Global Issue Problem Description
Diabetes is a chronic condition that interferes with the body’s ability to process blood sugar (glucose). Glucose is an essential source of energy for your cells, and it needs to be transported from your bloodstream into your cells with the help of insulin, a hormone produced by the pancreas (Sneha & Gangil, 2019). Diabetes is on the rise globally, with an estimated 463 million adults aged 20-79 living with the disease in 2019 (Porwal et al., 2020). This poses a serious public health issue because diabetes is linked to higher rates of morbidity and mortality, lower life expectancy, and a considerable financial burden on patients and healthcare systems. Risk factors for developing diabetes include genetics, lifestyle factors such as physical inactivity, poor diet, and obesity (Kaur & Kumari, 2018). The central theme of this assessment is to explore the issue of Diabetes in Mauritius and develop an evidence-based intervention to bring a better outcome for the whole community.
Analysis of an International Health Issue
Millions of individuals worldwide are impacted by the global health problem of diabetes. The World Health Organization (WHO) predicted that 463 million people worldwide were living with diabetes in 2019 (WHO, 2019). By 2045, this number is anticipated to reach 700 million. High blood sugar levels are a symptom of the chronic condition diabetes, which decreases the body’s capacity to process glucose (Kaur & Kumari, 2018).
Diabetes affects individuals and communities in all countries. However, the burden of the disease is not evenly distributed, and low- and middle-income countries (LMICs) are particularly affected. In 2019, over 75% of people living with diabetes were in LMICs. Diabetes disproportionately affects marginalized populations, including Indigenous peoples, immigrants, and low-income individuals. The countries most affected by diabetes are those with high rates of obesity and unhealthy lifestyles, such as sedentary behavior and diets high in sugar and fat (Mogre et al., 2019). The top five countries with the highest prevalence of diabetes are:
- Tokelau: 29.7%
- Mauritius: 24.3%
- Nauru: 23.8%
- Cook Islands: 21.1%
- Marshall Islands: 21.1% (Diabetes.co.uk, 2019)
Diabetes inequities across countries include disparities in access to healthcare and preventative measures, such as education and early detection. Additionally, socioeconomic factors, including poverty and education levels, play a significant role in the prevalence and management of diabetes. For example, individuals with low incomes and limited access to healthy food and healthcare services are at a higher risk of developing diabetes and experiencing complications. Indigenous and marginalized populations also experience diabetes inequities due to historical injustices and ongoing discrimination. Addressing these inequities is critical to achieving equitable and sustainable diabetes prevention and management globally (Kaur & Kumari, 2018).
Social or Political Ramifications of Health Issues
It is caused by the inability of the body to produce or use insulin, resulting in high blood sugar levels. If diabetes is not addressed correctly, it can have significant social and political ramifications (Hill-Briggs et al., 2020).
Social Ramifications
On the social front, individuals with diabetes can face discrimination and stigmatization, leading to social exclusion and a lower quality of life. They may also experience reduced job opportunities, education, and income due to their health condition. Diabetes can also affect the mental health of individuals, causing depression, anxiety, and stress (Kaur & Kumari, 2018).
Reduced Quality of Life: Uncontrolled diabetes can lead to multiple complications. Neuropathy, blindness, and amputations can seriously affect the patient’s quality of life (Powers et al., 2020).
Stigmatization: Diabetes is often seen as a lifestyle disease caused by poor eating habits. As well as the lack of exercise, leading to stigmatization and discrimination of patients (Mogre et al., 2019).
Social Isolation: Patients with diabetes may feel socially isolated due to the restrictions. They must impose on their diet, exercise, and other activities (Mogre et al., 2019).
Economic Burden: Diabetes management can be expensive, which puts financial pressure on patients and their families (Kaur & Kumari, 2018).
Healthcare Disparities: Diabetes is more prevalent in specific populations, including low-income communities and minority groups. This can lead to healthcare disparities (Kaur & Kumari, 2018).
Political Ramifications
Politically, the cost of treating diabetes can have a significant impact on the economy of a country. It can lead to a burden on the healthcare system, increased absenteeism from work, and reduced productivity. Governments may have to invest in expensive treatment options or develop policies to prevent and manage the disease (Hill-Briggs et al., 2020).
Increased Healthcare Costs: Diabetes is a costly disease to manage, and the increasing prevalence of the disease can put a strain on healthcare budgets (Powers et al., 2020).
Productivity Loss: Uncontrolled diabetes can lead to absenteeism and reduced productivity, affecting the economy (Powers et al., 2020).
The Burden on Social Services: Diabetes complications can lead to the need for social services. Such as disability benefits, social security, and Medicare, which can put a strain on the system (Kaur & Kumari, 2018).
Health Disparities: Diabetes disproportionately affects specific populations, which can exacerbate existing health disparities (Mogre et al., 2019).
Impact on the Insurance Industry: The increasing prevalence of diabetes can lead to increased insurance costs and premiums, which can affect the insurance industry (Powers et al., 2020).
According to research in the journal Diabetes Care, the annual economic cost of diabetes in the US is almost $327 billion (Ali et al., 2020). Additionally, a study in the Journal of Occupational and Environmental Medicine found that diabetes was associated with increased absenteeism and reduced productivity (Ali et al., 2020). A report by the American Diabetes Association states that diabetes disproportionately affects specific populations, including minorities, low-income individuals, and those with lower levels of education (Baptista et al., 2019).
Analysis of Data Regarding the Socioeconomic, Political, and Cultural Influences
The population most affected by Diabetes in Mauritius is middle-aged adults, with a higher prevalence in men. According to data from the International Diabetes Federation (IDF), the most diabetes in Mauritius adults aged 20-79 was 22.3% in 2019 (Saeedi et al., 2019). Social determinants such as education, income, and employment status are significant factors affecting Diabetes in Mauritius. Diabetes prevalence rates are correlated with low levels of education and poverty as well as access to nutritious foods and opportunities for physical activity. Socioeconomic Influences: One of the significant socioeconomic factors contributing to the high prevalence of Diabetes in Mauritius is the high rate of urbanization. The World Bank reports that over 40% of the population lives in urban areas, often leading to sedentary lifestyles and unhealthy diets. In addition, the high poverty rate in Mauritius also contributes to the problem, as individuals who cannot afford healthy food and access to healthcare are more likely to develop diabetes (Baptista et al., 2019).
Gapminder data supports the impact of socioeconomic, political, and cultural factors on the prevalence of Diabetes in Mauritius. The data shows that as the country has urbanized and become more economically developed, most diabetes has increased. Additionally, data from 2017 shows that the population living below the poverty line in Mauritius was 8.6%, indicating that poverty may contribute to the high prevalence of diabetes. Finally, data shows that traditional foods in Mauritius are high in fat and salt, supporting the cultural factors contributing to the diabetes epidemic (Ali et al., 2020).
Cultural attitudes toward diet and exercise may have an impact on the onset of diabetes. In Mauritius, traditional meals often include high-fat and high-carbohydrate foods, and sedentary lifestyles are typical, which can lead to a higher risk of diabetes. Geographical factors such as urbanization and access to healthcare can affect diabetes rates in Mauritius. Urbanization has led to changes in diet and lifestyle, which can contribute to diabetes development. Additionally, access to healthcare and diabetes treatment is limited in rural areas, which can result in higher rates of complications (Mogre et al., 2019).
Socioeconomic status has a significant impact on diabetes rates in Mauritius. Those with lower income and education levels have a higher risk of developing diabetes and are less likely to have access to diabetes prevention and management resources. Political systems can affect diabetes rates in Mauritius through policies and regulations promoting healthy lifestyles and healthcare access. The Mauritian government has implemented a sugar tax and national diabetes screening programs. Still, more can be done to address the socioeconomic and cultural factors contributing to diabetes in the country. Overall, the prevalence of Diabetes in Mauritius is influenced by socioeconomic, cultural, and political factors. Addressing these factors through targeted interventions and policy changes could help reduce the burden of diabetes in the country (Porwal et al., 2020).
Future Changes which can Increase or Decrease effects on the Diabetes
The future changes in Mauritius will likely be complex, and their effects on diabetes depend on multiple socioeconomic, political, and cultural factors. However, suppose policymakers and stakeholders work towards improving access to healthy foods. Healthcare, promoting physical activity, and addressing income inequality. In that case, it could help reduce the prevalence of diabetes in the country (Porwal et al., 2020).
Economic Growth: If the Mauritian economy continues to grow, there may be an increase in income. This could lead to improved access to healthy foods and better healthcare, potentially reducing the prevalence of diabetes (Mogre et al., 2019).
Income Inequality: If income inequality persists, people with lower incomes may have less access to healthy foods and healthcare, which could increase the prevalence of diabetes (Mogre et al., 2019).
Urbanization: As urbanization continues, people may have more sedentary lifestyles, increasing obesity and diabetes (Porwal et al., 2020).
Healthcare Policies: If the government implements policies to increase access to healthcare and promote healthy behaviors, it may reduce the prevalence of diabetes (Porwal et al., 2020).
Trade Agreements: If Mauritius enters into trade agreements that increase access to unhealthy foods and discourage local food production. It may lead to an increase in the prevalence of diabetes (Porwal et al., 2020).
Diet: If traditional Mauritian diets continue to be replaced with a more Westernized diet high in processed foods and sugar, it may increase the prevalence of diabetes (Porwal et al., 2020).
Physical Activity: If traditional physical activities, such as walking or cycling, continue to be replaced with sedentary behaviors, it may lead to an increase in the prevalence of diabetes (Porwal et al., 2020).
Evaluation of Strategies used historically to address the Global Health Issue
Historically, several strategies have been implemented to address the global health issue of diabetes. These strategies include prevention, treatment, education, research, and policymaking. However, the effectiveness of these strategies varies depending on the social, economic, political, and environmental contexts in which they are implemented (Mogre et al., 2019).
Prevention strategies have focused on reducing risk factors associated with diabetes, such as obesity, physical inactivity, unhealthy diets, and tobacco use. These strategies include community-based programs to promote healthy lifestyles, such as nutrition education, physical activity, and smoking cessation. The World Health Organization (WHO) has developed the Global Diabetes Compact, which aims to improve the prevention, diagnosis, and treatment of diabetes through partnerships and innovation (Mapa-Tassou et al., 2019).
Education strategies have focused on raising awareness about diabetes and its complications and improving health literacy among people with diabetes. Research strategies have focused on understanding the causes and mechanisms of diabetes and developing new treatments and interventions. These strategies include primary research, clinical trials, and translational research. International organizations, such as the International Diabetes Federation and the WHO, have also established research networks and initiatives to promote diabetes research (Mogre et al., 2019).
Policy-making strategies have focused on creating a favorable environment for diabetes prevention and management and promoting equity and social justice. These strategies include legislation, regulation, and public policy, such as promoting universal health coverage, addressing social determinants, and reducing health inequalities. Governments have also implemented procedures to protect the rights of people with diabetes, such as anti-discrimination laws and disability rights legislation (Mapa-Tassou et al., 2019).
Strategies in Mauritius
According to the International Diabetes Federation, in 2019, 7.4% of adults in Mauritius had diabetes, with an estimated 114,900 adults living with the disease. Chronic diabetes has an impact on the body’s capacity to control blood sugar levels. If improperly handled, it can result in serious problems like heart disease, stroke, and blindness (Dawonauth et al., 2019).
Historically, Mauritius has taken several measures to address the issue of diabetes, which has become a global health concern. These strategies have been diverse and have involved various stakeholders, including the government, healthcare providers, and community-based organizations. Public health efforts to increase awareness of the condition and its risk factors have been one of the main methods employed in Mauritius to fight the diabetes epidemic. Targeting both the general public and those who are at risk, such as those who are overweight or have a family history of diabetes, the government has put in place educational initiatives. The campaigns aim to educate the public about the importance of maintaining a healthy lifestyle, including regular exercise and a balanced diet, and the need for routine screening to detect early signs of diabetes (Dawonauth et al., 2019).
Another strategy that has been employed in Mauritius is the development of a national diabetes program. This program has been created to enhance the standard of treatment for diabetics and delay the beginning of the condition. The program includes the establishment of diabetes clinics, the training of healthcare professionals, and the provision of diabetes education and self-management programs (Mahomoodally et al., 2019). In addition, the government has also implemented policies to regulate the sale and consumption of sugar and unhealthy food products. This includes introducing taxes on sugary drinks and imposing restrictions on the marketing and sale of harmful food products (Mapa-Tassou et al., 2019).
While these strategies have shown some success in addressing Diabetes in Mauritius, several social, economic, political, and environmental concerns still need to be addressed. For example, poverty, unemployment, and lack of access to healthcare services can contribute to the high prevalence of diabetes in low-income communities. Additionally, political instability and weak governance can hinder the implementation of effective diabetes prevention and treatment programs (Shukla et al., 2021).
Environmental factors such as climate change, pollution, and exposure to toxins can also contribute to the development of diabetes. Therefore, addressing these issues will require a multi-faceted approach that involves collaboration between the government, healthcare providers, and community-based organizations. Overall, the key to addressing the global health issue of Diabetes in Mauritius is a comprehensive and integrated approach addressing the social, economic, political, and environmental factors contributing to the disease (Mahomoodally et al., 2019).
Current Prospects
Mauritius has taken significant steps to address diabetes as a public health issue. The government has implemented policies to increase access to diabetes screening and management services, including free medication and diagnostic tests for individuals with diabetes. The Ministry of Health has also launched a National Diabetes Prevention and Control Program to raise awareness and promote healthy lifestyles. The program involves diabetes care training for medical personnel, community education, and awareness initiatives. In addition, private healthcare providers offer various diabetes management services, including regular checkups, education, and counseling. The government has also encouraged private companies to participate in diabetes prevention and management programs (Shukla et al., 2021).
Predictions for Future Success
Diabetes is still a major public health concern in Mauritius despite the advancements. There is a need for immediate action because the COVID-19 pandemic is predicted to exacerbate the issue of the rising number of adults who have diabetes. One of the strategies that can be implemented is adopting a comprehensive approach to diabetes care. This approach includes prevention, screening, diagnosis, and management (Dawonauth et al., 2019). Additionally, the government and private healthcare providers must work together to provide more diabetes care services and make them more accessible. Also, it’s important to encourage healthy lifestyle choices like frequent exercise, a balanced diet, and weight management. This can be accomplished through instruction, public relations efforts, involvement of the community, and support networks (Mapa-Tassou et al., 2019).
Gaps
Some gaps could be addressed in making strategies to manage diabetes in the country. The public may lack awareness about the causes and effects of diabetes and the importance of prevention and management. In some parts of Mauritius, access to healthcare facilities may be limited, making it difficult for people to access diabetes screening, diagnosis, and treatment. The government may not allocate enough resources to tackle diabetes, including research, prevention, and treatment funding (Morrell et al., 2019). There may be limited collaboration between stakeholders involved in addressing diabetes, such as healthcare providers, policymakers, and community groups. Poor dietary habits, including a high intake of sugary and processed foods, may contribute to the high prevalence of Diabetes in Mauritius. Strategies to promote healthy eating habits may need to be developed and implemented (Chan Sun et al., 2022).
Educational Resource or Project Proposal
Title: “Empowering Mauritian Communities to Prevent and Control Diabetes: An Evidence-based Approach”
Background
Diabetes is a growing concern in Mauritius, with over 20% of adults affected by the disease. The increasing prevalence of diabetes is linked to several social determinants of health, including poor diet, physical inactivity, and obesity. The Mauritian government has initiated various programs to address the burden of diabetes, including the National Diabetes Program and the Non-Communicable Diseases (NCDs) Strategic Plan. However, more targeted and evidence-based approaches are required to address the unique needs of different communities in Mauritius (Shukla et al., 2021).
Target population
The target population for this project is Mauritian communities at high risk for diabetes, including adults with a family history of diabetes, overweight and obese individuals, and those with sedentary lifestyles. The project will focus on preventing and controlling diabetes, particularly lifestyle modifications and behavior changes (Mungloo-Dilmohamud et al., 2022).
Project objectives
The objectives of this project are:
- To increase knowledge and awareness of diabetes and its risk factors among the target population.
- To promote healthy lifestyles and behavior change through evidence-based interventions, including dietary modifications and physical activity.
- To develop a sustainable network of community-based diabetes prevention and control programs in Mauritius (Chan Sun et al., 2022).
Approach
The project will be implemented through educational resources and community-based interventions. The resources will be developed in collaboration with local health experts and community leaders to ensure cultural relevance and appropriateness (Mogre et al., 2019). The resources will include the following:
- Printed materials (e.g., brochures and posters) with information on diabetes prevention and control, healthy eating, and physical activity.
- Audio-visual materials (e.g., videos, podcasts) that can be shared through social media platforms and community radio stations.
- Workshops and training sessions for community health workers, volunteers, and local leaders to increase their capacity to deliver evidence-based interventions (Shukla et al., 2021).
The community-based interventions will be designed to reach the target population where they live, work, and socialize. They will include the following:
- Mobile clinics and health screenings to identify individuals at risk for diabetes and offer targeted interventions.
- Group-based interventions, such as walking clubs and healthy cooking classes, promote behavior change and social support.
- Community-based outreach activities, such as health fairs and cultural events, engage the community and promote awareness of diabetes prevention and control (Chan Sun et al., 2022).
Setting
The project will be implemented in selected communities across Mauritius. The selection of the communities will be based on their high prevalence of diabetes and other social determinants of health, such as poverty, low levels of education, and restricted access to healthcare services. The project will be implemented with local partners, including community-based organizations, health centers, and local government authorities (Morrell et al., 2019).
Assumptions
Assumptions made during the development of an educational resource or project proposal focused on driving evidence-based improvements related to Diabetes in Mauritius are as follows:
- The target population has access to and can understand health education materials that are culturally and linguistically appropriate. This assumes that the educational resource or project proposal has been translated into the local language, Creole, and considers the population’s cultural nuances (Shukla et al., 2021).
- The target population has access to healthcare facilities and can receive diabetes treatment. This assumes that the healthcare system in Mauritius is equipped to manage diabetes, including screening, diagnosis, and treatment (Mungloo-Dilmohamud et al., 2022).
- The target population knows the risk factors and symptoms associated with diabetes. This assumes that the educational resource or project proposal will include information on the risk factors and symptoms of diabetes, as well as ways to prevent or manage the condition (Mungloo-Dilmohamud et al., 2022).
- The relevant social determinants of health-related diabetes will be addressed, such as access to healthy food, physical activity, and social support. This assumes that the educational resource or project proposal will focus on medical management and the social and environmental factors that impact Diabetes prevention and control (Mungloo-Dilmohamud et al., 2022).
The project would occur in community-based settings, such as community centers, schools, and workplaces. The educational resource may also be distributed through local health clinics or pharmacies. The target audience for the project would include people at risk for or living with diabetes, as well as their family members and caregivers. The stakeholders to whom the project would be presented include representatives from the Ministry of Health, local healthcare providers, and community organizations (Mungloo-Dilmohamud et al., 2022).
Conclusion
The “Empowering Mauritian Communities to Prevent and Control Diabetes” project is a comprehensive and evidence-based approach to addressing the burden of Diabetes in Mauritius. The project seeks to lessen the prevalence and effects of diabetes in Mauritius by focusing on high-risk populations and tackling social determinants of health. The project can be adapted to other settings and serve as a model for other countries facing similar challenges. The project will require the support of stakeholders, including the Mauritian government, local health authorities, and community leaders, to ensure its sustainability and impact.
Summary of the Practicum Experience
During the practicum experience, I had the opportunity to present a project proposal on diabetes to a public health officer. Initially, I was nervous about conveying the proposition, but I had prepared thoroughly and felt confident in my topic knowledge. During the presentation, I could clearly articulate the purpose and significance of the project, which focused on developing educational resources to help individuals manage diabetes effectively (Ahn & Choi, 2019).
Overall, the public health officer was receptive to the proposal and provided valuable feedback for improvement. I was pleased with how the presentation went and appreciated the opportunity to share my knowledge and contribute to the public health sector. If I were to present at a similar meeting in the future, I would perhaps try to incorporate more visual aids to enhance the presentation and make it more engaging for the audience (Ahn & Choi, 2019).
Conclusion
To conclude, diabetes is a severe concern in the modern world. To address this problem, there is a need for a multi-faceted approach that involves both the prevention and management of diabetes. This includes initiatives to promote healthy lifestyles and diets, education and awareness campaigns, screening and early detection of diabetes, access to affordable and quality healthcare, and effective management of the condition. Overall, addressing the issue of Diabetes in Mauritius requires a collaborative effort from all stakeholders, including the government, healthcare providers, civil society organizations, and individuals. It is possible to decrease the prevalence of diabetes in Mauritius and enhance the country’s population’s health and wellbeing with persistent efforts and an all-encompassing strategy.
References
Ahn, Y.-H., & Choi, J. (2019). Incivility experiences in clinical practicum education among nursing students. Nurse Education Today, 73, 48–53.
https://doi.org/10.1016/j.nedt.2018.11.015
Ali, S. N., Dang-Tan, T., Valentine, W. J., & Hansen, B. B. (2020). Evaluation of the clinical and economic burden of poor glycemic control associated with therapeutic inertia in patients with type 2 diabetes in the United States. Advances in Therapy, 37(2), 869–882.
https://doi.org/10.1007/s12325-019-01199-8
Baptista, M. C., Burton, W. N., Nahas, A. K., Wang, Y.-P., Viana, M. C., & Andrade, L. H. (2019). Absenteeism and presenteeism are associated with common health conditions in Brazilian workers. Journal of Occupational and Environmental Medicine, 61(4), 303–313.
https://doi.org/10.1097/jom.0000000000001538
Chan Sun, M., Landinaff, M. A. S., & Thoplan, R. (2022). Use of biochemical markers for diabetes prevention in the new decade. Physical Sciences Reviews, 0(0).
https://doi.org/10.1515/psr-2021-0166
Dawonauth, L., Jeeawoody, R. B., Jankee, S., & L’Omelette, A. D. (2019). High rate of early-onset preeclampsia in Mauritius. Journal of Reproductive Immunology, 136, 102611.
https://doi.org/10.1016/j.jri.2019.08.002
Diabetes.co.uk. (2019, January 15). How many people have diabetes – Diabetes Prevalence Numbers. Diabetes.co.uk.
https://www.diabetes.co.uk/diabetes-prevalence.html
Hill-Briggs, F., Adler, N. E., Berkowitz, S. A., Chin, M. H., Gary-Webb, T. L., Navas-Acien, A., Thornton, P. L., & Haire-Joshu, D. (2020). Social determinants of health and diabetes: A scientific review. Diabetes Care, 44(1), 258–279.
https://doi.org/10.2337/dci20-0053
Kaur, H., & Kumari, V. (2018). Predictive modeling and analytics for diabetes using a machine learning approach. Applied Computing and Informatics.
https://doi.org/10.1016/j.aci.2018.12.004
Mahomoodally, M. F., Protab, K., & Aumeeruddy, M. Z. (2019). Medicinal plants brought by Indian indentured immigrants: A comparative review of ethnopharmacological uses between Mauritius and India. Journal of Ethnopharmacology, 234, 245–289.
https://doi.org/10.1016/j.jep.2019.01.012
Mapa-Tassou, C., Katte, J.-C., Mba Maadjhou, C., & Mbanya, J. C. (2019). Economic Impact of Diabetes in Africa. Current Diabetes Reports, 19(2).
https://doi.org/10.1007/s11892-019-1124-7
Mogre, V., Johnson, N. A., Tzelepis, F., Shaw, J. E., & Paul, C. (2019). A systematic review of adherence to diabetes self‐care behaviors: Evidence from low‐ and middle‐income countries. Journal of Advanced Nursing, 75(12), 3374–3389.
https://doi.org/10.1111/jan.14190
Morrell, S., Taylor, R., Nand, D., & Rao, C. (2019). Changes in proportional mortality from diabetes and circulatory disease in Mauritius and Fiji: Possible effects of coding and certification. BMC Public Health, 19(1).
https://doi.org/10.1186/s12889-019-6748-7
Mungloo-Dilmohamud, Z., Heenaye-Mamode Khan, M., Jhumka, K., Beedassy, B. N., Mungloo, N. Z., & Peña-Reyes, C. (2022). Balancing data through data augmentation improves the generality of transfer learning for diabetic retinopathy classification. Applied Sciences, 12(11), 5363.
https://doi.org/10.3390/app12115363
Organization, W. H. (2019). Global action plan on physical activity 2018-2030: More active people for a healthier world. In Google Books. World Health Organization.
https://books.google.com.pk/books?hl=en&lr=&id=RnOyDwAAQBAJ&oi=fnd&pg=PA48&dq=World+Health+Organization+(WHO)
Porwal, P., Pachade, S., Kokare, M., Deshmukh, G., Son, J., Bae, W., Liu, L., Wang, J., Liu, X., Gao, L., Wu, T., Xiao, J., Wang, F., Yin, B., Wang, Y., Danala, G., He, L., Choi, Y. H., Lee, Y. C., & Jung, S.-H. (2020). IDRiD: Diabetic retinopathy – Segmentation and grading challenge. Medical Image Analysis, 59, 101561.
https://doi.org/10.1016/j.media.2019.101561
Powers, M. A., Bardsley, J. K., Cypress, M., Funnell, M. M., Harms, D., Hess-Fischl, A., Hooks, B., Isaacs, D., Mandel, E. D., Maryniuk, M. D., Norton, A., Rinker, J., Siminerio, L. M., & Uelmen, S. (2020). Diabetes self-management education and support in adults with type 2 diabetes: a consensus report of the American diabetes association, the association of diabetes care and education specialists, the academy of nutrition and dietetics, the American academy of family physicians, the American Academy of pas, the American association of nurse practitioners, and the American pharmacists association. Diabetes Care, 43(7), dci200023.
https://doi.org/10.2337/dci20-0023
Saeedi, P., Petersohn, I., Salpea, P., Malanda, B., Karuranga, S., Unwin, N., Colagiuri, S., Guariguata, L., Motala, A. A., Ogurtsova, K., Shaw, J. E., Bright, D., & Williams, R. (2019). Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the international diabetes federation diabetes atlas, 9th edition. Diabetes Research and Clinical Practice, 157(157), 107843.
https://doi.org/10.1016/j.diabres.2019.107843
Shukla, A., Jain, S., Mohammed, N., Hussain, T., & Banerjee, I. (2021). Lived experiences of patients with coronary artery disease: A qualitative study from a Cardiac center of a regional hospital in Mauritius. Global Journal of Medical, Pharmaceutical, and Biomedical Update, 16.
https://doi.org/10.25259/GJMPBU_21_2021
Sneha, N., & Gangil, T. (2019). Analysis of diabetes mellitus for early prediction using optimal features selection. Journal of Big Data, 6(1).
https://doi.org/10.1186/s40537-019-0175-6
