Type Two Diabetes, Why It Is a Disease of the Young - Coursework Example

Type Two Diabetes, Why it is a Disease of the Young The purpose of this paper is to discuss Type Two Diabetes, as it is a disease which occurs in the many individuals including the young. The pathophysiology, etiology and rate of occurrence will be discussed as well. In addition, statistics which exhibit the prevalence of this disease, will be mentioned. By definition, Type Two Diabetes can be defined as “a disease in which the body does not produce or properly use insulin. Insulin is a hormone that is needed to convert sugar, starches and other food into energy needed for daily life. The cause of diabetes continues to be a mystery, although both genetics and environmental factors such as obesity and lack of exercise appear to play roles” (American Diabetes Association, 2007). Nearly 21 million individuals within the Unites States suffer from Diabetes. Some of these individuals are not even aware that they have the disease. There are several different types of Diabetes, Type One Diabetes, Type Two Diabetes and Gestational Diabetes. This paper will focus mainly on Type Two Diabetes, as most people diagnosed with Diabetes are in fact afflicted with Type Two. Specifically, Type Two Diabetes is an overall resistance of the body to the hormone insulin. It is the failure of the body to properly produce and use insulin as well as an overall insulin deficiency. Diabetes is more likely to occur in Native Americans, African Americans, Pacific Islanders and Latin Americans most likely due to its propensity to occur genetically. Diabetes can result from a genetic predisposition or as a result of lifestyle such as poor diet and lack of exercise. Type 2 Diabetes is more common now in the young than it was in the past due to America’s rapid decline in healthy diet and regular exercise. Fast food restaurants continue to be a billion dollar industry with a continuous increase in portion sizes and unhealthy menu choices. America continues to be one of the most obese countries in the world today. This has certainly worsened over the last few decades, as the popularity of fast food restaurants has increased. The cause of diabetes is again, either genetically predetermined or determined by behavioral or environmental factors such as diet and lack of exercise. Genetically speaking, Diabetes is a disease which accompanies several monogenic as well as digenic disorders. The fact that Diabetes is more likely to occur within siblings as monozygotic twins as opposed to dizygotic twins, indicates its ability to genetic transfer. It is true that Type Two Diabetes is more likely to occur as age of an individual increases, but the disease has truly affected more children that in past decades, again due to the eating habits adopted by American families. If an individual is not genetically predisposed to Type Two Diabetes, there are risk factors that may indicate one’s propensity to develop the disease. These factors include high blood pressure, high fat diets, heavy alcohol consumption, lack of physical exercise and obesity. In individuals who are at risk for Diabetes from a genetic standpoint, there are specific loci in which genetic variables can determine one’s likelihood of having Diabetes, “Studies have suggested associations with such genes (e.g. PPAR g and KCNJ11), as well as hepatocyte nuclear factors 1 and 4, calpain-10, and the genes encoding insulin and the insulin receptor. The mitochondrial genome has also been implicated in type 2 diabetes and genome-wide linkage studies have identified susceptibility loci at 1q, 5q, 8p, 10q, 12q and 20q” (Center for Disease Control, National Office of Public Health Genomics). Some research has led scientists to believe that a loci on chromosome 20 may be responsible for an individual’s development of Type Two Diabetes. Specifically on chromosome 20, two particular genes have been linked to a susceptibility to Type Two Diabetes. In addition, this particular research has identified 4 genetic variants in particular, “the teams identified four genetic variants, called single nucleotide polymorphisms (SNPs), which are strongly associated with type 2 diabetes in Finnish and Ashkenazi Jewish populations” (National Human Genome Research Institute, 2004). Incidentally, all of these SNPs happen to group on a particular gene’s regulatory region HNF4A which acts as a “master switch” witch directly influences beta cells within the pancreas. The pancreatic beta cells are responsible for insulin secretion in response to glucose levels in the body. Certain variations of this particular gene raise one;s chances of acquiring Diabetes by 30%. (National Human Genome Research Institute, 2004). Diagnosing Diabetes is critical for proper maintenance and treatment of the disease. Out of the approximate 21 million Americans who suffer with Diabetes, about 1/3 are not aware that they even have the disease. The symptoms of Type Two Diabetes are as follows: an increase in thirst, appetite increase, erectile dysfunction, frequent urination, slow healing processes and fatigue. (The New York Times Health Guide, 2007). When these symptoms are presented to a physician, the physician will need to run a battery of tests to determine for sure if someone is in fact a Type Two Diabetic. These tests include a fasting blood glucose test (this requires the patient to fast after drinking a fluid high in sugar, then their blood glucose levels are taken with a blood sample after a waiting period), random blood glucose test or an oral glucose test. An individual is considered to be diabetic if their blood glucose level is higher than 200mg/dL after a time period of two hours. (New York Times Health Guide, 2007). Once an individual is positively diagnosed with Type Two Diabetes, their doctor will attempt to treat them using a few different treatment options. The first priority the physician will most likely set for the patient, is to eliminate the symptoms. This is done originally by teaching the patient to self monitor their blood sugar levels so that they may administer insulin themselves when necessary. Also, a diet composed of low fat, low sugar foods is optimal in conjunction with smaller more frequent meals, in order to maintain a normal blood glucose level without putting too much strain on the body. The treating physician will also educate the patient as to how to handle days when they are sick as well as how to handle high or low blood sugar. Patients with Type Two Diabetes are often provided with a glucometer by their treating physician which allows them to perform self glucose tests before meals and at bed time. The likelihood of Diabetes being misdiagnosed for another disease is significant as there are other types of Diabetes as well as other diseases for which Type Two Diabetes can be confused with. Some common misdiagnosis’s associated with Type Two Diabetes are Cushing’s Disease, Type one Diabetes, Gestational Diabetes, Fructosuria, MODY Diabetes, Pancreatitis, Acute Pancreatitis, Impaired Glucose Tolerance, Hemochromatosis, Chronic Pancreatitis, Hereditary Hemochromatosis and Diabetes Insipidus. Misdiagnosis’s take place when symptoms of more than one disease are virtually the same. The symptoms of Type Two Diabetes are relatively general: obesity, frequent urination, fatigue and poor immune responses. These symptoms are shared by numerous other illnesses and sometimes may mislead physicians conducting diagnosis. (Diabetes -Program.com, 2008). Metabolic Syndrome is a disease that can sometimes be overlooked as physicians will assume that the patient merely suffers from Type Two Diabetes. In fact, Type Two Diabetes is a disease which accompanies Metabolic Disorder and is therefore a symptom of another disease. The symptoms of Metabolic Disorder are obesity, Diabetes, high blood pressure and high cholesterol. This disease can easily be mistaken for just Type Two Diabetes alone. (Diabetes-Program.com, 2008). Other undiagnosed causes of weight gain and obesity can be mistaken for Type Two Diabetes. Also, individuals presenting with obesity may not be tested at first for Diabetes, more specifically Type Two Diabetes. Thyroid problems may be present in cases where patients are extremely prone to weight gain despite diet and exercise. Polycictic Ovarian Syndrome can cause an onset of weight gain and is periodically misdiagnosed as Type Two Diabetes. A rare condition known as Hemochromatosis is an iron “overload” condition which only occurs in about 1 in 250 people. It can present with symptoms quite similar to many other disorders and is therefore often confused with Diabetes. Type Two Diabetes however, can result from this disorder as it directly affects the pancreas. (Diabetes-Program.com, 2008). In some cases, Type Two Diabetes can occur in conjunction with Cushing’s syndrome which is a disease resulting from the body’s overexposure to cortical either synthetically or naturally. Patients who are placed on corticosteroids for autoimmune disorders such as Lupus, can often develop Cushing’s Syndrome as well as Type Two Diabetes. (The National Endocrine and Metabolic Disorders Information Service, 2002). The most common treatments for Type Two Diabetes are as follows: Frequent lbut smaller, low sugar and low fat meals, moderate exercise, avoidance of stress, insulin injections when needed, frequent and consistent personal monitoring of blood sugar levels, and medication. Usually, if the patient is not able to regulate normal blood sugar levels through diet and exercise, a physician will prescribe some of the following medications: Oral sulfonylureas (which stimulate the pancreas into producing more insulin), “Biguanides (Metformin) tell the liver to decrease its production of glucose, which increases glucose levels in the blood stream. Alpha-glucosidase inhibitors (such as acarbose) decrease the absorption of carbohydrates from the digestive tract, thereby lowering the after-meal glucose levels. Thiazolidinediones (such as rosiglitazone) help insulin work better at the cell site. In essence, they increase the cells sensitivity (responsiveness) to insulin. Meglitinides (including repaglinide and nateglinide) trigger the pancreas to make more insulin in response to how much glucose is in the blood.” (Las Angeles Chinese Learning Center, 2008). These treatments tend to be relatively effective when used in accordance with a physician’s directions and a healthy diet. Certainly, individuals suffering from Diabetes run the risk of kidney damage, insulin coma resulting in death, infections which become lethal and other adverse events which can take place as a result of having Diabetes. In addition, there are always possible drug side effects when taking prescription medication. All of the above mentioned prescription medications can cause a rare but possible allergic reaction. Allergic reactions an individual may have can vary from person to person. In severe cases of allergic reaction, a person may suffer from reactions severe enough to result in swelling of the throat and tongue resulting in death. Specifically, medications such as sulfonylureas, can reduce blood sugars to such low concentrations that a person may become confused or lapse into a coma. The drug Metformin can cause kidney damage, especially in the elderly. Other medications such as Precose and Glyset may cause the patient to suffer form stomach upset and gas. Drugs within the class Thiazolidinediones can cause heart failure in some patients. Virtually any medication prescribed for Type Two Diabetes is designed to be taken regularly and should never be skipped by the patient. Skipping doses can result in dangerous blood glucose levels followed by coma or death. The future of Type Two Diabetes treatment holds new and improved medications as a second line of defense to an improved lifestyle. Type Two Diabetes is occurring in alarming rates and one’s chances of acquiring the disease increases with age. Children however, are becoming more and more apart of those suffering from the disease. This is in part due to genetic predisposition bu is mostly due to obesity. Childhood obesity is occurring in epidemic proportion in America such that more children than ever are suffering from Type Two Diabetes. Though medication may be an appropriate treatment option for many adults, Pharmacotherapy is considered a second line of therapy in adults, but its use in children is controversial” (Mallare M.D. et al, 2006). The rise of the fast food industry has literally caused a rise in the weight if American children and youth exponentially. Portion sizes and quantities increase every few years to astounding levels as does the number of fast food chains in every American city. Type Two Diabetes is a disease which can occur due to a genetic disposition but can be managed through a healthy lifestyle and prescribed medications. It can also be prevented though healthy lifestyles complete with low fat, low sugar diets and plenty of exercise. The children and youth of America that suffer with Type Two Diabetes, suffer and multiply due to environmental influences primarily, and will continue to increase in numbers as long as there are more fast food restaurants in any given city or town, then farmer’s markets or health clubs. Works Cited: Diabetes-Program.com, 2008, Misdiagnosis of Type 2 Diabetes, retrieved May 18, 2008 from website at: http://www.wrongdiagnosis.com/d/diab2/misdiag.htm Mallare, Johanna T., Karabell, Ana H., Valasquez Mieyer, Pedro.,Stender, Sarah., Christensen, Micheal. 2005, Current and Future Treatment of Metabolic Syndrom and Type 2 Diabetes in Children and Adolescents, Diabetes Spectrum num. 18 vol. 4 National Human Genome Research Institute, 2004, Gene Variants May Increase Susceptibility to Type 2 Diabetes, retrieved from website May 18, 2008 at: http://www.genome.gov/11510995 The National Indocrine and Metabolic Disorders Information Service, Cushing’s Syndrome, retrieved May 18, 2008 from website at: http://endocrine.niddk.nih.gov/pubs/cushings/cushings.htm The New York Times, 2007, Type 2 Diabetes, retrieved May 18, 2008 from website at: http://health.nytimes.com/health/guides/disease/type-2-diabetes/overview.html#Prevention PubMed, Genetics of Type 2 Diabetes, 2005, retrieved May 18, 2008 from website at: http://www.ncbi.nlm.nih.gov/pubmed/15842505 Las Angeles Chinese Learning Center, Treatment of Type 2 Diabetes, retrieved May 18 from website at: http://chinese-school.netfirms.com/diabetes-type-2-treatment.html WebMD, Illustrated Guide to Type 2 Diabetes, retrieved May 18, 2008 from website at: http://www.webmd.com/content/tools/1/iguide_diabetes_type2.htm#top 2001–2003 National Health Interview Survey (NHIS), National Center for Health Statistics, Centers for Disease Control and Prevention. Available at http://www.cdc.gov/nchs/nhis.htm. Read More