RESEARCH PROJECT

Name: Florinela Naida

ID:17000495
Group Name: HB-H-DO3
Supervisor Name: Mr. Solomon
Afework
 TITLE PAGE

Investigating reasons for

Diabetes among the elderly
people in England

This study is submitted in part fulfillment of an HND in health and

social care management in UKCBC

26 May 2019
 ABSTRACT

Purpose of the study:

The purpose of the research project is to see the feelings, causes
and efficacy of diets and treatment, as well as the complications of
diabetes among the elderly.

Methodology:
As a secondary research, the data presented will be reported and
sent and different procedures will be used to show diabetes
statistics among older people.

Findings:
Secondary research requires a reference list with all data and
information discussed in the research. All will be presented to the
end of the research project.
 ACKNOWLEDGEMENT

Diabetes is common in the elderly population. By the age of 75,

approximately 20% of the population may be afflicted by this
illness. Diabetes in elderly adults is metabolically distinct from
diabetes in younger persons and the treatment is different in this
age group. Diabetes is associated with an important poor life
quality and with significant morbidity due to macrovascular and
microvascular complications. The optimal glycemic level and the
changes in the risk factors can reduce the risk of complications in
the elderly population. With age, there are more changes in the
carbohydrates metabolism which interact with the genetical history
to explain the incidence of diabetes in the elderly. Moreover,
lifestyle plays an important role. Obese people (especially those
who have the abdominal obesity type), with a diet rich in saturated
fats or who are sedentary, have more chances to develop diabetes
once they age.

CONTENT
CHAPTER 1: INTRODUCTION OF THE RESEARCH
1.0 INTRODUCTION and BACKGROUND

Population aging represents a social problem, as it affects many

people, not only interested in the respective population, but also in
society in general, which sustains the important consequences.
One of the problems of the elderly is diabetes.

We chose to search for reasons why elderly people in England are

affected by diabetes, the causes and health problems that arose
from diabetes because my mother suffered from this disease.

Diabetes is a disease that affects the large-scale population in

London. According to statistics, it is estimated that 7.5 percent of
the adult population suffers from diabetes. According to Diabetes
in the UK, it is estimated that the cost of diabetes in the NHS is
more than £ 14 billion (Diabetes UK,2010).

Because the number of diabetes patients is on the rise, the cost is

expected to increase to more than 700,000 - 10.9 percent of the
adult population – through 2030 (Diabetes Uk,2010). Diabetes is a
serious illness that untreated can lead to heart disease, stroke,
blindness, and kidney failure. Genes, lifestyle, and environmental
factors make diabetes ill.

Diabetes is of two types, type 1 diabetes and type 2 diabetes, and

type 2 diabetes affects especially the elderly.

For generations, both diagnosis and treatment of diabetes have

been submerged in the swamp of error, ignorance, and
superstition, sometimes even by those who believe and claim
experts in these areas. The disease does not happen at random. All
diseases are due to the violation of the laws of nature in any way, at
some time in a man's life.

In the past, a diagnosis of diabetes was about the same thing, with
a leprous disease: once you get sick, you stay ill for the rest of
your life.

What seems important to me in the analysis I'm going to make in

this research project is extremely important to understand what
happens to people's lives from the onset of the disease. It is also
important to follow the help they receive from the authorities as
well as the laws in force.

1.1 RESEARCH AIM

The aim of this study is to investigate the causes of diabetes

among elderly people in England.

1.2 OBJECTIVES

To gather and present relevant secondary data on sickle call

diabetes

To make recommendations to the local authority on the cause of

diabetes.

1.3 RESEARCH QUESTION

The two main research questions are directly related to the

research objectives:
1. What are the main causes of diabetes among elderly people in
England?

2. What are the interventions in place to improve the lives of older

people suffering from diabetes?

CHAPTER 2: LITERATURE REVIEW

2.0 INTRODUCTION
Diabetes is a disorder of the body associated with a blood sugar
over the normal limit. The disease affects all age groups and is one
of the most serious chronic conditions in terms of the fact that
there is no cure to "cure" it, but only methods that keep it under
control and stop it, plus several other complications in the eyes,
heart, kidneys and neurological order.
2.1 Overview of Diabetes
Diabetes has been a known disease for over three millennia, and
the first reference to the disease was found in Erbes' writings 3500
years ago (Morley JE, 2000 ).
Diabetes mellitus is a chronic illness caused by the decrease or
absolute lack of insulin in the body, which causes the body's
inability to use carbohydrates as a source of energy. The disease is
a serious, untreated condition that can create major life-threatening
complications. This is due to the lack of quantitative or qualitative
insulin, denoting late signs of the disease. In diabetes, the
metabolic disorder is not only glucose but also lipids and proteins.
Prediabetic is when the blood sugar level is higher than normal,
increasing the risk that the person develops diabetes. It is very
important for the disease to be diagnosed early, to be treated early,
to prevent complications.

Source: https://publichealthmatters.blog.gov.uk/2016/09/18/the-week-at-phe-online-
highlights-and-national-conference-wc-12-sep/

It is very important to go see your family doctor when:

Feeling very thirsty, urinating more often than usual, having a tired,
low weight or muscle mass.
2.2 Complications of diabetes.
Diabetes is associated with various ophthalmic, neurologic,
neurological and cardiovascular complications, thus amputating,
stroke, heart disease or even definitive blindness. Therefore,
diabetics must perform regular checks on all these specializations.
General recommendations such as movement, physical activity,
balanced nutrition, stress avoidance, smoking cessation, and
moderate alcohol consumption are also vital.
Eye complications occur in about a third of diabetics, being the
most common cause of blindness in the entire population. Of the
forms of diabetic eye disease, the most common is diabetic
retinopathy, followed by cataracts and glaucoma.
In diabetes patients, hyperglycemia can affect the whole body's
nerves, leading to diabetic neuropathy. This is of several types and
is asymptomatic, often developing slowly over several months
without the patient observing obvious changes. Symptoms that
indicate this disease are tingling, numbness or pain in the legs,
reduction or increase of tactile sensitivity.
Studies have shown that there is a close link between heart disease
and type 2 diabetes. Diabetics are more prone to acute myocardial
infarction, 80% of cases being asymptomatic. In this case, the
diabetic patient does not experience the classic symptoms of the
heart attack, such as sudden pain in the chest, often confused with
an indigestion discomfort.
2.3 The impact of diabetes on an elderly person.

Prediabetes and diabetes have many risk factors. Researchers do

not fully understand why some people develop prediabetes and
type 2 diabetes, while others do not do this disease.
It is certain that certain factors increase the risk of diabetes, and
among these factors is the age of the patient.
Your risk of developing diabetes increases as you get older. The
explanation would be quite simple: this is because we tend to make
less movement, lose weight and gain weight (we accumulate many
kilograms) with age.
Source: http://www.londonscn.nhs.uk/wp-content/uploads/2015/02/dia-understanding-
ldn-challenges-022015.pdf

2.4 Strategies and intervention to control Diabetes

To avoid complications associated with diabetes,

compliance with the 5 golden rules is important, they are:
1. Check your blood sugar regularly.
2. Set up a healthy living plan:
• Change your eating habits, that is, choose a healthy diet with 3
main meals a day and possibly 2 intermediate snacks,
• Exclude concentrated sweets, carbonated juices, processed
foods, and fat or fried foods, instead choose full-grain vegetables
and whole grains, lean meats, low-fat dairy, and fruit,
• Choose an easy form of physical activity (eg walking) that you can
do at least 30 minutes a day every day or a more intense form of
exercise such as running or walking on the track do it at least 150
minutes a week.
3. Take care of your weight
• the body mass index is below 25 kg / m2;
• Abdominal circumference should be less than half the height or
<94 cm in men and <88 cm in women.
4. Periodically check your blood pressure and blood fats
• Optimal blood pressure is below 135/85 mmHg;
5. Consult the Diabetologist and cardiologist periodically.
With ophthalmic screening, eye problems can be detected even
before the patient experiences changes or visual disturbances.
The visit to the specialist at the time is more than recommended.
This consists of an investigative test that includes both a physical
examination based on patient symptoms and laboratory analysis
for a complete screening. This type of control is recommended to
be done once a year to prevent the occurrence of ulcers or
amputations. It is also important for people with diabetes to look
for signs of cracking or exfoliating the legs, the appearance of
vesicles, joint changes or walking and balance, "says the
diabetologist.
Diabetic kidneys can develop severe suffering. The most common,

diabetic nephropathy is a chronic, progressive kidney disease that

occurs in about a third of diabetic patients. If it is detected on time

and properly followed, therapeutic measures can be stepped up to

slow progression to chronic renal failure.

To find the early onset of renal impairment, it is recommended that

every patient with either type 1 or 2 diabetes should make a simple

analysis every year - microalbuminuria, urinary protein removal.

Once diagnosed, diabetic nephropathy should be monitored

annually. Measures that can keep diabetes under control should

also be stepped up. Increased attention should be paid to the

hygiene-dietetic regime. It does not mean restrictions but just that

it must be respected more rigorously, and medication is taken

correctly, plus smoking cessation, sedentary control, obesity

control and, finally, effective blood pressure control.

CHAPTER 3: METHODOLOGY

3.0 INTRODUCTION

This chapter informs you about the research done, as well as about
the methods used to address research questions. The main
sources used in research are based on other research, being a
secondary research inspired by online sources, books, journals.
3.1 THEORETICAL PERSPECTIVE

The theoretical perspective used in the research project is based

on social theories about the number of elderly people with diabetes
in London. I will also use the organizational theories, the theories
of the NHS organization and other organizations that deal with the

care and treatment of people suffer from this disease.

3.2 DESIGN/METHOD
The research method used in the research proposal is qualitative,
exploratory research used to understand the opinions, motivations,
and occurrences that underlie my research.
The methodology used in this research project, the most
information I will get from books, journals, and diabetes reports
that I will find on the internet.

3.3 DATA COLLECTION METHOD

For research, we will use secondary data that is a type of data that
has already been published in books, newspapers, magazines,
journals, online portals, etc.

3.4 SAMPLING TECHNIQUE

Source selection process will help the researcher to identify

research subject area and were the information can be found, then
gather the existing data were will be compared within different
sources that will be analysed.

3.5 DATA PRESENTATION & ANALYSIS

Data presentation and analysis helps people in understanding the

results of surveys conducted, makes use of already existing
studies to obtain new results. Helps to validate the existing
research or to add/expand the current research. Presenting the data
includes the pictorial representation of the data by using graphs,
charts, maps and other methods. These methods help in adding the
visual aspect to data which makes it much more comfortable and
quicker to understand.
3.6 LIMITATIONS.
In this research, I'm confronted with some limitations such as:
-time limit because I'm working full-time;
-I do not find enough information for my research project;
-another limitation is a language because English is not my mother
tongue;
- another limitation is because I do not have research experience
3.7 OVERCOMING LIMITATIONS.
I can go beyond study limitation, trying to spend more time
studying. Also, I must read more to find more information for my
research project
3.8 ETHICAL CONSIDERATIONS.
As a result of my research, as secondary research, no one suffers,
according to the Code of Conduct and Ethics (2009)

3.9 RESEARCH TIMELINE/TIMEFRAME

N Activity Nov. Dec. Ian Feb. March. Apr. May

r .
1. Research

proposal
2. Data

collection
3. Data

analysis
4. Draft
5. Feedback
6. Presentatio

Submission

CHAPTER 4: FINDINGS & ANALYSIS

4.0 INTRODUCTION

Diabetes mellitus is spreading throughout the world, regardless of

race. It believes that 2-3% of the world's population suffers from

this disease, becoming a social scourge causing chronic disorders

with serious repercussions on their social lives. Diabetes mellitus

is due to the lack of quantitative or qualitative insulin, which makes

possible the appearance of hyperglycaemia and glycosuria,

indicating late signs of illness and disease. In diabetes, the

metabolic disorder is not only glucose but also lipids and proteins.
4.1. What are the main causes of diabetes among elderly

people in England?

Diabetes mellitus is a condition that affects 415 million people

worldwide, with more than 5 million deaths associated with this

condition, according to the latest statistics (Diabetes Uk,2010).

Incriminated causes are most often encountered in what we call the

modern lifestyle. That is, foods rich in fats and fats, excess sugar,

sedentary, smoking, insufficient sleep, plus genetic predisposition

Causes of diabetes are diverse, from genetic inheritance to a

disorderly lifestyle, sedentary, but also an exaggerated

consumption of hypercaloric foods with rich sugar content.

Type 1 diabetes can develop rapidly in weeks or even days.

Many people have type 2 diabetes for years without realizing that

early symptoms tend to be general. Type 2 diabetes is the most

common form of diabetes. If you have passed the age of 50 or 60

years, it is good to know the most important information about this

disease, to avoid complications.

Diabetes is associated with an increased risk for several pre-

existing medical conditions in older adults. In addition to classical

cardiovascular and microvascular diseases, a group of conditions

(reunited under the term geriatric syndromes) may occur at a

higher frequency in elderly adults with diabetes and may affect

their quality of life.

Cognitive dysfunction - these patients may experience certain

types of dementia with Alzheimer's disease, especially as they are

twice as likely to occur in the elderly with diabetes. Memory

problems often occur among elderly people who suffer from

diabetes.

Deterioration of certain functions - advanced age and diabetes are

two risk factors for impairment of certain functions. People with

diabetes are less physically active compared to those without

diabetes. Problems may arise in these patients, either because of

the interaction between the medical conditions that occur at the

same time, due to peripheral neuropathy, because of problems in

the vision and hearing or in maintaining balance.

Risk of falling and fracture - The normal aging process and

diabetes as well as the conditions affecting functionality are

associated with a higher risk of falling and fractures. For example,

women with diabetes have a higher risk of hip and shoulder

fracture after passing a certain age. And the fact that your vision is

affected by diabetes can increase the risk of falls and fractures.

Polymedication - Older adults with diabetes have a higher risk of

polymerization, and thus increase the risk of adverse effects and

the risk of interactions between the medications these patients

take. In a study, polymerization (defined as the use of 6 or more

prescribed drugs) was associated with a higher risk of falling into

elderly people.

Depression - Diabetes is associated with a higher prevalence of

depression. The main signs of depression among the elderly are

severe sadness, apathy, fatigue, sleep disorders, loss/weight gain.

Diabetes is one of the most common causes of death among the

elderly. Most likely, the role of diabetes in mortality is

underestimated because, when elderly patients die from

cardiovascular causes, it is not among contributing factors to

death. The main cause of death among third-time diabetic patients

is cardiovascular disease, and these patients have almost double

the mortality rate. Mortality in these patients is closely related to

blood glucose levels and glycosylated haemoglobin (Meneilly

GS,2000).

4.2. What are the interventions in place to improve the

lives of older people suffering from diabetes?

Diabetes is a chronic condition and, if poorly managed, can lead to
devastating complications including blindness, amputation, renal
failure, stroke and early death.
Best practice guidelines say that patients should get regular
checks to ensure that they control their condition well enough to
avoid future complications. Guidance on clinical practices is
necessary to improve the health of the population, and for optimal
outcomes, diabetes care needs to be individualized for each sick
person of diabetes.
For proper care of people with diabetes, it is very important to have
a good partnership between professionals who are directly
responsible for the health of people in the community. They
encourage people to do their tests for the discovery of diabetes in
the early stages.
But the official NHS care audits in England show that many patients
do not receive these checks. Also, diabetes treatment is free of
charge, with diabetes being a chronic disease.
UK diabetes shows that in the past year there have been few
general improvements in diabetes delivery and some aspects of
care have worsened - such as fewer people with type 1 diabetes
who receive annual control.
It is said that only 41% of people with type 1 diabetes - who need to
be treated with insulin - receive all the annual checks
recommended by the National Institute of Health and Excellence
and only 16% meet the three recommended targets for the
treatment of blood sugar, cholesterol and blood pressure. Patients
with diabetes mellitus receive fewer vital controls than older
patients. There are also wide variations depending on where you
live in England.
People with diabetes who live in some areas benefit from better
care and treatment than people living in other areas, says charity.
Barbara Young, chief executive of Diabetes UK, said that the use of
high standards of care for people with diabetes will reduce
pressure on NHS resources and save money. This is why people
give you the support and education to manage their illness in good
health. This along with improving diabetes care, gives people with
diabetes the chance to have a long and healthy life, and save the
NHS a significant amount of money. In order to implement good
practices, working with local authorities is very important.
Prof. Kevin Fenton of Health Public England said free medical
check-ups were available to help identify and manage diabetes. He
said that disease prevention programs were also under way.
PHE and NHS England are developing a national type 2 diabetes
prevention program that will support people most at risk of making
essential lifestyle changes - such as weight loss, diet improvement,
and increased activity. Together help people take early steps to
reduce the risk of developing this serious condition.
Diabetes is currently estimated to cost UK £ 23.7bn. With diabetes
becoming more common, this figure is set to rise to £ 40bn by
2035-36.
4.3 FIGURE 1:

Estimated number of people with diabetes in 2018 and the

estimated number of people with diabetes in 2035.

Estimated 3.800.800 of the total population

number of ie 8.6% of the total population
people with
diabetes in 2018

Estimated is expected to grow to 4.900.000

of the total population
number of
people with ie 9,7 % of the total population
diabetes in 2035
Source: https://www.diabetes.org.uk/
4.4FIGURE2

Types of diabetes and its prevalence according to gender.

Types of
diabetes

Type 1 diabetes
occurs when the
Gender body does not
produce insulin
Type 2 diabetes
develops when
the body is
7,6% of the
9.6% of the unable to
number of
number of men produce enough
woman are
are diabetic insulin or the
diabetic
body’s cells
don’t react to
insulin

Source: https://www.diabetes.org.uk/resources-s3/201711/diabetes-key-stats-
guidelines-april2014.pdf
4.5 FIGURE 3:

Summary of expected diabetes prevalence (diagnosed and

undiagnosed) for London in 2018 by group ethnicity

White
,mixed,other
,8.0%
Group
ethnicity
South asian
and black-
15,2%

Source: https://www.diabetes.org.uk/professionals/position-statements-
reports/statistics/diabetes-prevalence-2018
4.6 FIGURE 4

Diabetes prevalence (diagnosed and undiagnosed) for England in

2018 by age group. Studies show the aging increases the chance of
suffering diabetes.
 9.0% of people aged
45-54 years, suffer
from diabetes

Prevalence of diabetes
over age groups

23,8% of people aged

75 and more,suffer
from diabetes
Source: https://www.diabetes.org.uk/professionals/position-
statements-reports/statistics/diabetes-prevalence-2018

CHAPTER 5: CONCLUSION

5.0 INTRODUCTION

Diabetes is the most common endocrine disease and, what is

important to know, is not transmitted. Causes of diabetes are not
fully known, but doctors around the world talk about hereditary
factors to the same extent that environmentalists also play an
important role.
The illness does not happen by accident due to violations of the
laws of nature at some point in the life of a person. This violation,
wilful or involuntary, occurring with many generations ago, is the
result of a natural calamity. For example, find the radiation of the
Tunguska meteorite, 80 years ago, causing genetic mutations
resulting in current affections with diabetes.

5.1 CONCLUSION
Because of the dramatic increase in prevalence, diabetes among
the elderly is one of the most important diseases in this age group.
Fortunately, understanding the pathogen as well as treating
diabetes plays an important role in increasing the quality of life of
elderly patients, as well as in reducing complications (micro and
macrovascular) that may occur more frequently in them. The
lifestyle of elderly patients (including diet and exercise in
particular) should be closely monitored.

5.2 RECOMMENDATION(S)

People with diabetes are twice as likely to have heart disease than
non-diabetic patients, the risk being caused by hypertension, high
cholesterol, atherosclerosis.
Keeping the diabetic under control includes reducing all
cholesterol risk factors by reducing cholesterol by using a diet
without animal products.
Stretching stress through physical and relaxing exercise, reducing
blood pressure through exercise.
Also, very important is smoking cessation, smoking increases the
risk of diabetes.
Diabetics, regardless of the type of disease, should eat lean meat,
fresh fruit (not containing much sugar), whole wheat and low-fat
dairy products.
Carbohydrate monitoring is a key element because they strongly
affect the level of sugar in the blood. A balanced diet includes a
variety of vegetables and fruits (low sugar), whole grains, beans,
fish, lean meats and fat-free dairy products. When you have
diabetes, you should follow a strict program of meals and snacks.
It is essential that, besides diet and sports, follow the prescribed
medication. Insulin injections and regular blood sugar testing can
be part of your daily life.

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 APPENDICES

APPENDIX 1: SAMPLE OF QUESTIONNAIRE