Showing posts with label Diabetes. Show all posts
Showing posts with label Diabetes. Show all posts

Diabetes

  1. Definition .
  2. Description .
  3. Demographics .
  4. Causes and Symptoms .
  5. Diagnosis .
  6. Treatment .
  7. Prognosis .
  8. Prevention .
  9. The Future .
Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes Diabetes

Definition

Diabetes melllitus, or DM, is a lifelong disorder in which the patient’s
body cannot regulate the levels of glucose (sugar) in the blood. The problem
may be caused by too little insulin—a hormone produced by the
pancreas that helps the body use the glucose properly—or the body’s
resistance to using the insulin that is secreted by the pancreas.

There are three major types of diabetes:
  • Type 1. Type 1 diabetes, which is sometimes called insulindependent
    diabetes because the patient must take a daily dose
    of insulin in order to live, is a disease in which the person’s
    immune system attacks the cells in the pancreas that produc
    insulin. This type of diabetes usually develops over a short period
    of time, most often in children and young adults. It accounts for
    5–10 percent of cases of diabetes diagnosed in the United States.
  • Type 2 diabetes. Type 2, sometimes called adult-onset diabetes,
    is the most common type, accounting for 90–95 percent of cases
    in North America. It usually develops relatively slowly and is
    associated with being overweight and a family history of diabetes.
    Most people with type 2 diabetes are resistant to insulin rather
    than having a pancreas that is not producing enough of the hormone.
  • Gestational diabetes. Some women develop a temporary form of diabetes
    toward the end of their pregnancy that goes away after the
    baby is born. Women with gestational diabetes have an increased risk of
    developing type 2 diabetes within five to ten years.
    Doctors also consider a condition known as pre-diabetes or impaired-
    glucose tolerance to be a health concern. People with this condition have
    a higher-than-normal blood glucose level but not high enough to meet
    the criteria for a diagnosis of diabetes. Many people with pre-diabetes
    will develop type 2 diabetes within ten years.

Description

People with type 1 diabetes are likely to feel sick fairly suddenly. The
most common symptoms are increased thirst, weight loss in spite of
increased appetite, nausea and vomiting, and blurred vision. If the person
is not diagnosed and treated with insulin quickly, they can fall into a
coma and die.
People with type 2 diabetes may not have any noticeable symptoms
for some years. When they do develop symptoms, they may feel thirsty
and hungry, urinate more frequently, tire easily, have vision problems,
or notice that wounds and sores heal slowly. Women with gestational
diabetes may not have any symptoms at all.
Diabetes is a serious disease because it often leads to complications
that seem far removed from digestive issues. People with diabetes are
at increased risk of blood vessel injury, stroke, blindness, heart disease,
kidney failure, gangrene leading to limb amputations, and nerve damage.
Women with gestational diabetes are more likely to have babies with birth
defects.

Dr. Banting’s Breakthrough

Prior to the early 1920s, type 1 diabetes was
not only incurable but fatal within a relatively
short period of time. Although doctors were
aware that the disease was caused by the lack
of insulin secreted by the pancreas, early
attempts to treat diabetics by feeding them
fresh pancreas had failed. Frederick Banting
(1891–1941), a Canadian doctor, worked
together with a medical student named Charles
Best at the University of Toronto to see
whether they could successfully extract insulin
from the pancreas and use it to treat diabetics.
The two men first tested the extracted insulin
on diabetic dogs. Their first human patient was
a man named Leonard Thompson, who was
close to death from diabetes. The success of
Thompson’s treatment led to Banting’s winning
the Nobel Prize in physiology or medicine in
1923.

Demographics

About 21 million people in the United States, or 7 percent of
the population, have diabetes.
Unfortunately, 6.5 million of these people have not been diagnosed
with the disease. Between 54 and 57 million Americans were thought to
have pre-diabetes as of 2007. Diabetes is the sixth leading cause of
death in the United States; about 65 percent of deaths among patients with
diabetes are the result of heart attacks and stroke, but diabetes is
the underlying cause.
Diabetes is a major cause of disability and
death in the United States. It costs the country about $135 billion each
year, including $42 billion in indirect costs (disability payments, lost
work time, and premature death) and $93 billion in direct medical costs
(hospital admissions, medical care, and treatment supplies).

The risk factors for type 1 and type 2 diabetes are different. People at
increased risk of type 1 diabetes include:
  • Children and young adults rather than older adults
  • Caucasians, particularly people of Swedish or Finnish background
    Risk factors for type 2 diabetes include:
  • Family history of diabetes.
  • Personal history of gestational diabetes or pre-diabetes.
  • Age over forty-five.
  • Obesity. 80 percent of persons diagnosed with type 2 diabetes are
    overweight.
  • Ethnicity. African Americans, Hispanics, Native Americans,
    Pacific Islanders, and some Asian Americans are at greater risk than
    Caucasians. Native Americans have the highest rates of type 2 diabetes
    of all ethnic groups in the United States.
  • High blood pressure.
  • High blood cholesterol levels.
  • Not getting enough exercise. Exercise helps the body use blood
    sugar more efficiently.

Causes and Symptoms

The basic cause of type 1 diabetes is an insufficient supply of insulin
from the pancreas caused by an autoimmune disorder. What triggers the
immune system’s attack on the patient’s pancreas, however, is not yet
known. In type 2 diabetes, the patient’s pancreas is secreting insulin but
the body is not using the hormone efficiently—a condition known as
insulin resistance. In type 2 diabetes, there are increased levels of insulin
in the blood as well as sugar.

The central symptoms of both type 1 and type 2 diabetes are:
  • Increased thirst
  • Increased urination
  • Increased appetite
  • Fatigue

Diagnosis

The American Diabetes Association recommends that all adults over
forty-five be screened for type 2 diabetes at least every three years, and
that people with several risk factors be screened yearly.

Diabetes is diagnosed by the results of blood tests. There are several
different types of blood tests that may be used:
  • Fingerstick. This type of test is often used as a screener in the doctor’s
    office. The doctor pricks the patient’s fingertip with a needle
    and touches a test strip attached to a small handheld glucometer to
    the drop of blood, which provides a blood sugar reading within a
    few seconds. This method is used by diabetic patients at home
    to monitor their blood sugar levels.
  • Fasting blood glucose test. The patient has blood drawn first thing
    in the morning after having eaten nothing since midnight of the
    previous night. A score over 126 milligrams per deciliter (mg/dL)
    indicates possible diabetes.
  • Glucose tolerance tests. In this test, the patient has blood drawn
    twice, the first time after fasting for eight hours and the second
    time two hours later, after drinking a very sweet drink. A score
    over 200 mg/dL suggests diabetes.
  • Hemoglobin A1c test. This test is used to monitor blood sugar
    control in people known to have diabetes. It measures the amount
    of blood sugar attached to the hemoglobin in red blood cells. If
    more than 7 percent of the hemoglobin has excess sugar attached
    to it, the person needs to get better control over their blood sugar
    levels.

Treatment

There is no cure for diabetes. Treatment is based on a combination of
diet and weight control; physical exercise; injected insulin or oral medications
to reduce blood sugar levels; and home monitoring of blood glucose
levels. The goal of treatment is to control blood sugar levels and to lower
the patient’s risk of blindness, frequent infections, heart disease, and
other complications of diabetes:
  • Diet: Patients with type 2 diabetes usually need to lower their
    weight. In addition, they must learn to eat roughly the same size
    meals at the same times each day so that their insulin doses will not
    lower their blood sugar level too quickly or too far.
  • Exercise: Exercise reduces the patient’s risk of leg ulcers, stroke,
    heart disease, kidney failure, and other complications of diabetes.
  • Insulin and oral medications: Patients with type 1 diabetes must
    use injected insulin. Type 2 diabetics can be treated with oral medications
    that increase the body’s sensitivity to insulin, stimulate the
    pancreas to produce more insulin, or decrease the amount of glucose
    produced by the liver. They may need insulin injections in
    addition to these oral medications.
  • Home monitoring. Patients with either type of diabetes must
    check their blood sugar levels four times a day—before each meal
    and at bedtime—and keep a careful record of the test results.

Prognosis

The prognosis of diabetes depends on the type and the patient’s willingness
to take responsibility for their health. Patients who do not take their
insulin or other medications regularly or fail to monitor their blood sugar
at home run the risk of severe complications.

According to the American Diabetes Association, people with diabetes
are at risk for the following complications:
  • Diabetics are two to four times more likely to develop heart disease
    than those without diabetes.
  • Between 12,000 and 24,000 diabetics lose their eyesight each year.
  • About 48,000 diabetics develop end-stage kidney disease each
    year.
  • Around 71,000 amputations of legs and feet are performed each
    year in people with diabetes.
  • Thirty-five percent of people with diabetes have periodontal
    disease.
  • About 60–70 percent of diabetics have some degree of damage to
    the nervous system.

Prevention

There is no way known to prevent type 1 diabetes, since its triggers are
not yet understood.

People can prevent or lower their risk of type 2 diabetes by a combination
of lifestyle changes and self-care:
  • Keeping one’s weight at a healthy level and eating a low-fat, highfiber
    diet.
  • Not smoking.
  • Getting regular exercise, at least 30 minutes of walking or other
    activity five days a week.
  • Keeping alcohol intake low.
  • Getting regular checkups for blood pressure and blood cholesterol
    levels, and taking any medications prescribed by the doctor.
  • If over forty-five, getting screened regularly for type 2 diabetes

The Future

Diabetes is expected to be a growing public health problem in the developed
countries in the future. One reason is the aging of the population;
the highest rates of diabetes in the United States are in people over 60.
Another reason is the rise in obesity among children as well as adults.
The Centers for Disease Control and Prevention (CDC) predicts that
one in three Americans born in the year 2000 will eventually develop
type 2 diabetes. By 2050, the CDC expects the rate of diabetes in the
United States to increase by 165 percent over the figures for 2006.
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