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HLTH 266 Diabetes Management Question Discuss the greatest emerging threat to the health of the saskatchewan population. is your threat unique to this provience or does it reflect a wider national level risk. Answer Diabetes Prevalence In Saskatchewan Introduction: Saskatchewan can be described as the prairie as well as a boreal province in the western part of Canada and is the only province that has no natural borders. It is spread over an area of about 651900 square kilometres and comprises of about 1098352 people according to that data collected in the year 2016. Over the years, a growing trend of people getting affected by diabetes is observed in the nation. The number of people suffering from diabetes is increasing over the years and it is suspected to reach a number that will impact the economy of the nation (Bird et al., 2015). Eventually it will be acting as one of the biggest health burden on the nation affecting the quality of life of people and making them suffer physically, mentally, emotionally as well as socially. This assignment will mainly be describing the advent of diabetes as a major threat in Saskatchewan and will also discuss whether diabetes is affecting Saskatchewan only or posing a threat to entire Canada. Brief Overview Of The Disorder And Its Associated Complication: Diabetes mellitus can be defined as the group of disorders that are mainly characterised by high levels of blood glucose levels that result from the defects of insulin production, insulin action as well as both. Insulin is a hormone that is mainly released from the pancreas and helps the cells of the body to accept the glucose whose levels increase in blood after a meal. This glucose helps the cells to take part in respirations and thereby release energy helping in performing different metabolic functions of different organs of the body (Alsabbagh et al., 2015). However, when individuals get affected by diabetes type 1, insulin cannot be successfully produced by the body and hence insulin remains absent and so cells cannot accept glucose and gets deprived of energy. In case of diabetes type 2, the pancreas release insulin but the cells of the body become resistant to insulin action. Therefore, they cannot take glucose inside them and gets deprived of energy. The blood glucose level increases in blood resulting in different complications as well as life threatening situations in affected individuals (Lipscombe et al., 2018). Diabetes dramatically increases the different types of risks that result into cardiovascular disorders and even strokes. Neuropathy and nerve damage can also result in affected individuals with many severe outcomes like food infection and amputation as well. Kidney damage and nephropathy affects the health of the people resulting in threatening situations and even poor quality lives. Eye damage or retinopathy  can result in partial blindness along with foot damage and hearing impairment along with skin conditions are also quite common among the affected individuals (Spurr et al., 2018). Alzheimer’s disorder and depression are also seen to be quite common among people. Therefore, this wide variety of complications result diabetic patients to live lives of suffering and restrictions that affect their poor quality life. It not only affects the economic conditions of people but also affects their emotional stabilities and social lives. Prevalence: Data as released by the Government of Saskatchewan gives a detailed insight about the results of the statistical analysis about diabetes prevalence conducted in Saskatchewan. Diabetes was found to be most common in the people who were between the age of 65 and older. In this cohort, about 1 in every 4 people had been seen to be suffering from diabetes (Wesiman et al., 2018). Moreover, about 1 in every 13 Saskatchewanian residents accounting for about 7.4% belong to the age cohort of 1 year or older had been seen to be suffering from diabetes. When gender based study was conducted, it was seen that diabetes was about 24% more common in the males than that of the females. It was also found that about 71% of the people who were suffering from diabetes also suffered from high blood glucose level (, 2017). A critical analysis had also provided us with detailed knowledge about how the disorder is gradually becoming a diseases burden on people in Saskatchewan. From the year 2010/11 to that of 2014/15, for all causes of hospitalisations and death of the Saskatchewanians when compared to patients suffering from diabetes, it could be seen that people with diabetes had spent 3.5 times more days in the hospital and also had 2 times higher risk of death. Further data which was updated by the government in 2016 in the month of July is about 81000 people accounting for about 7% of the Saskatchewan residents of one year of older had been affected by diabetes (Feng et al., 2018). This prevalence rate gives a concerning picture of how residents of Saskatchewan are suffering from poor quality life due to diabetes. Critical Review Of The Statistical Data: Diabetes Charter for Canada as published by Canadian Association had given a detailed data about the condition of diabetes affected people in Saskatchewan. The key statistics state that estimated diabetes prevalence in Saskatchewan in 2015 is about 93000 that accounts for about 8.5% of the population (Kosar et al., 2018). The experts have analyzed the trend and had stated that it might grow up to the level of 129000 in the year 2025 that would account for about 11.1%. This data shows the instance where the chronic disorder of diabetes might impact the province as a major threat to health conditions in the coming years.  The estimated pre-diabetes prevalence that was found in the year 2015 in people who are above the age of 20 was about 175,000 which accounted for about 23.6% (Puntakhee et al., 2018). This number is suspected to increase to about 187,000 in the year 2025 which is about 24.8% of the total population. It could be seen that almost one fourth of the population in the year 2025 would become highly vulnerable to the development of diabetes which might have severe impact on the economy of the nation. The data also gives an idea about the estimated cost of diabetes in Saskatchewan. In the year, the estimated cost of diabetes is found to be about &482 million and this is believed to be increased to an amount of $567 million in the year 2025. This can give a wide idea about how diabetes can emerge as one of the most threatening chronic health concern in Saskatchewan affecting the economic stability of the province as well. The estimated annual out of the pocket cost for type-1 diabetes along with the administration of insulin with an insulin pump over the age of 26 based on the $ 43,000 annual income is found to be $5385 that shows about 12.5% of the income of an individual is spent on diabetes treatment (Harissa et al., 2016). Similarly, estimated annual out-of-pocket cost for type-2 diabetes based in the annual income of 43,000 annual incomes is found to be $2330 accounting for about 5.4% of the income being spent on treatment of diabetes type-2. It has been clearly stated by the experts after analysing the data collected that estimates diabetes prevalence increase in Saskatchewan would be about 38% from 2015 to 2025 (, 2015). The estimated diabetes cost would be also expected to increase by about 18% from the time 2015 to that of 2025. Therefore, it can be clearly stated that diabetes would be emerging as one of the largest threat in the province of Saskatchewan if no proper care measures and policies are undertaken to handle the situation effectively. A CBC news report published on 13th January in the year 2017 had also provided interesting data describing about the major threat that Saskatchewan would be facing in the coming years due to the chronic disorder of diabetes. The report is clearly of the opinion that the rates of diabetes in Saskatchewan continues to climb with 1 in every 10 residents in the province are living with the disorder (, 2017). This report is of the opinion that two in every 10 people are either pre-diabetic or are found to remain unaware that they have diabetes. The report had clearly stated that the number of the diagnosed people with the disorder in Saskatchewan had increased by 58% in the past ten years. Therefore, the experts are of the opinion that if the current trends tends to continue, the number is expected to rise further by a further 37% over the next ten years. The regional director of the province of Saskatchewan working with the Canadian Diabetes Association namely Brie Hnetka is of the opinion that the increasing rates of the disorder can be attributed to a number of factors. The regional director is of the opinion that Saskatchewan has the second largest number of indigenous population and this population are at about three to five times at the greater risk for the development of the diabetes than that of the general population. Moreover, the recent immigrants whom she is also quite concerned of to develop the disorder are the South Asian, Asian as well as the African people. Moreover, the respected person has also made people aware of the risk factors that contribute to the disorder. Aging puts an individual at a higher risk of developing the disorder as well as the risk factor for presence of diabetes in the family (Craig, 2016).  Moreover, being obese and having sedentary lifestyles and not eating a balanced diet put individuals at higher risks. Low income earners and people in isolated communities are also seen to be vulnerable as they cannot but nutritious foods in the Saskatchewan province. The ministry of Saskatchewan had accepted that there is no regular screening session for the complication as well as glycemic control across the province. Moreover, the province also lack endocrinologists and this had prompted the CDA for advocating for the government to put proper infrastructure in place for treating diabetes in better way. Hnetka is of the opinion that dieticians, social workers, your optometrist, diabetes educators, and foot care specialists all need to work together as a team for mitigating the threat (Nichols et al., 2017). She is also of the opinion that better communication as well as provincial program would seek for better employment and help in treating endocrinologists for treating the rising diabetes rates in diabetes educators, in best ways possible. This will help in handling the major threat that is approaching towards the province of Saskatchewan in the form of diabetes epidemic. Comparison With Canada As A Whole: According to the most recent data that had been provided by Public Health Agency of Canada (PHAC), it has been found that the scenario of prevalence of diabetes in the nation of Canada is quite similar to that of Saskatchewan. About 3 million people in the nation accounting for about 8.1% are living with the disorder as per the data of 2013-2014. It represents 1 in every 300 children and youths (1 to 19 years of age) and 1 in every 10 adults of the age of 20 years and older are living with the condition.  The prevalence of the diagnosed diabetes is seen to generally increase with age and that the numbers are higher among males accounting for about 8.7% than that of the females which accounts for about 7.6% (, 2017). Between 2003-2004 and 2013-2014, a relative increase of about 37.3% was found among the age –standardised prevalence of diagnosed diabetes from about 5.6% to that of 7.8%. Moreover, it is also found that Canadians with diabetes are now living longer. With the growth and aging of the Canadian population, the number of Canadians living with diabetes would be expected to increase in coming years (Mejia et al., 2016). Conclusion: From the above discussion, it becomes quite clear that diabetes had affected the province of Saskatchewan in a massive way with huge number of people being diagnosed with the disorder in the present years. Moreover, the trend shows that the number of affected individuals by the disorder would tend to increase in ways that would result in huge economic burden of health issues on the nation. Therefore, experts are of the opinion that immediate interventions like policies, recruitment of multidisciplinary healthcare teams with experts are necessary. When compared to Canada, the entire nation also shows similar scenario with huge number of people being affected by diabetes and living poor quality lives. Hence, healthcare departments of the government should undertake immediate interventions and strategies that would help in preventing the threat from affecting lives of the nation. References: Alsabbagh, M. W., Mansell, K., Lix, L. M., Teare, G., Shevchuk, Y., Lu, X., … & Blackburn, D. F. (2015). Trends in prevalence, incidence and pharmacologic management of diabetes mellitus among seniors newly admitted to long-term care facilities in Saskatchewan between 2003 and 2011. Canadian journal of diabetes, 39(2), 138-145. Bird, Y., Lemstra, M., Rogers, M., & Moraros, J. (2015). The relationship between socioeconomic status/income and prevalence of diabetes and associated conditions: A cross-sectional population-based study in Saskatchewan, Canada. International journal for equity in health, 14(1), 93. (2017) Diabetes in Canada, Public Health Agency of Canada Retrieved from: (accessed on 8th December, 2018) (2017) Diabetes rates in Saskatchewan continue to climb, CBC news report –online, Retrieved from: (accessed on 8th December, 2018) Craig, (2016) Saskatchewan diabetes rate more than doubles in the last decade, Global News, retrieved from: on 8th December, 2018) (2015) Diabetes Charter For Canada, Canadian Diabetes Association,  Retrieved from: Feng, C., Osgood, N. D., & Dyck, R. F. (2018). Low birth weight, cumulative obesity dose, and the risk of incident type 2 diabetes. Journal of diabetes research, 2018. Harrisa, S. B., Tompkinsa, J. W., TeHiwia, B., Harris, S. B., Tompkins, J. W., & TeHiwi, B. (2016). Call to Action: A New Path for Improving Diabetes Care for Indigenous Peoples, a Global. Kosar, L., Alsabbagh, W., Lu, X., Lix, L. M., Shevchuk, Y., Teare, G. F., … & Blackburn, D. F. (2018). Trends in Blood Glucose Test Strip Utilization: A Population-Wide Analysis in Saskatchewan, Canada. Canadian journal of diabetes, 42(1), 5-10. Lipscombe, L., Booth, G., & Butalia, S. (2018). Diabetes Canada 2018 clinical practice guidelines for the prevention and management of diabetes in Canada: pharmacologic glycemic management of type 2 diabetes in adults. Can J Diabetes, 42(Suppl 1), S88-S103. Mejia, S. B., Ireland, C., Augustin, L. S., Vidgen, E., Kendall, C. W., Mitchell, S., … & Coveney, J. (2016). Effect of Dietary Pulses in a Low Glycemic Index Diet on Renal Function in Participants with Type 2 Diabetes Mellitus. The FASEB Journal, 30(1_supplement), 421-5. Nichols, J., Gomes, T., Shah, B., Mamdani, M., Casey, C. G., & Yu, C. (2017). Impact of a Guideline Dissemination Strategy on Provincial Blood Glucose Test Strip Prescription Rates: An Interrupted Time Series Analysis. Canadian Journal of Diabetes, 41(5), S77. Punthakee, Z., Goldenberg, R., & Katz, P. (2018). Diabetes Canada 2018 clinical practice guidelines for the prevention and management of diabetes in Canada: definition, classification and diagnosis of diabetes, prediabetes and metabolic syndrome. Can J Diabetes, 42(Suppl 1), S10-S15. (2017), Health Status Report – Diabetes, Government of Saskatchewan,  Retrieved from: Spurr, S., Bally, J., Bullin, C., & Trinder, K. (2018). Let’s Make A Difference: Early Screening For Prediabetes And Type 2 Diabetes In Canadian Aboriginal Youth. Paediatrics & Child Health, 23(suppl_1), e3-e3. Weisman, A., Lovblom, L. E., Keenan, H. A., Tinsley, L. J., D’Eon, S., Boulet, G., … & Brent, M. H. (2018). Diabetes care disparities in long-standing type 1 diabetes in Canada and the US: a cross-sectional comparison. Diabetes care, 41(1), 88-95.

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