Diabetes Essay, Research Paper
Diabetes, Diabetes Mellitus, is a chronic illness this means that it has no cure and the symptoms persist over a long period of time. This illness is a result of an imbalance of hormones, insulin, produced in the pancreas. Insulin plays an important role in how the body uses food. Insulin enables the cells in the bloodstream to absorb and use glucose for fuel. If the pancreas produces too little or no insulin or if the insulin doesn?t work properly the person may become diabetic. Therefore, diabetics are not able to properly convert food into fuels needed by the body to function, which can seriously lead to physical consequences.
The pancreas, located behind the stomach, is a long, thin organ about the length of the hand. It is the organ that is responsible for the development of diabetes. The pancreas has two different types of cells, called alpha and beta cells, which produce insulin. Insulin is responsible for breaking down food that enters the body, turning into fuel that can be used by the body, and distributing it to the various parts of the body. The fuels needed for the body to function are known as glucose.
Glucose is sugar manufactured when the carbohydrates we eat are digested. Carbohydrates are foods that contain a large amount of sugar or starch. Bread, fruit, ice cream, and cereal are good examples of foods that are high in carbohydrates. Glucose is the main provider of energy for the majority of bodily functions. The glucose level in the blood changes in response to a person?s a daily activity, from eating a meal, to stressful situations.
Attempts to transplant part of a normal pancreas into a diabetic have not been very successful. The operation is a difficult one and only about 40 percent of the transplanted organs are still working. One major problem is that some way has to be found to stop the digestive juices leaking out and digesting the insulin. Pancreatic transplants have mainly been attempted in patients who have kidney failure due to the diabetes. Since the pancreas lies up against one of the kidneys, it is technically possible to transplant the two organs together, simultaneously. But, this operation has only ever been attempted a few times.
A possibly more promising hope for the future is transplanting just the islet cells. They could be injected into the abdomen without any surgery. The problem is how to stop the body from recognizing them as foreign cells and trying to destroy them. Tiny jelly-like beads have been developed to protect the islet cells from white blood cells, which would otherwise attack the islet cells and gobble them up. But, the insulin can still seep out through the beads.
Normally the level of glucose in the body rises after a person eats a meal. This rise in blood glucose stimulates the beta cells to release insulin. Insulin then either helps body cells take up glucose to use as energy or promotes the conversation of glucose to fat, which are used by the cells later. Some glucose maybe stored in the liver this is called glycogen. Then the level of glucose drops (usually several hours after the meal has been eaten), other cells in the pancreas stimulate the conversion of glycogen to glucose and its release into the bloodstream. In this way, the level of glucose in the bloodstream stays relatively constant until the next meal is eaten.
The body tends to deal with this imbalance by filtering out excess glucose throughout the kidneys, resulting in high levels of sugar in the urine. As glucose level rises the kidneys over-whelmed and don?t function normally. They lose their ability to absorb much water the result is frequent urination. This is commonly the earliest sign of diabetes. It is often followed by unquenchable thirst as the body tries to regain the lost fluids. It often seems that more fluid comes out than went in.
The name ?diabetes mellitus? describes two striking symptoms of disease. The first part of the name, meaning a siphon or drain, seems quite appropriate. The urine of a person with diabetes contains sugar, which is the reason for the ?mellitus? part, from the Latin word for honey. Most people just talk about ?diabetes?, but physicians prefer to use its more precise, full name, diabetes mellitus. In this way they avoid confusion with another much rarer disease called diabetes insipidus, in which great qualities of urine are also produced, but it does not contain sugar.
Although it is still unclear exactly what causes diabetes, doctors and scientists believe that there are a number of possible causes:
The body?s immune system plays an important role in the development of diabetes. The immune system protects us from foreign substances that may enter our bodies, such as viruses and bacteria. For some reason that scientists have yet to understand, the immune system of people with diabetes seeks out the cells that produce insulin and destroys them. This causes people with diabetes to stop producing insulin partially or completely. Without the presence of insulin, diabetes develops. Scientists are still trying to discover what causes the immune system to attack these cells. Heredity plays a role in determining who will develop diabetes.
Diabetes-especially Type II diabetes-tends to develop in people with a family history of the disorder. Along with other traits, such as eye color and height, parents can also pass on certain characteristics that may predispose their children to develop diabetes. In the case of Type I diabetes, scientists believe that if a father has diabetes, his children have a 5 to 10 percent chance of developing the disorder before the age of twenty. If a mother has Type I diabetes the children have half the risk, a 2 to 5 percent chance of developing the illness. In addition, the risk of developing Type I diabetes increases with the number of relatives affected. For example, if one sibling has Type I diabetes, there is only a small risk that a brother or sister will have it, too. However, if two siblings have Type I diabetes, the risk of third sibling developing the disease rises to 10 percent. For Type II diabetes, the genetic ling is even stronger. If one parent has this condition, his or her child has as much as a 25 to 30 percent chance of developing the disease. If both parents have Type II, the risk of inheriting the illness rises to nearly 75 percent.
Scientists strongly believe that one or many forms of stress in the body may trigger the onset of diabetes. For example, these can include surgical operations, a serious accident or injury, and even emotional trauma, such as a divorce or a death in the family. Also the results of extensive research show that certain viruses (disease causing microorganisms) may infect the pancreas, reducing or destroying its ability to produce insulin.
One of the first steps diabetics have to control is their blood pressure. Two-thirds of adults with diabetes have high blood pressure, or hypertension. This condition is serious because it leads to an increased risk of stroke, heart disease, and kidney and eye problems. Hypertension does not, or rarely has symptoms, so it is important to have your blood pressure checked regularly. Though blood pressures do vary, if it is 140/90 or higher you should consult your doctor for the best treatment. In addition to medication blood pressure can be regulated through exercise and a healthy meal plan low in fat and salt-actions that also limit the risk of other complications associated with diabetes.
Diabetes does not cause cavities, nor does it increase the chances of having cavities. But people with diabetes are more prone to gum disease or periodontal disease if their glucose levels are not relatively stable. High glucose levels make it more difficult for the body to fight infection. Periodontal disease can cause gum loss and eventually tooth loss. Smoking also increases the risk of periodontal disease. Tooth loss makes it difficult to chew food and thus may discourage proper nutrition. Teeth that come out as a result of periodontal disease cannot be replaced. Because periodontal disease damages the gums, dentures will not be able to fit properly, and again this will discourage proper dietary habits. It is very important to maintain good dental hygiene at home by brushing and flossing daily and to have regular dental checkups at least every six months.
Diabetes may cause similar changes in the blood vessels of the kidneys. This condition, called diabetic nephropathy, may lead to kidney failure. The nerves may also be affected by diabetes. This complication, known as diabetic neuropathy, can result in loss of felling or abnormal sensations in different parts of the body. Various treatments can control many cases of diabetic retinopathy, diabetic nephropathy, and diabetic neuropathy. Diabetes can also lead to atherosclerosis, a form of arteriosclerosis, hardening of the arteries, that may cause a stroke, heart failure, or gangrene.
Diabetic neuropathy can occur with long-term diabetes, usually after several years of uncontrolled high blood glucose. Glucose proteins, called glycoproteins, form in the nerves, primarily those of the leg and feet. When the nerves in the feet are damaged, the brain can not recognize pain in that area. Nerve damage from diabetic neuropathy can lead to weakness in the muscles of the leg and feet. Because there muscles work as a system, neuropathy can lead to other foot problems, such as hammer toes, calluses, bunions, and other foot deformities. These deformities are dangerous because of their risk of infection. A simple blister from tight shoes can spell disaster for diabetics. When diabetes is out of control (the blood glucose is consistently high) the risk of infection is always present. A foot infection can begin after a minor injury because the high blood glucose impairs the white cells? ability to correct the problem. Left untreated, infections can be life threatening.
Diabetic foot ulcers are crater-like depressions caused by neuropathy, poor circulation, or both. If bacteria are present, infection can develop. When not treated properly, such ulcers can lead to diabetic gangrene or death of the tissue. In gangrene, the tissue is black, and this alone should cause immediate concern. The black tissue can be dry or wet and must be given immediate attention. Many times, amputation is necessary when gangrene is present.
All bruises, scratches, nicks, abrasions, cuts, swelling, or any change in the condition of diabetic?s feet must be taken seriously. This does not mean they should panic over one scratch on the foot, but not to take it lightly either. Wash the scratch with a mild antibacterial soap and apply an antibacterial ointment such as bacitracin. Then watch that this scratch heals properly and does not become infected. Some people might be tempted to soak their feet in warm water, maybe even with Epsom salts, to soothe their feet or get rid of dead skin. But soaking actually dries out the skin, which then leads to cracking and peeling. That opens the door to bacteria and infections.
In addition to nerves, diabetes affects blood vessels. It is among the top four risk factors for premature hardening of the arteries, or atherosclerosis and arteriosclerosis. Cigarette smoking decreases peripheral vascular blood flow (circulation in the extremities). Diabetes also peripheral vascular blood flow. Diabetics are particularly prone to this narrowing of the arteries in the legs and feet. If they have poor circulation they may notice a lack of hair growth on the tops of their feet and nails may look deformed and unhealthy.
Neuropathy can also affect sexual functioning. Until now it was thought that sexual dysfunction was only limited to men, but it has been found that women also develop this with long-term diabetes. Impotence in the diabetic man has long been recognized. It is now more fully understood. In men, damage to the pelvic autonomic nerves can lead to a complication called retrograde ejaculation. Instead of moving forward, semen is propelled backward into the bladder. Problems of fertility and sterility must be considered if retrograde ejaculation is diagnosed in the diabetic male.
Diabetic men have a 50 to 60 percent incidence of impotence, much higher than among men in the general population. Impotence may occur any time after adolescence. If the nerves that stimulate erection are damaged, there will be no erection. Other causes of impotence include hormone imbalances, blood vessel and heart diseases, and some medications. Men and women are at equal risk of neuropathic damage to the pelvic autonomic nerves. For women, difficulty with lubrication or difficulty reaching orgasm may be caused by decreased nerve sensitivity.
According to the American Diabetes Association, diabetics spend a total of more than 24 million days in the hospitals each year in the US. Nearly 6000 people lose their eyesight annually because of diabetes, making it the most common cause of adult blindness. People with diabetes are at least twice as likely to develop heart disease and suffer heart attacks and strokes. They have kidney problems 17 times more frequently than people without diabetes undergo 40 times as many amputations. Diabetes is the direct cause of more than 40000 deaths a year and an indirect cause of more than 300000 deaths a year, counting patients who die of diabetes-related kidneys, heart, and circulatory problems. Diabetes is the third most common cause of death in the US today, after heart disease and cancer. Although these statistics can be frightening, most people are able to live normal lives. This requires keeping blood sugar levels under control. For some diabetics, daily injections are necessary. For most people with diabetes, however, a proper diet and regular exercise are sufficient. Recognizing the early signs of diabetes is crucial to finding out the risk of getting this disease. Unfortunately, as many as 5 million people in the US have diabetes and do not know it.
Diabetes is divided into two main types: insulin dependent and non-insulin dependent. They are sometimes mistakenly called ?sugar diabetes?.
Insulin-dependent diabetes or Insulin Dependent Diabetes Mellitus (IDDM) is called Type I diabetes. In the past it was called juvenile-onset diabetes because it seemed to appear only during childhood or adolescence. Now doctors know that it can appear at any time in life. It is an auto immune disorder that stems from the destruction of the insulin-producing cells in the pancreas. The body produces little or no insulin, and is unable to lower the level of glucagon. The glucagon accumulates in the blood, raising a person?s blood sugar level. This is called hyperglycemia or high blood sugar. When the blood sugar level gets too high, glucose is removed from the body in urine as waste. Because most waste is removed from the body in urine, a person with high blood sugar may go to the bathroom as often as his or her body gets rid of the extra glucose. Frequent urination can result in loss of water, because water is the main component of urine. This may cause a person to feel very thirsty or experience a dry mouth. Dehydration can cause dry skin and blurry vision.
Also if the cells cannot get the glucose they need, they ?starve?. This may make a person feel very hungry even when he or she has just finished eating. Diabetics do not get the fuel that their body needs. That person may often feel weak and tired. Weight loss may also occur as the body?s demand for fuel force the breakdown of fat cells. High glucose levels also damage nerves, which may result a tingling feeling in the feet or leg cramps at night. High glucose levels make it easier for bacteria to grow and may result in various skin infections.
If hyperglycemia is not treated, the result can be diabetic ketoacidosis (DKA) coma. When there is a lack of insulin, the body looks for alternative fuel. That alternative fuel is fat. When fat is broken down into energy, it produces a poisonous waste called ketones. Ketones will accumulate in the blood and eventually the urine. Eventually if the condition is not treated, the person will lose consciousness and possibly die. Insulin-dependent diabetes affects males and females equally. Treatment for Type I diabetes includes daily injections of insulin to help the body use the glucose it needs. Insulin treatment is often balanced with diet and exercise.
Most people with Type I diabetes must take insulin on a daily basis. The insulin is injected beneath the skin into the body?s subcutaneous tissue. If it were taken orally in pill form, the stomach?s digestive juices would destroy the hormone before it worked. The symptoms of Type I often seem to come on suddenly and in some crisis situations the person?s life may even be at risk unless immediate medical attention is sought. Unlike people with Type II diabetes, who tend to be overweight, those with Type I are frequently lean. There are key signs in Type I diabetes which are a significant weight loss in a short period of time by someone who hasn?t been dieting, excessive urination and drinking, irritability, and nausea and vomiting.
Effectively controlling Type I diabetes largely depends on achieving a correct balance of food, exercise, and insulin. While hyperglycemia may result when a person with diabetes? blood sugar level soars, another dangerous condition can occur when the opposite is true. Hypoglycemia, also known as low blood sugar or an insulin reaction, appears when the blood sugar level drops. In a person with Type I diabetes it is often the result of too little food, too much exercise, or too much insulin.
The physical symptoms of hypoglycemia include irritability, headache, nausea, hunger, weakness, and confusion. Insulin reactions often come on suddenly and are dangerous, since an individual in this condition can slip into unconsciousness. To counteract hypoglycemia the person should take some milk, orange juice, about two packets of sugar, honey, or a sugared soft drink.