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Diabetes and Obesity: Engaging Health-Promoting Behaviors


Diabetes and obesity are major public health priorities that are highly associated with environmental factors and correlated with the availability of open space in neighborhoods and communities.

Diabetes and obesity are major public health priorities due to their substantial increase nationwide and their long-term health implications for the US population.1


In 2011, almost 38% of the population had diagnosed or undiagnosed prediabetes, which indicates high blood sugar levels that are not high enough to be called full-blown diabetes. Studies suggest that one-third of Americans with diabetes don’t know they have it. In 2010, 25.8 million (8.3%) Americans had diabetes versus 29.1 million (9.3%) in 2012. In 2010, out of 25.8 million, 18.8 million were diagnosed and 7.0 million were undiagnosed. In 2012, out of 29.1 million, 21 million were diagnosed and 8.1 million were undiagnosed. In addition, in 2008-2009, 18,436 of America’s youth had type 1 diabetes and 5089 with type 2 diabetes. These findings should be a wake-up call for everyone to get proper treatment and plan healthy lifestyle to reduce and prevent the onset of diabetes.2

Diabetes occurs more in non-white populations. The rates of diagnosed diabetes by race/ethnic group are 7.6% of non-Hispanic whites, 9% of Asian Americans, 12.8% of Hispanics, 13.2% of non-Hispanic blacks, and 15.9% of American Indians/Alaskan Natives. The breakdown among Asian Americans consists of 4.4% Chinese, 11.3% Filipinos, 13% Asian Indians, and 8.8% for other Asian Americans.3 The American Diabetes Association demonstrates a clear breakdown among Hispanic adults that shows 8.5% among Central and South Americans, 9.3% for Cubans, 13.9% for Mexican Americans, and 14.8% for Puerto Ricans.

In 2012, total costs associated with diagnosed diabetes in the United States were $245 billion that includes $176 billion for direct medical expense and $69 billion in reduced productivity.3 It is necessary to educate the public on etiologic factors associated with diabetes that include obesity, diet, aging, physical inactivity, predisposing diabetogenic factors, certain antihypertensive drugs, and gender.4 The ultimate goal for patients with diabetes is to manage the disorder and control any symptoms related to hyperglycemia. In addition, it is also important to reduce the severity of chronic complications through medications, diet to manage weight, regular physical activity, and other therapeutic approaches. People must be cognizant that regular exercise is one of the best preventive measures they can take in order to avoid contracting diabetes. The exercise helps to regulate glucose—insulin requirements and will also reduce risk factors for cardiovascular disease.

People must also be aware of some of the symptoms associated with diabetes that may include fatigue, polydipsia (thirst), Polyuria (frequent urination), polyphagia (hunger), weakness, weight loss, and burning feet. These symptoms adversely affect the individuals’ quality of life, impair their functionalities, and contribute to psychological agony.5 It is important to educate the public about risk factors, preventive measures, and lifestyle changes to prevent and reduce risks.


People are considered overweight if their body mass index (BMI) is between 25 and 29.9; they are considered obese if their BMI is 30 or more. People must be aware that being overweight and obese are directly associated with many chronic conditions, such as hypertension, heart failure, diabetes, osteoarthritis, and cancer. These findings must be a wake-up call to create policies that are designed to fight against overweight and obesity. A collaborative effort is needed across the country to stop this trend, which is compromising and adversely affecting the lives of many. There is a need for comprehensive wellness programs for such individuals.6

Environmental Factors

Diabetes and obesity are highly associated with environmental factors and are correlated with the availability of open space within neighborhoods and communities. The inclusion of the open space and its association with increased physical activity in adults and adolescents are of considerable interest.7 Physical activity and regular exercise can prevent, reduce the severity of complications, and ameliorate the onset of diabetes and obesity.

Evidence seems to suggest that increased open space means a greater amount of available land within a community to promote exercise and physical activity, which can be the best preventive measure to combat obesity. The amount of open spaces, including public and private outdoor facilities, in a neighborhood is inversely associated with BMI as it promotes opportunities for physical activity.7 Physical settings, including the design of neighborhoods and providing opportunities for individuals to engage in health promoting behaviors have direct and positive impacts on health.8

Access to open space plays an important role in shaping people’s physical activity, which ultimately has positive effects on individuals’ health.9 People who live in regions that have more green and open space have significantly lower rates of diabetes, higher rates of physical activity, lower prevalence of high-fat diets, fewer smokers, and more individuals who eat at least 5 portions of fruits and vegetables daily compare with those with less open space.

Supportive environments, such as parks and other green spaces, are extremely beneficial to promote an active lifestyle. Conversely, living in economically underserved neighborhoods increases risk factors for obesity and diabetes.10 It is essential for local policy makers to identify the needs of community in order to prevent and control the situation.1 People must be encouraged to be well-informed about their health status and participate in physical activity to decrease the risk of diabetes and obesity and improve quality of life.


1. CDC. (2009). MMWR: Morbidity & Mortality Weekly Report, 58(45), 1259-1263.

2. Reinberg S. (2015). Half of U.S. adults have diabetes or prediabetes. Retrieved from http://www.cbsnews.com/news/half-of-us-adults-have-diabetes-or-high-risk-prediabetes/

3. American Diabetes Association. (2015). Statistics about diabetes. Retrieved from http://www.diabetes.org/diabetes-basics/statistics/

4. Pessoa Marinho NB, de Vasconcelos HA, Garcia Alencar AP, de Almeida PC, Coelho Damasceno MM. (2013). Risk for type 2 diabetes mellitus and associated factors. Acta Paulista De Enfermagem, 26(6), 569-574.

5. Sullivan MD, Evans G, Anderson R, O’Connor P, Raisch DW, Simmons DL, Narayan KV. (2012). Diabetes symptoms and distress in accord trial participants: Relationship to baseline clinical variables. Clinical Diabetes, 30(3), 101-108.

6. Kelly M. (2015). More than two-thirds of Americans are overweight or obese. Retrieved from http://www.foxnews.com/health/2015/06/23/more-than-two-thirds-americans-are-overweight-or-obese/

7. Oreskovic N, Winickoff J, Kuhlthau K, Romm D, Perrin J. (2009). Obesity and the built environment among Massachusetts children. Clinical Pediatrics, 48(9), 904-912.

8. Norman G, Adams M, Kerr J, Ryan S, Frank L, Roesch, S. (2010). A latent profile analysis of neighborhood recreation environments in relation to adolescent physical activity, sedentary time, and obesity. Journal of Public Health Management & Practice, 16(5), 411-419.

9. Dehghan M, Akhtar-Danesh N, Merchan AT. (2005). Childhood obesity, prevalence and prevention. Retrieved from http://www.nutritionj.com/content/4/1/24

10. Fiore K. (2013). More open space leads to less diabetes. Retrieved from http://www.medpagetoday.com/Endocrinology/Diabetes/41564

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