Title?

Example: Prevention and Management of type 2 Diabetes

The prevalence of diabetes are alarming and rapidly getting worse.
This is a worrying world-wide trend Margaret Chan 2016.
WHO defines Type 2 diabetes (T2D) as an increased concentration
of glucose in the blood (hyperglycaemia), due the bodys ineffective
use of insulin. On the 7th of June 2016, WHO dedicated the World
Health Day to diabetes and launched their first global report on
diabetes. Define/briefly explain in your own wording
There are 3.1 million adults in England having diabetes and half of
them undiagnosed (Kamlesh Khunti and Melanie Davis). With figures
like these, coupled with limited financial and human resources, it is
only rational to expect a growing debate on whether or not
screening for T2D should be recommended.
In this essay, I will summarise arguments put forward by Kamlesh
Khunti and Melanie Davis (in favour of screening for T2D), and those
by Elizabeth Goyer and Colleagues (supporting a population
approach as opposed to screening). To conclude, l will weigh both
arguments and make a standpoint on whether or not we should
screen for T2D. Dont need to include your work plan in the report
Firstly, in accordance with According to Kamlesh Khunti and Melanie
Davis, half of the 3.1 million people with diabetes in UK are
undiagnosed, only getting a diagnostic test later when complications
are already taking place. With this in mind, targeted screening for
T2D could lead to early diagnosis as such giving rise to possible
discovery and hence, potential patients can be better managed and
treated. Kamlesh and Melanie drew evidenced from the addition
ADDITION Study which showed a great improvement (75%
reduction) in cardiovascular risk factors in patients with screen
detected T2D who received intensive treatment, compared to those
who only received basic primary care. They also cited the ACCORD
and Veterans Administrative Diabetes Randomised trials, which
concluded that early diagnosis due to screening, followed by
effective management, was beneficial to patients as well.
To enlightened this point, Kamlesh and Melanie look at two cost
effective models. One of the models puts the cost of screening at
6242 for each quality of life gained, while the other model proved
that screening for type 2 diabetes between the ages of 30years and
40years was cost effective, as opposed to no screening. They stated
that screening will reduced death incidence by 2-5 events per 1000
people screened, and mentions another review which supports
targeted screening.
In addition, Kamlesh and Melanie cited two initiatives in England, the
National Health Service (NHS) checks program (which includes
diabetes amongst others), and The National Institute of Health for
Clinical Excellence (NICE) guidelines on identification and prevention
of T2D (both for adults aged 40 and 70 years). For both strategies,
their claimed are in support of screening with the latter proven to be
cost effective.
On the other hand, Elizabeth Goyer and colleagues, while
acknowledging the benefits of screening, argued that an approach to
targeting the general population is a better strategy. They disputed
that screening is not worthwhile since People at risk of T2D will
always be advised and motivated to make lifestyle changes whether
they are screened or not. They went on to suggest that the
estimated 30million cost of screening in England should be better
spent on the clinical managing of diabetes.
Furthermore, Elizabeth and Colleagues, put forward that despite high
cost of screening programs, it is not certain whether or not people
will change their behaviour. They mentioned that health inequalities
may be increased due to screening because personalised behaviour
change advice means that richer people would be able to afford
these changes compared to poorer people.
Since advice giving to people at risk of T2d (eating healthier and
exercising more) can also be used to target the general population
and have positive effect on other health conditions, Elizabeth and
colleagues argued that it is therefore reasonable to consider a
population approach rather than target only those at risk of T2D.
They state that a Population approach have other benefits like
promoting active travel (for example, exercise by cycling to work),
and making healthier food options like fruits and vegetable readily
available (such as regulating the food and drink industry.
Elizabeth and colleagues concluded that the rise in the number of
cases of obesity diabetes can be avoided and that instead of
screening, more focus should be aimed at the wider population.
To conclude, from citing studies and Trials like ACCORD AND
ADDITTION, to cost effectiveness models and initiatives like NHS
Checks and NICE guidelines on the identification and prevention of
T2D, Kamlesh and Melanie make a clear point why we should screen
for diabetes. Elizabeth and colleagues meanwhile pointed out that
screening has various disadvantages and list some advantages of a
population approach.
Screening for T2D may be important to identifying those who can
benefit from a combination of drugs treatment and lifestyle changes
(WHO 2001 REPORT) while a population based approach proves
beneficial reducing the risk factors of T2D. Thus, to prevent and
manage this health malicious (type 2 diabetes), it will be better to
apply Screening in conjunction with a population based approach.