The aim of this literature review is to demonstrate an understanding of the research process by reviewing and analysing contemporary literature on type 2 diabetes, linking it to socioeconomic position relevant to adult nursing. According to the World Health Organisation (WHO) type 2 diabetes is a huge public health issue (WHO, 2018) the reason why this topic was chosen. A literature review is the critical thinking and understanding of a literature regarding a specific subject (Hart, 2018) with the purpose to recognise and critique the existing research pointing out any discrepancy and justifying a new viewpoint for the research (Aveyard, 2014). From a nursing point of view a literature provides the ability to critical challenge and analysis as this enhances the capacity to continuously improve in practice, care and knowledge base (Polit et al., 2014). The Nurses and Midwifery Council (NMC) (2015) stated nurses have a great role in health promotion providing people with information that will improve their health. Potter and Perry (2005, p.97) shows how, individuals can positively obtain stable levels of health because of health promotion. Ewles (2005) defines public health as “the art and science of preventing disease, prolonging life and promoting health through the organised efforts of society” (p.27). Whilst the World Health Organization (WHO) (2013) on the other hand suggests public health does not focus only on individual actions to improve their health but also focus on environmental and social interventions (WHO, 2013).
Type 2 diabetes is a degenerative condition whereby the amount of sugar referred as glucose in the blood is significantly high due to the body’s incapacity to use glucose effectively (The National Institute for Health and Care Excellence NICE, 2017). Type 2 diabetes prevalence according to the International Diabetes Federation (IDF) is globally on the rise as 400 million people aged 25 years and above worldwide were identified with Type 2 diabetes in 2017 (IDF, 2017). The International Diabetes Federation also highlighted more than 52 million roughly 10.3% men and 9.6% women have type 2 diabetes in Europe (IDF, 2017) whilst Public Health England (PHE) National Cardiovascular Intelligence Network (NCVIN) originated a Diabetes Prevalence Model, which estimated approximately 3.8 million individuals in the United Kingdom (UK) to have type 2diabetes. The progressive prevalence of type 2 diabetes in the UK is a significant public health issue as leading to enormous financial consequences on the National Health Service (NHS) along with increase rate of morbidity and mortality (PHE, 2016). Most recent statistics of IDF identified 14,593 type 2 diabetes related deaths in the UK in 2017 (IDF, 2017) pointing out type 2 diabetes costs the NHS £8.8 billion every year (PHE, 2016). According to the National Diabetes Audit in 2015-2016 there was a significant increase of hospitals admissions due to type 2 diabetes complications. More than 1 in 10 people admitted in hospital presented symptoms of type 2 diabetes (NHS Digital, 2017) and NICE (2017) stated the care of this condition currently cost more than 5% of the UK healthcare expenditure increasing to 10% of the NHS budget. NICE (2017) suggest Africans, South Asians and Caribbean’s as ethnicity groups who are more diagnose with the condition. Diabetes UK (2010) closely associated type 2 diabetes with the remarkable increase of aging population and the unhealthy lifestyle (ons.gov.uk, 2018) therefore, it will not be unfair to consider type 2 diabetes may increase accordingly. As a fact, based on the present population 4.9 million people will present symptoms of type 2 diabetes by 2035 in the UK (gov.uk, 2018). In addition to these factors some studies have proven there’s a link between type 2 diabetes and socioeconomic status (Supriya Krishnan et al., 2010). Type 2 diabetes is more diagnose within people who are socially and materially underprivileged among the middle and low-income countries (WHO, 2018). Considering aspects such as race, gender, age and socioeconomic position type 2 diabetes affects unequally various patient groups. Even though health outcomes should not be single cause of poverty, WHO point out it is a key factor because socioeconomic position can impact on the accessibility of community resources, quality of care and the social support an individual can receive (WHO, 2018). This may significantly affect treatment choices; people’s knowledge of diabetes, accessibility to medication or diet and exercise regiments to reduce type 2 diabetes risk factors. Michael Marmot (2009) stated “among other things, the nature of children’s upbringing, adults’ workings lives, or older people’s experiences of ageing are critically shaped by the quality of social relationships, access to particular material resources and services, and the nature of our neighbourhoods and wider environments”. Although, previous studies suggest there’s a link between type 2 diabetes and socioeconomic position there’s not much information on their co-occurrence. Nevertheless, it has been proved that bad health behaviours and clinical problems such as overweight/obesity can increase the risk of type 2 (NICE, 2017).