Diabetes Mellitus Paper
The Type 2 diabetes mellitus (also known as ‘adult-onset diabetes’ or ‘non-insulin diabetes’) is a chronic condition characterized by a rise in level of glucose (sugar) in blood, due to the abnormal manner of metabolism of insulin by the body, and body becomes less resistant to the effect of insulin (a hormone produced by the pancreas that regulates the level of sugar in the body). The condition develops widespread symptoms and if untreated can make the person die. Type 2 diabetes is the most common form of diabetes, the other form being gestational diabetes and type 1 diabetes.
One of the most preventable forms of diabetes is type 2 diabetes mellitus, but the disorder is still in rise due to sedentary lifestyle and dietary changes followed by the you and me. It is important to remember that there is no cure or hope for it, for the disorder, and lifestyle, dietary and medical changes may be required for the rest of somebody’s life. The condition more often occurs in adults, but recently there has also been a rise in the children. About 8 to 45 % of all new diabetes cases found in children are from the pediatric age groups (Silvio E.
Inzucchi, 2007, Kevin Peterson, 2007, Eric Felner, 2008). Exact cause for type 2 diabetes is not understood by many, but it may usually be a decrease in the insulin secretion, resistance to insulin secretion, improper manner of the body of using insulin, or a combination of several factors, may play a role in the development of the disorder. When the glucose is consumed in the diet, it is absorbed into the bloodstream, and once the sugar enters the blood, insulin helps to control the level. It controls the manner in which the cell would be utilizing glucose for metabolism.
Insulin helps to decrease the level of the glucose and increasing storage as glycogen in the liver and the muscle cells. Once the level of glucose in the blood drops, the insulin level also decreases. From the liver, the glucose may be transported to other parts of the blood, once the insulin level decreases. In individuals suffering from diabetes type 2, the insulin may be defective in quality or the cells may be resistant to the action of insulin, leading to improper usage by the cells and a rise in the blood.
Besides, in diabetes, the muscle and the fat tissues tend to react abnormally to the insulin (Silvio E. Inzucchi, 2007, Mayo, 2007, Elizabeth H. Holt, 2008). In the general population of US, about 7 % are affected with Type 2 diabetes. More than 15 % of the elderly population is affected with diabetes type 2. Hispanics, Native Americans and African-Americans are at a higher risk of developing diabetes type 2. The incidences of the disease may be two to three times than that of White people. In actual sense, several of these populations are resistant to diabetes in their homeland.
However, once they have migrated to the US, the inability to adapt to the US diet and lifestyle increases them to develop the disease. Diabetes type 2 is a disorder that tends to occur more often in families. Having an affected mother or father increases the risk of developing the disorder (Silvio E. Inzucchi, 2007, Preeti Kishore, 2008, Elizabeth H. Holt, 2008). There may be several risk factors for developing diabetes including:- • Having a close family member or relative suffer from the disorder • Having a twin identical twin – 100 % risk (higher risk than a non-identical twin)
• Elderly age group (especially people crossing 65 years) • Obesity or overweight • Sedentary lifestyle • Lack of exercise • Those with high waist to hip ratios • History of gestational diabetes • Having babies weighing greater than 9 pounds • Presence of heart disease • High cholesterol levels in the blood • History of polycystic ovarian disease • History of an impaired glucose tolerance test result • Hypertension • Certain races or ethnic groups • History of prediabetes (Silvio E. Inzucchi, 2007, Preeti Kishore, 2008, Elizabeth H. Holt, 2008, Mayo, 2008) Method(s) of diagnosis
Diagnosis of diabetes type 2 is made based on that person’s history, symptoms, signs, physical examination, urine sugar tests, blood sugar tests, oral glucose tolerance tests, hemoglobin A1C tests, and other tests. A fasting blood sugar of above 125 mg/dl and a random blood sugar of 200 mg/dl of blood are diagnostic of diabetes mellitus. If the glucose level is above 200 mg/dl of blood after two hours of glucose tolerance test, it is suggestive of diabetes. HBAIC tests are also very useful not only to determine the past levels of glucose over the last 3 to 6 months, but also to monitor the condition (Elizabeth H.
Holt, 2008, Mayo, 2007, Silvio E. Inzucchi, 2007). Symptoms and complications of the disorder An individual who develops type 2 diabetes can have a range of signs, problems and symptoms. These usually develop due to the increased levels of glucose present in the blood or due to complications. Some symptoms of type 2 diabetes include blurriness of the vision, polyphagia, polydipsia, tiredness, hunger, polyuria, weight loss, loss of appetite, drowsiness, nausea, poor tolerance to exercise or increased physical activity, dehydration, frequent infection, mental confusions, seizures, etc.
Bladder, vaginal and skin infections are frequent in diabetic individuals or wounds take very long to heal. To get rid of the excess sugar in the blood, the body eliminates the sugar in the urine once it reaches the level of 180 mg per dl of blood. To get rid of the excess sugar in the blood, water is lost, leading to polyuria. The individual would have to consume high amounts of water in order to meet this water shortage. As there is loss of calories through urine, the individual tends to lose weight. Hence, hunger is a common.
Due to the excessive present of sugar in the blood, the fluids tend to accumulate and even in the tissues of the eyeball, there is high intra-ocular pressure leading to blurring of vision. In certain cases, especially when high amounts of glucose is lost in the urine, there would be a drop in the blood glucose level leading to hypoglycemia leading to several symptoms such as tiredness, fainting, breathlessness, etc. Acanthosis nigricans is a condition characterized by the formation of dark shiny patches on skin folds (Elizabeth H.
Holt, 2008, Mayo, 2007, Preeti Kishore, 2008, Eric Felner, 2008, Kevin Peterson, 2007). People affected with type 2 diabetes can develop several symptoms especially during the later stages of the disease. Several organs including the heart, lungs, brain, blood vessels, eyes, kidneys, etc are troubled. The blood sugar levels may often drop especially during periods of stress leading to a condition known as ‘hypoglycemia’. Diabetic hyperosmolar coma is a condition characterized by a rise in the blood glucose level resulting in confusion, seizures, seizures, sweating and drowsiness, etc.
In individuals who tend to fast more, fat is broken down excessively resulting in the production of toxic substances ‘ketones’. The individual may develop several symptoms such as nausea, vomiting, fever, stomach pain, sickly ketone odor, etc. This condition is known as ‘diabetic ketoacidosis’. The heart and the blood vessels are also affected resulting in coronary heart disease, angina, stroke, hypertension, etc. Risk of stroke increases several fold in individuals suffering from diabetes. The blood vessels that supply the nerve endings are also affected resulting in nerve disorders.
The individual would have tingling, burning sensations, numbness, etc, in various parts of the body including the fingers, toes, etc. Besides, the nerves of the autonomic nervous system may also be involved. Kidney damage may also occur resulting in kidney failure. The blood vessels of the eye may also be involved resulting in blindness. The bone density decreases leading to osteoporosis (Mayo, 2007, Preeti Kishore, 2008, Elizabeth H. Holt, 2008). Treatment of the disorder There are several modes which are required to help treat the condition. However, currently no cure is available for diabetes.
Some measures include:- • Monitoring glucose levels to ensure that the sugar levels are within control. • Lifestyle changes including those involving diet (avoid sugars), physically active, keeping away from alcohol and tobacco, and managing stress more effectively. • Insulin therapy to help control the level of sugar in the body. It is given in the form of injections. The individual can use subcutaneous injections or an insulin pump. Several forms of insulin fast-acting, slow-acting, intermediate forms or combinations are available which can help to control the blood glucose levels as and when required.
• Oral hypoglycemic agents are required because insulin may not be very effective in type 2 diabetics. The two groups of drugs which are utilized include sulfonylureas and biguanides. Sulfonylureas encourage the pancreas to produce greater amounts of insulin, whereas biguanides improve the reaction of the cells and tissues towards insulin. • Insulin can also delivered in the form of nasal sprays. • Foot care is every essential for diabetics as a small wound can result in gangrene and leg amputations (Silvio E. Inzucchi, 2007, Kevin Peterson, 2007, Eric Felner, 2008, Mayo, 2007, Preeti Kishore, 2008).
Methods of prevention There are several means which can help to prevent the diabetes. The measures should especially be followed when the risk of the diabetes are high. The individual should consume healthy food, rich in proteins, vitamins and minerals. The intake of fats and carbohydrates should be controlled. Physical activity may be required for about 30 minutes everyday. Individuals who are overweight or obese should consider losing weight. A weight loss of 5 kilograms should significantly help reduce the risk of developing diabetes.
Oral hypoglycemic agents have also been administered in individuals with high risk of developing the disease, and studies have shown that it helps to prevent the disease to certain extents (Eric Felner, 2008, Mayo, 2007). Directions for future research Current field of research is the introduction of insulin-producing cells in various organs of the body so that the level of insulin can be improved and help control diabetes. However, immune cells can destroy these transplanted cells and hence require immune-suppression. Newer techniques are aiming to prevent the need for immune-suppression (Preeti Kishore, 2008).
Several research studies are trying to determine the cause for the higher incidences of diabetes in the pediatric population. They are also defining effective ways of reducing the risk for type 2 diabetes in these populations (Kevin Peterson, 2007). Conclusion Diabetes type 2 seems to be a disease which has affected mankind from a long time, and today it is affecting the even our children. Modern and westernized lifestyles are only increasing the chances of developing the disease, and science cannot help lower the incidence of it. Studies should concentrate on increasing the preventive aspects of the disease.
Today diabetes groups are concentrating heavily on developing newer drugs and insulin introduction methods to treat the disease. However, it is important to note that preventive methods can be utilized effectively, even in the high risk groups. Works Cited Felner, E. and F. Kaufman. “Type 2 Diabetes in Children. ” The Hormone Foundation July (2008). (Journal) Holt, Elizabeth H. “Diabetes. ” 17 June 2008. Medline Plus. 6 December 2008 http://www. nlm. nih. gov/medlineplus/ency/article/001214. htm (Web site) Holt, Elizabeth H. “Type 2 Diabetes. ” 17 June 2008. Medline Plus. 6 December 2008 http://www.
nlm. nih. gov/medlineplus/ency/article/000313. htm (Web site) Inzucchi , Silvio E, and Robert S. Sherwin. Goldman: Cecil Medicine. Philadelphia: Saunders, 2007. (Textbook) Kishore, Preeti. “Diabetes Mellitus. ” June 2008. Merck Manual. 6 December 2008 http://www. merck. com/mmhe/sec13/ch165/ch165a. html (Web site) Mayo Clinic Staff. “Type 2 Diabetes – Introduction. ” 24 October 2008. Mayo Clinic. 6 December 2008 http://www. mayoclinic. com/health/type-2-diabetes/DS00585 (Web site) Mayo Clinic Staff. “Type 2 Diabetes – Symptoms. ” 24 October 2008. Mayo Clinic. 6 December 2008 http://www. mayoclinic.
com/health/type-2-diabetes/DS00585/DSECTION=symptoms (Web site) Mayo Clinic Staff. “Type 2 Diabetes – Test and Diagnosis. ” 24 October 2008. Mayo Clinic. 6 December 2008 http://www. mayoclinic. com/health/type-2-diabetes/DS00585/DSECTION=tests-and-diagnosis (Web site) Mayo Clinic Staff. “Type 2 Diabetes – Treatment and Drugs. ” 24 October 2008. Mayo Clinic. 6 December 2008 http://www. mayoclinic. com/health/type-2-diabetes/DS00585/DSECTION=treatments-and-drugs (Web site) Peterson, Kevin. “Management of Type 2 Diabetes in Youth: An Update. ” American Family Physician 76. 5 (2007): 658-664. (Journal)