Understanding Diabetes

Original text by Eliane Zavala

According to the center for Disease Control and Prevention last numbers (Feb, 2012) the number of diabetes cases had triple between 1990 and 2010. As an attempt to make the public more aware of this trend, I have decided to write a small article sharing what I had learned firsthand about Diabetes. First of all, the causes of diabetes are yet not completely clear. However, there are two common factors involved on the onset of diabetes a hereditary factor and environmental factor. Research shows that people who develop diabetes have certain hereditary traits. Patients with Type I share some common genes (DR3/DR4) which indicates the presence of an immune system disorder. With Type II diabetes patients, both family history and the ethnic group of origin play a role determining the onset. The other element determining who might develop diabetes has been identified as environmental triggers. For example, in Type I diabetes a virus or microorganism happens to cause an infection. The body over-reacts to the infection by attacking itself, consequently destroying the actual beta cells that make insulin. In the case of Type II Diabetes, a combination of environmental factors and life-style are present on the onset, such as poor diet, obesity, natural aging, and lack of exercise.

This is an oversimplified explanation of how disease develops; however, the purpose of this article is to inform the public about the basics facts on diabetes, and hopefully generate more awareness about the disease Lets discuss the two most prevalent forms of diabetes, which are Type I Diabetes (also known as Juvenile diabetes or insulin-depend diabetes), and Diabetes Type 2 (also known as non-insulin dependent diabetes). Type I begins normally in childhood, although, a person may carry the genetic predisposition for it, and not develop the disease until later in life. More and more adults over thirty are developing Type I, and the triggers are not necessarily known. One of the characteristics of Type one is the sudden onset of the disease signaled by the rapid decline of the pancreas ability to produce enough insulin or any insulin at all. It is still considered a rare disease since Type I counts for about 5% of the overall diabetic population. Since the pancreas does not produce insulin in Type I patients, they must take insulin injections daily to control the spikes of hyperglycemia (high levels of glucose in the blood). Regardless of the food intake and life-style, Type I patients will always have to rely on insulin to survive, a fact many people do not understand. Strict dietary guidelines and an active life-style minimize blood sugar spikes, consequently avoiding other health complications. Still, Type I patients must take insulin in order to deliver nutrition into their cells. Type II diabetes generally happens in people over 40 years old, with a history of obesity and sedentary habits. However, nowadays, more and more younger people are developing Type II due to sedentary life-style. Diabetes type II impacts 95% of the diabetic population. According to an article in Science News by Janet Rallof dated October, 2005 adolescents are increasingly

dining out on fried foods, a new study finds, and the older they are, the more frequently they do so. Those trends may portend hefty risks down the line In Type II diabetes, the pancreas may produce enough insulin, but the cells became resistant to the insulin produced and the body does not use it properly. This process is called insulin resistance. The excess weight common in Type II patients forces the pancreas to work extra-hard putting it under stress. Consequently, the pancreas does not produce enough insulin to cover the amount of carbohydrates intake. The disease develops slowly over the years, quite often without any signs. Once it is diagnosed though, it can be controlled mainly though diet, exercise and oral medication. In more severe cases, insulin injections may also be added as treatment. Early diagnosis is crucial, regardless of which type of diabetes one may have. Being on the lookout for the main symptoms of diabetes can ensure early treatment, so lets take a look on the most common ones: Excessive urination Extreme thirst Weight lost Constant hunger Fatigue Blurred vision Difficulty concentrating Numbness of feet and legs Wounds that do not heal easily Vomiting Loss of consciousness 3

Aside from the symptoms described above, there is another one that is a very peculiar and associated with Type I diabetes: a fruity, sweet unusual breath. This sweet breath, indicates ketoacidosis, a condition that is caused by a built up of acids in the blood system. When the body cannot get energy from the glucose into the cells, it starts to break down protein and fats to keep the body functioning. In other words, the body is starving because no nutrition is getting to the cells to sustain normal body functions. Hospitalization is necessary immediately or coma and death can follows. Now that we had covered what causes diabetes, the main types of Diabetes, and symptoms associated with it, we shall attempt to briefly discuss the complex daily task of managing diabetes. Diabetes type I and diabetes type II have different causes, and actually respond to treatment differently. First of all, type I Diabetes patients need insulin 24 hours a day. Remember their pancreas do not work or work inconsistently. Today there is a variety of insulin types used to customize a patient treatment. The insulin most commonly used by all diabetic patients is called Lispro or Humolog, and its given with their meals based on the carbohydrate count. It works fast, within 15 minutes and it lasts about 3-4 hours. Another one called Glargine or Lantus is given at nighttime before bed, and works through the night with a slow-release formula. The ratio or amount given to each patient is based on trial and error starting with very small controlled dosages. Dosages are also based on trial and error testing. Technology is constantly changing and many options for treatment are now available; for example, an insulin pump. The pump replaces the need for periodic injections by delivering rapid-acting insulin continuously throughout the day using a catheter. Another component of a diabetic management plan is the very planning of meals, and carbohydrates counting. Its important to keep a close eye on what and how much food is

consumed so that the right amount of insulin is given. Keep in mind that we are trying to emulate the role of the pancreas for great glucose control and assimilation. Remember many patients of with type I diabetes are kids, and they need food from all groups to grow. Balancing them is the key for success. Being active is essential to any human being, but that is especially true to diabetic patients. Regardless of their age, they need to exercise to avoid over-stressing their pancreas. Of course, a doctor close supervision, regular checkups, and dietary education are critical to avoid serious health complications. Type II diabetes patient control program is mostly based on life-style and carbohydrate counting. First of all, they must keep an accurate count of their food intake. Since they are not growing kids anymore, cutting down on carbohydrates do not impact their health. By doing so they also stay lean, a must to avoid stress on the pancreas. By exercising daily, the patient is helping the body to properly use the insulin it produces. Finally, oral therapy can be used, and in more severe cases, insulin injections are used to keep glucose levels in control. Just as the Type I diabetes, Type II diabetes patients must be screened and advised by a medical doctor and a nurse educator on a regular basis in order to maintain good health. A crucial part of any diabetic patient daily management health plan is glucose monitoring. Several times a day, especially before meals, they must check their glucose levels to adjust insulin levels, and the food intake.

Citation:

Centers for Disease Control and Prevention, National diabetes fact sheet: general information and national estimates on diabetes in the United States, 2007, GA: U.S.

Department of Health and Human Services, Centers for Disease Control and Prevention, 2008. http://www.cdc.gov/diabetes/pubs/pdf/ndfs2007.pdf

Title: Prevalence of diabetes and impaired fasting glucose levels among US adolescents: National Health and Nutrition Examination Survey, 1999-2002. Author(s)Glen E. Duncan. Source: Archives160.5 (May 2006): p523 (6). Document Type: Magazine/Journal

Smith, Liz. "Researchers assess ways to involve communities in diabetes prevention." American Family Physician 74.8 (Oct 15, 2006): 1268. Expanded Academic ASAP. Gale. Moorpark College <http://find.galegroup.com/itx/start.do. Library. 12 Oct.2008

Gale Document Number:A153706286

http://www.sciencenews.org/view/generic/id/6648/title/Food_for_Thought__When_Kids_Eat_O utOD for Thought: When Kids Eat Out Home / Bogs / Food for Thought / Food for Thought: When Kids Eat Out Adolescents who often Eat French fries and other fast food away from home tend to be heavier and to gain weight faster than those who eat most of their meals at home. Published: Wednesday, October 5th, 2005