According to International Diabetes Federation,(2015), over 415 million people have been estimated to be living with diabetes worldwide, with type 2 Diabetes occurring in over 90% of the adults. Diabetes is a major cause of heart attacks, kidney failure and blindness in the UK and USA.
Diabetes (Diabetes Mellitus) is a group of metabolic diseases resulting from high blood sugar levels. This is as a result of either the pancreas not producing adequate insulin or the associated body cells not responding to the insulin produced. Anyone, regardless of their age can be a victim of diabetes.
Diabetes was first described in an Egyptian manuscript around 1500BCE. The first cases are believed to be Type 1 DM. Around the same time, Indian physicians identified and classified it as ‘madumeha’ (honey-urine). The word ‘diabetes’ or ‘to pass through’ was first used around 230BCE by Apollonius of Memphis. Diabetes was considered a rare disease during the time of the Roman Empire. This is possible considering the diet and lifestyle of the ancients or perhaps due to clinical symptoms observed during early stage of the disease.
Type 1 & 2 Diabetes Mellitus were classified as a separate condition for the first time by the Indian physicians Sushruta & Charaka around 400-500CE. with type 1 associated with young adults and type 2 with being overweight.
The term ‘mellitus’ was first developed by Briton in the late 1700s as a way of separating THE Condition from diabetes insipidus.
Types of Diabetes
There are three main types of Diabetes.
1. Type 1 Diabetes Mellitus:
This is a form of Diabetes that results from the destruction of Insulin producing cells in the pancreas. A short of such cells in digesting and regulating glucose levels results in Type 1 Diabetes. The cause of Type 1 DM is unknown (Source). A lot of explanatory theories have been portrayed and the cause may be from genetic susceptibility or an exposure to an antigen. Type 1 Diabetes can be distinguished from other types of DM using autoantibody testing (a process of measuring endogenous insulin production). The actual figure of people with DM Type 1 is cannot be ascertained yet, research estimates that it accounts for 5% to 10% of diabetes cases. It’s more frequent in whites than African-American. Type 1 DM is a disease that comprises many genes (over 50 genes have been associated to Type 1 DM)
Some people have been diagnosed with a rare condition of DM called secondary Diabetes. Quite similar to Type 1 DM excepts that it is completely annihilated by something else, like a disease or injury to the pancreas.
Signs and Symptoms
Symptoms of Type 1 MD include:
- Dry skin,
- Rapid deep breathing,
- Excessive urination: when there is extra sugar in the body, you pee more. It is the body’s way of getting rid of excess sugar level.
- Weight loss: When you pee more, you eject glucose which contains calories hence resulting in weight loss.
- Vomiting, drowsiness
- About 12 percent of Type 1 Diabetes patients have been diagnosed with clinical depression. Classical Symptoms of Type 1 DM also includes abdominal pain, increased thirst, and fatigue.
- It has been reported that some patients with Type 1 DM experience Loss of Consciousness (rare), rapid breathing, abdominal pain, shaking and confusion
Type 1 DM is currently not preventable, (source), making it one of the most deadly human degrading cell diseases. Some Researchers aver that it is possible for it to be prevented as far as it is halted at the latent autoimmune stage, i.e before it starts destroying beta cells.
Many people with Type 1 Diabetes usually live long and healthy lives. The key to such good health is to keep your sugar level at its barest minimum – a level recommended by your doctor. All patients with Diagnosed Type 1 Diabetes must use insulin to help keep their blood sugar under control. Most insulin comes in a small bottle widely called ‘vial.’ You draw it out using syringe and inject it into your body. Your doctor will assist you in selecting shots level, and choosing shots frequency.
Exercise is a crucial part of treating Type 1 MD but it is not just going out for a run because you need to balance your insulin dose with the food you take minus the quantity of calories you burn when you exercise.
2. Type 2 Diabetes Mellitus
This is a long term metabolic disorder characterized by insulin resistance or lack of insulin. Type 2 Diabetes is caused mainly by Obesity and insufficient exercise in those genetically predisposed. This type of Diabetes makes up about 90% of Diabetes diagnosed patients.(Source) There are approximately 27million people in the U.S with Type 2 DM. Typically, it begins at Middle age. The risk of getting type 2 DM is exponentially higher as we get older. Experts are not so sure why, but aver that when we age, we tent to put on weight, become less physically active which can result in the accumulation of calories.
According to a research at the University of Edinburgh, Scotland, low testosterone levels are highly linked to Insulin resistance.
Factors responsible for type 2 DM:
1. Genes: Scientists believe that a combination of different bits of DNA affects how the body makes insulin. An individual with rare Gene combination is likely to be diagnosed with Type 2 DM.
2. Extra Weight: Obesity can cause insulin resistance. Drinking Just one bottle of soda per day may raise your risk of developing type 2 diabetes by 22%
3. Broken Beta Cells: If the associating cells in charge of Insulin distribution sends out the wrong quantity of Insulin at the wrong time, your blood sugar levels gets thrown off.
Cause: Medical conditions
There are quite a number of medications and other health problems related to diabetes. Some of these are; gluccocorticoids, beta blockers, statins, atypical antipsychotics, thiazides. Patients who previously had gestational diabetes are at a much higher risk of developing type 2 diabetes. Other medical problems associated also include; acromegaly, Cushings’s syndrome, hyperthyrodism, pheochromocytom and certain cancers like glucagonomas.
Signs and Symptoms
The symptoms of Type 2 DM can be mild, that you don’t notice them early. About 80 million people don’t know they have diabetes.
Here are signs you should look out for:
- Frequent Urination
- Tingling in the feet or your hands
- Wounds that don’t heal
- Dull vision
- Being Very very thirsty
- Unexplained weight loss
- Long term complications are heart disease, strokes, retinopathy, kidney failure and poor blood distribution, sight deficiency.
- Diabetes can damage blood vessels around your genitals resulting in loss of feeling and slackness in your genitals. Women will experience vaginal dryness. Between 35% and 70% of men diagnosed with Type 2 DM will have at least some degree of impotence in their life time.
Important Facts about Diabetes
Here are some key facts about Diabetes Mellitus
|1.||Diabetes is a long-term sickness that results in high blood sugar level|
|2.||In 2015 it was estimated that over 450 million people around the world had diabetes. (Williams textbook of endocrinology)|
|3.||Type 1 DM: In this case, the body does not produce insulin needed. Approximately 10% of all diabetes cases worldwide are type 1 DM|
|3.||Type 2 DM: A case where the body does not produce enough quantity of Insulin for proper function of the body. Approximately 89% of all cases of Diabetes worldwide are of this type.|
|4.||Gestational Diabetes: is a type that affects women during pregnancy|
|5.||Most common diabetes symptoms include Frequent Urine discharge, extreme thirst and hunger, weight gain and unusual weight loss, male genital dysfunction, tingling in the feet and hands|
|6.||Those that have Type 1 DM can live a normal, healthy life by eating healthy diet, doing adequate exercise, taking insulin shots.|
|7||For Type 2 Diabetes patient, they also need to eat healthy, do exercise, frequently test their bool glucose level. They may also take prescribed oral medication plus insulin to control their blood sugar levels|
|8.||It is essential that blood pressure and cholesterol level are monitored frequently as the risk of cardiovascular disease is much higher for Diabetes patients.|
|9.||Smoking is highly discouraged as it may have serious cardiovascular effect on diabetes patients.|
|10||Hypoglycemia (low blood sugar level) can have serious negative effect on the patient.|
|11.||Hyperglycemia (High blood sugar level) can also have negative effect on the patient.|
|12.||Between 2000 and 2009, the prevalence of Type 1 DM among under 20s in the US rose 23% according to SEARCH for diabetes in youth (data issued by the CDC) (Source)|
Type 2 Diabetes is a chronic disease associated with a ten year shorter life expectancy (Williams textbook of endocrinology. (12th edition. Philadephia: Elsevier/Saunders. Pp. 1371-1436. ISBN 978 1 4377 0324-5) This is due to a number of complications with which it is associated, including: 2 to 4 times risk of cardiovascular diseases, ischemic heart diseases, stroke and impotency. Also included is a 20 fold increase in lower limb amputations and increased rates of hospitalization. Type 2 DM is the major cause of non-traumatic blindness, kidney failure and an increased risk of cognitive dysfunction. Other sever complications include: nigrican acanthosis, and frequent infections.
3. Gestational diabetes
This is the third main form of Diabetes and occurs majorly when a pregnant (especially during their third trimester.) woman with no previous history of diabetes develop high blood glucose level. This is likely due to a pregnancy related factors such as presence of human placental lactogen which interfere with susceptible insulin receptors. This causes inappropriately elevated blood glucose levels. Gestational DM is defined as ‘any degree of sugar intolerance with first recognition during pregnancy.’ This definition identifies the possibility that a female may have undiagnosed diabetes mellitus or may have developed diabetes coincidentally with pregnancy.
Gestational DM has few symptoms as compare to Type 1 DM. It is mostly diagnosed during pregnancy screening. The screening is positioned to detect high levels of sugar in the blood.
There are two sub-types of gestational diabetes:
- Type A1: This is an abnormal tolerance during oral glucose test but normal blood glucose levels during fasting and few hours after meals; diet rescheduling is sufficient to control glucose levels.
- Type A2: This is an abnormal oral glucose tolerance test (OGTT), complicated by abnormal glucose levels during and after meals. Further therapy with Insulin shots is highly advised during medications.
According to a study by eMedecine, Gestational diabetes affects 3-10% of pregnancies. Typically, gestational DM will disappear after the baby is born. Babies born to mothers with gestational diabetes are at increased risk of complications such as problem during child delivery, low blood sugar level and Jaundice. If left untreated, it can cause seizures, still birth or deformity. Gestational DM is a treatable ailment and females who have adequate control of their glucose levels can decrease these risks. A proper food schedule is highly recommended for a better GDM management.
Women with gestational diabetes are at risk of developing Type DM after pregnancy and as well as having higher risk of pre-eclampsia and Ceasarean section
Insulin is the fundamental hormone that is in charge of glucose moderation in the blood and also regulates the flow of glucose into most cells in the body especially muscle, adipose tissue and liver. The deficiency of insulin plays a central role in major or all forms of diabetes mellitus
The body absorbs glucose from 3 main processes: the intestinal absorption of food, the breakdown of glycogen, glyconeigenesis and the storage form of glucose present in the liver.
Insulin is released into the body via beta cells (found in the islets of langerhans), in response to rising level of blood glucose, mostly after eating. Two third of the body’s cells use insulin from the blood for conversion to other needed molecules or for storage. This process is majorly controlled by glucogon (the hormone which acts in the opposite manner to insulin)
When the sugar level in the body remains high over time, the kidney will reach a point of re absorption and glucose will be excreted in the urine. This increases the pressure of Osmotic in the urine and inhibits absorption of water by the kidney.
In some cases, transplant of the pancreas is occasionally considered for people with Type 1 diabetes who exhibits signs of sever complication such as kidney failure and end stage kidney diseases. There are some short term mortality risks (1%) from surgery. It advised that this option be considered for patients who are unable to lower their blood sugar level or keep their body weight in check.
The occurrence of diabetes in the UK and United States is likely to increase due to several reasons. First, a large part of the population is ageing. Also, Native Americans and other minority groups make up the highest populated segment of the United States. Finally, Americans are increasingly getting overweight, sedentary with poor diet plan. According to recent estimates, the increase of diabetes in the US and UK alone is predicted to reach 10.7 % of the population by 2025. From an economic view, the total amount spent on diabetes since 2012- 2015 was estimated to be 845 billion dollars in the United States. This includes direct medical costs and other fatal, severe cases. Diabetes is the 7th leading cause of death in the UK listed on death certificates.