The Causes and Epidemiology of Diabetes

The Causes and Epidemiology of Diabetes

Diabetes is an endocrinological condition that is characterized by raised levels of blood glucose. It results from a defect in the insulin production, action or both (Wu et al., 2014). It can also be described as a metabolic disorder with multiple causes and is manifested via chronic hyperglycemia. These symptoms are followed by subsequent disturbance of fat, carbohydrate and protein from the defect in the pancreas that produces insulin and then affects its function. Diabetes has many risk factors which make the condition a lifestyle disease (Waller, 2016). For its prevention, healthy living concerning diet and exercises ought to be maintained.

PICOT format.

It provides a standard formula for developing research questions (Melnyk et al., 2014). It entails the following:

(P) – Population refers to the sample of the population that one wishes to recruit in a study. In this case, the population will encompass the known patient having diabetes.

(I) – Intervention refers to the treatment that the target population is subjected to and observing the expected outcome or the response.

(C) – The comparison determines the plans of using a separate group to compare the results of the treatment. The group can have standards to meet hence forming a control group that acts as a point of reference to the researcher. In this case, the reference group with diabetic patients not enrolled in the support group.

(O) – Outcome encompasses the results that are measured to monitor and evaluate the efficiency of the intervention. Improved management and fewer instances of complications of diabetes will form the outcomes to be measured.

(T) – Time entails the duration of the collection of data to determine the impact generated.

PICOT question

Among patient having diabetes, how do enrollment to support groups enhancing their management of the condition as well as reducing the development of diabetes-related conditions when compared to individuals who have not joined the units within six months?

Stress and Diabetes in Socioeconomic Context: A Qualitative Study of Urban Indians

Background of the study

Although there exists sufficient qualitative information concerning the diabetic patient from high-income countries, there is scanty information that provides insight into experiences of diabetes in India and low-income groups. Mendenhall et al.,. (2012) carried out a study by venturing into the personal illness narratives to understand diabetes and peoples experiences in various groups.

Method of study

In-depth qualitative interviews and Hopkins Symptoms Checklist were used for data collection. A convenience sample of 59 was recruited into the study. 20 of them were identified to be eligible for the study as they were from low-income areas. The qualitative interviews covered their daily activities, living conditions and the causes of their diabetes. These were obtained and recorded in narrative form.

Results of the study

From the study, Mendenhall et al. (2012) realised that about 55% of the population in the low-income group had co-morbid depression. This percentage was relatively higher compared to the overall occurrence of depression (41%) in addition to the middle-income group at 38% and the high-income group at 29%. Among the low-income participants, 55% reported having been diagnosed with diabetes ten years before the interview as compared to the 76% among the middle-income groups and 79% among the high-income groups.

On diabetes beliefs, 49% were unaware of the causes of their diabetes while 24% associated it with stress, 17%  associating it with eating habits while 14% relating their condition to heredity. These results reflect the global distribution of diabetic cases in various communities as well as their causes. This consideration attributes to its relevance and credibility.

Ethical considerations

Throughout the study, the privacy of the participants was maintained. Confidentiality was also taken care of because the report was only made as a summary representing views of all the participants. Mentenhall et al.,(2012) acknowledged the authors of all the articles used via citations and the making of reference lists hence making the material original and free of plagiarism.


This article provides a significant attribute to the nursing practice. This contribution can be associated with the determination of various aspects that related to causation of diabetes in multiple communities. These include social distress and depression, inadequate access to healthcare as well as low diabetes knowledge. With this information, nurses cab strategise on their interventions to curb the continuously increasing incidence and prevalence of diabetes.

Epidemiology of diabetic ketoacidosis in Arab patients with type 1 diabetes: a systematic review

In various countries, the disease burden of diabetes is already high and continues to rise day by day. This burden is increased further by the worldwide rise in the prevalence of unhealthy lifestyles and obesity amongst populations. Zayed (2016) estimated that in 2013, the globals prevalence of diabetes was at 382 million with the figure expected to rise by 2035. Type I and Type II diabetes are the main types of diabetes. Out of the total prevalence, type II diabetes accounts for the majority of the patients. Zayed (2016) carried out a systematic review of the epidemiology of diabetic ketoacidosis in Arab patients with type I diabetes.

Background of the study

The Arabic speaking countries are 26 comprising of both high and low-income nations. The countries inhabit immigrants from Turkey, Europe and Rome leading to the mixing of the demographic distributions of the ethnic groups. Among the population type I diabetes is the most common chronic condition affecting a majority of the children. The condition is responsible for about 5 to 10% of the total cases in diabetes worldwide and increases at the rate of 3% on an annual basis. The incidence rate varies among different populations globally.

Diabetic ketoacidosis occurs at any age of type I diabetes with most instances occurring in patients with age less than 19 years. Despite the death rate being reduced, DKA continues to claim more lives. The mortality rates are also relatively high in developing nations than the developed nations. With all the above known, this study aimed at determining the frequency of DKA in Arab countries and quantify the prevalence rate among the patients with type 1 diabetes (Zayed., 2016). The author established the significance of the study basing it on the increased number of patients affected by diabetes type 1 hence was prompted to determine its frequency.

Research questions

  1. What is the frequency of diabetic ketoacidosis among Arabic countries?
  2. What is the prevalence rate in patients with type I diabetes among Arabic nations?

These questions are related to the purpose of the review hence there answering will be able to achieve the objectives of the review (Creswell & Creswell, 2017).

Method of study

The results of the review will benefit the targeted population as it would quantify the burden of type 1 and its complications in the Arabic nations. The report was approved by the institutional review board through the administration of a questionnaire to the researcher concerning the study and the manner unto which it was going to be conducted. In his review, Zayed (2016) determined various variables that formed the basis of observation despite the fact that they were not defined in the report. These variables included the age of patients, prevalence of diabetes type I diabetes and DKA. Data collection was done through the review of various articles that were scholarly and peer-reviewed.

The data collection entailed using search terms such diabetes ketoacidosis or DKA in combination with the name of each Arabic country. The search language was English. Relevant articles were determined by title and abstract. The data collected were reviewed three times for accurate and correct capture of the patients. The data collected were analyzed concerning the contribution of the various countries to the overall prevalence of diabetes ketoacidosis.

Results of the study

Zayed (2016) determined 574 citations with 329 remaining after removal of duplicates and 246 unrelated articles. The 38 legible citations were screened and information obtained from them. Quantitative analysis was carried out on 29 studies and summarised in a table. According to Zayed, the rate of prevalence in 12 Arab nations ranged from 17% to 100% with the frequency of DKA being 46.7%. There existed variation in the incident rates of type 1 diabetes among the Arab nations. The rates were high in Saudi Arabia and low in Oman. These results reflect the global occurrence of diabetes hence reliable.

The review was limited to the fact that there were no studies related to patients with type I diabetes especially the complications of type 1 diabetes (Zayed et al., 2016). There also existed variations of various studies among different countries hindering the development of trends on the prevalence of ketoacidosis in nations within the Arabic world. The review was further limited by the presence of guest workers that were working in the Arabic counties but were from other regions thus making it difficult to reflect the exact picture of the countries of interest.

The raised prevalence and incidence rate of diabetic ketoacidosis from type I diabetes signifies the burden of the condition and the complication in the Arab countries. This is significant to the nursing team as it calls for interventions both at the prevention level to reduce the incident rate and also on the management to prevent the complication that develops from type I diabetes such as diabetic acidosis(Storgaard et al., 2016).

Ethical considerations

In spite of the review using hospital records, no patient or participants name was determined in the process of the review. The results and the reports were made s general observation of all participants and records used. The articles used by Zayed (2016) were cited and referenced hence keeping off plagiarism and maintaining originality.


Arabic world contributes significantly to the global burden of type I diabetes and diabetic ketoacidosis. This review allows for the determination of incidence and prevalence rate in these countries. The outcome of the review impacts the nursing practice by calling for intervention strategies that need to be employed both in management to prevent complications as well as preventing the occurrence of the condition in general.

The link between the PICOT statement and the research critiques.

The PICOT statement poses a research question that seeks to be evaluated in determining the impact of interventions towards diabetes among patients. It interrogates the interventions that can be put in place at the pointy of causation of diabetes in curbing its occurrence and the incidence of diabetes-related complications such as diabetic ketoacidosis (Meyer, 2017). The question is related to the two study articles in that in the Mendenhall et al.,(2012) article, the authors determined various associative factors that cause diabetes. This translates to the need for intervention groups to venture into areas such as exercise, diet and medical checkups.

The increased incidence and prevalence rate of diabetes ketoacidosis among Arabic population also acts as an alert for the interventional groups as stated in the PICOT statement to dwell on prevention of the development of diabetes as well as managing the condition to prevent the complications such as diabetic ketoacidosis.


This article provides a vivid view of the causes of diabetes as well as the presence of the condition in Arabic nation and the world as a whole. This is significant to the nursing team as they need to strategize on employing various ways at the causal stage to reduce the incidence and prevalence of the condition amongst various populations.




Creswell, J. W., & Creswell, J. D. (2017). Research design: Qualitative, quantitative, and mixed

            methods approaches. Sage publications.

Ellis, P. (2016). Evidence-based practice in nursing. Learning Matters.

McMillan, J. H., & Schumacher, S. (2014). Research in education: Evidence-based inquiry.

Pearson Higher Ed.

Melnyk, B. M., Gallagher‐Ford, L., Long, L. E., & Fineout‐Overholt, E. (2014). The

establishment of evidence‐based practice competencies for practicing registered nurses

and advanced practice nurses in real‐world clinical settings: proficiencies to improve

healthcare quality, reliability, patient outcomes, and costs. Worldviews on

EvidenceBased Nursing11(1), 5-15.

Mendenhall, E., Shivashankar, R., Tandon, N., Ali, M. K., Narayan, K. V., & Prabhakaran, D.

(2012). Stress and diabetes in socioeconomic context: A qualitative study of urban

Indians. Social Science & Medicine, 75(12), 2522-2529.

Meyer, M. N. (2017). Evidence-based practice: Success of practice change depends on the

question. Evidence-Based Practice in Nursing: Foundations, Skills, and Roles.

Storgaard, H., Bagger, J. I., Knop, F. K., Vilsbøll, T., & Rungby, J. (2016). Diabetic

ketoacidosis in a patient with type 2 diabetes after initiation of sodium–glucose

cotransporter 2 inhibitor treatment. Basic & Clinical Pharmacology &

            Toxicology118(2), 168-170.

Waller, D. G. (Ed.). (2016). Diabetes and endocrine E-Book: Key Articles from the Medicine

            Journal. Elsevier Health Sciences.

Wu, Y., Ding, Y., Tanaka, Y., & Zhang, W. (2014). Risk factors contributing to type 2 diabetes

and recent advances in the treatment and prevention. International Journal of Medical

            Sciences11(11), 1185.

Zayed, H. (2016). Epidemiology of diabetic ketoacidosis in Arab patients with type 1 diabetes: a

systematic review. International Journal of Clinical Practice, 70(3), 186-195.