the development and wider spread of type-2 diabetes while unhealthy lifestyle also influences the wider spread of type-2 diabetes in China and other countries of the world.

It may be implied that the global efforts have to face some critical challenges and issues to fight against type-2 diabetes even though it has been observed that numbers of type-2 diabetes patients are growing significantly which creates extra pressure in the healthcare of a country. Additionally, massive financial support is required to provide the proper treatment to type-2 diabetic patients, however, some countries of the world do not have proper infrastructure and sufficient financial support to deal with type-2 diabetics. It may be derived that the health infrastructure of China needs to be developed and improved to provide proper treatment to type-2 diabetic patients which will help to prevent type-2 diabetes in that country.

 

 

6. Reference

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Centers for Disease Control and Prevention. 2021. Smoking and Diabetes. [online] Available at: <https://www.cdc.gov/tobacco/campaign/tips/diseases/diabetes.html> [Accessed 21 July 2021].

Chatterjee, S., Khunti, K. and Davies, M.J., 2017. Type 2 diabetes. The lancet, 389(10085), pp.2239-2251.

Commonwealthfund.org. 2021. China | Commonwealth Fund. [online] Available at: <https://www.commonwealthfund.org/international-health-policy-center/countries/china> [Accessed 21 July 2021].

Diabetes. 2021. The number of people with diabetes in China is estimated to be 1 in 10 out of Chinese adult.. [online] Available at: <https://www.diabetes.co.uk/global-diabetes/diabetes-in-china.html> [Accessed 21 July 2021].

Fan, Y., Wang, R., Ding, L., Meng, Z., Zhang, Q., Shen, Y., Hu, G. and Liu, M., 2020. Waist circumference and its changes are more strongly associated with the risk of Type 2 diabetes than body mass index and changes in body weight in chinese adults. The Journal of nutrition, 150(5), pp.1259-1265.

Forouhi, N.G., Misra, A., Mohan, V., Taylor, R. and Yancy, W., 2018. Dietary and nutritional approaches for prevention and management of type 2 diabetes. Bmj, 361.

Hemmingsson, E., 2021. The unparalleled rise of obesity in China: a call to action.

Hu, C. and Jia, W., 2018. Diabetes in China: epidemiology and genetic risk factors and their clinical utility in personalized medication. Diabetes, 67(1), pp.3-11.

K Papazafiropoulou, A., Papanas, N., Melidonis, A. and Maltezos, E., 2017. Family history of type 2 diabetes: does having a diabetic parent increase the risk?. Current diabetes reviews, 13(1), pp.19-25.

Luo, Z., Fabre, G. and Rodwin, V.G., 2020. Meeting the challenge of diabetes in China. International journal of health policy and management, 9(2), p.47.

Mambiya, M., Shang, M., Wang, Y., Li, Q., Liu, S., Yang, L., Zhang, Q., Zhang, K., Liu, M., Nie, F. and Zeng, F., 2019. The play of genes and non-genetic factors on type 2 diabetes. Frontiers in public health, 7, p.349.

Mattei, J., 2017. Reducing the global burden of type 2 diabetes by improving the quality of staple foods: The Global Nutrition and Epidemiologic Transition Initiative. Global Health.

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Papagianni, M. and Tziomalos, K., 2018. Healthcare reform in China: challenges and opportunities.

Roden, M. and Shulman, G.I., 2019. The integrative biology of type 2 diabetes. Nature, 576(7785), pp.51-60.

Sartorius, N., 2018. Depression and diabetes. Dialogues in clinical neuroscience, 20(1), p.47.

Who.int. 2021. Rate of diabetes in China “explosive”. [online] Available at: <https://www.who.int/china/news/detail/06-04-2016-rate-of-diabetes-in-china-explosive-> [Accessed 21 July 2021].

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Yuan, S. and Larsson, S.C., 2019. A causal relationship between cigarette smoking and type 2 diabetes mellitus: A Mendelian randomization study. Scientific reports, 9(1), pp.1-4.

Zhao, Q., Laukkanen, J.A., Li, Q. and Li, G., 2017. Body mass index is associated with type 2 diabetes mellitus in Chinese elderly. Clinical interventions in aging, 12, p.745.

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