Pathology Fall 2010
Abstract
Diabetes is a disease that affects currently 23.6 million people, about 7.8% of the population. Diabetes comes from a high level of sugar in the blood for a long period of time. Ways to control it are by diet, exercise, medicine and insulin injections. There are four known types of diabetes: Prediabetes, which is a condition that raises the risk of developing type 2 diabetes; Type 1, which generally affects primarily the younger population; Type 2, which generally affects the adult population; and gestational diabetes which affects women during their third trimester of pregnancy. While scientists are not sure of the exact cause of the disease they do know that it is caused by a variety of factors. Such factors are heredity, being overweight, and problems with the beta cells in the pancreas. Diabetes can result in blurred vision, retinopathy, nerve problems, dry skin, and kidney issues. Diet plays a major role in preventing these problems. Sugar concentration in the blood is a major factor for diabetics, so understanding the sugar content of fats, proteins, and carbohydrates is essential. The goal from a diet perspective is to control your sugar in your bloodstream in such a way that the insulin in your bloodstream can manage it effectively. In addition to diet, medication and exercise play an important role in controlling this disease. Currently, while there are great advancements in the treatment and prevention of, there is no known cure for diabetes.
Definition of Diabetes
Diabetes is a disorder of metabolism—the way the body uses digested food for growth and energy. Most of the food people eat is broken down into glucose, the form of sugar in the blood. Glucose is the main source of fuel for the body. After digestion, glucose passes into the bloodstream, where it is used by cells for growth and energy. For glucose to get into cells, insulin must be present. Insulin is a hormone produced by the pancreas, a large gland behind the stomach. When people eat, the pancreas automatically produces the right amount of insulin to move glucose from blood into the cells. In people with diabetes, however, the pancreas either produces little or no insulin, or the cells do not respond appropriately to the insulin that is produced. Glucose builds up in the blood, overflows into the urine, and passes out of the body in the urine. Thus, the body loses its main source of fuel even though the blood contains large amounts of glucose. (NDIC, what is diabetes?)
Type 1 and Type 2 Diabetes
Type 1
Also known as insulin-dependent diabetes mellitus (IDDM) or juvenile-onset diabetes. The primary targets for this type of diabetes are children or young adults, but it has been known to affect people of any age. It accounts for approximately 5-10% of diagnosed cases of diabetes. (AADE, diabetes fact sheet, 2007) With Type 1 diabetes, the pancreas produces little or no insulin. So they must take daily insulin injections. Injections are necessary because if taken orally the stomach acids will make it ineffective to the body. The cause of type 1 diabetes is when the immune system destructs the beta cells in the pancreas. Treatment for Type 1 is typically insulin injections in conjunction with diet and exercise.
Type 2
Also known as non-insulin dependent diabetes mellitus (NIDDM) or adult onset diabetes. It accounts for 90-95% of the diagnosed cases of diabetes. (AADE, diabetes fact sheet, 2007) With Type 2 diabetes the beta cells in the pancreas do not produce enough insulin to meet the needs of the body. Some factors that contribute to type 2 are heredity, being overweight, lack of exercise, and age. Treatment involves a good exercise regimen and diet counseling to help combat obesity which is a growing cause of type 2 diabetes. Treatment also includes monitoring of insulin levels and oral drugs when needed.
Source: 2004–2006 National Health Interview Survey
Effects Type 1 and 2 have on Society
Diabetes is not a contagious disease; it is not something that can be passed to one like a cold or the flu. But it is something that is continually on the rise. “There have been more than one million new cases each year since 2002, when 12.1 million Americans were estimated to have Diabetes.” (AADE, Diabetes fact sheet, 2007) Diabetes affects both men and women, increases with age and also affects certain racial/ethnic groups more than others. Women also need to be aware of gestational diabetes. Women that develop gestational diabetes have a 40-60% chance of developing diabetes in the next 5-10 years. (AADE, diabetes fact sheet, 2007) Certain factors involved in increase of diabetes include heredity, diet and exercise. Source: 2003–2006 National Health and Nutrition Examination Survey estimates of total prevalence (both diagnosed and undiagnosed) were projected to year 2007 Source: SEARCH for Diabetes in Youth Study.
NHW=Non-Hispanic Whites; AA=African Americans; H=Hispanics; API=Asians/Pacific Islanders; AI=American Indians
Complications of Diabetes
Many complications can arise from diabetes. It affects many areas throughout the body. Some of the known affected areas are the pancreas, kidneys, nerves, feet, eyes and skin. The pancreas produces insulin and a hormone called glucagon. Insulin and glucagon balance the sugars in the bloodstream. But in Type 2 diabetes a complication will arise where the pancreas cannot produce enough insulin resulting in impaired metabolism. In the eyes you can get blurred vision which is due to swelling or distortion. Also Retinopathy is where the retina has breaking and bleeding of the blood vessels. Kidney failure, also known as nephropathy happens when the nephrons which are small filters become damaged. Those filters are to cleanse out waste products and other substances. With the nerves, there is a painful condition called neuropathy. It can feel like pins pricking your skin or even loss of feeling in the feet or hands. Those are the most common complications of diabetes. Some are pretty debilitating but most of these complications can be corrected once the blood sugar is under control.
Life of a diabetic
My cousin was diagnosed with Type 2 diabetes when she was 30. She had a child when she was 24 and developed gestational diabetes in her third trimester. She really didn’t think too much of it because she thought it would just go away after she had the baby. She started to experience extreme fatigue a few years ago, but just thought that it was the life of a busy mom. Then she started getting blurred vision and her feet started to tingle a lot. She didn’t really know what to make of it; no-one in her side of the family was diabetic. She wasn’t terribly overweight but she could lose a few pounds. She went to the doctor and they ran some tests and sure enough she had type 2 diabetes. She said that as the life of a single mom, she rarely pays attention to herself and since she’s been diagnosed that had to change. She is very focused on her diet, making sure she has well balanced meals. Ensuring that she doesn’t indulge in too many carbs, watches her sugar intake and has good protein sources. She also has passed on these eating habits to her daughter because she doesn’t want her to develop diabetes herself. She really wasn’t a very active person before she was diagnosed but that changed as well. She said it actually improved her relationship with her daughter because she now has more energy and is fit to be able to do more activities with her. Being diagnosed with diabetes for her wasn’t the best news that she wanted to hear but she said it was one of the best things that had happened to her. She now has a better quality of life, she feels a lot better, she has her days but overall it woke her up to paying attention to her body. Right now she’s the happiest she’s been in a long time and looks forward to enjoying a long healthy life.
Conclusion
Diabetes is definitely a diagnosis that no one wants to receive. Although there have been many recent breakthroughs in technology that gets us closer to finding a cure, the life of a diabetic is a manageable disease. Diet, exercise and the right medication can keep it under control. Having blood sugar that is out of control can result in some irreparable damage to the body. Educating you and keeping up to date on the newest technology and developments is the best in managing this disease.
References
i National Diabetes Information Clearinghouse (NDIC), www.diabetes.niddk.nih.gov, Diabetes Overview. ii Centers for Disease Control and Prevention, www.cdc.gov/diabetes, Diabetes and me, Basics of Diabetes, Groups affected by diabetes, What are the Types of Diabetes? iii American Association of Diabetes Educators (AADE), www.diabetesamerica.com, Diabetes fact sheet, 2007.
References: i National Diabetes Information Clearinghouse (NDIC), www.diabetes.niddk.nih.gov, Diabetes Overview. ii Centers for Disease Control and Prevention, www.cdc.gov/diabetes, Diabetes and me, Basics of Diabetes, Groups affected by diabetes, What are the Types of Diabetes? iii American Association of Diabetes Educators (AADE), www.diabetesamerica.com, Diabetes fact sheet, 2007.