Diabetes - Literature review Example

Running Head: DIABETES Diabetes of the of the Diabetes Sconce has progressed to a large extent and there have been innovations and improvements in all the domains ranging from extraction and manufacturing to medicine and nursing. New cures, treatment methods and healing procedures have been developed paving the way for further advancements and ease in the human life. This paper will discuss diabetes, its symptoms, signs, managements and consequences. Diabetes Diabetes is generally known to be among the most disabling, deadly, and costly diseases that the nation is encountering at present and are continually rising at the epidemic proportions. Majority of women have been known to be hit hardest by the diabetes globally. The women in the ethnic groups and minorities possess the highest rates prevailing along with three or four times the rates of prevalence of diabetes in the white population. The term "diabetes" has been derived from the Latin word diabetes, which has come from Ancient Greek and, in literal terms, mean "a siphon; a passer through". The word was used by Aretaeus of Cappadocia, Ancient Greek physician, and meant "unnecessary discharge of urine", as the disease name. It was in 1425 that the word "diabetes" was recorded first in the medical text in English. Mellitus is the term derived from the word mellitus in classical Latin which meant honey-sweet or sweetened with honey. The ancient Chinese, Greeks, Indians, Persians, and Egyptians have noticed the sweet taste in urine. The condition of pre-diabetes refers to the levels of blood glucose that are higher than moderate yet they are not sufficiently high as to be categorized as diabetes. Through the condition of pre-diabetes, there is an increased risk for the development of type 2 diabetes in the individual, along with stroke, and heart disease. The people suffering from the condition of pre-diabetes possess impaired glucose tolerance (IGT) or impaired fasting glucose (IFG). On the other hand, there are some people who suffer from both IGT and IFG. The condition of Impaired fasting glucose (IFG) pertains to the fasting level of blood glucose, after an overnight fast, which is between 100 and 125 milligrams per deciliter (mg/dL). The impaired glucose tolerance (IGT) refers to the level of blood glucose which is between 140 and 199 mg/dL subsequent to the 2-hour tolerance test of oral glucose. The pre-diabetes have an inevitable progression to diabetes. It has been shown by the studies that if the individual having pre-diabetes tend to enhance their physical activity and lose weight, they might delay or prevent diabetes and also normalize their levels of blood glucose. The disease, diabetes, is chronic and takes place in situations when human the pancreas in human body are unable to produce sufficient amount of insulin which is hormone that is responsible for the regulation of blood sugar or, in other words, the condition in which body is not able to utilize the manufactured insulin in an effective manner. Diabetes or Diabetes mellitus (DM) is defined as the group comprising of multiple metabolic diseases in which an individual faces the problem of high blood sugar. The symptoms of increased thirst, increased hunger, and frequent urination are common in case of high blood pressure. Besides this, many complications are likely to arise from the diabetes, if left untreated. The other long-term, serious complications may include kidney failure, heart disease and eye sight damage. Thus, the major cause of diabetes is either the non-responsiveness of cells to the insulin produced in the body or the due to the insufficient production of insulin in pancreas. Generally the people who die of diabetes are more than double of the number of people dying without diabetes. Types There are for broad classes into which diabetes mellitus could be categorized. They are as follows: Type 1 The primary feature of Type 1 diabetes mellitus include the loss of beta cells that produce insulin in pancreas which ultimately results in the deficiency of insulin. The Type 1 can be categorized further in idiopathic or immune-mediated responsiveness and sensitivity towards the insulin are the usual aspects of Type 1 in the initial stages. Adults and children both can be affected likely by this disease, but it has been conventionally known as "juvenile diabetes" for the reason that most of the children suffered from this disease. Labile diabetes or "Brittle" diabetes was conventionally used for the description of recurrent and dramatic variations in the levels of glucose, that usually take place for no obvious causes in the diabetes that is insulin-dependent. Type 1 diabetes is usually escorted commonly with ketosis, unpredictable and irregular hyperglycemia, and serious hypoglycemia sometimes accompanies it. Besides this, there are numerous other complications which include infection, damaged counter regulatory reaction to hypoglycemia, gastroparesis, and endocrinopathies. One of the other characteristics of the Type 1 diabetes is that it is partially inherited, and has many genes which also include specific HLA genotypes, that are known for their influence regarding the occurrence of diabetes. Type II The insulin resistance factor characterizes the Type 2 diabetes mellitus, which is likely to be a blend of the insulin secretion that is relatively induced. The insulin receptor is involved in the damaged response of the tissues of body to insulin. The diabetes mellitus 2 occurs when the insulin sensitivity id reduced predominantly. The hyperglycemia, at this phase, can possibly be reversed through adopting various medications and measures that are used to enhance the sensitivity to insulin or diminish the production of glucose in the liver. The primary factors for the occurrence of the Type 2 diabetes include genes and lifestyle factors. Many of these factors include poor diet, obesity, stress, lack of physical activity, and urbanization. The type 2 diabetes is also developed due to the risk of dietary factors that include, for instance, the excessive consumption of the drinks that are sugar-sweetened. Moreover, the type of fat intake is also of significance in the diet, which means that Trans fatty acids and saturated fats that boos the risk and the monounsaturated and polyunsaturated fat which lead to the decline in the risk. Gestational diabetes Type 2 diabetes and gestational diabetes mellitus (GDM) are similar to each other in many respects, and involve a blend of comparatively insufficient responsiveness and secretion of insulin. About 2-10% of all the pregnancies are affected by this diabetes and this is also most likely to disappear or improve after the delivery. This type of diabetes is treatable to the complete extent, but it needs the medical supervision in a careful manner all through the stages of pregnancy. The management of gestational diabetes includes the monitoring of blood glucose monitoring, changes in diet and in various conditioned, it may also requires insulin. Despite being transient in nature, gestational diabetes that is left untreated may also become the reason of damaging the health of mother or fetus. There are multiple risks to baby which comprise of high birth weight (macrosomia), central nervous system and congenital cardiac anomalies, and malformations of the skeletal muscle. The production of fetal surfactant may be inhibited by the enhanced fetal insulin and become the reason of the respiratory distress syndrome. The destruction of red blood cells may be the reason of hyperbilirubinemia. There are chances of the occurrence of perinatal death in many cases, which is commonly the outcome of the poor perfusion of placenta because of vascular impairment. Other Types Besides the Type 1 and Type II diabetes, there are also various other types. One of the conditions is prediabetes which takes place when the blood glucose levels in an individuals body are higher in comparison to that of the normal. Another condition is the latent autoimmune diabetes in the adults (LADA) which results in the development of type 1 DM in adults. Besides this some other situations of diabetes are usually the results of the non responsiveness of receptors of the tissues in body to insulin. Mitochondrial or autosomal Genetic mutations may also result in damaging the functions of beta cell. In some other cases, there is also a genetic determination of the abnormal insulin action (Risérus, Willet, 2009). Any disorders or disease causing general harm to the pancreas are also likely to result into diabetes. Besides this, those diseases that are linked to the extraordinary secretion of hormones that are insulin-antagonistic may also be big factors of causing diabetes. Some other types of diabetes mellitus are congenital diabetes, cystic fibrosis-related diabetes, steroid diabetes, and various other types of monogenic diabetes. History The Egyptian manuscript from c. 1500 BCE had described diabetes among the first diseases and mentioned it as "too great emptying of the urine". The cases that were initially described are believed to be of the type 1 diabetes. This disease was then identified at the same time by the Indian physicians and they categorized it to be the "honey urine" or madhumeha taking into account that fact that ants would be attracted by urine. The diseases known by "diabetes" which means "to pass through" was used by the Greek Appollonius of Memphis first in the 230 BCE. At that time, it was taken to be rare in presence at the time of the Roman empire, and Galen had commented to this that only two cases were witnessed by him in the period of his career. This may have happened because of the life-style and diet maintained by the primitive people, or may have been due to the observation of the clinical symptoms in the course of the advanced stage of the disease (Shoback, 2011). The disease, diabetes, was named as "diarrhea urinosa" (diarrhea of the urine) by Galen. Aretaeus of Cappadocia has performed the initial work to be surviving now and having a detailed reference with regards to during the period of early 3rd century CE. The symptoms and duration of the disease were described by him, and he attributed theses to the coldness and moisture which mirrored the beliefs carried by the "Pneumatic School". A correlation of diabetes was hypothesized by him with few other diseases and the differential diagnosis was discussed with regards to the snakebite which was also indicative of provoking extra thirst (Selvin, Steffes, Zhu, Matsushita, Wagenknecht, 2010). For the first time, Charaka and Sushruta, the Indian physicians identified the Type 1 and type 2 diabetes on the basis of separate conditions during the 400-500 CE. Diabetes of type 1 was connected with youth and that of type 2 was associated with the individual being overweight. Briton John Rolle added the term "mellitus" or with diabetes, which meant "from honey", during the period of late 1700s. This was done so that the condition from diabetes insipidus could be separated, which is also associated with frequent urination. However, the effective management and treatment for the disease was developed in the earlier part of the 20th century. At the same time, during 1921 and 1922, Charles Herbert Best and Canadians Frederick Banting purified and isolated the insulin which was later followed by the introduction of NPH, a long acting insulin, during 1940s (Risérus, Willet, 2009). Prevalence Diabetes is considered to be one of the primary cause of 71, 382 deaths in America every year. The diagnosed diabetes is attributed $245 billion annually according to 2013 statistics, of which $69 billion allocated in work loss, disability, and premature mortality, and $176 billion in direct costs. Besides this, the individuals having diagnosed diabetes incur 2.3 times higher costs on healthcare than those without the disease. In the United States, about 26 million adults and children suffer from diabetes, and 79 million have prediabetes. The aggregate measures show that, about 10% of the entire population of United States is suffering from diabetes. Besides this, united States incur $245 billion per year in the economic costs (Wild, Roglic, Green, Sicree, King, 2004). There are various reasons due to which diabetes has been increasingly prevailing the countries and causing complications from people of all ages and genders. There are various social, economic, and cultural trends that have contributed to the rising risk and complications of various other diseases along with diabetes. It was held by the national surveys that diabetes has been spreading at an exponential rate since last few decades and people living in poverty are more prone to the disease. There are some who render their services in small firms which provide their employees lower pay and fewer benefits. Such people also encounter significant challenges in order to harmonize their family and job responsibilities, thus paying lesser attention to their health (Selvin, Steffes, Zhu, Matsushita, Wagenknecht, 2010). Those who have a lack to the access to health care or are not insured for health are also vulnerable to the diseases. Beside this, people with difficulties in managing their lifestyles with diabetes, along with others who are in increased risk of depression and stress, along with individual that avoid regular exercises and are overweight, tend to fall victim to the disease at higher rates. Treatment and Management The disease of diabetes mellitus is considered to be chronic, and has no particular cure or treatment besides in particular conditions. The management of the diseases focuses upon the maintenance of sugar in blood stream level closer to as normal or moderate levels as possible, and not to cause hypoglycemia. This objective can be usually reached through exercise, diet and usage of suitable medications. It is vital for the people with diabetes that they gain information regarding the disease participate in the management and treatment in an active manner (Ripoll, Brian, Ignacio, 2011). This is essential as the diabetes has complexities that are far less severe and far less common in those individuals who managed their blood sugar levels well. HbA1C level of 6.5% is the primary objective of the treatment; however, it should not persist on levels lower than this, and may be maintained for higher levels. The harmful impacts of diabetes may be accelerated through other factors including higher levels of cholesterol, smoking, high blood pressure, obesity, and lack of daily workout or exercise (Malik, Popkin, Bray, Després, Hu, 2010). People having may manage their disease through changing their lifestyles. They may take advantage of the education an awareness regarding the treatment of the disease, sensible exercise and good diet and nutrition for the achievement of a normal weight of the body, and can work with the objectives of maintaining both long-term and short-term levels of blood glucose in the bounds that are acceptable. Medications The first line cure for the diabetes of type 2 usually recommended is Metformin, for the reason that has presented evidences of decrease in mortality. The regular utilization of aspirin has not been known t enhance the results in the uncomplicated diabetes. The outcomes are improved by the angiotensin converting enzyme inhibitors (ACEIs) in individuals with diabetes while it is not so by the same medicine angiotensin receptor blockers (ARBs). The conventional treatment of the Type 1 diabetes is performed with the synthetic insulin analogs and/or a mixture of NPH and regular insulin. In case of the utilization of insulin in type 2 diabetes, there is usually an addition of the long-acting formulation, along with the continuation of the oral medications. The effect is then enhanced by increasing the dosage of insulin (Risérus, Willet, 2009). Transplantation of Pancreas People with Type 1 diabetes usually take treatment in the form of pancreas transplant. Such individuals suffer from the severe complexities of the disease, which also includes the renal disease at end stage needing transplantation of kidneys (AMA, 2014). Prevention It has been shown by the RCTs that people at high risks of having diabetes can adopt ways to prevent the disease from occurring. The rate of the onset of Type 2 diabetes may significantly be diminished with the help of specific interventions which include programs of intensive modifications of lifestyle which have been proven to be extremely effective. It may also include the utilization of the pharmacological agents such as α-glucosidase inhibitors, metformin, thiazolidinediones, and orlistat and allof these have been proven to lessen the occurrence of diabetes to a large extent. The studies of this lifestyle intervention have indicated a maintained decline in the rate of diabetes conversion to diabetes type 2 (Maria, Pala, Mannucci, 2013). Individuals having the prediabetes situation frequently encounter other diseases too such as risk of increasing cardiovascular factors, including hypertension, obesity, and dyslipidemia. The identification, assessment and treatment of such risk factors have been a significant part of in the reduction of cardio metabolic risk. It is also important that the public awareness programs of diabetes management and prevention be conducted in order to make the people familiar with the disease and its treatment. The general objectives in the extent of lifestyle modification and control needs to be realistic in nature. There should be availability of guideline by the general practitioners which is likely to pose significantly positive influence on the lifestyle of patients. It is also important that the carers and partners are educated with respect to managing the positive changes in lifestyle of patients suffering from diabetes. In addition to this, the general practitioner may be consulted in order to guarantee that the responsibility of management is individualized with respect to the educational, cultural and financial status of the person. The therapeutic teams are also responsible in playing their part with regards to the management or prevention of diabetes. Conclusion The Egyptian manuscript was the source of introducing diabetes mellitus as a major disorder. Diabetes refers to the metabolic disorder in which individual suffering from the disease either face the insulin shortage or do not possess sufficient ability to use up the insulin in bodily functions. Among many types of diabetes, Type I and Type II are the most prevalent ones among people. The disease may be cured through medication, support, changing lifestyle, and adopting various other measures. References AMA. (2014). Pancreas Transplantation. American Diabetes Association. Web. Retrieved on May 1, 2014 Kitabchi A.E., Umpierrez G.E., Miles J.M., Fisher J.N. (2009). Hyperglycemic crises in adult patients with diabetes. Diabetes Care 32 (7): 1335–43 Malik, V.S.; Popkin, B.M., Bray, G.A., Després, J.P., Hu, F.B. (2010). Sugar Sweetened Beverages, Obesity, Type 2 Diabetes and Cardiovascular Disease risk. Circulation 121 (11): 1356–64. Maria Rotella, C; Pala, L; Mannucci, E. (2013). Role of Insulin in the Type 2 Diabetes Therapy: Past, Present and Future. International journal of endocrinology and metabolism 11 (3): 137–144. Ripoll, Brian C. Leutholtz, Ignacio. (2011). Exercise and disease management. 2nd Rd. Boca Raton: CRC Press. p. 25. Risérus U, Willet W. (2009). Dietary fats and prevention of type 2 diabetes. Progress in Lipid Research, 48 (1): 44–51 Selvin E., Steffes M.W., Zhu H., Matsushita K., Wagenknecht L. (2010). Glycated hemoglobin, diabetes, and cardiovascular risk in nondiabetic adults. N. Engl. J. Med. 362 (9): 800–11. Shoback, edited by David G. Gardner, Dolores. (2011). Greenspans basic & clinical endocrinology (9th Ed.). New York: McGraw-Hill Medical Wild S, Roglic G, Green A, Sicree R, King H. (2004). Global prevalence of diabetes: Estimates for the year 2000 and projections for 2030. Diabetes Care. 27 (5): 1047–53 Read More