Diabetes Mellitus, Its Causes, and Treatments - Term Paper Example

Running Head: DIABETES MELLITUS Diabetes Mellitus Name Institution Date Diabetes Mellitus Introduction Diabetes mellitus is known as metabolic disease in which an individual normally has high blood sugar. It takes place when the body does not generate sufficient insulin. However it can also occur when cells do not respond to the insulin produced. They are so many conventional signs associated with high blood sugar such as polyuria which is a condition of recurrent urination, polydipsia whereby there is increased thirst and also polyphagia where there is increased hunger (Serrano, 2006). They are three known types of diabetes; the first one is referred to as Type 1 diabetes which occurs when there is malfunction within the body and it is unable to produce sufficient insulin, normally the patient has to be injected with insulin. It is also known as Insulin-dependent diabetes mellitus. The second type is known as Type 2 diabetes whereby there is an increased insulin resistance a situation in which cells stops working and cannot utilize insulin properly. The last one is gestation diabetes mostly it’s associated with expectant mothers who initially had no diabetes, sometimes may develop high blood glucose level during pregnancy. Nevertheless this can result to type 2 diabetes mellitus (Everson, 2005). Causes of Diabetes Diabetes mellitus may arise when the pancreas fails to make sufficient insulin or does not produce at all, however insulin secreted can fail to function efficiently and this can lead the levels of blood to mount up too high. In Type 1 diabetes the cells within pancreases that are responsible for making insulin they are damaged; this lead to severe lack of insulin .This situation has brought a conclusion why the body has some of it cells in the pancreas attacking its own cells which is known as autoimmune reaction (Elliott, 2005). The autoimmune reaction has numerous explanations that try to explain why it occurs but the probable triggers have been suggested such as infection with a particular virus or bacteria, it can also be due to introduction to food-borne chemical toxins and also introduction to a very immature infant to cow’s milk such that the element that is responsible for this response in the body is unknown after all this are hypothesis. The autoimmune condition releases antibodies in circulation and this can lead to beta-cell death and this result to depletion of available insulin. In conclusion insulin-dependent diabetes mellitus is a hereditary shortcoming of immune system (Steven, 2003). In type 2 diabetes the receptor on the cell that normally acts in response to the insulin function fails to get stimulated and this results into insulin resistance. In reaction more insulin is secreted thus this over secretion can exhaust the cells that make insulin within the pancreas thus the amount available may be irregular thus it works in sufficiently. Other factors that lead to type 2 diabetes are obesity, lack of exercise and old age. The least factors that cause diabetes are some drugs, for instance steroid or dilantin. They modify blood sugar through various processes. Drugs like, alloxan, streptozocin and thiazide diuretic are be dangerous to beta cells of the pancreas this may contribute to start of diabetes. Pregnancy is a minor cause of diabetes thus it results mostly to gestation type of diabetes (Serrano, 2006). Indigenous communities, mostly those in rural and remote areas, have several challenges when it comes to the management of a complicated chronic disease such as diabetes. Turnover of health care practitioners is normally high, accessing the medical and associated health services can be hard, and language and cultural barriers can complicate patient and medical staff education. The ability of a diabetic patient to take care of himself or herself is normally influenced by poor availability as well as costly fresh food and reduced physical and social environmental supports for physical activity (Philips, 2010). Incidence of diabetes in indigenous Australian population Type 2 diabetes is very common among indigenous Australians who normally have a higher prevalence of about 11% compared to the other general population whose prevalence is about 3%. Basically, diabetes onset takes place at early age and leads in higher morbidity as well as mortality from diabetes complications. In spite of the fact that diabetes complications can be controlled using suitable community-based primary health care, the complications have continued to cause several deaths among the indigenous Australians. For instance, diabetes contributed about 18% of deaths among indigenous Australians within 1999-2001 (Philips, 2010). The best practice when it comes to the management of diabetes recommends that an integrated and coordinated approach is the most effective way to offer services to the indigenous communities. For instance, a multidisciplinary Goorie Diabetes complication and Assessment Clinic had been set up to offer all-inclusive outreach services within four isolated rural aboriginal communities around Casino. Philips (2010 ) notes that locations vary from sufficiently equipped medical centre to an old school structure two hours drive from the support hospital. The teams offers medical services to the four communities every month and it centers on both primary and secondary care and interventions to avoid further complications which are allied to undiagnosed as well as poorly managed diabetes. Normally the medical professions make use of a holistic approach with evaluation of risk factors as well as health matters, which also consists of cultural and environmental, that affect a person’s health (Michelle, 2007). The aboriginal health professionals from every community have played a big role in the success of the medical clinics. They normally encourage the society to attend the clinics and also offer a culturally safe environment through welcoming those who visit the clinics and making them feel comfortable while there. Furthermore, the aboriginal health professionals inform other team members regarding the relevant and most appropriate environmental and community issues that best suits the indigenous community. Several changes have been made regarding how clinics are operated in response to their knowledge of local matters (Humphrey, 2006). Aboriginal health professionals also get regular formal and informal education regarding diabetes and vascular health and they also get trained on how to assist within the laboratories, administration of eye drops, taking of anthropometric measurements, computation of body mass index in addition to testing of visual acuity by using a Snellen chart. The aboriginal health professionals have an ever more significant role in provision of clinical support. The clinic welcomes each and every aboriginal community members, offers diabetes screening in addition to managing diabetes as well as its complications (Humphrey, 2006). Diabetes complications Diabetes may affect several organ systems within the body and with time it can result grave complications. Complications from diabetes can be categorized as microvascular or macrovascular. Microvascular complications consist of nervous system damage which is neuropathy, renal system damage which is nephropathy as well as damages to the eyes which is known as retinopathy. On the other hand, macrovascular complications consist of cardiovascular diseases, stroke in addition to peripheral vascular diseases. Peripheral diseases can result into bruises or injuries that take long to heal or do not heal, gangrene and finally amputation (Sinta, 2005). Control of risk factors to reduce diabetes complications Among all diabetes related complications, the most vital risk factors include high blood pressure, hyperglycemia in addition to hypercholesterolemia. Studies have shown that improvements in controlling hyperglycemia, blood pressure and also cholesterol level can greatly decrease an individual’s risk to diabetes complications (Everson, 2005). For example, in an individual having diabetes, every percentage point decrease in glycosylated hemoglobin level has the probability of reducing that individual’s risk by about 40%. A 10 mm Hg reduction in blood pressure can also reduce that individual’s risk to any diabetic complication by about 12 percent and also controlling the serum lipids can decrease that individual’s risk for cardiovascular complications by about20% to 50% (Ring, 2003). Evidently, improved and effective control of the risk factors in individuals with diabetes can result into more favorable results; this means reduced mortality rate due to diabetes as well as from diabetes complications (Sinta, 2005). Social economic impact of diabetes among indigenous Australians According to various studies, the prevalence of diabetes mellitus is much higher in much higher among indigenous Australians. Social disadvantage is the most significant factor that has been noted to contribute to the high prevalence of diabetes among indigenous Australians. However, even within the least disadvantaged region, incidence of end stage renal disease has been found to be basically higher among the indigenous Australians when compared to the total Australian population. One reason for this could be the interaction of tradition genetic as well as economic social factors. Furthermore, psychosocial factors like stress, racism and inequity as well as a legacy of anguish, loss and dispossession can also play an important role in development of diabetes (Sinta, 2005). Even if decreasing the social disadvantage of indigenous Australian by education and also employment is undoubtedly a long term undertaking, there are also challenges for the health sector within the short term. Detecting diabetes on time offers raised chance for effective management of the disease. At present, there are two annually adult health checks for the aboriginal community as well as Torres Strait Islander aged between 15 and 54 years are funded by Medicare which is the Australian government Department that deals with health issues (Shaw, 2006). The effective realization of the health checks, which includes screening for diabetes as required is dependant on several factors, for example raising awareness among common practitioners, improvement of cross-cultural communication, offering suitable incentives, increasing demand within indigenous patients in addition to abolishing out-of-pocket expenses by bulk billing. Sufficient follow-up of the screening results that seem abnormal is necessary, even though this can be at times challenging for any health service, even the ones that are normally controlled by the indigenous community (Kerin, 2008). Hjelm (2003) argues that diabetes is a significant contributor to the health in imbalance between the aboriginal and non aboriginal Australians. This mostly results from impaired fasting glucose (IFG) as well as impaired glucose tolerance (IGT) among aboriginal community within remote community. One of the main public health challenges facing indigenous Australians and other minority communities within the developing countries is how to develop and employ successful, up to standard as well as sustainable approaches for prevention of non insulin dependent diabetes mellitus (Wang, 2008). According to Shaw (2008), the incidence rate of diabetes among the aboriginal adults who participated in the study was higher than those reported within the common Australian population as well as within European and American black and white population. For instance, diabetes incidence rate within aboriginal women were four to eight as high as those within the common Australian women for diverse age groups, whereas the equivalent values within aboriginal men were two to four of their common Australian counterparts (Wang, 2008). Provided that the life expectancy of about sixty years for Aboriginal Australians, the cumulative incidence of diabetes at sixty years computed within the study in this research article, offers a near estimate of lifetime risk of developing diabetes within this population. This means that the life span risk of diabetes for the Aboriginal men is one within two, and among these Aboriginal women is two three (Wang, 2008). Now, with less Aboriginal community living a customary lifestyle and most of them being exposed to the current Westernized lifestyle, with foods rich in fat and sugar, alcohol, cigarette smoking and a sedentary lifestyle, their once-competent metabolism can now be acting against them. The genetic make-up that made it possible for Aboriginal individuals to survive when food was in short supply may now be a big disadvantage, encouraging weight increases, diabetes, and allied conditions like high blood pressure as well as heart disease. Research has illustrated that Aboriginal populaces that live a Westernized lifestyle have high rates of obesity, impaired glucose tolerance, high blood pressure, high levels of triglycerides (fats) in the blood, and extremely high insulin levels within the blood ( Shaw, 2008). Treatment Diabetes mellitus is a chronic illness that is hard to cure. Management of the disease concentrates on maintaining blood sugar levels close to standard as possible without presenting too much patient risk. This can normally be with close dietary, management, exercise as well as usage of suitable medications. Type 1 diabetes requires insulin medication while type 2 diabetes requires both oral medications as well as insulin. Education of patients, understanding and their involvement is important because the complications of diabetes are far less frequent and less grave in individuals whose blood sugar levels are well managed (Nakanishi, 2007). Wider health problems may accelerate the harmful effects of diabetes. These consists of smoking, increased cholesterol levels, obesity, high blood pressure, as well as lack of standard exercise. Type 1 treatment normally consist of combinations of ordinary or NHP insulin or synthetic insulin analogs. There are responsibilities for patient education, dietetic support, reasonable exercise, with the objective of maintaining both short-term and long-term blood glucose levels within acceptable levels (Nakanishi, 2007). Conclusion Improved and efficient health education in addition to health literacy is also necessary in order to provide people with the necessary tools and information required in protecting and maintaining their own health. Moreover, interventions to augment resilience and resistant to the harmful effects of stress and also interventions to decrease the levels of racism and prejudice within Australian society can also have a positive impact on the health of indigenous Australians. The success of any such initiatives to decrease the burden of diabetes as well as other chronic diseases which mostly are also associated with diabetes will need the leadership, engagement and vigorous participation of indigenous people within Australia (Richard, 2004). References Wang, Z. (2008). Incidence of type 2 diabetes in Aboriginal Australians: an 11-year prospective cohort study: Centre for Chronic Disease, School of Medicine. Vol. 4/5. Mohan, V. (2007). Association of C-reactive protein with body fat, diabetes and coronary artery disease in Asian Indians: the Chennai Urban Rural Epidemiology Study (CURES-6). Diabetic Med 2005. Vol. 22(7):863-870. Kerin, O. (2008). Socioeconomic status and diabetes among urban Indigenous Australians aged 15-64 years in the DRUID study. Ethnicity & Health. Vol. 13/1. Nakanishi, N. (2007). Serum gamma-glutamyltransferase and risk of metabolic syndrome and type 2 diabetes in middle-aged Japanese men. Diabetes Care. Vol.27 (6):1427-1432 Richard, A. (2004). Pathophysiology of diabetes Mellitus. Crit Care Nurs Q. Vol. 27/2. Serrano, R. (2006). Aboriginal community. Type 2. Diabetes Mellitus. New Delhi. Vol.3/5. Everson, J. (2005). Socio economic status, obesity and prevalence of Type1 and type 2 diabetes mellitus. Diabetic Medicine. Vol. 17/478-480. Shaw, J. (2006). Study protocol; Diabetes and related conditions in urban Indigenous people in Darwin, Australia region. Public Health. Vol. 6/7. Philips, A. (2010). Recognizing Pre-diabetes. Practice Nursing. Vol. 21/ 1. Michelle, C. (2007). It’s not easy caring for Aboriginal clients with diabetes in remote Australia. Contemporary Nurse. Vol. 25/1-2. Humphrey, K. (2006). 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