Introduction
Diabetes is an illness that is serious, common and costly but yet one that can be managed, affecting millions of people globally. According to the centers for disease control and prevention (CDC), diabetes is among the top ten leading death causes in the U.S. and affects many Americans of over 26 million, with 7 million individuals undiagnosed and another 18.8 million Americans diagnosed with this disease. This disease has become a major concern for public health with its complications imposing both economic and health consequences on families, people, health systems, and on the country at large. Thus, it calls for the integration of pharmacy, dentistry, podiatry, and optometry (PPOD) providers into the team of health care to provide care that is integrated and of high-quality. On this background, this paper focuses on discussing diabetes as a disease. The paper will cover the description of disease and systems it affects, relevant anatomy of the disease, signs and symptoms, available treatments and relevant diagnostic tests. Additionally, the paper will also address the reason for choosing to discuss the topic of diabetes.
Description of Diabetes and the Body Systems Affected
Diabetes, which is also called diabetes mellitus by doctors, refers to a metabolic illnesses group in which a person has high blood glucose, either because the body cells do not properly respond to insulin, or due to inadequate production of insulin, or both (Goldenberg & Punthakee, 2013). According to Lal (2016), diabetes mellitus comes from a Greek word meaning “siphoning off sweet water” because people with diabetes pass a lot of urine with excess glucose (also called sweet water). CDC (2013) accentuate that insulin is a hormone which secreted by the pancreas, an organ which is situated close to the stomach, and this insulin assist to facilitate the uptake of glucose/sugar into the cells of the body for use as energy that people require for daily activities. This glucose/sugar comes from the food that people eat. Thus, when a person is suffering from diabetes, it means that either their body is not producing enough insulin or it can be the case that their body does not utilize its insulin properly as it should. This results in the buildup of sugar in the blood, which is eventually passed out as urine from the body. As such, even though the blood contains a lot of glucose, the cells are not receiving this glucose for their essential growth and energy requirements (CDC, 2013).
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The development of diabetes involves many pathogenic processes. This ranges from pancreatic b-cells autoimmune destruction with resultant deficiency of insulin to abnormalities which result in resistance of insulin action. The basis of the abnormalities in protein, carbohydrate, and fat metabolism in diabetes, as American Diabetes Association (2014) explain, comes from deficient insulin action on some targeted tissues. This deficiency of insulin action results from insufficient secretion of insulin or reduced response of tissues at one or many points in the intricate hormone action pathways. Often, both defects in the action of insulin and insulin secretion impairment coexist in the same patient, making it difficult to determine which abnormality is the key hyperglycemia cause.
The majority of cases of diabetes fall into three main categories: gestational, type 1, and type 2 diabetes. However, assigning a particular to a person frequently depends on the conditions existent at the diagnosis period, and most of the patients with diabetes do not easily fit into one category (American Diabetes Association, 2014). For instance, an individual diagnosed with gestational diabetes mellitus (GDM) may continue to have high blood sugar levels even after delivery, and may, in fact, be determined to be suffering from type 2 diabetes (American Diabetes Association, 2014).
Type 1 diabetes: this type of diabetes results from defective secretion of insulin due to cellular-mediated pancreatic b-cells autoimmune destruction. It is also referred to as “juvenile diabetes, insulin-dependent diabetes, or early-onset diabetes,” and it accounts for 10 percent of those affected with diabetes, meaning that it not common like type 2 diabetes (Lal, 2016). As American Diabetes Association (2014) explain, this type of diabetes normally develops in teenage years or early adulthood, and because of inadequate secretion of insulin, individuals with this type of diabetes require insulin injections for their lifetime. Besides, they must ensure proper levels of blood glucose by performing regular tests of blood and maintain a special diet.
Type 2 diabetes: also called non-insulin dependent diabetes or adult-onset diabetes is caused by the resistance of insulin or due to inadequate production of insulin for proper functioning. This type accounts for 90 percent of all diabetic cases globally, meaning that it is more common than type 1 (Lal, 2016). According to the American Diabetes Association (2014), many of the patients who suffer from type 2 diabetes are obese, and obesity itself leads to some insulin resistance degree. In this case, patients suffering from type 2 diabetes do not depend on the injection of insulin. Moreover, some patients may be able to control their symptoms of diabetes type 2 through losing weight following plenty of exercises, healthy diet, and monitor of glucose levels in the blood. However, this type of diabetes is a progressive illness, it worsens gradually and the patient may end up taking insulin in the form of a tablet. People who are overweight and obese have a risk that is very high of developing diabetes type 2 than those with body weight that is healthy (Lal, 2016). Particularly, individuals with abdominal obesity, central obesity or those with a lot of fat in the belly are at risk. This is because being obese or overweight causes the body to produce chemicals which destabilize the metabolic and cardiovascular systems of the body (Lal, 2016).
Being physically inactive, eating foods that are wrong, and overweight all increase the risk of developing diabetes type 2, and the scientists have a belief that soft drinks that are sugary may have an impact that is direct on the diabetes risk, instead of just simply having an influence on the weight of the body. Additionally, the risk of getting diabetes type 2 also increases as people get older and experts are not certain why but they tend to allude that as individuals get older, they add weight and get less active physically. Moreover, men who have a low level of testosterone have also been revealed to have a greater possibility of developing diabetes type 2 (Lal, 2016).
Gestational diabetes: this is another type of diabetes which affects females at the time of pregnancy. This is because, particular women glucose levels that are high in their blood, and during pregnancy their bodies become unable to secrete insulin that is enough to transport all the sugar into their cells, leading to increasingly escalating glucose levels (Lal, 2016). American Diabetes Association (2014) accentuates that most of the gestational diabetes patients are able to control this disease with diet and exercise, and close to 20 percent of these patients will require to take medications that control blood glucose. When gestational diabetes is uncontrolled or undiagnosed, result in some complications during the birth of a child.
The Body Systems that Diabetes Affects
According to the American Diabetes Association (2014), this disease is associated with dysfunction that is long-term, failure, and damage of different organs, specially the nerves, blood vessels, eyes, heart, and kidneys. WHO (2010) highlights some of the complications of health from diabetes including diabetic retinopathy, which is a substantial cause of blindness. This blindness arises as a result of long-term accrued damage to the tiny blood vessels in the retina. Close to 10 percent of patients develop visual impairment that is severe after 15 years of being diabetic. Another complication is kidney failure. Diabetes is the leading kidney failure cause resulting in 10-20 percent of the death of individuals with diabetes. Besides, diabetes also results in a complication known as diabetic neuropathy, which is damaging of the nerves due to diabetes leading to numbness, weakness or pain in the hands and feet. Moreover, diabetes can increase the risk of heart disease, stroke and hypertension and the chance of developing foot ulcers and ultimately limb amputation. Foot ulcers may be due to reduced flow of blood combine with neuropathy in the feet (WHO, 2010). Other than health complications, diabetes also causes some economic complications such as the direct impact of expenses that families feel and often linked to treatment and family income loss when diabetes impedes work (WHO, 2010).
The Reason for Choosing the Topic
Diabetes is a chronic illness that has been a major public health concern to many nations, especially developed countries where it is prevalent and therefore, it is an issue that needs to be addressed. According to the U.S. Centers for Disease Control and Prevention (CDC), among the top ten leading cause of death in America, diabetes ranks seventh, affecting 25.8 million individuals as stated by the 2011 Behavioral Risk Factor Surveillance System (BRFSS). Similarly, it is a major risk factor for disability resulting from the serious health complication that it causes such as stroke, bloodstream and soft tissue infections, and cardiovascular diseases (CDC, 2013). As such, CDC (2013) asserts that diabetes is a key cardiovascular ailments contributor, which is the leading death cause in the U.S. In this case, approximately 68 percent of diabetic individuals die from cardiovascular infections.
Accordingly, the World Health Organization (WHO) projects that if no urgent action is taken now, deaths related to diabetes will increase by over 50 percent by 2030, making it a serious cause of death not only in the U.S. but also worldwide. In 2012, this disease cost the country an approximate of $245 billion in indirect and direct costs. This is a higher figure of dollars that can be channeled towards the development of the nation if diabetes can be controlled and managed. It as well reflects the increasing rates of diabetes in the U.S., thus calling for the need to address the disease. It is because of these reasons that I chose the topic of diabetes because addressing it requires an understanding of its causes, signs and symptoms, diagnosis and available treatments, all of which this paper is going to address.
Signs and Symptoms of Diabetes
The most common symptoms of diabetes according to Lal (2016) include first, frequent urination. The frequent urination is as a result of too much sugar in the blood, and because of no or ineffective insulin, the kidneys are incapable of filtering the glucose back into the blood, but instead draw away water from the blood for dilution of the glucose. This, in turn, makes the bladder full resulting in frequent urination. Second, diabetes results in extreme hunger (WHO, 2010). This intense hunger is due to the body cells not getting enough energy because of no or defective insulin, and thus the body tries to react by finding more energy (food). As such, a diabetic individual becomes hungry (Lal, 2016).
The third symptom is weight gain, which according to Lal (2016), might be as a result of intense hunger resulting in eating too much food. Forth, is excessive thirst (WHO, 2010). Lal (2016) calls it disproportionate thirst, and he explains that the thirst comes because of frequent urination, thus creating the need to replace the lost liquid leading to an unusual intake of liquids. Unusual weight loss is another symptom of diabetes. Lal (2016) asserts that this symptom is more common among type 1 diabetic patients, and it happens because of the inability of the body to make insulin and thus the body seek out another source of energy. As such, muscle fats and tissues will be broken down for energy leading to weight loss.
Additionally, diabetes also leads to increased fatigue, and this comes about because of no or ineffective insulin resulting in an inadequate intake of glucose in the body cells to provide energy. Thus, this will make a diabetic individual listless and tired (Lal, 2016). Besides, people with diabetes may experience blurred vision as another symptom for diabetes (American Diabetes Association, 2014). According to Lal (2016), the blurred vision may be as a result of tissue being pulled from a person’s eye lenses, affecting the focus ability of an eye. These are severe cases and can be cured if properly treated. Moreover, diabetic individuals may be susceptible to year or skin infections, which is a diabetic symptom that comes because of too much sugar in the body, impairing the ability of the body to recover from ailments if affected (Lal, 2016). This is particularly common among diabetic women who find it challenging to heal from vaginal and bladder infections.
Furthermore, according to Goldenberg and Punthakee (2013), other symptoms of diabetes include itchy skin; wounds that are slow to heal; red and swollen gums; erectile dysfunction in men; hands and feet numbness or tingling; and very dry skin. The numbness or tingling of hands and feet may be due to too much sugar in the body which may damage the nerves as well as the minute blood vessels feeding those nerves (Lal, 2016). WHO (2010) alludes that some of these symptoms may be accompanied by vomiting, stomach pains or nausea in the abrupt onset of type 1 diabetes.
Relevant Diagnostic Tests
Diabetes can frequently be detected through performing a urine test, which reveals if excess glucose is present in the body, a condition called hyperglycemia. This test is usually backed up by a test of the blood which measures the levels of glucose in the blood and is capable of confirming if the cause of the symptom is actually diabetes (Lal, 2016). In this case, there are three types of tests that doctors can use to determine if an individual is diabetic or not. The first one is the fasting plasma glucose test, with at least 126 mg/dl will mean diabetes is present and less than 100mg/dl means normal (Kerner & Brückel, 2014). Fasting means an individual has not taken any food overnight or for the last eight hours. The second test is called the A1C test, which will mean diabetes is present if it indicates at least 6.5 % while below 5.7% will mean normal (Kerner & Brückel, 2014).
According to Goldenberg and Punthakee (2013), A1C has several advantages compared FPG for the diagnosis of diabetes. One, A1C can be tested at any moment of the day unlike FPG and is, therefore, more convenient compared to FPG. Additionally, A1C tests avoid the issue of day-to-day variability of glucose values as it reflects the glucose in the plasma that is average over the prior two to three months (Kerner & Brückel, 2014). However, A1C test can be misleading for persons with different iron deficiency, severe renal and hepatic disease, hemoglobinopathies, and hemolytic anemias. The third one is the oral glucose tolerance test (OGTT), which will indicate diabetes presence if it reads at least 200 mg/dl and less than 14 mg/dl to mean normal (Kerner & Brückel, 2014).
Available Treatments
According to Lal (2016), all types of diabetes discussed above are treatable. However, diabetes treatment depends on the severity, condition type, and the patient’s ability to make changes in lifestyle. There is no known cure for diabetes type 1, and thus it lasts for a lifetime while type 2 also last for a lifetime, however, some individuals have managed getting rid of their symptoms without treatment and only through a combination of diet, exercise, weight control, and yoga. In this case, Lal (2016) asserts that individuals with type 1 diabetes get treated using regular injections with insulin to control blood sugar in the body, as well as exercise, special diet, and yoga. Similarly, patients suffering from type 2 diabetes are also treated using tablets, special diet, and exercise but at times, insulin injection is also needed at some point because the tablets may fail to work.
WHO (2010) accentuate that regular exercise (physical activity) assists in increasing the sensitivity of insulin thus improving the control of blood sugar; helps to control blood pressure; improves the flow of blood in vessels and in the heart; assist in weight loss and healthy body weight maintenance. Examples of exercise a diabetic patient can involve in include walking, gardening, housework, climbing stairs, cycling, jogging, swimming, rope jumping, weightlifting, playing games, and indoor exercises like press ups and sit ups (WHO, 2010). Similarly, apart from treatment, diabetes can be prevented as CDC (2013) asserts. Prevention strategies include being physically active by maintaining a regular activity that moderates in intensity on most days, maintaining healthy body weight and a balanced diet, and cessation of tobacco to avoid complications. If diabetes is not treated or properly controlled, the patient may have a higher risk of complications development such as heart problems, foot, eye, and skin complications among others.
Risk Factors for Developing Diabetes
Risk factors refer to factors which may signal an increased diabetes risk. According to McBean (2017), among the diabetes type 1 risk factors include family history, geography (where a person resides), environmental factors such as exposure to viral infections, the presence of autoantibodies which damages the cells of the immune system, and genetics. For type 2 diabetes, there are those risk factors that are avoidable while others are unavoidable. On one hand, the unavoidable ones include race, family history, and age. In this case, African-American, Latino-Hispanic-American, Native American, Asian-American, and Pacific Islander have a greater chance of getting type 2 diabetes compared to other groups, and also, it tends to affect older adults of 45 years and above. On the hand, the risk factors which can be avoided entails obesity, high blood pressure, stroke, smoking, stress, particular conditions of mental health, too little or too much sleep, and high-fat levels. For gestational diabetes, the risk factors include prediabetes, which is high glucose in the blood without diabetes; being obese or overweight, personal or family history of obesity, unhealthy or unbalanced diet, being over 25 years old, and race (McBean, 2017).
Conclusion
Diabetes is a debilitating disease that is common, and affecting millions of people worldwide as evident from the above discussion. This disease is characterized with hyperglycemia due to insufficient secretion of insulin or defective function of insulin in the body. The most common known types of diabetes are gestational, type 1, and type 2 diabetes, and the symptoms which are most common of these diabetes types include intense hunger and thirst, unusual weight loss, frequent urination, fatigue, bruises and cuts which are slow to heal and numbness of feet and hands. The good thing is all these types are manageable and treatable. Maintaining a healthy diet and regular exercise are among the major ways of preventing diabetes.
References
American Diabetes Association. (2014). Diagnosis and classification of diabetes mellitus. Diabetes care , 37 (Supplement 1), S81-S90.
Centers for Disease Control and Prevention (2013). National diabetes fact sheet, 2011. Fast facts on diabetes . Atlanta, GA: U.S. Department of Health and Human Services.
Goldenberg, R., & Punthakee, Z. (2013). Definition, classification and diagnosis of diabetes, prediabetes and metabolic syndrome. Canadian journal of diabetes , 37 , S8-S11.
Kerner, W., & Brückel, J. (2014). Definition, classification and diagnosis of diabetes mellitus. Experimental and Clinical Endocrinology & Diabetes , 122 (07), 384-386.
Lal, B., S. (2016). Diabetes: causes, symptoms and treatments. Public Health Environment and Social Issues in India, Edition 1, pp 55- 67
McBean, B. (2017, April 27). Type 1, type 2, and gestational diabetes risk factors. Medical News Today . Retrieved December 28, 2018, from https://www.medicalnewstoday.com/articles/317168.php
World Health Organization. (2010). Diabetes fact sheet. Retrieved December 28, 2018, from https://www.who.int/nmh/publications/fact_sheet_diabetes_en.pdf
