Diabetes Mellitus as a Chronic Health Condition - Essay Example

Diabetes mellitus Diabetes mellitus is a chronic health condition where body fails to produce a sufficient amount of insulin or the body has abnormal response to insulin. There are three types of diabetes mellitus. There is Type 1 diabetes, Type 2 diabetes and gestational diabetes. The overall outcome of the three types of diabetes is a high level of blood glucose or hyperglycemia. Diabetes mellitus has complex pathophysiology. This is because the disease has different etiologies but share the same symptoms, signs and other complications. According to studies conducted on diabetes, mellitus suggest that abnormal metabolism of insulin hormone is the major cause of this problem. Despite that there are three types of diabetes mellitus they almost share the same characteristics, symptoms and complication. The pathophysiology of diabetes mellitus has relation with hormone insulin secreted by the beta cells of the pancreas. This hormone is responsible for the maintenance of the glucose level in the blood. It allows the body cell to be able to use glucose as a source of energy. However, for a victim of diabetes there is a failure of body cells and tissues to make use of the glucose as a result of abnormal insulin metabolism. High glucose level in the blood stream leads to severe complications, for example, eye disorder, kidney damage, cardiovascular diseases and other body problems (5). In Type 1 diabetes, there is a failure of pancreas to synthesis enough Amount if insulin hormone as the body requires. The physiology of Type 1 of diabetes mellitus suggests that this is usually an autoimmune disease. This is where the immune system of the body generates secretion of substances, which destroy beta cells of the pancreas. At the same time, the pancreas secretes little or no insulin. This type of diabetes mellitus is usually common in children and young adults who are around twenty years. Insulin is used to treat this type of diabetes mellitus. As a result of this, it is mostly referred to as Insulin Dependent Diabetes Mellitus (IDDM) or the juvenile diabetes. In the Type 2 diabetes mellitus, there is normal secretion of insulin hormone, but despite this, the body cells are resist insulin. As a result, of the body cells and tissue being non responsive to insulin glucose remains in the blood stream. This is problem, which affects people who are in the middle age or those who are above forty years. Insulin is not necessary for treatment of Type 2 diabetes. This makes this type of diabetes mellitus to be referred as Non-insulin Dependent Diabetes Mellitus or the adult onset diabetes. Gestational diabetes usually affects pregnant women. Its main cause is the fluctuations of the level of hormones during pregnancy. The blood glucose level returns to its normal state after the mother gives birth (1). As I had mentioned the signs and symptoms of the three types of diabetes mellitus, are the same. Some of the major symptoms include increased thirst, increased urination, increased in appetite, fatigue, body weight loss and body irritation. According to research, the Type 2 diabetes is the most common occurring among the three (1). Pancreas plays a great role in the metabolism of glucose because it is the one, which secretes insulin and glucagons. Inadequate secretion of insulin, inadequate structure, or malfunction of its receptors results, in impairment, in the metabolism of glucose, proteins, carbohydrates and fats. This results in hyperglycemia and glycosuria. Hyperglycemia is the most common sign of diabetes. It is the etiologic source of diabetic complications in the body and in the eyes. Glucagon is a hormone that affects the functioning of insulin. It is usually secreted when the level of glucose in the blood reduces. It leads to increased blood glucose concentration by breaking down glycogen in the liver. The rise in the glucose level leads to the formation of sugar alcohol. This sugar alcohol cannot diffuse readily through the cell membranes, resulting in changes, in the function of the body. In the eyes tit leads to the evolution of premature cataractogenesis and sight threatening diabetic retinopathy (1). There are three main emergencies, which can result in diabetes meritus. Myocardial infarction is one of the problems, which many people with diabetes mellitus face. This is a disease, which affects the heart. It is a problem, which cause many deaths among the patients of diabetes mellitus. People with diabetes mellitus are likely to have this acute problem as compared to these who do not have thee disease. They also have worse outcomes, and they do not survive for a long time as compared to those people who do not have diabetes. This is life threatening complication, which affects those patients who have Type 1 diabetes and those with Type 2 diabetes (1). It comes about as a result of absolute shortage of insulin. This causes the body burn fatty acids, which leads to the production of acidic ketone bodies that cause the symptoms and severe complications. This problem causes vomiting, dehydration, confusion, deep gasping breathing and sometimes it leads to coma. This problem is diagnosed with blood and urine test. Insulin is injected to the patient in order to suppress the production of ketone bodies. This can also be controlled by close observation to prevent and identify complications. This is usually an emergency medical condition, which if it is not treated well can lead to sudden death. The symptoms of this problem usually take a period of twenty four hours. When the symptoms start appearing it is good for victims who measure their glucose level, take the measurement and take the necessary steps as prescribed by a physician. The most severe symptoms of the problem are vomiting, excessive urination and abdominal pains. There is also labored deep breath accompanied with gasp. There are acute abdominal pains and vomiting of altered blood. This then leads to confusion, lethargy and then coma (5). On physical examination, there is usually clinical evidence of dehydration, for example, dry mouth and decreased skin turgor. Increased dehydration leads to a decrease of blood volume, fast heart rate and low blood pressure. Small children with this problem are prone to cerebral oedema, which causes headache, coma, papillary light reflex which then leads to death. Diabetic ketoacidosis come about due to lack of insulin in the body. The lack of insulin and the excess glucagons makes the liver to release increased glucose. The increased glucose spills over and mixes with urine. It takes water and all the solutes such as sodium along with it. This makes the body to be dehydrated. The absence of insulin also results to free release of fatty acids, which are then converted as ketone bodies in the liver. The ketone bodies usually have low PH and, therefore, hey make the blood acidic. This makes the water level of the body to fall and makes the body to low level of substance such as sodium chloride, and phosphates, which are required in body mechanisms (3). The other emergency that results because of diabetes mellitus is Hypoglycemia. This is a very common problem with patient of diabetes mellitus. This is a situation where there is low blood sugar and glucose. According to medical research, this problem affects those patients who adhered more to a strict control of their blood sugar. This problem arises because of excessive insulin in the blood. This causes excessive low blood sugar levels. The severity of this problem ranges from person to person (4). Hypoglycemia has symptoms, which occurs gradually and has warning signs such as. Increased heart beat, perspiration, anxiety and shakiness. Ignorance of these signs leads to continued fall of blood sugar levels, which may lead to behavior change, stupor and unconsciousness. Most of the symptoms results due to reduction in fuel source of the brain. This may also result to long term brain damage (3). There is a need for patients who suffer from diabetes mellitus to have standard prehospital care. The disease requires continued medical care and patient self management education in order to control and prevent the emergent and acute complications. This also helps to reduce long term complications. Pre hospital care for diabetes is a complex process, which requires many issues to be addressed. The standard of care is supposed to provide clinicians and patients with information on how the disease can be managed before it develops to be uncontrollable. The standard prehospital care includes diagnostic and therapeutic actions, which would favorably affect the health outcomes of the patient with diabetes mellitus (2). There is standard prehospital care, for example, self monitoring of blood sugar, which allows that patient to monitor their response to therapy and asses if there, is an improvement in the target set (2). This is usually dictated by particular needs and goals of the patient. This is usually necessary for patients treated with insulin in order to monitor for and control asymptomatic hypoglycemia. This is mostly recommended for patients with Type 1 diabetes and pregnant women who are taking insulin. It is recommended that they should monitor their blood sugar three or more times in a day. Patients also need to be taught how to use the data in order to have adjustment on food intake, exercise in order to achieve their goals. There is also other prehosptial care, which includes the AIC test, which is done routinely to patients to find out the degree of glycemic control. There is also the medical nutritional therapy, which helps treatment and prevention of chronic complication of diabetes, assist in improving health through food choices and physical activity (4). References 1. Braun, C. & Anderson C. Pathophysiology: Functional Alterations in Human Health, Baltimore, Lippincott Williams & Wilkins, 2006. 2. Cleary, V. Prehospital care: administrative and clinical management, Michigan Aspen Publishers 1987. 3. Harbermann, T. Mayo Clinic Internal Medicine Concise, Canada, CRC Press, 2007. 4. Lippincott Williams & Wilkins. Diabetes mellitus: a guide to patient, Baltimore, Lippincott Williams & Wilkins, 2006 5. Winter, W. Diabetes mellitus: pathophysiology, etiologies, complications, management, and laboratory evaluation: special topics in diagnostic testing, New York, Amer. Assoc. for Clinical Chemistry, 2002. Read More