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Perspective on the Problem:
Diabetes mellitus is common, serious, and costly. Approximately 16 million people in the U.S. have diabetes (6.5% of the population). Typically Type 2 diabetes mellitus occurs in obese older individuals. Americans are gaining weight due to our high fat Western diet and decreased physical activity. With increases in our life expectancy, therefore, diabetes mellitus is assuming proportions of an "epidemic". While Type 2 diabetes is generally considered a disease affecting adults, an alarming increase in this disease is occurring in children-again, related to increased weight and inactivity.
As diabetes progresses, it affects almost every major organ or body system (i.e. kidneys, eyes, skin, heart, blood vessels) producing devastating diseases, disability, and premature death. Billions of dollars are spent each year on diabetes care and the complications it causes.
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This chronic illness and related complications are responsible for 25% of all health expenditures in the Medicare program {Golden,W., (2/8/00) Arkansas Foundation for Medical Care Manuscript}. Residents of the Delta are certainly at risk for developing Type 2 diabetes. Prevalence varies with race and ethnicity. An increased incidence occurs among African Americans between the ages 65-74. Native Americans and Hispanics also develop the disease more commonly than Caucasians. Poverty and low education levels in the Delta Region result in poor diets and lifestyles that increase the risks of diabetes. Diabetes is a disease that is greatly affected by the patient's own knowledge base and skills. As a result, teaching patients to maximize their self-care through the acquisition of knowledge, skills and attitudes is essential. Health care providers are challenged to communicate in a culturally sensitive manner that will provide individuals with the needed
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