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1. Use the examples (- pick 3 – )provided in the file , and see whether they answer the “so what?” and “who cares? questions. Probably some do, some don’t. How do the authors who answer these questions do so? Do they use any strategies or techniques that you could borrow for your own writing? Are there any strategies or techniques that you’d recommend to these authors? ( few sentences ) 2. Look over the research paper, how the “so what” or “who cares” questions were answered. ( Answer in a few sentences)( it’s a short in class assignemnt )


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Use this research for question 2 ( scroll down)
There are a variety of health challenges faced in the United States as well as across the
world. Nowadays, diabetes is one of the major health challenges that is faced in the world. This
research paper focuses on the causes of Diabetes, which is a lifestyle disease. Diabetes is a body
condition where the pancreas in the body does not produce adequate insulin to regulate the
sugars in the body. Diabetes type 2 comes as a result of the body being unable to regulate the
sugar levels in the body and this leads to the body having higher levels of sugar. The current rise
in cases of diabetes type 2 is due to unhealthy living styles in society. Unhealthy eating habits are
one of the key causes of diabetes type 2. Consuming fast foods and sugary candies, for instance,
leads to obesity as well as diabetes. Lack of exercises also causes obesity hence increasing the
risk of one contracting diabetes. For this reason, to manage and control diabetes in society,
people should eat healthy foods as well as exercise daily. Avoiding fatty and sugary foods leads
lowers the risk of a person becoming diabetic. In addition, useful exercises are also very essential
since they help burn calories in the body. This reduces the risk of an individual becoming obese
as well as becoming diabetic.
Globally, diabetes type 2 has continued to rank as one of diseases that burden the health
sector and health care funds. The lack of cure also makes it worse, leaving those who have it to
experience high cost in the management of the illness. The effect this has on the patient is not an
easy way of managing the disease since it comes with a bundle of adjustments such as change of
lifestyle. Another factor that limits proper management of the illness is the lack of incorporation
of a healthy diet and exercising. Most people, especially the youth have a life of not maintaining
good health, and they end up getting diseases like diabetes type 2. This also applies in the United
State where most people are into bad health habit that entails eating junk food and no exercising
(Micha et al. pp 913-918). With such eating and exercising habits, it takes less time before they
start having prediabetes. During the time, the blood sugar of an individual is at 125 milligrams
per deciliter unlike where normal blood level is 70 to 99 milligrams per deciliter. Individuals
undergoing prediabetes stage face the risk of developing type 2 diabetes without experiencing all
the symptoms of disease.
The risk factors associated with prediabetes and type 2 diabetes are similar. They entail an
individual experiencing an increase in weight, high–density lipoprotein with lower cholesterol
level at 40 mg/dl at times at 50 mg/ml, increased blood pressure, having gestational diabetes,
polycystic ovary syndrome, women giving birth to children with a birth weight of above ten
pounds, and having a sedentary life (Micha et al. pp 913-918). The occurrence of prediabetes
causes the doctor to recommend health-related change be made as a way of limiting the
occurrence of type 2 diabetes. Weight loss through exercise and eating a healthy diet is
recommended to restrict the occurrence of diabetes type 2. The patient if not careful and fails to
stick to the advised healthy behaviour change ends up getting the type 2 diabetes which by then
is irreversible.
a) Development of diabetes type 2
The body requires food as the main source of energy. The type 2 diabetes takes place
when the body fails to use energy, and no response occurs in the body towards energy as
illustrated by Norwood and Inlander (pp. 8-9) and similarly the issue is backed by evidence
offered by Semple (7). Energy giving food such as carbohydrates, vegetables, fruits, and candy,
when taken in excess may lead to the occurrence of diabetes. According to Collazo-Clavell (pp.
5-8) and Norwood and Inlander (pp. 8-9), diabetic patients who consume energy giving foods
experience hardship when their bodies cannot convert food to energy as require. After intake of
carbohydrates, they are converted to glucose in the digestive and then absorbed into the
bloodstream for distribution around the body as indicated by Norwood and Inlander (pp. 8-9).
Regulation of blood sugar is made by insulin which is produced in the pancreas by beta cells.
Where insulin is not provided there are elevated levels of blood sugar, this where diabetes type 1
occurs. If the body starts to resist insulin of failure of the pancreas to give enough, diabetes type
2 happens, and in the end, the beta cell becomes functionless. Further, in type 1 diabetes, there is
a rare occurrence of the body destroying the beta cells.
b) Risk Factors that contribute to Diabetes type 2
The risk factors associated with type 2 diabetes are weight, inactivity, fat distribution,
age, race, family history, darkened skin on the neck and armpits, prediabetes, polycystic ovarian
syndrome and gestational diabetes (Wu et al. pp. 1186-1190). Being overweight and obese leads
to type 2 diabetes based on increase fat distribution in the body. Since the body cannot
breakdown the carbohydrates stored in the form of fats; they result in increased blood sugar.
Lack of physical exercises and activities increases the risk of getting diabetes type 2 since the
glucose in the body is not utilized to get energy during workouts. There are people with a high
chance of getting diabetes type 2 as they grow older, especially when one reaches the age of 45
years. The reason for this is lack of exercise, loss of muscle mass, and increase in weight. Of late
children, adolescents and young adults are also under the risk of getting type 2 diabetes, which is
associated with lifestyle and diet they take.
When it comes to family history, a family with many people in the family tree has had
diabetes type 2 are under risk of inheriting the disease. In America, there is also the likelihood of
getting diabetes based on race. The races with the highest possibility of getting the disease are
African Americans, American Indians, Hispanic, and Asian Americans (Wu et al. pp. 11881190). Darkened skin on the neck and armpits is a condition identified with type 2 diabetics
which leads to insulin resistance. Elevated blood sugar levels below diabetes’ range are another
risk factor. This stage that may lead to the development of diabetes is what is called prediabetes.
When the condition is left untreated, it leads to acquiring of diabetes type 2. Also, the lack of
unhealthy behaviour change and unhealthy diet ends up causing diabetes type 2.
Women with the polycystic ovarian syndrome, which is associated with the irregular
menstrual cycle, obesity and excess hair growth, have an increased risk of getting diabetes type
2. The reason is they have increased levels of glucose in the body which is not always dealt with
by insulin through blood sugars regulation mechanism (Wu et al. pp. 1189-1190). The second
risk factor associated with diabetes type 2 for women is Gestational diabetes. The condition
comes about during pregnancy due to an increase in weight and excess carbohydrates due to
increase consumption of food. Also, while giving birth, women who give birth to babies with
baby weigh of above 9 pounds have a high risk of getting the condition. The reason for this is
associated with the increase in carbohydrates and fats in the mother’s diet which is taking up by
the fetus through the umbilical cord. When this happens, there high chances that the mother is
obese and hence they are at risk of getting the condition based on the diet which has a lot of
carbohydrates which leads to high cholesterol levels.
c) Complications of type 2 Diabetes
There are various complications associated with diabetes type 2, and they include,
diabetic neuropathy, cardiovascular disease, diabetic nephropathy, cancers, and diabetic
retinopathy. Diabetic neuropathy, which is related to sexual dysfunction, foot ulcers, slow
healing skin wounds, and amputations, limit proper functioning of body system from the
reproductive system to the immune system. In the immune system, it limits a patient from
healing properly (Wu et al. pp. 1187-1188). Hence there are issues like slow healing wounds.
The complication comes about due to loss of protective responsiveness of the feet. It brings
about painful formations that are followed by ulceration of the skin. Other injuries do bring about
skin infection for diabetic type 2 patients. For the skin, it causes a condition called cellulitis.
When it attacks the bones, a patient gets osteomyelitis and gangrene. Sexual dysfunction is
associated with young diabetic patients (Kautzky-Willer et al. pp. 280-310). The dysfunction
results from oxidative stress in cavernous tissues. A second condition due to diabetes type 2 is a
cardiovascular disease which might led to death, as a significant factor in prediabetes and types
two diabetes (Rawshani et al. pp. 1410-1414). Due to the condition, an occurrence of lowdensity lipoproteins oxidation occurs due to oxidative stress that limits atherogenesis. Complex
interactive treatments with antihypertensives, repetitive administration of a low dosage of aspirin
and lowering agents of lipids are used to prevent premature cardiovascular occurrence. When it
comes to diabetic nephropathy, a diabetic patient experiences microvascular complications
which have the earliest manifestation during urination where the last drops have minute droplets
of proteins. The condition is called microalbumin. Through routine urinalysis, it is detected when
done by appropriate testing. Where detection is not done during the early phase, nephropathy
occurs. The lack of sensitivity in the detection of microalbuminuria is at times overlooked due to
lack of awareness during a routine urinalysis.
The way type 2 Diabetes Mellitus is associated with cancer is through colorectal cancer,
bladder cancer, liver cancer, kidney cancer and breast cancer, is different based on the specific
cancer complication that comes about (Chen et al. pp. 1025-1029). Based on research evidence,
the occurrence of the above cancers is determined by what the disease expose the patient to due
to the presence of elevated sugars in the bloodstream. Primarily, underlying mechanisms linking
cancer and T2DM follows the presence of various risk factors like obesity, age, smoking,
sedentary lifestyle, refined carbohydrates consumption, increased intake of saturated fats, and
some psychological factors. Secondly, increased levels of insulin circulating the bloodstream
have similarities with the manifestation of type 2 diabetes mellitus. The condition which is
known as hyperinsulinemia promotes carcinogenesis of cells. Thus, it directly brings about
cancer by facilitating the increase in the number of colonic tumours in experimental and vitrro
animals. Serum levels and plasma are positively associated when diabetes type 2 leads to the
occurrence of cancer’s risk factors. According to Nentwich et al. (489), how T2DM causes
diabetic retinopathy is based on increased insulin levels (hyperinsulinemia) leading to damage of
the retinal vessels. When this happens the eye, most vascular part of the body, fails to convert
high oxygen and light into electrical energy which normally takes place in cones and rods. In the
case of chronic hyperglycemia, microvascular damage occurs to bring about damage to retinal
vessels. This occurrence is due to vascular permeability that occurs in the retina. In the real
sense, an appearance of dysglycemia in most case happens before the diabetes patients get
diagnosed. The occurrence is shown in approximately 20% of new cases of diabetes type 2 who
show symptoms of retinopathy (Chen et al. pp. 1025-1029).
Diabetes type 2 continues to increase as one of the significant health cases related to
lifestyle one lives. The process which leads to much-getting diabetes if detected early enough
can lead to prevention of the illness. Another preventive measure is when prediabetes people
change their lifestyle and eating habits. The factors of the condition, for most people, it has led to
the occurrence of various complications which have increased medical implications. The risk
factors associated to these implications include weight, lack of being active, fat distribution, age,
race, family history, darkened skin on the neck and armpits, prediabetes, polycystic ovarian
syndrome and gestational diabetes, lead to worsening of the condition.
When of type 2 Diabetes happens, patients face complications that worsen their health
even if management of the causing illness is contained. Complications resulting from type 2
diabetes diabetic neuropathy, cardiovascular disease, diabetic nephropathy, cancers, and diabetic
retinopathy, have also been known to worsen the illness since most of the patients by this stage
may experience financial constraints that limit access to medical care. Awareness has to be
created as a way of ensuring people do not time and time again get diabetes which is burdening
most economies as increased budget spending are made every year as more and more people to
understand the disease. Following a healthy eating habits and daily exercises will help with
preventing the disease.
Works Cited
Chen, Yu, et al. “Association between type 2 diabetes and risk of cancer mortality: a pooled
analysis of over 771,000 individuals in the Asia Cohort Consortium.” Diabetologia 60.6
(2017): 1022-1032.
Collazo-Clavell, Maria. Mayo clinic on managing diabetes. Rochester: Mayo Clinic, 2001. Print.
Kautzky-Willer, Alexandra, Jürgen Harreiter, and Giovanni Pacini. “Sex and gender differences
in risk, pathophysiology and complications of type 2 diabetes mellitus.” Endocrine
reviews 37.3 (2016): 278-316.
Micha, Renata, et al. “Association between dietary factors and mortality from heart disease,
stroke, and type 2 diabetes in the United States.” Jama 317.9 (2017): 912-924.
Nentwich, Martin M., and Michael W. Ulbig. “Diabetic retinopathy-ocular complications of
diabetes mellitus.” World journal of diabetes 6.3 (2015): 489.
Norwood, Janet, and Charles Inlander. Understanding diabetes. New York: Macmillan, 1999.
Rawshani, Aidin, et al. “Mortality and cardiovascular disease in type 1 and type 2 diabetes.” New
England Journal of Medicine 376.15 (2017): 1407-1418.
Semple, Carol. Diabetes. Rev. ed. Aldershot: Enslow, 2000. Print.
Wu, Yanling et al. “Risk factors contributing to type 2 diabetes and recent advances in the
treatment and prevention” International journal of medical sciences vol. 11,11 11852000. 6 Sep. 2014, doi:10.7150/ijms.10001
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