Type 2 diabetes, a disease caused by the impairment in the way body regulates and uses sugar as a fuel, is one of the most widespread diseases in the world. In particular, the United States has one of the highest rates of type 2 diabetes (T2D) due to the high obesity level across the country. Thus, it is crucial to analyze the development of this disease in the United States and provide recommendations on the psychosocial concerns and workplace environment measures to decrease incidences. With the increasing number of type 2 diabetes incidents and the cost of its treatment in the United States, proper measures are necessary to address psychosocial proliferation and the workplace environment concerns.
Development of T2D in the United States and Comparison with Developing Countries
Development of T2D in the United States
Although the scholarly consensus lacks, the body of evidence indicates that the number of T2D incidences has been increasing over the last several years. According to the findings of Weng et al. (2016), between 2007 and 2012, the incidence of T2D has decreased. Meanwhile, Jensen and Dabelea (2018) argue that there has been an increase in diabetes cases. The National Diabetes Statistics Report of 2020 indicates that for the entire period of 2002-2015, overall incidence of T2D have significantly increased (Centers for Disease Control and Prevention [CDC], 2020). During the 2002-2010 and 2011-2015, the incidence of T2D among the US population aged 10-19 years remained stable among non-Hispanic whites but significantly increased for all other groups, primarily non-Hispanic black people (CDC, 2020). Rowley et al. (2017) predict that the prevalence of the disease will increase by 54% between 2015 and 2030. Thus, the T2D development statistics stipulate the disease incidences have been increasing over the last several years and are predicted to increase for the upcoming decade.
Comparison with Developing Countries
On a global and regional scale, the United States has one of the highest rates of T2D. International Diabetes Federation (2019) reports that the North America and Caribbean region (NAC) has the highest number of adults diagnosed with diabetes in the world. The US has the highest number (31 million) in this region, followed by developing countries such as Mexico (12.8 million). On a global scale, the US has a higher rate of diabetes incidences than many developing countries, including Libya, Chad, Somali, and most African countries (International Diabetes Federation, 2019). However, the lower rate of T2D in developing countries might result from low data collection capacity, and hence the lack of credibility. Nevertheless, the existing data indicates that both on a regional and global scale, the US has the highest population with T2D.
Comparison of T2D Rates on the State and National Level
Similar to the national level trends, T2D rates in the home states of the US are also increasing. Out of 10 states with high rates of T2D, eight are located in the South (“Diabetes in the United States,” 2019). Specifically, West Virginia has the highest adult rate of diabetes at 15.7%, followed by Mississippi (14.8%) and Alabama (14%). Meanwhile, Wyoming (7.8%), Montana (7.6%), Alaska (7.3%), and Colorado (7%) have the lowest rates of T2D (State of Childhood Obesity, 2019). Statistics for the 1990-2019 period indicate that all states have demonstrated an increasing trend in T2D incidences (“Diabetes in the United States,” 2019). Thus, comparing state statistics to the national level reveals a similar trend of increase in the cases of T2D.
Cost of Treating T2D and Psychosocial Proliferation of the Disease
Cost of Treating T2D in the Community
The increasing costs of T2D treatment are among the most critical issues patients and their community are now encountering. The research has found that the cost of treatment and care for people with diabetes currently accounts for around one-quarter of the health care dollars spent in the U.S (Riddle & Herman, 2018). Nevertheless, community and group-based care for T2D patients is a cost-effective treatment (Davis et al., 2019). This type of treatment is also efficient as it prevents local hospitals from being overcrowded. Thus, although the cost of treating T2D is generally high, group-based treatments can be cost-effective.
Steps to Address the Psychosocial Proliferation
The psychosocial proliferation of T2D is another crucial aspect that needs carefully considered recommendations. A strong relationship has been found between depression and T2D, with potential mediators being the low level of physical activity, distress by being diagnosed by the disease, and its advanced duration (Darwish et al., 2018). These psychological difficulties proliferate to family and surroundings who need to care for their close ones. Thus, to provide the patient with the optimal medical care and psychological well-being, the following five steps of psychosocial care can be recommended (Young-Hyman et al., 2016):
- Facilitate the collaboration of patient-centered medical care and psychosocial care accessible to all people with diabetes. The involvement of both medical and psychosocial specialists is essential since the change in the treatment methods can significantly affect the psychosocial state of the patient;
- Both medical professionals and therapists should frequently visit patients to assess and detect the early symptoms of psychosocial difficulties;
- Professionals should also consider the life circumstances of the patient before the intervention into the physical and psychological health of the patient;
- Psychosocial specialists should address problems immediately after the identification since otherwise, the patient’s condition can escalate;
- The patient’s caregivers and family members should be involved in the decision-making process. Specialists should also address the caregivers’ psychological concerns since they often experience mental and psychological struggles such as overwhelmedness and distress while taking care of the patient.
These steps can alleviate the psychosocial struggle of both the patient and caregivers. A close collaboration of medical professionals and psychosocial experts can provide the optimal health and cognitive outcome for T2D patients.
Steps to Address T2D in the Workplace Environment
An individual’s working environment can have a significant impact on the risk of being diagnosed with T2D. Especially in jobs that require a minimal amount of physical activity, employees are more likely to increase their obesity level and, hence, be more vulnerable to diabetes. Moreover, individuals with a T2D diagnosis often face discrimination and stigma based on their health problem, including T2D and obesity problems (Olesen et al., 2020). Hence, employers should address these issues as part of their strategic goals to create a comfortable psychosocial working environment. Employers can implement the following six steps to address this concern:
- Create an environment where employees can disclose their T2D diagnosis to their employers without fearing repercussions. For instance, employers should not fire or cut salaries for workers with diabetes, believing that their productivity will decline. Instead, employers should offer flexible working hours and conditions so that employees will not be afraid of disclosing their diagnosis (Olesen et al., 2017). If employees do not disclose their diagnosis, employers cannot gather credible data, implement programs, and assess their effectiveness;
- Incorporate more physical exercises into the corporate culture. Employers can install more in-door exercise tools within the workplace building, and encourage employees to participate in marathons and other physical activities (Plotnikoff et al., 2017);
- Organize educational programs, talks, and webinars on the importance of emotional and psychosocial support for individuals and colleagues diagnosed with T2D. Employers should create a platform or mechanism through which workers who experience discrimination based on their diagnosis can report with confidentiality or anonymity ensured;
- Offer healthy eating and living programs as a mandatory part of the health plan. For instance, employers can reward those workers who stopped smoking, which is often one of the causes of T2D;
- Assess the effectiveness and costs of the health plans and programs through surveys to understand what programs have a positive effect;
- Systematically conduct screening programs of employees to identify at-risk employees and offer recommendations. Crucially, occupational health staff should monitor employees’ engagement with these recommendations (Kullgren et al., 2016).
Although these steps cannot guarantee the prevention of T2D for the workers, the existing review of the Diabetes Prevention Programs (DPP) indicates consistently positive outcomes (Brown et al., 2018). Hence, employers should carefully consider each of these recommendations and incorporate them into their programs.
Type 2 diabetes is one of the most acute health problems in the world. Despite having one of the most established economies globally, the United States has one of the highest rates of T2D. The adult population of ethnic and racial minorities is the most vulnerable to be diagnosed with T2D. Most importantly, the increasing rate of T2D diagnosed people is continuing across state and national levels and is predicted to double by 2030. Thus, policymakers and public healthcare officials should engage in a comprehensive strategy to address the challenges associated with T2D. Namely, physicians and psychosocial experts should implement the five suggestions mentioned above to address the psychosocial proliferation of the disease. In addition, employers should apply the six recommendations emphasized above to prevent the incidences for at-risk individuals and alleviate the psychological and physical difficulties for workers with T2D.
Brown, S. A., García, A. A., Zuñiga, J. A., & Lewis, K. A. (2018). Effectiveness of workplace diabetes prevention programs: A systematic review of the evidence. Patient Education and Counseling, 101(6), 1036–1050. Web.
Centers for Disease Control and Prevention. (2020). National diabetes statistics report: Estimates of diabetes and its burden in the United States. U.S. Department of Health and Human Services. Web.
Darwish, L., Beroncal, E., Sison, M. V., & Swardfager, W. (2018). Depression in people with type 2 diabetes: Current perspectives. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, Volume 11, 333–343. Web.
Davis, T. M., Drinkwater, J. J., Fegan, P. G., Chikkaveerappa, K., Sillars, B., & Davis, W. A. (2019). Community‐based management of complex type 2 diabetes: Adaptation of an integrated model of care in a general practice setting. Internal Medicine Journal, 51(1), 62–68. Web.
Diabetes in the United States. (2019). State of childhood obesity. Web.
International Diabetes Federation. (2019). IDF diabetes atlas (9th ed.). Web.
Jensen, E. T., & Dabelea, D. (2018). Type 2 diabetes in youth: New lessons from the SEARCH study. Current Diabetes Reports, 18(6), 2-7. Web.
Kullgren, J. T., Knaus, M., Jenkins, K. R., & Heisler, M. (2016). Mixed methods study of engagement in behaviors to prevent type 2 diabetes among employees with pre-diabetes. BMJ Open Diabetes Research & Care, 4(1), 1-8. Web.
Olesen, K., Cleal, B., Skinner, T., & Willaing, I. (2017). Characteristics associated with non-disclosure of type 2 diabetes at work. Diabetic Medicine, 34(8), 1116–1119. Web.
Olesen, K., Cleal, B., & Willaing, I. (2020). Discrimination and stigma among people with type 2 diabetes in the workplace: Prejudice against illness or obesity? Public Health, 180, 100–101. Web.
Plotnikoff, R., Wilczynska, M., Cohen, K., Smith, J., & Lubans, D. (2017). Integrating smartphone technology, social support, and the outdoor environment for health-related fitness among adults at risk/with T2D: The Ecofit RCT. Journal of Science and Medicine in Sport, 20(1), 53. Web.
Riddle, M. C., & Herman, W. H. (2018). The cost of diabetes care—an elephant in the room. Diabetes Care, 41(5), 929–932. Web.
Rowley, W. R., Bezold, C., Arikan, Y., Byrne, E., & Krohe, S. (2017). Diabetes 2030: Insights from yesterday, yoday, and future trends. Population health management, 20(1), 6–12. Web.
Weng, W., Liang, Y., Kimball, E. S., Hobbs, T., Kong, S. X., Sakurada, B., & Bouchard, J. (2016). Decreasing incidence of type 2 diabetes mellitus in the United States, 2007–2012: Epidemiologic findings from a large US claims database. Diabetes Research and Clinical Practice, 117, 111–118. Web.
Young-Hyman, D., de Groot, M., Hill-Briggs, F., Gonzalez, J. S., Hood, K., & Peyrot, M. (2016). Psychosocial care for people with diabetes: A position statement of the American Diabetes Association. Diabetes Care, 39(12), 2126–2140. Web.