Classic Signs and Symptoms of Diabetes - Essay Example

?Diabetes Mellitus, often termed as “the silent killer”, is defined as a chronic disease marked by high levels of sugar in the blood. It’s been around for centuries, and is one of the most common diseases worldwide that claims millions of lives every year. In 2000, at least 171 million people suffered from Diabetes. That is 2.8% of the global population. In this illness, either the body does not produce enough insulin, the enzyme needed to break down glucose so that is can be utilized by the body, or the cell does not respond to the insulin that is produced. This results in increased amounts of sugar in the blood, causing complications usually involving the heart and kidneys. (Wikipedia, 2011) There are three main types of Diabetes. Type 1 Diabetes, or insulin-dependent diabetes, occurs when the pancreas fails to secrete insulin, thus the glucose taken in from food cannot be broken down. The result is a buildup of sugar in the blood that causes complications like kidney failure, retinopathy, heart failure, and hypertension. A patient with this condition requires artificial insulin to be injected regularly in order to control the blood sugar levels. Type 2 Diabetes, or non-insulin dependent diabetes, is similar. In this case, the pancreas is able to secrete small amounts insulin, but the body’s cells cannot receive it. The result is identical. The sugar builds up in the bloodstream, and causes the above complications. The third type is Gestational Diabetes. This occurs in pregnant women only. During pregnancy, the overworked body of the mother is unable to secrete the excess insulin required, leading to increased blood sugar levels. Women with gestational diabetes are most likely to have large babies. Diabetes is caused by different factors. Obesity is a big predisposing factor. In obese persons, insulin is less able to facilitate the entry of glucose into the liver and adipose tissues. In addition, fat buildup presents a suitable environment for circulatory overload. As sugar builds up in the blood, the density and concentration gradient increases, making the blood thick and viscous. This prevents it from properly circulating around the body. And because the hands and feet are the furthest from the pump center, the heart, they receive the least amount of blood. Lack of nutrients from the blood kills the tissue surrounding the area. Eventually, the hand or food necrotizes, or dies, leaving amputation as the only solution. Not surprisingly, most amputees are a result of Diabetes Mellitus. Heredity also plays a big role. If one of your ancestors or family members had a health history of diabetes, you have more chances of acquiring it, and as you age these chances increase. In spite of all these, the principal factor is a sedentary lifestyle. When your body lacks enough exercise, the heart pumps less blood to the extremities, causing tissue death. (Black, 2001) Classic signs and symptoms of Diabetes are increased thirst, increased hunger, and frequent urination. The thirst occurs when the body mistakes the concentration of sugar in the blood for lack of water, thus it triggers the thirst center in the brain, causing the person to drink more water, which in turn causes him to urinate more. The hunger occurs because the cells cannot utilize the sugar and nutrients, causing them to “starve”. The body interprets this as lack of food; hence, the person eats more and more. Increase of blood sugar also affects the eyes. Absorption of glucose causes the lens to change shape, resulting in vision changes. The heart usually suffers the most. Because of an increased workload, the heart muscles grow, causing cardiomegaly. As this progresses, the heart, out of exhaustion and overwork, eventually gives up and stops pumping, causing heart failure, and death. Heart attacks are common in chronic high blood pressure. Kidney failure also occurs. The main job of the kidneys is to remove waste from the blood and return the cleaned blood back to the body. In diabetes, the high levels of sugar damage the nephrons, the millions of tiny filtering units within each kidney. A person with diabetes is most likely to get kidney failure whether they use insulin or not. And there is no cure. The treatment is lifelong and costly. The patient has to visit the dialysis center weekly for artificial blood cleansing. (Tortora, 2006) Insulin medications are a must for persons suffering from type 2 diabetes. Without it, organ death would be inevitable. Insulin injections have to be carried everywhere so they can be taken on time or when necessary. This does not mean that the person cannot take in sugar-filled foods or snacks. There are moments when the blood sugar concentration, instead of rising, drop to dangerous levels. Hypoglycemia is as much threat as hyperglycemia. This calls for an emergency intake of something sweet, most possibly a simple sugar, so that it can be broken down easily and utilized by the body. That’s why a diabetes patient also needs to carry along sweets like candy or chocolate, or juice. All these maintenance medications cost a lot. And they have to be purchased in a regular basis. In the case of Gestational Diabetes, it has fewer symptoms, and is less critical than the other types. It affects less than 5% of pregnant women. It can be managed by diet and exercise, and usually goes away after the baby is born. Women are at risk for this if they have a family history of diabetes, stillbirth, or birth defects. The can also develop it if they are obese or over the age of 30. This type of diabetes cannot be treated, but it can be managed through physical activity, changing one’s meal plan, and when necessary, injecting insulin medications. (Wikipedia, 2011) Because of the high incidence of Diabetes and its chronic nature, many health agencies, including governments, allocate huge funds to combat this killer disease. Scientists and Medical experts worldwide have worked years in labs in attempts to discover a cure, but to no avail. Many people around the world have discovered that the only way is prevention. Simple activities like daily exercise and proper nutrition have been found most effective. Those who practice this have the least chances of acquiring this illness. As much as individual action is necessary, a killer like this requires much more. Governments and Health agencies have a major role to play if ever this disease will be contained. People, in both urban and rural locations, know little about it. Educating the public should be the number one objective. Knowledge is power, and only when people know what they are up against will they be able to move forward. The mere fact that millions around the world acquire this disease every year is evidence that not enough is being done. Diabetes mellitus is far underestimated. It is growing rapidly globally. Medical experts are baffled as to why so simple a disease cannot be treated. The statistics alone are upsetting. In the United States alone, 25.8 million people have been diagnosed, accounting for almost 8.3% of the population. What makes these figures more alarming is that an excess of 7 million people in the US now have diabetes but don’t know it, and almost 80 million people are at risk. Early detection has been proven to help. As the disease progresses, it affects more organs, causing more damage. This has cost the United States 116 billion dollars in the past year alone for direct medical intervention. Altogether, the US spent 218 billion dollars. In the United Kingdom, 2.8 million people, almost 5%, are reported as having Diabetes, most cases of which are type 2. Worldwide, 285 million suffer from it. The extent in terms of statistics is significant. (Whitaker, 2001) In Asia, the disease is literally burgeoning. Those frequently affected are the young and those struggling with obesity. Sugar intake is also common. Many young children are given sweets and candies. This not only predisposes them to the disease, but also weakens their immune system, paving the way for more killer diseases in the future. As opposed to first-world countries whose diets have been slightly modified as a result of health reforms, Asian countries still have an increased intake of foods high in sugar and cholesterol, both of which are influential in bringing about diabetes. In Africa the problem has serious consequences. In a continent where health care systems are overburdened and unable to even effectively diagnose the disease, cases are bound to rise. Five years ago, an estimated 7 million people were suffering from the disease, which was less than 1% of the African population. Since then, cases have steadily been on the rise, and in a few years it is projected to more than double. National surveys in most parts of Africa indicate that diabetes is on the rise due to rapid urbanization and fast-changing diets which are favoring western diets in place of the traditional ones. The rise in diseases places the continent’s millennium goals in jeopardy. With rising illnesses comes rising health costs. And that will greatly cripple an already weakened economy. When it comes to exercise, Africans get comparatively more physical workouts. The main cause is in the diet. If only they were to return to their primitive, simple diets, then they would realize the wisdom of their ancestors. Until then, Diabetic deaths will still be on the rise. Diabetes usually occurs in people over the age of 40. But recently, more children are diagnosed with the condition, some even as young as seven. Type 1 diabetes is usually termed as Juvenile diabetes, as the onset of it begins at childhood. But recently, type 2 diabetes is being seen in young children. This is due to current societal lifestyles and obesity. Managing children diabetes requires a specialized method. Thus, most children are cared for by the hospital rather than by their parents. The good news is that a child who develops diabetes will live longer than someone who develops diabetes at adulthood. All of these recorded cases of Diabetes are expected to keep increasing. As a disease that has no cure, we can expect to have it around for a few more years. And in developed countries like the United States and Europe, cases will soar due to the complacent and mechanized lifestyle. In developing, or third world countries, the chief reason for the growth and spread of Diabetes is ignorance and lack of public health workers. Urban cities are centers of disease. The pollution from cars and factories, coupled with stressful jobs put people at high risk for cardiovascular diseases like Diabetes. (Whitaker, 2001) Many universities and educational institutions are training public health workers who, in co-operation with the government, are intended to solve health issues in the rural and suburban communities, when in truth, more aid is needed right here in the cities. If they are to succeed in solving the urban health crisis, the rural areas will have better hope. But diabetes is a lifestyle disease. And with the careless and indulgent lifestyle of our present generation, there doesn’t seem to be hope for a decrease in cases. If ever it will decrease, it will require commitment from governments, both locally and internationally. Public Health workers need to emphasize the need for proper lifestyle. Not only does it prevent Diabetes, but it has also been reported to “cure” it. People who maintain their exercise regimen and get the needed nutrients from the right sources have eventually eliminated the use of insulin injections. The heart pumps better after jogging or performing some vigorous exercise. Circulation is improved, and more glucose is broken down. The pancreas functions in a much better state and starts produces insulin. If health agencies started to focus on prevention rather than cure, they would achieve much more. As previously mentioned, the prevalence of diabetes is increasing worldwide, as are the economic costs to both countries and to individuals. There is evidence that shows that prevention strategies can work to prevent type 2 diabetes, and that the education of health care workers and people with diabetes can be able to play a key role in improving the set outcomes. These efforts are most likely to be effective if embarked on within a comprehensive framework that includes society, the health system and a supportive policy environment. There have been many national programs that have been developed to help combat the ever-increasing statistics of diabetes. In 1989, the World Health Assembly passed Resolution WHA42.36, which was for the prevention and control of diabetes. Shortly after that, five regional declarations were adopted in response to the cry. In Europe, the St. Vincent Declaration brought about a lot of benefits globally by providing leaders, motivation, inspiration, and actions for diabetes that had a lot of influence worldwide. Then some years later in 1994, the Declaration of the Americas was established for the same purposes. In 2000, the Western Pacific Diabetes Declaration and Plan of Action came about, then in 2006, the Declaration and Diabetes Strategy for Sub-Saharan Africa was started and most recently in 2008, the Kathmandu Declaration began. (IDF Diabetes Atlas, 2011) Ever since, there have been many National Diabetes Programs (NDPs) that have devoted time and commitment for countries that are fighting diabetes. These programs help countries by allocating resources to prevent diabetes and to care for people afflicted with it. In 2006, another UN resolution was made UN Resolution 61/225 with messages on developing national policies on prevention, treatment and care of diabetes by development of health care systems. In response to this resolution, the International Diabetes Federation surveyed the 202 member associations under them to see what the statuses of the NDPs in their countries were. The results found were that in two-thirds of the countries with an NDP, it would function as an integrated component of a national non-communicable disease strategy. The other third of the countries stated that there was funding dedicated exclusively for the NDPs. As important as it is to have programs that are dedicated to combatting diabetes, it’s just as important to check the quality of care that these programs have to offer. To check this, the Diabetes Quality Improvement Project developed a standard of care that was to be used. They selected nine indicators for diabetes, among which were annual Hba1c testing, annual LDL cholesterol testing, annual screening for neuropathy, annual eye examination, Hba1c control, LDL cholesterol control, lower extremity amputation rates, kidney disease in persons with diabetes, and cardiovascular mortality in persons with diabetes. The selection of these criteria was based on a feasibility study. But even now, there have only been reports on two of the nine criteria: annual eye examinations and lower extremity amputation rate. As a result, the lack of standardization in the definition of indicators and the systems to provide such indicators in representative groups of people with diabetes limit the ability to monitor the quality of care being given globally. (IDF Diabetes Atlas, 2011) Even though the results don’t always come as expected, plans are still made for fighting the disease. The Western Pacific region developed a plan of action that covered the prevention of diabetes in susceptible communities and individuals, the prevention of consequences and complication of the disease in infected individuals, and the enhancement of the capacity of national health systems to deliver and monitor effective services for the prevention and care of diabetes and its complications. There is a lot of evidence that tells us that type 2 diabetes can be prevented, or its onset can be delayed. Behavior modification and different pharmacological interventions have proved to be successful and been able to reduce the onset of new diabetes up to 60%. In addition to these measures, lifestyle change is encouraged, such as losing weight to those who as overweight, increasing exercise and physical activity, and following a healthy diet regimen. Following these measures have proven to be more effective than the pharmacological interventions. Results from China show that the benefits of following a positive lifestyle change are still apparent up to 20 years after. The challenge comes when it is time to translate the findings and applying them to the community. It’s difficult to find a method that is both cost-effective and efficient in identifying people who are at high risk for developing diabetes and providing an intervention that is reasonable and affordable for the local setting. At times it may be the case that an initiative that has been developed and that has worked for one population may not necessarily work for another population. There is need for identifying measures to be applied not only at the individual level, but for reducing the risk of the whole population as well. A lot of attention needs to be given to this side as well. A good example is given in the Developmental Programme for the Prevention and Care of Diabetes in Finland (DEHKO). This organization implemented a national diabetes programme that addressed the problem on a population-wide level. It is now on its final phase after nearly a decade of activity. (IDF Diabetes Atlas, 2011) In Latin America, measures are also being taken to face prevention and promotion of health. This Latin plan will implement the programme in Argentina, Brazil, Colombia, Ecuador, Peru, Uruguay and Venezuela. The programme plans to develop and implement a curriculum for training diabetes prevention managers in Latin America, who will provide a basis for long-term activities at population level. It also hopes to ensure sustainability and continuity at the community level. In addition to all this, education is important. Diabetes-specific education is important for healthcare personnel and those infected. This education will help them develop a positive lifestyle change. It’s been known that without a purposeful, planned method of changing clinical behavior, very little can happen. It’s important to invest in this diabetes-specialized education so that it is accessible to the community and healthcare workers. Being able to provide the proper diabetes care for a population requires the cooperation of health systems along different levels. At the center is the person with diabetes, the family and immediate caregivers. The middle level is the community and healthcare organizations where the care is given. Many countries today have experienced success in their endeavors to combat diabetes. The main reason is because they develop and implement plans that are realities to their settings. The progression of diabetes care weighs upon not just increasing knowledge and changing behaviors, but also using proven methods to advance the health care systems. (IDF Diabetes Atlas, 2011) Diabetes self-management education and on-going self-management are critical components of effective diabetes care, and significant contributors to metabolic and psychological outcomes. There are many areas in the world where people suffering with this disease cannot receive treatment that is essential for their well-being. This is where the education comes in. This helps them understand their condition, and be able to make the right choices that will protect them from harm, and also to make the lifestyle change that optimizes their health. In 2008, a study was carried to determine the status of education in different regions. Results showed that two-thirds of the countries had NDPs, and the diabetes education was being practiced in a variety of settings by the health care providers. When asked about the significant barriers to the education, the primary answer was the lack of resources. This survey showed a clear need for an increase in the number of diabetes educators and support for diabetes self-management education for people suffering with the disease. In the United Kingdom, measures are being taken as well to fight this disease. Different organizations, such as Diabetes UK have been developed. They provide different programs such as organizing events where people living with diabetes can meet and talk and learn from each other’s experiences. They have also made a program called Healthy Lifestyle Roadshow where they visit 70 of the most deprived areas in the UK, and they provide them with information of how to lead a healthier lifestyle, giving free diabetes risk assessments, and demonstrate physical activities. There’s also a “Careline” where trained counsellors can provide information about living with diabetes as well as the time to talk things through. (Diabetes UK, 2011) There are programs that provide training and awareness workshops that help people suffering from diabetes. There are many local support groups that people can meet where they can find understanding, help and an important support line. There is usually a speaker with a topic for diet or exercise. These are just a few of the many programs that are being offered for diabetes-afflicted individuals in the UK. (Diabetes UK, 2011) In other areas of the world, many of the same kind of programs are at the public’s disposal. For example, in the Philippines, there are many support groups that cater to people living with diabetes. In Kenya, there are a lot of programs devoted to raising the education level of diabetes. In the United States, finding aid for diabetes, looking for any information on the matter is just a phone call away. Not just regionally, but internationally as well, with resolutions such as UN Resolution 61/225, it’s getting easier to face this problem in the eye and look toward a better future. The thrust from regional, to national, to local has begun with the formation of the alliance and the endorsement of the declaration and the plan of action. Now the momentum needs to be sustained by national governments. They must recognize the need, raise the priority of diabetes in their public health agendas, and invest resources accordingly. WORKS CITED: 1. Black, J. M. et. al., Medical-Surgical Nursing: Clinical Management for Positive Outcomes, Vol. 2 6th edition. Singapore: Elsevier Science (Singapore) Pte. Ltd. 2001. 2. Diabetes Mellitus, retrieved from: http://www.wikipedia.org. 3. Diabetes UK. Retrieved from: http://www.diabetes.org.uk/How_we_help. 1 May, 2011. 4. International Diabetes Federation Diabetes Atlas. Retrieved from: http://www.diabetesatlas.org. 1 May, 2011 5. Tortora, G. J. and Grabowski, S. R., Principles of Anatomy and Physiology 10th edition. New Jersey: John Wiley and Sons, Inc. 2006. 6. Whitaker, Julian. Reversing Diabetes. Warner Books Inc.: New York, NY. 2001. Read More