Biology of Diabetes - Research Paper Example

?Biology of the disease Diabetes is characterized by a rise in blood sugar levels which occurs when the body is unable to metabolize the sugar through the insulin hormone. Insulin is a pancreatic hormone which is produced by the islet cells and is secreted to move the glucose in the blood stream to the muscle and fat tissues for later metabolism into energy. However, when the level of insulin decreases due to the lesser production by the islet cells or the resistance from muscle and fat cells in response to the insulin hormone, the sugar in the blood stream remains unused, which is reflected by the rise in the blood sugar level. Based on the level of insulin secreted, diabetes is classified under three types: 1. Type 1 diabetes, which is present from childhood, in which the body secretes little or no insulin. This is also referred to as insulin dependent diabetes and genetics, viruses or autoimmune problems with the islet cells have been proposed as major causes for this type of diabetes. 2. The type 2 diabetes is a more common form of the disease which manifests only in adulthood when the islet cells begin to secrete less amounts of insulin or the body does not respond well to the secreted insulin. Increasing lifestyle changes such as lack of body exercise and food habits have been considered to be the major causative factors along with a genetic predisposition to the disease. 3. The third and an increasing occurring type is gestational diabetes wherein the mother develops the type 2 form of the disease during pregnancy which increases the risk for both the mother and the developing infant. (Diabetes, 2010) Genetic factors In the case of type 1 diabetes, which is present from childhood, studies have shown that more than 20 regions of the genome might be responsible for genetic susceptibility to the disease. Increased risk to the disease has been found to be associated with the genes present in the HLA region of chromosome 6 which includes HLA-DR, DQ, and DP. The various haplotypes of these genes are associated with increased risk for the disease in various populations and the presence of two such haplotypes together further compounds the risk for the disease. In addition, the presence of variants of the INS (insulin) gene located in chromosome 11, also predisposes the individual for the disease. Another gene that have been associated with the disease include variants of the CTLA-4 (cytotoxic T-lymphocyte associated 4) gene which is located on chromosome 2. The genes associated with type 2 diabetes are those which are involved in pancreatic beta-cell function, insulin action, metabolism of glucose and other conditions such as lipid metabolism and energy uptake and release. Some of the candidate genes for the disease include PPAR?, ABCC8, KCNJ11, and CALPN10. In the case of maturity-onset diabetes of the young, which is the type 2 form of the disease that occurs before 25 years of age, is linked to mutations that occur in at least 6 genes which are associates with beta cell function as all the genes are expressed within the islet cells of the pancreas (Genetics and Diabetes, n.d). Psychological aspects of the disease The initial response of the individual to the disease is associated with shock and anger as it is a lifelong condition and demands a lot of restrictions and a strict life style for controlling the disease. Beginning with food restrictions and following a routine of walking and exercise, the condition also requires continuous follow-ups and is also interlinked with various other illnesses. The long term nature of the disease has also been linked to development of anxiety and depression which in turn depend on their ability to cope with the limitations imposed by the disease. Such individuals also often feel isolated and dependent on people for their daily activities, which would be more obvious in case of children (Chandra, 1997). Medical and psychological interventions The presence of diabetes needs to be confirmed through proper diagnostic and screening procedures. Diagnostic tests are taken when an individual exhibits the signs and symptoms of the disease such as in the case of type 1 diabetes who normally present with the acute signs of the disease along with elevated blood sugar levels. Screening tests are done for individuals who are asymptomatic and are likely to have the disease. The tests conducted to detect the presence of diabetes include the oral glucose tolerance test (OGTT) or the fasting plasma glucose levels (FPG). Those who have been detected with the disease should be afforded with a comprehensive medical care by diabetes specialists. Medications are prescribed both to lower the incidence of the disease and to control further progression of the disease (Standards of Medical Care, 2005). In case of type 1 diabetes, in which the individuals are unable to secrete the required amounts of insulin, insulin injections are given according to their daily activities. Those with the type 2 form of the disease are usually treated with drugs in combination with exercise and diet (Diabetes, 2010). The drugs that are being regularly prescribed include: the biguanide metformin, ?-glucosidase inhibitor acarbose, and the thiazolidinedione troglitazone. In addition to pharmacological interventions lifestyle modifications such as exercise and dietary changes are also being advised as an effective way to control or reduce the risk of incidence. Moderate exercise such as brisk walking for about 30 minutes daily, a low-fat diet along with calorie restrictions are usually recommended in combination with drugs. Such interventions have shown to reduce the blood glucose levels in addition to reducing the cardiovascular risk factors, weight loss and improving the general well-being of the individual. In addition, glycemic control could also be achieved through regular monitoring of blood glucose levels, undertaking the A1C test at least twice every year (Standards of Medical Care, 2005). People with diabetes should also be subjected to psychosocial screening in which the general quality of life of the individual should be ascertained along with their attitude towards the disease, their expectations from medical interventions and their psychiatric history. In addition the individual should also be assessed for any non-compliance with medications, symptoms of depression and eating disorders as these could also interfere with the disease control. If the presence of any of the above problems is indicated suitable psychological treatment could be incorporated in the routine (Standards of Medical Care, 2005). Emotional problems can only be alleviated through effective counseling measures and participation in group meetings and events provided at the time of diagnosis which will enable the individual to take better care of them without adding a burden on their family members. Improvements associated with such programs will motivate those with the disease to maintain their lifestyle and lead a happy life (Chandra, 1997). In addition to problems related to an elevated blood sugar level such as cardiovascular diseases, delayed healing of wounds and hypertension, diabetes also affects the eyes, nervous system, kidney and foot. In case the disease is left unchecked it could lead to a multi-organ failure which would be difficult to control in the more advanced stages. Thus it is vital to take the necessary precautions if there is a risk for developing diabetes or take adequate measures to control the progression of the disease if it has been diagnosed. Though the chances of preventing the development of the type 1 form of diabetes is unlikely as it is present from childhood, the type 2 form and the gestational form of the disease can be prevented if adequate preventive measures such as consuming a healthy diet with adequate exercise and maintaining a clean lifestyle is followed. In addition, regular monitoring of blood pressure, blood sugar, cholesterol and kidney function test are also vital as it could signal the presence or absence of the disease (Diabetes, 2010). Thus in conclusion, though the onset of the type 1 form of the disease cannot be prevented, individuals who are at increased risk of developing the type 2 form of the disease can follow suitable prevention strategies. In case of individuals who have been diagnosed with the disease suitable pharmacological, psychological and lifestyle modifications should be adopted and strictly adhered to in order to prevent further complications as a result of the disease and for better prognosis of diabetes. Reference 1. Chandra, P. (1997). Psychological Aspects of Diabetes. International Journal of Diabetes in Developed Countries, 17: 111-112. Retrieved April 18, 2011, from http://www.diabetes.org.in/journal/1997_oct-dec/article5.pdf 2. Diabetes. (2010). PubMed Health. Retrieved April 18, 2011, from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002194/ 3. Genetics and Diabetes. (n.d). Retrieved April 18, 2011, from http://www.who.int/genomics/about/Diabetis-fin.pdf 4. Standards of Medical Care in Diabetes. (2005). Diabetes Care, 28(1): s4-s36. Retrieved April 18, 2011, from http://care.diabetesjournals.org/content/28/suppl_1/s4.full#sec-1 Read More