These are significant diabetes-care issues in multicultural countries like Australia. Concern in the advancement of diabetes treatment has been motivated in recent years by awareness of the disease's public health burden and the increasingly growing prevalence. In this essay the unmet needs of CALD and refuges and Old adults of Australia have been discussed. The National Diabetes Strategy have underlined new programs to help recognize patients with special care needs and ensure access to high-quality multidisciplinary comprehensive care.
Challenges faced by this group
In the migrant groups, CALD and refugeesthere are higher cases of diabetes across all socio-economic strata than the people born in Australia (Abouzeid, Philpot&Januset al., 2013). As there is rise in migration, Australia's planning and delivery of health service, policy and preventive efforts are having difficulties in handling the situation. These CALD groups have been found to have ahigh risk for type 2 diabetes including other diseases like obesity, cardiovascular disease, high BP and gestational diabetes.
The main obstacles and enablers to access to health care arelinguistic and geographical barriers particular socio-cultural and religious views, health care professional interactions and lack of information about health care services (Smythe et al., 2015). In one of the studies,the refugees compared to the Australian population had no desire to access and use medical services when signs of ill-health appeared; their treatment-seeking behaviours were adamant (Au, Anandakumar, & Prestonet al., 2019).Food insecurity in another problem these group are responsible for a higher mortality rate, and higher rates type-2 diabetes and some cancers.(Stojanovska, Naemiratch&Apostolopoulos,2017).
Suggestions for Diabetic management
The increase in diabetes should be taken as a warning sign for the Australian economy and the administration and authorities have to rethink on the problem areas. The barriers to access health care services can be overcome by providing education, food security and the employment to the CALD group and refugees. A requirement of cultural awareness of these group among the health service staff and the building of cordial relationships between these communities and health care staff.Intervention initiatives aimed at lowering risk factors for type 2 diabetes in CALD populations and other chronic diseases have mainly focused on increasing physical activity and modifying dietary habits.
Older adults and their unmet needs to manage diabetes
A study with more than 2000 diabeticpatient, aged 60 years at baseline were compared with normal individuals. In older Australians, it was shown that the baseline diabetes has risen along with BMI and cardiometabolic factors like high BP and cholesterol problems (Koye,Shaw, & Magliano, 2017). Another study on adults having diabetes, identifies that people with diabetes have to self-manage their health-related activities. This study also focusses on the lacks the information the clinicians and patients have about self-management. The patients can be guided towards creating manageable and doable plans that can be followed by them.
While most young people with diabetes spend on health-related activities on average less than 30 minutes a day (excluding exercise).A large number of older Australians with serious health conditions and especially the patients who have pain related problems seek advice from Complementary and alternative medicine practitioners (CAM). But for the diseases like hypertension, asthma, and diabetes there are clear guidelines for health-related issues and availability of conventional medicines.
Suggestions for Diabetic management in the older adults
These study findings indicate that weight control measures, and cardiometabolic factor treatment and prevention can avoid diabetes-related disability and promote healthy aging in individuals. The diabetic patients not often use CAM (Yen, Jowsey, & McRae, 2013).The better coordination of the health authorities with the people with chronic disease are required. The findings with old age people with diabetes showed the communication with the health services should be improved so that the older people can not be hesitant to access the health services. For older people with diabetes the time demands for physical activity can be substantial (Yenet al.,2013). The involvement of patients in a better self-management programmes could result in a better match between the complications and problems of the disease and the availability of patient time. And by these steps the old age people hospital admissions can be reduced.
The National Diabetes Strategy (NDS) have prioritised the need for the patients suffering from diabetes and are seeking for new approaches like high quality of care and services to reduce the cases of diabetes in the country. The NDS provides a basis for concerted initiatives by governments and people with diabetes, health care providers, NGO’s, families and communities to reduce the incidence of morbidity and death due to diabetes.The NDS also putting in great effort to align the patient needs with the investments for the cause. The aim is to improve all sectors in designing, implementing, and assessing an integrated and organized approach in reducing, human, social and economic effects of diabetes.
Also, it is having an articulated vision for preventing, detecting, and managing diabetes and for diabetes research efforts.The clear key aspects that make such approaches effective are culturally relevant, informative, collaborative and realistic programs. Strategies to encourage local food production, active transportation and better working conditions that effectively facilitate physical activity would have many benefits including a decrease in the incidence of diabetes (Tewari& Lin, 2016).
The government of Australia is taking diabetes as a major concern on the country’s economy and health related issue which is burdening the health care system. Different approaches are required for the diabetic people depending on the geographical areas, age, socio-economic factors to treat the disease. Several intervention programs by the National Diabetes Strategy for identified cultural groups like CALD and refuges and for older Australian adults are warranted to provide better service and improve disparities in diabetes care.
Abouzeid, M., Philpot, B. &Janus, E.D. et al. (2013). Type 2 diabetes prevalence varies by socio-economic status within and between migrant groups: Analysis and implications for Australia. BMC Public Health 13, 252. https://doi.org/10.1186/1471-2458-13-252.
Au, M., Anandakumar, A.D., Preston, R. et al. (2019). A model explaining refugee experiences of the Australian healthcare system: A systematic review of refugee perceptions. BMC Int Health Human Rights 19, 22. https://doi.org/10.1186/s12914-019-0206-6
Koye, D. N., Shaw, J. E. & Magliano, D. J. (2017) Diabetes and disability in older Australians: The Australian Diabetes, Obesity and Lifestyle (AusDiab) study. Diabetes Research and Clinical Practice. 126, 60-67. https://doi.org/10.1016/j.diabres.2017.01.016
Smythe, K., Siddiqui, N., Sidhu, B., Simmons, D., Flack, J. & Wong, V. Challenges associated with integrating care for people from culturally and linguistically diverse backgrounds who have diabetes.International Journal of Integrated Care https://drr.lib.uts.edu.au/51605/
Stojanovska, L., Naemiratch, B. &Apostolopoulos, A. (2017). ‘Type 2 diabetes in people from culturally and linguistically diverse backgrounds: Perspectives from nutritional therapy and dietician professions’, Section of Medical Sciences, 38(1), 15-24.
Tewari, S. & Lin, S. (2016) Managing diabetes in CALD communities. Endocrinology Today. https://drr.lib.uts.edu.au/51608/
Yen, L., Jowsey, T. & McRae, I.S. (2013). Consultations with complementary and alternative medicine practitioners by older Australians: Results from a national survey. BMC Complement Alternative Medicine.13, 73. https://doi.org/10.1186/1472-6882-13-73
Yen, L.E., McRae, I.S., Jowsey, T. et al. (2013) Time spent on health related activity by older Australians with diabetes. Journal of Diabetes Metabolic Disorders. 12, 33 https://doi.org/10.1186/2251-6581-12-33
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