Course

: Sports & Recreation Management (SPRB113)

Section

: 01

Academic Year

: Sem 1, 2016/2017

Title

: Diabetes among Young Adults

Lecturer

: Dr. Mastura bt Johar

Group

: 3

Group Member

Name

ID

Chew Ting Liang

CE095243

Nur Izuara binti Ibrahim

EP094024

Nursuhaila binti Rosli

ME094959

Tay Siang Choong

ME096830

Nur Syafrina binti Saharudin

EP095422

Wan Mohamad Shakir Bin Wan Shamsuddin

EP095308

Wan Suhaila bt Wan Jaafar

EE095865

Muhammad Afzal Bin Fahrurrazi

ME095525

Thennavan A/L Janarthanan

ME093086

Bandar Salem Ahmad

EP097229

Table of Contents
1.0 Introduction.3
1.1 Introduction about Diabetes...3
1.2 Research Objectives/Questions..5
2.0 Literature Review....8
2.1 Discuss about similar to research topic..8
2.2 Theory related to research topic10
3.0 Methodology..12
3.1 Population/Sample.12
3.2 Instrument used in research...13
3.3 Analysis.17
3.4 Results and Findings.21
3.5 Discussion and Recommendation.24
4.0 Reference...29
5.0 Appendix...30
Article 1....
Article 2
Article 3

1.0 INTRODUCTION
1.1 INTRODUCTON ABOUT DIABETES
Diabetes is a life-long disease that affects the way your body handles glucose, a kind of sugar, in
your blood. The condition where the amount of glucose in your blood is too high because the
body cannot use it properly. This is because your pancreas doesnt produce any insulin, or not
enough insulin, to help glucose enter your bodys cells or the insulin that is produced does not
work properly (known as insulin resistance).

Diabetes is one of the top killers in the country but could be prevented by simply limiting sugar
intake and exercising regularly. At present, there are 347 million people worldwide suffering
from diabetes and more than 80% of diabetes deaths occur among low and middle-income
populations. The World Health Organisation (WHO) projects that diabetes will be the seventh
leading cause of death by 2030.

Diabetes was common among those above 50 years of age but now even those in their 20s are
becoming diabetic. Young generation should be taught at an early age about diabetes and how it
can be prevented.

Type 1 Diabetes:
Type 1 diabetes develops when the insulin-producing cells in the body have been destroyed and
the body is unable to produce any insulin. Type 1 diabetes accounts for about 10 per cent of all
adults with diabetes and is treated by daily insulin doses taken either by injections or via an
insulin pump. It is also recommended to follow a healthy diet and take regular physical activity.
Type 1 diabetes can develop at any age but usually appears before the age of 40, and especially
in childhood. It is the most common type of diabetes found in childhood.

Type 2 Diabetes:
Type 2 diabetes develops when the insulin-producing cells in the body are unable to produce
enough insulin, or when the insulin that is produced does not work properly (known as insulin
3

resistance). Type 2 diabetes usually appears in people over the age of 40, though in South
Asian people, who are at greater risk, it often appears from the age of 25. It is also increasingly
becoming more common in children, adolescents and young people of all ethnicities. Type 2
diabetes accounts for between 85 and 95 per cent of all people with diabetes and is treated with
a healthy diet and increased physical activity. In addition to this, medication and/or insulin are
often required. In Type 2 diabetes there is not enough insulin (or the insulin isnt working
properly), so the cells are only partially unlocked and glucose builds up in the blood.

1.2 RESEARCH OBJECTIVES/QUESTIONS

Diabetes is a condition in which the bodys levels of blood sugar and the hormone insulin are out
of balance. It is one of the most common diseases in Malaysia, and its numbers are constantly
rising. There are a lot of campaigns carried by the government organizations and also by nongovernment organizations in order to give awareness to the folks about the danger and showed
them ways of preventions. However, it seems that numbers of patient that have been diagnosed
with diabetes keep rising year by years especially among the young adults. Diabetes occurs
mostly because of our daily food intake and also the lifestyle we practiced in our everyday life.
For instance, many young adults nowadays love to have fast food and also not having a good and
proper sleep.
We had identified several objectives for our report so that we can gather as much
information as we can to conduct our research on diabetes among young adults. The overall aim
of this study is to undertake a comprehensive needs assessment survey of young adults with
diabetes to identify and document their specific concerns and emerging issues.
The more specific objectives were as follow:
1. To determine in-depth about how much the young adults understand and aware about
diabetes at various stages of their physical and psychosocial development. For example:

What is the challenges face by young adult when first diagnosed with diabetes?

Did the young adults know the precautious way to prevent or to get the treatment
(if they have diabetes)?

Did the young adults know the types of diabetes and how much of information
they know on diabetes?

How does it feel for the young adults to be diagnosed with diabetes?

How often has diabetes kept them from going about their normal daily activities,
such as attending school, working, having a social life, and others?

2. To determine what young adults with diabetes require in terms of areas of need in relation
of health and support. For instance:

What health care services have young people used in relation to their diabetes?

Which services have been most helpful?

What services would young people like to see improved?

When was the last time they had relevant health care checks in relation to their
diabetes

How would they rate ease of access to each of these services?

3. To identify areas of need in relation to young peoples education and information

requirements. For example:

How much do young adults know about diabetes?

What are the key gaps in understanding and knowledge of diabetes and its
management?

Where do young people seek information about diabetes and diabetes management?

What is the current awareness and usage of diabetes information resources?

How helpful have doctors and health professionals been in terms of helping them to
understand how to manage diabetes?

4. To identify the cause of diabetes among young adults. For instance:

What kind of food intake do young adults consumed in their daily life?

How much exercise do they perform in a week?

What lifestyle do young adults adapt in their everyday live?

Does diabetes occurs through the trait of genetics?

Does fast food affect and influence young adults towards having diabetes at the
young age?

5. To explore reactions of the target audience and key stakeholders to possible future
developments. For example:

How useful would this be for young people?

What format would be of greatest use to young people?

How could it be promoted?

An awareness program aimed at building awareness of type 1 and type 2 Diabetes

and the psychosocial impact of diabetes on families and carers.

What are the problems experienced in the workplace by young people who have
diabetes?

What would assist young people overcome these problems?

What is the role and value of camps for young people with diabetes?

What strategies have been successful in helping young people cope with problems
in the workplace? How can these be communicated to other young people?

The overall aim of this research is to undertake a comprehensive needs assessment survey of
young adults with or without diabetes to identify and evaluate the increasing trend of diabetes
among the young adults based on their basic information, recent eating habits, and physical
activity.

2.0 LIERATURE REVIEW

2.1 DISCUSS ABOUT SIMILAR TO RESEARCH TOPICS
There are more forms of diabetes than the commonly known type 1 and type 2. Type 1 diabetes
is much more common in children and adolescents but continues to arise through young adult
life while for type 2 diabetes is much more common in middle to old age but increasingly these
days we are see seeing it among younger people too. A researcher, Katherine Owen, said that
people are much less likely have heard about some other rare forms of diabetes caused by
changes in single genes also called monogenic diabetes which also sometimes called maturityonset diabetes of the young people. The interesting thing about these forms of diabetes is that
they also arose in young adulthood so when they meet a patient who has been diagnosed between
the ages of 10 and 40, there is quite a wide range of possible causes for that diabetes for doctors
to think about.
Type 1 diabetes strikes young people suddenly, making them insulin dependent for the rest of
their lives, and at risk of developing devastating complications. Whilst most cases of diabetes in
children and adolescents are type 1, there has been an increase in the number of type 2 or noninsulin dependent diabetes being diagnosed at an early age, particularly amongst Aboriginal and,
Pacific Islanders, people of Chinese descent, and those from the Indian sub-continent. The
occurrence of type 2 diabetes in adolescents and young adults has been linked to a lack of
exercise, poor diet, and obesity. Because it is typically associated with older people, diagnosis
may be delayed and complications may arise before treatment is provided.
An article had discuss the type 2 diabetes mellitus in children and adolescents around the world
in all ethnicities where the majority of young people diagnosed with type 2 diabetes was found in
specific ethnic subgroups such as African-American, Hispanic, Asian/Pacific Islanders and
American Indians. In the article also state that the obesity is the hallmark of type 2 diabetes
among young adults or extremely obese at diagnosis and present without ketonuria, absent or
mild polyuria. Diabetes is also a major cause of morbidity and mortality in the United States,
costing billions of dollars in 2012 due to increased use of health resources and lost productivity.

Studies have shown that total diabetes among young adults has increased in the US population
during the past decades through the prevalence of diagnosed diabetes. These diabetes trends are
consistent with other studies showing that the prevalence of obesity affect diabetes also has
generally been increasing in the US population. According to the surveys from researchers they
made, a standardized questionnaire was used to collect data on every age, race, sex and education
level and used the data collected to estimate the recent trends in diabetes prevalence.
Generally, the rates of childhood obesity were higher in urban areas than in rural areas and
highest in countries with greatest economic development in Asia such as Japan, Malaysia, and
the Republic of Korea. Levels of physical activity and rapid changes in the diet of young adults
in Asian populations also have been identified as the principal drivers of this emerging epidemic.
Asia already accounts for a sizeable proportion of the worlds population with diabetes and have
been warning about the rapid increase in the rates of diabetes. Type 2 diabetes is now being
diagnosed more often in adolescents and even young children and it is not unusual nowadays.
Many researchers have looked into account of Asian populations too to the development of
weight-related health problem that place Asian young adults at increased risk of developing type
2 diabetes early in their life.

2.2 THEORY RELATED TO RESEARCH TOPIC

For the time being, international agencies have warned about the rapid increases in the rates of
diabetes and other chronic disease in Asian countries. As we know that, diabetes is a problem
with our body that causes blood glucose levels to rise higher than normal. This is also called
hyperglycemia. Scientists have done their studies to estimate how important genes are in
determining one's risk of developing diabetes. They have found that if one identical twin has
type 1 diabetes, the chance that the other twin will get the disease is roughly 40 or 50 percent.
For type 2 diabetes, that risk goes up to about 80 or 90 percent. This might suggest that genes
play a bigger role in type 2 than in type 1, but that isn't necessarily so.
There are 2 types of diabetes:
Type 1
Type 1 diabetes also known as juvenile diabetes is usually diagnosed in children and young
adults. For this type, the body does not produce insulin. The body breaks down the sugars and
starches that we eat into a simple sugar called glucose, which it uses for energy. Insulin is a
hormone that the body needs to get glucose from the bloodstream into the cells of the body.

Type 2
In type 2 diabetes, our body does not use insulin properly. This is called insulin resistance. At
first, the pancreas makes extra insulin to make up for it. But, over time our pancreas is not able to
keep up and cannot make enough insulin to keep our blood glucose levels back to normal. Type
2 diabetes is treated with lifestyle changes, oral medications (pills), and insulin.

Having more fat in the body increases the risk that some of it will get misplaced.
But exercise may also have a role in fat placement. Exercise is known to reduce insulin
resistance one way it may do this is by burning fat out of the muscle. Because of this, getting
enough exercise may stave off type 2 in some cases. Genes may also help orchestrate the
distribution of fat in the body, which illustrates how lifestyle and genetics interact.
There are other factors that also fall into the category of environmental (as opposed to genetic)
causes of diabetes.
10

1) Certain injuries to the pancreas, from physical trauma or from drugs, can harm beta cells,
leading to diabetes. The researchers have also found that people who live in polluted
areas are exposed to type 2, perhaps because of inflammation.
2) Depression also seems to predispose people to diabetes. Researchers speculate that the
emotional connection may have to do with the hormone cortisol, which floods the body
during periods of stress. Cortisol sends glucose to the blood, where it can fuel a fight-orflight response, but overuse of this system may lead to dysfunction.
With type 1, a disease that often seems to strike suddenly and unexpectedly, the effects of
environment and lifestyle are far less clear. The three main suspects are:
1) Too little sun
In the sunshine, molecules in the skin are converted to vitamin D. But people stay indoors
more these days, which could lead to vitamin D deficiency. Research shows that if mice
are deprived of vitamin D, they are more likely to become diabetic. In people,
observational studies have also found a correlation between D deficiency and type 1.

2) Too good hygiene

Good housekeeping and hygiene habits mean far fewer interactions with germs, which in
turn may foster an immune system prone to going awry.
3) Too much cow's milk
In the 1980s, researchers noticed that the decreasing numbers of risks in type 1 is children
who had been breast-fed which mean that there is a component of breast milk that is
particularly protective for diabetes.

11

3.0 METHODOLOGY
3.1 POPULATION/SAMPLE

The method that we used to conduct the research is random population sampling. Population
sampling is the process of taking a subset of subjects that is representative of the entire
population. The sample must have sufficient size to warrant statistical analysis. Sampling is done
usually because it is impossible to test every single individual in the population. It is also done to
save time, money and effort while conducting the research.

Besides, the survey methodology/instrument that we used to conduct the research is through
online survey. Questionnaires are the most commonly used tool in survey research. Thus, a set of
questionnaires were made for the online survey. The online survey was conducted by creating
google form. The targeted numbers of respondents for our research were 100 persons. The
participants for the survey are mainly focus on the young adults only. A set of questionnaire was
completed by 100 young adults aged 18 to 30 years old with or without diabetes.

12

3.2 INSTRUMENT USED IN THE RESEARCH

The survey methodology/instrument that we used to conduct the research is through online
survey. Questionnaires are the most commonly used tool in survey research. Thus, a set of
questionnaires were made for the online survey. The online survey was conducted by creating
google form.
In the questionnaire, the participants were asked about their basic information such as gender,
age, height, weight and some healthcare questions. After that, there were 3 categories such as
diet knowledge and skills, diet decision making, and eating problems to be asked in the
questionnaire.

Diabetes Survey Questionnaire

Answer each question as accurately as possible. This questionnaire is for young adults which age
range from 18 to 30. If you are not within the age range, please do not answer the questionnaire
below.
1. Gender:
o Male
o Female
2. How old are you? _______ years old (18-30 years old)
3. Height:__________cm

Weight:____________kg

4. What is your desired weight?________________kg

5. Did you recently go medical checkups?
o Always
o Occasionally
o Not often
o Never
6. Are you currently trying to lose weight?
o Yes, I am
o No, but I am trying to gaining weight
o No, I satisfied with my current weight.
13

7. How often you do/play sports?

o 5times above in a month
o 2-4times in a month
o Never do unless certain conditions apply. (exp: pokemon go)
8. Did you always take care of the food/nutrition that you consume daily?
o Yes, very often
o Sometimes
o Nope, did not thought of it/ does not care

A. Diet Knowledge and Skills

Please answer all of the following questions about your eating.
During the past 3 months, how often did you:
A:
B:
C:
D:
E:
F:

Never
1times per month or less
2-3times per month
1-2times per week
4-6times per week
1 or more times a day
A

Use the information about the number of calories in

foods to make decisions about what to eat?
Use information about the of carbohydrates in foods to
make decisions about what to eat?
Use information about the number of grams of fat in
foods to make decisions about what to eat?
Deliberately skip a meal or snack to cut calories or fat?

Deliberately take small portion sizes to cut calories,

sugar or fat?
Use low-calorie, lite, reduced-fat, or fat-free products?
Use sugar free or reduced sugar products?

14

Resist the temptation to eat a food you want because it

is too high in fat, sugar, or calories?
Use a written diet or meal plan to decide what foods to
eat?

B. Diet Decision Making

Even if you are not using a diet or meal plan as part of your diabetes care, please answer all of
the following questions.

During the past 3 months, how often did you:

A:
B:
C:
D:
E:
F:

Never
1times per month or less
2-3times per month
1-2times per week
4-6times per week
1 or more times a day
A

Eat your meals and snacks at the

same time each day.
Choose the portion sizes of foods carefully so that your
blood sugar will not be too high or too low.
Use the exchange system to decide what foods or how
much of certain foods to eat.
Use information about the grams of carbohydrates in
foods to make decisions about what or how much to eat.
Use information about the grams of carbohydrates in
the foods you are eating to decide how much insulin to
take.
Deliberately eat more or less food to adjust for a change
in your usual exercise or physical activity.

15

Eating problems
This section focuses on behaviors that make it hard for people to lose weight and control blood
sugar.
During the past 3 months, how often did you:
1. Overeat? By overeating, we mean eating until you fell stuffed or too full.
o 1 time a month of less
o 2-3 times per month
o 1-3 times a week
o 4-6 times a week
o 1 or more times per day
2. Eat unplanned snacks? That is, how often do you find yourself snacking on foods then
thinking I wish I had not eaten that?
o Never
o 1 time a month or les
o 2-3 times per month
o 1-3 times a week
o 4-6 times a week
o 1 or more times per day

Eating problems when feeling, stressed, anxious

depressed, angry, or bored.
Eating problems because of hunger or food cravings.
Eating problems because family or friends tempt you or
are not very supportive of your efforts to eat right.
Eating problems when eating away from home (e.g.,
fast food, restaurants, relatives, pot lucks).
Eating problems because you feel deprived due to
trying to follow a diet.
Eating problems because you feel discouraged due to
lack of results (e.g., no weight loss, high blood sugars).
Eating problems because you are too busy with family,
work, or other responsibilities.

16

3.3 ANALYSIS
The data in our research is based on the information that we collected from the 100 participants
aged from 18 to 30. The data will be interpreted by calculating the percentage of each option
provided in the question in 3 categories such as Diet Knowledge and Skills, Diet Decision
Making, and Eating Problems. By this analysis, the percentage of the questions can be identified.
Participants (N)
Gender
Age

Male
Female

54

18-30

100

46

Did you recently go medical

checkups?
8 5 6

Always
Ocaasionally
Not often
Never

81

Respondents trying to lose weight

Yes,trying to lose weight

24

No,trying to gain weight

20

56
Satisfied with current
weight

17

How often you do/play sports?

12
40

5 times above in a month

2-4 times in a moth
Never do

48

Did you always take care of the

food/nutrition that you consume daily?

Yes, very often

Sometimes
No, did not thought of it/
does not care

18

Diet Knowledge and Skills

Figure 1 : Percentage analysis for part 1 which is Diet Knowledge and Skills

Diet Decision Making

Figure 2 : Percentage analysis for part 2 which is Diet Decision Making

19

Eating Problem

Figure 3: Percentage analysis for part 3 which is Eating Problem

20

3.4 RESULTS AND FINDING

Diet Decision Making

According to the data, the 40% of respondents did not choose the portion sizes of foods carefully
in order to maintain their standard blood sugar, it is very risky for their health to ignore their
portion sizes of foods. Besides, there are 36% of respondents did not use the information about
the grams of carbohydrates in foods to make decisions about what or how much to eat, it may
cause overeat problem occurs. Lastly, the data shows there are as many as 40% of respondents
did not deliberately eat more or less food to adjust for a change in their usual exercise or physical
activity, it may also cause a long term health issues.
In general, this finding shows how poor Malaysian young adults are in the daily diet decision
making and illustrate that perhaps young adults should put more efforts to diet decision making.
Besides, many young adults did not know they are in a high risk of getting diabetes.

21

Diet Knowledge and Skills

In the results, there are many of the respondents did not use the information about the number of
calories and carbohydrates in foods to make decisions about what to eat. This data shows that
young adults are not practicing a good nutrition in their daily lives. A good nutrition can help us
to avoid or manage common diseases like cancers, high blood pressure, diabetes, obesity and
heart disease. Therefore, a good nutrition is very important throughout our life.
Besides, there are also 40% of the respondents deliberately skip there meal to cut calories or fat.
This data shows that they are at a high risk for some diseases such as type 2 diabetes and blood
pressure problems. Luckily, there are also 28%-32% of the respondents used low-calorie, lite,
reduced-fat, or fat-free products, sugar free products to maintain or lose their weight and blood
sugar. In addition, there are 40% of the respondents resisted the temptation to eat a food that are
high in fat, sugar and calories. This shows a good sign for the young adults as they are able to
control and resist the temptation to eat unhealthy foods.
In general, this findings show Malaysian young adults diet knowledge and skills are average.
There are more young adults knew the diet knowledge and skills compared to those young adults
that do not know.

22

Eating Problem

In the results, there are many of the respondents not having any eating problems when feeling
stressed, anxious, depressed, angry or bored. It is a good sign for young adults. However, there
are still a few percentages of respondents having eating problems 1-2 times per week because
family or friends are not very supportive of their efforts to eat right.
Eating problems can be caused by varies ways and everyone has a different sign of eating
problem. Eating problems frequently appear during the teen years or young adults. These
problems may leads to several diseases such as diabetes, high blood pressure and heart diseases.
Nevertheless, there are not many young adults suffer from eating problems or eating disorder.

23

3.5 DISCUSSION AND RECOMMENDATION

1. What causes diabetes in young adults?
Quite a few things actually, we might have heard of Type 1 and Type 2 diabetes, which are the
common forms of diabetes. Type 1 diabetes is much more common in children and adolescents
but continues to arise through young adult life. Type 2 diabetes is much more common in middle
to old age but increasingly these days we are seeing it in younger people too. But what people
are much less likely to have heard about are some other rare forms of diabetes caused by changes
in single genes also called monogenic diabetes and its also sometimes called maturity-onset
diabetes of the young or MODY. The interesting thing about these forms of diabetes is that they
also arise in young adulthood so when we meet a patient who has been diagnosed between the
ages of 10 and 40 there is quite a wide range of possible causes for that diabetes that we have to
think about as doctors.

Managing diabetes in young adults is challenging for a number of reasons:

Erratic eating patterns and variable exercise

Greater exposure and susceptibility to viral illness

Hormonal changes associated with growth spurts

Rapid destruction of beta cells, leading to a total loss of capacity to secrete insulin.

Moreover, the psychosocial pressures on young people and their families can affect how well
diabetes is managed. It is not uncommon for young adults to go through a period of rebellion,
when they ignore or reject the advice they are given by health professionals and their parents. As
they move into adolescence and/or young adulthood, the urge to live for the moment may
become more powerful than the threat of the long-term complications. They may refuse to take
on the responsibility for managing their diabetes, start eating whatever they fancy (or whatever is
offered by peers), experiment with drugs and alcohol, and even fabricate test results to get
concerned parents and doctors off their case. Diabetes may also have a huge impact of young
peoples emotional well-being and self-confidence. Many young people with diabetes feel

24

isolated from their peers, and experience discrimination at school or in the workplace. This in
turn compromises their ability to cope.
2. Is it easy to distinguish between different types of diabetes?
It often isnt and thats one of the problems that we have. Theres quite a lot of overlap between
the clinical features of these different forms of diabetes. For instance if we think about
monogenic diabetes, there are some features in common with type 1 diabetes and some in
common with type 2 diabetes and because medicine is not an exact science often we cant always
tell very easily.
3. How does a correct diagnosis effect treatment?
Its very important. If we are thinking about type 1 diabetes then the appropriate treatment is
insulin treatment for the rest of your life. However for type 2 diabetes the usual first tablet thats
used to treat this is called Metformin. However if we take the commonest types of MODY then
for one form a tablet called Sulphonylurea is much more effective than Metformin and for
another kind of Monogenic diabetes we dont need any treatment at all. What can happen is for
example someone has been diagnosed with diabetes at the age of 20s, theyre often assumed
because of their age to have type 1 diabetes and commence insulin injection treatment. But if we
subsequently find that theyve got monogenic diabetes or MODY then they can actually stop
taking those insulin injections and have tablets or no treatment at all and we can imagine that has
a huge impact on peoples lives.
4. What are the most important lines of research that have developed over the past 5 or 10
years?
From the global viewpoint, trying to increase uptake of testing for these rare forms of diabetes is
very important because theyve estimate that only 10 to 20% of people who actually have
monogenic diabetes have been given the correct diagnosis and having the opportunity for those
treatment changes. What theyve been doing over the last 5 years or so in Oxford are to try and
work out what the key clinical features are for diagnosing people who have monogenic diabetes
and also are there additional biochemical or immunological blood tests that can do to add to the
clinical features. So their overall aim is to make diagnostic protocols that all clinicians all over
25

the country can use in order to identify all the people who have got monogenic diabetes rather
than just a small percentage of them.
5. Why does the line of research matter? Why should we put money into it?
We can see the direct impact that the research has on those individuals. People are always very
keen to know more about what has caused their diabetes and how it might affect their family. If
were able to make a treatment change such as stopping insulin then obviously that has a huge
impact on those individuals and the ultimate aim is to try and put this personalized medicine
there for everyone with diabetes.
6. How do young adults prevent diabetes?
To aid in the prevention of diabetes, particularly among those with prediabetes, policymakers
should consider the following:

Support diabetes prevention efforts.

Most people with prediabetes do not know they have the condition. Providing coverage for and
ensuring the regular medical practice of appropriate screening can identify people with
prediabetes while it is still possible to prevent the onset of type 2 diabetes. In addition, insurance
coverage for and referral to recognized diabetes prevention programs can remove critical barriers
to education and care for people with prediabetes and can facilitate lifestyle changes that can
prevent diabetes.

Promote community and workplace environments that support healthy eating.

Local and state policy initiatives can improve the food and beverage environment by increasing
access to fruits and vegetables, decreasing marketing of unhealthy options, encouraging large
institutions such as hospitals to follow healthy food procurement guidelines, developing
educational strategies to assist consumers in making more informed food and beverage choices,
and ensuring the availability of safe and low-cost drinking water.

Promote built environments that encourage regular physical activity.

26

Lack of physical activity is a significant risk factor for diabetes, and further policies should be
developed to facilitate active livingfor example, creating safe environments for walking and
biking, providing access to safe parks and other places for recreation and physical activity, and
offering worksite programs to facilitate regular physical activity for adults of all ages.

Support adequate access to quality primary and specialty care.

At-risk individuals need to have adequate and sufficient access to quality health care services.
Lack of continuous health insurance coverage and insufficient benefits packages create
significant financial barriers to accessing primary and specialty care services. In addition,
increased access to recognized diabetes-prevention lifestyle modification programs has been
shown to be particularly beneficial for adults with prediabetes.

Briefly speaking, there are several steps for young adults to avoid themselves from getting
diabetes:
1) Eat well to help prevent or delay type 2 diabetes. Choose whole grain foods such as
whole wheat bread, crackers, cereals, brown rice, oatmeal, and barley.

2) Skip the sugary drinks, and choose water, coffee, or tea instead.

27

3) Limit red meat and avoid processed meat; choose nuts, whole grains, poultry, or fish
instead.

4) Get regular exercise at least twice a week.

5) Quit smoking and stop consuming alcohols.

28

4.0 REFERENCE
1. Tim Gill. (2007). Young people with diabetes and obesity in Asia: a growing epidemic.
DiabetesVoice
2. Thomas Reinehr. (2013). Type 2 diabetes mellitus in children and adolescents. 2013
Baishideng Publishing Group Co., Limited.
3. Andy Menke, PhD., & Sarah Casagrande, PhD., & Linda Geiss, MA., & Catherine C.
Cowie, PhD., (2015). Prevalence of and Trends in Diabetes Among Adults
in the United States, 1988-2012. American Medical Association.
4. Kelly J. Acton., & Nilka Ros Burrows.,& Kelly Moore.,& Linda Querec.,& Linda S.
Geiss.,& Michael M. Engelgau,. (2012). Trends in Diabetes Prevalence Among American
Indian and Alaska Native Children, Adolescents, and Young Adults. American Journal of
Public Health.
5. JOYCE M. LEE.,& MEGUMI J. OKUMURA.,& GARY L. FREED,.& RAM K.
MENON,.& MATTHEW M. DAVIS,. (2007). Trends in Hospitalizations for Diabetes
Among Children and Young Adults. American Diabetes Association.

29

5.0 Appendix

1. Article 1 (Young people with diabetes and obesity in Asia: a growing epidemic)
2. Article 2 (Type 2 diabetes mellitus in children and adolescents)
3. Article 3 (Prevalence of and Trends in Diabetes Among Adults in the United States,19882012)

30