Diabetes Interventions
Dietary Counseling and Physical Education
Education on food intake and physical activity is considered the most important intervention when it comes to the health of those affected by diabetes (NIDDK, 2016). A study done to show what education of these aspects in the Northern Plains Indians of the Cheyenne Sioux Tribe in South Dakota supports this intervention. This study was done over six months with six lessons on health and dietary consumption education. It consisted of 114 of the tribal members with type 2 diabetes. The outcome of the study showed that even though the lessons were only short and on a small group, their dietary health and being more cautious with diabetes improved (Kattelmann et al., 2010).
This intervention correlates directly with the issue of the Pennington County Oglala Lakota Nation as it is a recent study done on another South Dakota tribe. This intervention would be implemented greatly with the Stages of Change/Transtheoretical public health model. This model identifies the steps it takes to complete a behavioral change. These steps include precontemplation (not changing), Contemplation (thinking about what to change), Preparation (getting ready for the change), Action (taking the first steps of change), and finally Maintenance (keeping up with their new lifestyle) (Riegelman & Kirkwood, 2019).
Treatment
of/Facilities and Care for Type 2 Diabetes
Rather than preventing diabetes, this intervention tackles what happens when individuals get diagnose, referring to the treatment and care of diabetes. This first and primary treatment of type 2 diabetes that almost all physicians recommend is medicine. The medicinal intervention for type 2 diabetes is known to have high levels of safety, efficacy, and a relatively low cost (Sanchez-Rangel, 2017). The medication typically prescribed is a biguanide known as metformin. Metformin works by improving insulin sensitivity in the body which in turn lowers blood glucose levels (Mayo Clinic Staff, n.d.). Studies conducted using metformin found that individuals lost weight and saw a reduction in BMI (Lentferink et. al., 2018). Metformin was also found to significantly decrease A1C levels when combined with drugs such as sulfonylurea (Bennett et. al., 2011).
Other treatments for type 2 diabetes include Insulin therapy and weight loss surgery. Insulin therapy is a great intervention for when individuals are having trouble meeting target blood sugar levels. Just like metformin, insulin therapy is one of the first treatments prescribed for patients. Insulin therapy can even be prescribed to individuals that are meeting all lifestyle changes and not just for not doing everything they should. 66.3% of people using insulin therapy short-term, were found to enter drug-free remission within three months and gain better glycemic control one study found (Weng 2017). Weight loss surgery is another great intervention for the treatment of diabetes but can only occur after dieting and physical exercise have occurred as it will not work alone (Mayo Clinic Staff, n.d.). This form of treatment has been shown to increase insulin secretion and insulin sensitivity while decreasing cardiovascular risk and improving glycemic control (Pareek et. al., 2018).
Genetic Testing
This final intervention for diabetes is exactly how it sounds. Testing of the genes in individuals with diabetes through blood tests. This intervention will help future generations as well to help understand if they are at a higher risk for diabetes. Testing will help individuals learn more about themselves, and what they can do to help their family members and others that they love. One study over genetic testing showed that not only will genetic testing help the future generations, it will help the individual get on track for treatment and education of the disease (Kleinberger & Pollin, 2015).
This intervention would be efficient for those of the Pennington County area as many of these individuals are currently undiagnosed. It will also help this area to put a stop to the issue by catching it and preventing the future generations from this disease. When concerning how to implement this intervention the Health Belief Model would be the most effective. This model focuses on the individuals beliefs and their attitudes toward acting on the issue. The constructs of this model on diabetes include; being perceived susceptibility (someones bias on getting diabetes), perceived severity (an opinion on the consequences and severity of diabetes), perceived benefits (belief in the advised action to "catch early"), perceived barriers (belief about the costs of diabetes genetic testing), modifying variables (a person's characteristics that influence beliefs), cues to action (events that affects one to act on getting tested), and finally, self-efficacy (the availability to take action on tested) (Riegelman & Kirkwood, 2019).