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The study is based on the identification of the effectiveness of the “Diabetes Prevention Programme (DPP)” by the NHS in the management of type 2DM among the adult population in the UK. The study also shades on the effectiveness of the behavioral intervention in the management of the issues associated with the diabetes mellitus among the adult population. The study suggests the main cause of developing cases of type 2DM is associated with obesity and an inactive lifestyle of the adult population. It is clear that inactivity and improper eating habits or lifestyle directly affect the pancreas, which is the main part of the body, producing sufficient amounts of insulin to maintain sugar levels in the blood.
There are several reports on the diabetes problem in the UK. According to government repoprt of UK, it shows that nearly 3.8 billion people have been suffering from the disease diabetes (Gov.uk, 2016). The patient, who is diagnosed with a diabetic problem has main symptoms of reduction in the normal level of blood sugar, which causes abnormality in the normal mechanism system of the body. There is also an increasing rate of death in the UK due to the diabetes problem which increases the comorbidity in case of the treatment of another disease (Diabetes.co.uk, 2015). Therefore, it is a very important phenomenon to understand the importance of the effectiveness of the prevention of diabetes. A better understanding of the effectiveness of preventive measures can reduce the future risk of diabetes in the country of the UK.
Diabetes mellitus is one of the greatest medical issues and most prevalent lifestyle disorders that the UK is facing at present. The introduction section of this study is going to discuss the background of diabetes mellitus and the prevalence of type 2DM among the adult population in the UK. The rationale of the introduction is going to discuss the issues associated with the prevalence of type 2DM and the risk factors for developing the type2DM among the population. This section of the study will also shade upon the objectives and the research question of the study.
The cells in fat, muscles, as well as liver, do not react to the insulin which prevents it from performing its desired function as they become resistant to it. How the cells should normally react or interact with insulin does not take place and the sugar taken in by the cells is not enough as most of it gets left in the bloodstream (Finer et al. 2018). The major reason behind this issue is not yet known clearly but having an inactive lifestyle and being overweight can be some of the major contributing factors behind the onset of this disease.
As the study suggests the risk factors for developing Type 2 DM among the adult population are such as being overweight and having high obesity, Blood pressure increases, Polycystic ovary syndromes, Family history of having diabetes as in the genetics, Level of blood lipid, Age variation (NHS, 2020), Pre-diabetes.
The main reason behind choosing this topic for the research purpose is the lack of primary data which is related to the topic. the lack of information regarding the association between diabetes and other diseases. The main cause of choosing this topic is to identify the effectiveness of the diabetes management program in the NHS for the management and prevention of the rate of Type 2DM among the adult population. The relevant data is not present in the past studies regarding how the NHS program affects and influences the behavioral modification of the adult population in the UK. The past studies are also lacking information regarding how much the adult population shows faith in the behavioral intervention for preventing lifestyle disorders including Type2DM.
To scrutinize 2 academic databases for relevant articles
To review the 2 databases in order to analyze relevant themes that occurred in searches.
To identify intervention programs to prevent Type 2DM in the UK.
To evaluate the effectiveness of “The Diabetes Prevention Programme (DPP)” by the NHS in the management of Type 2DM in the UK.
To analyze the impact of the intervention among the adult population in the UK.
To evaluate the effectiveness of behavioral modification in the prevention and management of Type 2DM in the UK.
To analyze the impact of behavioral modification among the adult population in the country.
This research is based on the critique analysis of the previous studies regarding Type 2DM and its prevalence in the literature review section of the study. This research is based on the identification of the two databases from PubMed and ScienceDirect and the analysis of those databases to evaluate the effectiveness of NHS DPP programs in their management of Type 2 DM among the adult population of the UK.
Introduction
This section of the study is based on the critique review of the literature regarding the chosen topic. The broad section of the study will be discussed in the previous portion of the literature review such as the Concept of Health care, Effectiveness of diabetes, Importance of health improvement programs, Problem Statement and Research Justification.
Concept of Health care
Heath care programs found activities that help individuals or a community to live a healthy life by providing information about factors that can affect their health and well-being. Social care mainly supports people by providing knowledge regarding "proper activities", "personal care" and "social works'' to live a healthy life (Kingsfund.org.uk, 2017). Is apparent that diabetes is now the most abundant health disease in the UK. One in ten people in their 40s age group is now suffering from diabetes. 4.7 million people in the UK in current years are suffering from Type-2 Diabetes (Diabetes.org.uk, 2019). Inactivity and improper lifestyle influence the tendency of Type-2 Diabetes in people. Additionally, improper lifestyle and inadequate levels of physical exercise are the primary reason behind diabetes in this era. It increases blood sugar levels that increase the chances of other comorbidities. As per sources in the UK, due pandemic situations and restrictions on the normal lifestyle of people increase the number of patients affected by diabetes (Carr et al, 2021).
Effectiveness on diabetes
Effectiveness of diabetes type II involves the use of each medication that is necessary and effective. This will help in reducing the A1C(what is that)by 2%. Other aspects can also be reduced by using 1%. Most people think it is necessary to lower the A1C level. Various complications are present in diabetes. It also includes the comorbidities that are present in heart and blood vessel disease (Galicia-Garcia, 2020). Diabetes even increases the risk of heart disease, high blood pressure, and stroke. Other diseases are also present due to the impact of diabetes in type II.
There are several health and social care programs present in the UK to increase awareness among people regarding diabetes and also help to support patients through effective treatment, as NHS Diabetes Prevention Programme (NHS DPP).As per the concept of improvement programmes, the main purpose of this programme is to deliver effective services to the people suffering from diabetes. It cannot be denied that at the time of pandemic due to restriction over citizens regarding movement, people with diabetes faced challenges regarding their treatment. Moreover, it affected their mental as well as physical health. In this regard, virtual clinic processes were used to provide effective support to the patients and also reduce the burden of treatment or clinical experiences at the time of the pandemic.
This process of virtual treatment programs provides beneficial prospects regarding treatment and solutions to reduce challenges (Quinn, Davies, & Hadjiconstantinou, 2020). Moreover, "Diabetes self-management education(DSME)" helps to provide education and support to their patients to reduce the impact of diabetes and intervention of technologies in the health care system support this DSME programme by attractive presentation to enhance awareness among patients regarding "self-management" (Pal et al, 2018).
Importance of health improvement programmes
Various ways are present that help in improving health such as eating healthy, moving around, skip diets, and making healthier choices. Different principles are present for planning the health education in diabetes type II. The plans should be made accordingly keeping in mind the need and the main context. The basic needs as well as the community interest need to be maintained in order to plan the education process in type II diabetes (Zheng, 2018). Appropriate planning needs to be carried out for maintaining the implementation of an activity. The community resources should also be identified and managed in order to solve the issues. These are the principles in planning of health education in type II diabetes.
Prevalence of diabetes and the health-related recent issues among adult population in the UK
There is a high prevalence of diabetes in the UK. The aspect of obesity has been understood as the main contributor present in increasing the prevalence of diabetes. Different factors are also present like aging, and lifestyle (Foretz, 2019). Other physical, as well as mental activities, are present. The process has been discussed in this part. The mitigation practice that can be followed in this research is following a proper diet plan. Physics exercises should be carried out by individuals in order to maintain the diabetic rate. It can also come from the family if the parents and grandparents have a diabetic problem it can be got by the next generation through them this is the problem called family history diabetic problem, this consists due to the family medical history that is also common like the genetic factors that are responsible for the diabetic problem but it is not mandatory to have a diabetic problem always affected by the family it can also generate from own disorder order it can happen due to the absence of insulin due to some problem in the pancreas, the normal body fails to produce insulin this is the problem that can also be noticed due to the inactive lifestyle of the people know a day it is very common to for every person due to their irresponsibility behavior towards their body as well as it is very problematic to handle mental stress that causes lack of rest in an everyday busy schedule that changing the concept of healthy living this causes the diabetic problem.
Current programs of NHS to manage diabetes
The program which was launched by the Government of the UK to manage diabetes is “The NHS Diabetes Prevention Programme (NHS DPP)”. “Public Health England and Diabetes UK'' also provide approval for this program. This program is based on the evidence and science-based intervention for behavioral modification to prevent, manage and reduce the risk associated with Type2DM. This program will take 12 weeks of online classes for behavioral and lifestyle modification. “The NHS Digital Weight Management Programme” was also launched by NHS for the management of the weight to prevent diabetes among the population in the UK.
Conclusion
The literature review section of the study can conclude that the effectiveness of the diabetic problem is near about 3. 8 billion people are suffering from a diabetic problem that mainly includes the decrease in the normal blood sugar level that causes malfunction and the normal activity of the body. This also includes the high level of cholesterol and it also includes obesity. According to the research, it can be said the normal blood sugar level is nearly about 140 mg /dl. Most importantly this increases the disability of the society that also creates the problems like obesity and Inappropriate distribution of fat which is the most effective problem for diabetic patients.
This study is mainly focused on the “preventive measure for performing a health care program” for type-2 DM. In this case, the main focus of the study is the determination of the effectiveness of the health care program regarding the preventive measures for the disease of diabetes. therefore the methodology of this study mainly refers to the strategy of overarching this study. it involves mainly the methods which are included in this study to express and define the theories and principles that are helpful to develop some approaches that can mitigate the problem associated with type two DM. In this methodology to collect data and information are collected, are analyzed by qualitative data analysis. Qualitative data analysis can actually help in this study by structurally studying, identifying, and examining the data by the means of observation or interpretation. the research philosophy in this research is pragmatism and the method followed to properly define the study is the interpretivism method.
The methodology of this study mainly helps in defining the proper rationale of the research study regarding diabetes and its prevention. by the study of the methodology, it becomes easier to understand how it involves the identification n, examination of the factors behind the increased diabetes risk, and the intervention of preventive measures with the help of data interpretation. The research philosophy for this topic is followed is mainly the pragmatism method which is followed to meet the research philosophy. Pragmatism mainly works based on the question that is generated by a researcher which mainly helps min get the answers of “how, when” of the questions of interest (Rorty, 2020) The theme that is selected is mainly analyzed by the application of the interpretivism method, in this case, the interpretivism method is mainly used to understand the actual interest of the researches on a particular topic ( Ryan, 2018). Interpretivism mainly is based on the principle that helps in the analysis of the data searched by the researcher. in this methodology, the research data are mainly collected and analyzed based on the qualitative methods of the research which basically help in the interpretation of the data or the information that are mainly characteristically observed and analyzed.
There are two types of research approaches in the form of inductive and deductive approaches that can be usually adopted in the research. The inductive approach of research is taken when there is not enough previous literature available on the research topic and a new theory has to be developed by observing the prevalent situation and finding appropriate patterns in them. The findings obtained through the inductive approach cannot be proven. The research approach that has been chosen for this research is the deductive approach as this enables the researcher to test the various existing theories and literature to find if the developed research hypothesis holds true or not by extensive analysis of all data. The cross-sectional data requirement includes the primary quantitative method. The process of the survey is maintained in this research. The sample size needs to be in a bigger number in order to analyze the in and out of the research. This research is totally dependent on the primary and the secondary research keeping in mind the literature review (Taylor, 2019). The research methodology includes the quantitative and the qualitative research methods.
Article 1:
Carris, N. W., Magness, R. R., & Labovitz, A. J. (2019). Prevention of diabetes mellitus in patients with prediabetes. The American journal of cardiology, 123(3), 507-512. https://www.sciencedirect.com/science/article/pii/S0002914918320472
Article 2:
Penn, L., Rodrigues, A., Haste, A., Marques, M. M., Budig, K., Sainsbury, K., Bell, R., Araújo-Soares, V., White, M., Summerbell, C., Goyder, E., Brennan, A., Adamson, A. J., & Sniehotta, F. F. (2018). NHS Diabetes Prevention Programme in England: formative evaluation of the programme in early phase implementation. BMJ open, 8(2), e019467. https://doi.org/10.1136/bmjopen-2017-019467
3.5 Validity, reliability and ethical issues considered while shortlisting
In article 1 the research is conducted based on the qualitative research. In this qualitative research measurement interview on a group of individuals is conducted. in this study mainly the data are collected and the informations are gathered by discussions with stakeholders, examination of recruitment and fidelity procedure. according to the study of Carris (2019), in this case the study is based on the prevention of the diabetes diasease mainly in ten people who are at the high risk. therefore in this study total of 7 NHS-DPP programming site were selected and divided based on 27 wave side access the area of england. this shows the important of the intervention of preventive measure in the diabetes controll program in the health care system (Carris et al.2019). in this case the main focus of the study is to determine the factors of increase cases in the diabetes and to improve the preventive measure for reducing the death rate due to the diabetes and the comorbidity regarding diabetes.
In the article 2 , the research is based on the secondar y rteserch . in this case the data and the informations arte collected through the qualitative data collection method. thuis study manly focuses on the normalization of the prediabetes, which mainly focuses on the reducing the number of diabetes cases while imporoving the condittion of the patient regarding diabetes. according to the study of Penn et al. (2018), in this case a diagnosis of prediabetes condition is considered to be the preventive measure of the disease treatment strategy. Therefore in this case to reduce the chances of the diabetes cases in the people the preventive treatment strategies are developed with the medication procedure and healthy daily lifestyle chyanges.
3.6 Topic generated (from the shortlisted articles)
Research question
Theme 1: Evidence base preventive health programm
The evidence based prevention programm is a process of preventive measures that are taken when a diseses creastuibng a huge increase in the death rate asnd increasing the mortality rate in the health care system. this evidence based preventiion program mainly referds tio the styrategies and the policies that are mainly taken and followed by the members of the health care program to improve the health quality among the population to improve the prevention measure reduce the death rate and the mortality rate due to a particular disease (Carris et al. 2019). Therefore the eveidece based prevention progaam plays a crucial role in order to determine the efficacy of the preventiove program in the health care system.
Theme 2: Delevery of intervention of preventiove care
The intervention of the new strategies and the new preventive measure to a huge population or to a community of a country is the most important area of the health acre system. in this case the preventive programm faces several challenges such basd the literacy gap, wrong concept practice about the diasaese outcome, lack of concern about the unhealthy food habit and the cost effective reason opdf the people (Penn et al. 2018). these area creastes problem while intervention and implementation of anf changes in the healthcare system and in the health strategy.
Theme 3: Prediabetes care
pre diabetes is a condition when the diabetes uis nopt diagnosed due tio a mild changes in the susghar ,level of a patient but by the measurement oofg the opther factors bthe rtisk of the disease in a patirent can be measured. this canb help in taking action before the condition get worsen (Penn et al. 2018). Therefore the prediabetes care is very important to reduce the risk and prevent the bigger copmplecation in case of a patient who have chances and risk of getting the disease.
3.7 Conclusion
The research methodology that is adopted in this research for the collection of data would comprise of secondary qualitative data. in this research, thye main focyusn ogf the topic is to determine the effectivenerss of the importance of health improvement and preventive care program in the Diabetes treatment in the UK. therefore bthe methodology help in the understanding of the importance of the topic by generating some question and providing enough informations against the questions. by the help of generating some thens based on the selected article which are relevant to the topic it becomes easy to understand how the program can be achieved succersfully. The research journals that will be collected for this research would be from the year of 2017 to 2022 and others will be excluded to make sure that the data is relevant and latest. The keywords that will be used for this research would include diabetes, health improvement programs, risks of type 2 diabetes, diabetes treatment and importance of the program among others. All these journals will be collected in English to make sure that it is understood by a large section of people.
Here is this research paper, it is using the secondary qualitative daqta. Here in this research paper, it is used because it is the easiest and cheap or it can be said that it is free to get the data about the data on the diabetic patients that also include the time that also allows generating new insights from the previous research or analysis (Aiello, et al.2018). And the most important to use this data is it is very easy to access as well as anyone can collect the data.Some limitations of this data are the quality of the data may be poor and may not satisfy the researcher's need. It is also very important to follow the strategies that are required for the research work that can result in incomplete research work.
Both Primary and secondary qualitative data analysis has been used in this research (Rübsam, 2018). The primary qualitative data means interview analysis has been carried out. In the secondary qualitative research, the thematic analysis has been carried out. Different themes have been entailed in this research. In the interview, analysis tables and charts have been designed by the researchers.
In order to get the findings, primary qualitative and secondary qualitative data will be used. This will help in establishing the findings. In the primary qualitative data, interview analysis will be carried out. Different interviews will be carried out, as well as statistics have been provided for mitigating the objectives of the research. The ongoing collection of data helps in accessing the codes to establish proper discussion levels.
Primary Qualitative:This specific pattern in research helps in applied health sciences (Vujosevic, 2020). The outcome will be provided in a coded frame that will help in providing knowledge regarding the perinatal services. The barriers, areas of satisfaction, and improvement areas will be studied in this research. This interview pattern will be carried out by a sixstep process of Braun and Clarke for mitigating the research.
Secondary Qualitative: The secondary qualitative data looks after the thematic analysis. Different themes will be established by the researchers to mitigate the objectives of the research. The themes will be derived from the objectives of the research (Vujosevic, 2020). The data collection processes will be helping in developing the codes and the patterns needed for discussion. The qualitative analysis of data regarding the software is Nvivo. This will help in managing and organizing the data for analysis.
This research is quantitative research as well as qualitative research, the informed consent needs to be clear. Proper rules and ethics should be followed throughout the project in order to complete the project. The copyright act has been followed in this research. The data protection act has flowed into this research. The individuals were informed about the research topic. Proper consent was taken from them. No data has been manipulated for carrying out this research. Confidentiality of all individuals has been maintained (Taylor, 2019). All the data have been deleted by the researchers after research completion.
This research helps to identify the importance of improvement in the health programs for diabetes. This chapter also focuses on the cause and effect of the disease on normal people in the parts of the country within a community or within a particular population. The health program in this case mainly aims to be explored for the health care improvement program and preventive care program improvement (Scharp, 2019). The program of preventive measures for the disease of diabetes type II and its treatment as preventive care can be identified in this research. Therefore, the preventive care program can be held and the effectiveness of this program can be determined by this research study which may have a great impact on the future status of the disease cases.
According to Article 1 the data are mainly collected based on the epidemiologic way and observational methods. This data demonstrates that the symptoms and effectivity of the disease diabetes T2 are mainly associated with increased cost-effectiveness, mortality, and morbidity. according to the study of Article 1 high-intensity changes in lifestyle and the use of metformin demonstrates that this procedure has an effective impact on the prevention of diabetes (Carris et al. 2019). According to the report of article 2 based on the agreement of ADA and AACE/ACE guidelines it shows that patients who have been diagnosed with prediabetes, the plasma glucose during their fasting is 100-125 mg/dL and after that on the tolerance of 75 gram oral glucose the test shows a resultr of 140-199 mg/dL which is 2hour post parandial. in this case the medical cases and the medical study shows the ADA guideline includes mainly HbA1c levbel of 5.7-6.4% as an indicative for the prediabetes patient.30 Through the course of standard care, cardiologists will invariably identify patients with dysglycemia (Carris et al. 2019). We bly advocate for cardiologists to increase action on abnormal results.
According to Article 2 the report of NHS DPP Management said that 6577 people were at high risk from 1 April of 2015 to 31 March of 2016 (Penn et al. 2018). The intervention of prevention were strted on rest 48% of those people who were reffered to seven demostator site of progam. 43 606 people from 1 April of 2016 to 31 March of 2017 with NDH were total of 116% who were referred to the first wave programmes. after the fully implemented of NHS DPP, it is shown that it can provide the public an evidence-based lifestyle programm of intervention to prevent the case of T2D in adults and those whjo are at high risk (Penn et al. 2018). In this study it has been shown that the “NHS DPP implementation’s” formative evaluation program gives an idea about the intervention specification whiuuch actually reflects current evidence.
4.3 Effectivness of intervention program
Here this research study mainly concludes the basic research work that has been done on the topic of diabetic disability in the country that mainly includes the benefits to find out about the increasing rate of diabetic disability and their symptoms here in this portion of the research work that mainly concludes the steps to prevent diabetes and it also includes different strategies that can be used for the future research purpose it also includes the different statistical data along with the informational sheet. This research includes the benefits of the mixed data that have been taken here. It also includes the prevention management procedure that will be very efficient in the analysis process. This also includes the theme that deals with the different health improvement programs.
This study focuses on reducing the mortality rate due to a particular disease that is the death rate of type 2 diabetes. It mainly includes the concerns about the morbidity and the complications that are associated with the diseases that can harm and affect the condition of the patient's health which may lead to an increased mortality rate in a community or in a population. This study discusses the prevention procedure so that the risk of getting the disease and suffering from the disease gets reduced. Therefore the study shows different types of improvement strategies for reducing the rate of diabetes cases. It thus can help in the improvement of a program that includes the major steps and effective planning. The health care programming and the planful step of preventive care for the diabetes disease are more relevant to the current condition to improve the situation and the health-related conditions of the patient.
Type-2 diabetes mainly occurs due to obesity and a defective lifestyle. Inactivity and unhealthy eating habits and an unhealthy lifestyle directly affect the body’s mechanism system. The pancreas is an important body part that functions in the regulation of hormonal balance in the body by producing particular amounts of insulin. The level of insulin mainly maintains blood sugar levels in the human body. This issue of death and mortality rate is very high due to the type 2 diabetes among the population of the UK. There are almost 4.7 million people who are suffering from the disease and related complications. The number of people currently facing type 2 diabetes is about 7% of the total population in the UK.
Prevention measures for the disease of diabetes are a serious issue. There are several ways through which the actual prevention measures can be taken. Several health programs can be held in the areas where there are huge cases of diabetes among the population. There are many health care Program principles that can be applied for planning to promote diabetes prevention measures. There are also other ways to prevent diabetes in a huge population by providing health education on the importance of preventing diabetes type II and the impact of the disease on public health (Carr et al. 2021).
The structure of the healthcare system should be developed so that mobile preventive care can be implemented as a healthcare plan. In this case, the health care system should hold some campaigns in a remote area or in the community where there is an increasing tendency among the people to develop the disease according to the lifestyle of a particular community (Goff et al. 2019).
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Appendix A
Findings of primary qualitative data
Q1. What are the primary causes of type II diabetes?
According to this table, five different doctors have been interviewed; each and every one of them had a different perspective. The first doctor stated that cells in the muscle, fatty livers are the reason for type II diabetes. Second doctor that was interviewed stated that the cells do not interact in a normal way which leads to insulin loss. Third doctor stated high blood triglyceride is the reason for this problem (Scharp, 2019). The fourth doctor had a different perspective; he said that Heart diseases are the reasons for this problem. Lastly, the fifth doctor stated intake of alcohol is the reason for type II diabetes and it is bad for health.
Q2. What is the impact of type II diabetes on general body systems?
According to this table, again five different doctors have been interviewed and again each of them had a different perspective. The question asked to them was the impact of type II diabetes on human health. The first doctor stated, the major organs are affected in the body due to this. The second doctor was clear about his perception, he stated eyes, kidneys, and nerves are affected by this problem of type II diabetes. The third doctor stated Respiratory systems are affected by this problem of type II diabetes (Rübsam, 2018). Fourth doctor stated that individuals suffering from diabetes will lead to diabetes in their future generations. This means they are having diabetes in their genetics. . Lastly, the fifth doctor stated, the whole immune system gets affected by this problem.
Q3. What is the future impact of the pre-existing improvement activities in diabetes II?
According to this table, an interview was carried out regarding the future impact of pre-existing improvement activities in diabetes II. Again five different doctors were interviewed; each and every one of them had different perspectives. The first doctor stated, Bariatric surgery can be used for improving the glucose control. Second doctor stated, the newest technology regarding the artificial pancreas can be used for testing certain patients. Then the third doctor stated, scientists are working their ground fit to understand the cure. Fourth doctor had a different perspective regarding the whole matter. He stated Proper healthy diet and exercise will be helping eradicate the impact of pre-existing improvement activities in diabetes II. Lastly, the fifth doctor stated, Achievable targets should be set to mitigate the problem.
Appendix B
Findings of secondary Qualitative data
Thematic analysis
Question 1 What is the importance of health improvement in diabetes II treatment ?
Question 2 HowExploring the functions of health improvement programs can be done?
Question 3 What will be the future impact of the pre-existing improvement activities?
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