Diabetes Types and Treatment of the Disease

Background of the Design Problem:

Diabetes is a disease that has been on the rise over time and affects approximately 415 million people globally (Trikkalinou, A., Papazafiropoulou, A. K., & Melidonis, A. 2017). It is estimated by researchers that “by 2040 one in 10 adults, approximately 642 million, worldwide will suffer from diabetes (Trikkalinou, A., Papazafiropoulou, A. K., & Melidonis, A. 2017). In addition, type 2 diabetes is also the most prominent diabetes affecting 85-95 percent of all diabetics (Ramachandran, A.2014). This is an important phenomenon affecting not only individuals globally but many Canadians as well. Statistics Canada estimates 3 million Canadians are affected in total and 2.3 million people from that population reported being diagnosed with diabetes above the age of 12 (Brule, S., McDiarmid, C., & McDonald, H.(2018). Research suggests that there is an urgent need to raise awareness about the disease in today's society and the serious consequences of this chronic disorder (Ramachandran, A.2014). Therefore, the purpose of this study is to research diabetes facilities and how the built environment can affect the users’ experience. The interior design problem that is discussed throughout the study arises from the lack of emphasis being placed on young individuals who have been diagnosed with diabetes (Papoutsi, C., Hargreaves, D. S., Colligan, G., Hagell, A., Patel, A. K., Viner, R. M., Finer, S. 2017, p.2). In addition, this is an important topic to discuss and make everyone aware of due to diseases deadly effects. The younger generation of today will soon grow up to be the majority of the population by 2040 (Papoutsi, C., Hargreaves, D. S., Colligan, G., Hagell, A., Patel, A. K., Viner, R. M., Finer, S. 2017, p.2). Therefore, current research in diabetes and education systems for young individuals indicates that a new model for early education and preventative initiatives could reduce the number of deaths and further health complications that diabetes causes every year.

Problem Statement:

Currently, Ontario is offering many opportunities for diabetics to seek help and care. However, current research into Ontario diabetes facilities revealed that there is a lack of facilities suited to the needs of young populations diagnosed with diabetes. Research suggests that this population group is the primal transition period for diabetics (American Diabetes Association. 2019). During this age group many diabetics are starting to become more independent and less reliant on their parents or guardians (American Diabetes Association. 2019). Therefore, the quality of existing education facilities, and if they are efficient enough to enable young diabetics to become independent managers of their health, will be researched. As well as exploring existing facilities, education quality and ability to provide effective educational experiences for young diabetics will be discussed throughout the study.

Purpose of Design Research:

Through the findings and evidence, this study aims to propose a new model for educational diabetes facilities suited for individuals between the ages of 16 and 25. Based on the data collected in the study, a new model will be proposed that provides individuals with interactive educational experiences and evoke positive emotions for both diabetics and their caregivers. The overall goal is to design a facility that motivates young diabetics to independently manage their diabetes and prevent long-term health complications.

Rationale and Significance of the Study:

It is often a misconception that only older populations can develop diabetes, however, research and evidence show that this belief is false. The effort to study this problem is valid because both type 1 and type 2 diabetes are the 7th leading cause of death in the United States (American Diabetes Association. 2019). Not only is there a rise in diabetes across all generations, but there is a significant rise being discovered in children; “About 193,000 Americans under age 20 are estimated to have diagnosed diabetes… “ (American Diabetes Association. 2019). Moreover, diabetes is affecting populations world-wide and is the result of many deaths (American Diabetes Association. 2019). This study is important for everyone, to become knowledgeable about the disease and to learn treatments. Specifically, this research topic is important to the younger population who have been diagnosed with diabetes because early education in diabetes’ self-management practices can help prevent health complications and reduce the need for medication in their future (Papoutsi, C., Hargreaves, D. S., Colligan, G., Hagell, A., Patel, A. K., Viner, R. M., Finer, S. 2017). Thus, education and knowledge on the topic can potentially reduce the number of deaths and health complications diabetes causes every year.

Researcher’s Rationale:

This research topic is of significance to me because after three years of being on a plant-based diet, I have learned through my own research that diabetes is on the rise. I also learned that diet and nutrition play a key role in diabetes management. However, I came to discover that many people, although it is considered one of the leading deaths in North America, are not educated on the topic of diabetes (American Diabetes Association. 2019). Furthermore, this topic is being approached through the lens of educational and health-care design. The proposed design outcome aims to create a facility that supports education, provides resources and activities for young individuals experiencing diabetes. The overall goal is to highlight the importance of preparing young diabetics with the proper education, skills, and resources to be able to manage their health while also reducing the risk of lifelong health complications. Much research has been conducted in health-care and workplace environments to gain a deeper understanding of how the inter-relationship between a thoughtful interior design solution and human behavior can contribute to health and wellness (Lavela, S. L., Etingen, B., Hill, J. N., & Miskevics, S., 2015). The knowledge and background gained through designing in other sectors in the interior design field can help assist the research in creating a positive environment that enhances the overall well-being of patients and their caregivers.

Research Question:

How can a new model of design for a diabetic facility provide educational experiences, promote independence and support the needs of young teens and adults experiencing diabetes?

Hypothesis:

Research suggests that current diabetic facilitates do not place enough emphasis on young people who have been living with diabetes. Educating young adults to become independent managers of their health can help reduce the risk of developing lifelong health complications.

Theoretical Framework:

A grounded theory framework will be used that is based on a mixed-method research methodology. Data collection methods employed are literature reviews, observations of two clinics and interviews from three participants. The literature that will be discussed within the study, specifically in chapter two, are the effects of healthcare environments on users’ experience, as well as the effects of nutrition, diet and self-care/education for diabetes. Research on the effects of health-care environments in relation to users’ experience is beneficial for the study because the future design of the facility is also a health-care environment. The findings gathered through literature will help to discover ways to improve users’ overall well-being and experience within the educational diabetes facility environment. This will also provide evidence as to what elements to not include and how certain features can cause negative effects on the users. 

Theories of diet and nutrition in relation to diabetes will also be beneficial to provide supporting evidence for the future design decision to include an educational kitchen. The goal of an educational kitchen is to teach users how to cook for themselves and which foods can help manage their diabetes. This research will also provide supporting evidence on the importance of having a dietitian specialist as a part of the team working within the proposed facility. Moreover, theories in relation to care and education on diabetes will help provide evidence for therapies and different learning methodologies to use within the facility. Overall, all theories are appropriate for the research topic and will be a starting exploration point for further research.

Conceptual Theory:

The conceptual framework of the study came from my perspective of adopting a plant-based diet, learning the many benefits of food, my education in interior design and my family member’s recent diagnosis of diabetes. The conceptual framework includes the understanding that diabetes is on the rise and is a disease that many people are uneducated about. It was noticed through personal experiences that diabetes is not well taught to individuals who have been diagnosed and is often self-taught through online sources. It was also noticed through personal research the power of food and the many powerful healing properties of a healthy diet.

The focus of the study is to understand the design elements that can potentially support the needs of young diabetics and their caregivers. The study seeks to understand how the built environment can help patients and caregivers acquire the skills and education to live a healthier lifestyle. The study explores answers to these questions through observing diabetes clinics to gain a better perspective on current design elements within these spaces. The study also gathers information through three different perspectives within the health-care and interior design industry. Personal opinion and experience questions are asked about what participants believe is important to a successful educational diabetes design that supports users’ needs. The diagram identifies the diabetics and their caregivers as the central focus of importance and what they require in an educational diabetes facility to acquire skills to succeed in becoming managers of their health.

Scope and Limitations of the Study:

The scope of the study will include the observation of two diabetes clinics located in Ontario and three participants were recruited to partake in interviews. Due to the small number of clinics observed and the limited number of interviewees in the research study, generalization beyond the study’s context is not possible. The study is still valuable despite the findings not being generalizable as it gives insight into different diabetes clinics located in a city and in a rural area. In addition, participants were also chosen for the study to gain a wider perspective in the health-care and interior design industry. The main limitation within the study is the time frame of gathering literature, recruiting participants and observations which was limited to a four-month period, September 2019 and December 2019.

Moreover, another limitation was the scope of the study required a defined focus. The study then needed to be limited to interviewing administrative staff working within the diabetes clinic. These staff members could provide the study with insight into the perspective of diabetics and caregivers. Answers were not sought through asking young diabetic patients or their caregivers due to confidentiality and the vulnerability of these populations. Overall, the goal of this study and research design is to gain a stronger understanding of patients’ and caregivers’ experiences within a diabetes facility environment and to seek answers as to how educational diabetes facilities can be improved to support the needs of the users.

Summary:

In summary, the goal for this research design study is to create a space that facilitates motivation for young diabetics to self-manage their diabetes. By providing educational, social, and treatment experiences, the proposed model for an educational diabetes facility could support and prepare both diabetics and their caregivers for a healthy future. Furthermore, chapter two will further discuss the literature and evidence that will support the facilities design decisions. Chapter three will discuss in detail the research and design methodologies used to gather data. Chapter four will examine the proposed building site for the future of the educational diabetes clinic and exterior and interior data will be discussed in detail with supporting images. Chapter five will examine the overall findings and analyze all the data collected in chapters three and four. Finally, chapter six will explore design recommendations and implications for the educational diabetes facility.

Terms & Definitions:

The following terms and definitions are mentioned throughout the study. These terms are of interest to the study, therefore definitions are provided in the context of the research study:

Type 1 Diabetes:

According to the organization Diabetes Canada, type 1 diabetes is a disease that affects the pancreas production of insulin. Most commonly, type 1 diabetes is treated with insulin injections. The majority of people diagnosed with type 1 diabetes are diagnosed during childhood or early adulthood. The cause of the disease is still unknown to researchers, however it is believed that the environment and genes play a role in type 1 diabetes.

Type 2 Diabetes:

According to the organization Diabetes Canada, type 2 diabetes is a disease in which the body can not produce enough insulin or does not effectively use the insulin it makes. As a result, glucose (sugar) can build in the bloodstream that eventually leads to serious health complications. Many risk factors are known to cause type 2 diabetes.

Insulin:

According to the organization Diabetes Canada, insulin is a hormone that helps the body to control the sugar levels located within our blood.

Self-management education (SME):

According to a journal released by the Canadian Journal of Diabetes, SME is an educational process that provides diabetics with the knowledge and skills to enable them to apply these skills to their daily life. The education includes psychological, behavioral, and collaborative teaching strategies that are designed specifically to the individual's needs.