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Diabetes Research Paper Conclusion

Diabetes Mellitus

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Diabetes mellitus has a long historical record dating back to second century AD. The word "diabetes" was first used by the Greek physician Aretaeus. The word diabetes means "siphon". It was first used to describe patients with excessive thirst and urination. In the 17th century, the word mellitus, meaning "like honey", was added when diabetes patients' urine was noticed to be sweet. However, the disease is not directly related to urine, but instead to the pancreas. Today many other symptons and complications of the disease are known. Although, the disease has many complications there are also simple treatments to follow to avoid serious problems. Diabetes is a familiar health problem that affects millions of people world wide.

Diabetes results from the failure of the pancreas to produce a sufficient amount of insulin. Insulin is the hormone that regulates the body's use of glucose. Therefore, the excess gluce remains in the bloodstream and passes out the body in urine. In some cases, the pancreas produces a sufficient amount of insulin, but the insulin is blocked from the body's cells and cannot be used. This causes diabetes patients to have abnormally high amounts of sugar in their blood and urine. Diagnosing a patient with diabetes is more complicated than measuring the glucose level of urine only one time. Instead the diagnosis involves several hours of glucose-tolerance tests. These tests measure the rate in which sugar is removed from the bloodstream. After the test are complete, a high glucose level indicates insufficient insulin and the patient is diagnosed with diabetes.

There are several symptoms and complications involved with diabetes mellitus. The symptoms are excessive thirst and urination, unusual hunger, a lot of weight loss, and fatigue. The complications are heart attack and stroke, chronic kidney disease, lower-extremity amputations, blindness, and death. Arteriosclerosis is a condition caused by prolonged high levels of blood sugar that causes the walls of small blood vessels to thicken. This condition results in heart disease and stroke. Kidney failure may be caused by inadequate blood circulation. Poor circulation in the legs leads to gangrene which may require amputation of the toes or the legs. New cases of blindness in adults between the ages of 20 and 74 are caused by diabetic retinopathy. This condition causes hemorrhages in the capillaries of the eye's retina resulting in a loss of vision. Pain or a loss of feeling in the arms or the legs is caused by neurophathy which damages the nerves.

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Women infected with diabetes may also experience complications with pregnancy. Diabetes is the seventh leading cause of death; and therefore, a serious health problem.

Although diabetes is not a curable disease, there are several treatments that contribute to keeping the disease stable and its side effects to a minimum. A healthy diet is important and can control the disease. Fifty percent of all diabetics rely on a healthy diet to keep their disease under control. Calorie intake must be consisten and fats, carbohydrates, and proteins must be evenly distributed into three main meals throughout the day. On the other hand, other patients require insulin injections to control the disease. These injections are used to fulfill the required amount of insulin the blood is not receiving from the pancreas. It is very important that diabetes patients follow these treatments to decrease their risk of future complications.

Diabetes is a widespread disease that affects millions of people. Approximately ten million people are affected with diabetes; which is 5.9% of the entire population. There are several risk factors involved with diabetes including old age, obesity, gender, ethnicity, a family history of diabetes, and lack of physical activity. Diabetes mellitus is more likely to develop in people over the age of forty. Of all the people in the United States over sixty-five years old, 18.4% of them have diabetes. Between sixty and ninety percent of diabetes patients are overweight. The disease is more common in women than in men with a 27 to 25 ratio. The ethnic groups that are at high risk of developing the disease are Pacific Islanders, African Americans, Hispanic/Latino Americans, American Indians, and Asian Americans.

In conclusion, diabetes mellitus results from a failure of the pancreas to produce a sufficient amount of insulin. There are several symptoms and complications of the disease. Although, the disease has many complications there are also treatments to follow to avoid serious problems. Diabetes is a familiar health problem that affects millions of people world wide.

Works Cited

1. Compton's Encyclopedia

2. Microsoft Encarta '95

3. The Marshall Cavendish Illustrated Encyclopedia of Family Health, "Diabetes", published by Marshal Cavendish House, 1984, pp. 383-385

4. Www.cdc.gov/diabetes/pubs/facts98.htm. National Diabetes Fact Sheet

5. Www.cdc.gov/nccdphp/diabetes.htm. National Center for Chronic Disease and Prevention and Health Promotion



Introduction

Diabetes (or Diabetes mellitus) is a complex group of diseases caused by a number of reasons. Individuals suffering from diabetes have hyperglycemia (high blood sugar) either because there is low production of insulin or body cells do not use the produced insulin. About 350 million people suffer from diabetes globally (Danaei et al., 2011). The World Health Organization (1999) has predicted that diabetes will rise to the top seventh cause of death worldwide by 2030. There are three common forms of diabetes: type 1 diabetes, type 2 diabetes and gestational diabetes. This paper mainly discusses these major forms of diabetes considering their causes and consequences.

Type 1 Diabetes

In type 1 diabetes mellitus, body cells fail to produce insulin due to a compromised immune system causing damage to the cells where production of insulin takes place. The cause and prevention of type 1 diabetes are not particularly known; however, it is suspected to be a consequence of certain genetic factors.

Type 2 Diabetes

In type 2 diabetes mellitus, there is low production of insulin by the body cells or the body does not effectively make use of the produced insulin. Type 2 diabetes is known to be the commonest type of diabetes; in fact, 90% of diabetes sufferers have type 2 diabetes (World Health Organization, 1999). The cause and cure of type 2 diabetes remains unknown; however, genetic factors and manner of living take part in its causes, and watching blood sugar level can control the disease.

Gestational Diabetes

Gestational diabetes happens when there is a development of high blood sugar level in pregnant women not previously diagnosed of diabetes. For mothers who had gestational diabetes during their first pregnancy, the probability that it will occur in subsequent pregnancies is approximately two-thirds. Furthermore, some patients may subsequently develop type 2 diabetes. After pregnancy, diabetes type 1 or 2 may occur and will require obligatory treatment.

Genetic Factors and Markers

The role of genetic factors as a cause of diabetes has been proven definitively. This is the main etiological factor for diabetes.

IDDM is considered to be a polygenic disease which is based on at least two of the mutant genes in diabetic chromosome 6. They are associated with the HLA system (D-locus), which determines the individual, genetically determined response of the body and B cells to various antigens.

The hypothesis of polygenic inheritance of IDDM suggests that diabetes is caused from two mutant genes (or two groups of genes) that have a recessive inherited predisposition to autoimmune lesions of the insular apparatus or increased sensitivity of B cells to viral antigens or attenuated antiviral immunity.

Genetic susceptibility is linked with particular genes of HLA systems, which are considered markers of such a predisposition.

Patients with a genetic predisposition to IDDM have an altered response to environmental factors. They have weakened antiviral immunity, and they are extremely susceptible to cytotoxic damage to the B cells by viruses and chemical agents.

Viral Infection

Viral infection may be a factor that provokes the development of IDDM. The most common occurrence of IDDM clinically is preceded by the following viral infections: measles (rubella virus has a tropism to the islets of the pancreas, accumulates, and can be replicated in them), Coxsackievirus and hepatitis B virus (can be replicated in the insular apparatus), mumps (1-2 years after the epidemic of mumps, the incidence of IDDM in children dramatically increases), infectious mononucleosis, cytomegalovirus, influenza virus, etc. The role of viral infection is confirmed by seasonality in the incidence of IDDM development (often, the first diagnosed cases of IDDM among children occur in autumn and winter months, with a peak incidence in October and January), the detection of high titers of antibodies to the virus in the blood of patients with IDDM, and the detection by immunofluorescent methods for studying viral particles in the islets of Langerhans in people who have died of IDDM. The role of viral infections in the development of IDDM is confirmed in experimental studies. Viral infections among individuals with a genetic predisposition to IDDM are involved in the development of the disease as follows:

  • the cause of acute injury to B cells (Coxsackievirus);
  • leads to viral persistence (congenital cytomegalovirus infection, rubella) with the development of autoimmune reactions in the islet tissue.

In modern diabetology, the next staging of IDDM is expected.

First stage – a genetic predisposition, due to the presence of certain antigens in the HLA system, as well as genes of chromosomes 11 and 10.
Second stage – the initiation of the autoimmune process in islands of B cells influenced with viruses, cytotoxic agents and any other unknown factors. A crucial point in this step is the expression of B cells HLA-DR-antigen and glutamic acid, and therefore, they become autoantigens that cause the development of autoimmune response reactions.
Third stage – the stage of the active immunological process with formation of antibodies to B cells, insulin and autoimmune insulitis development.
Fourth stage – the progressive reduction of insulin secretion stimulated by glucose (1-phase secretion of insulin).
Fifth stage – clinical diabetes (the manifestation of diabetes). This step develops during the occurrence of the degradation and death of 85-90% of the B cells.
Many patients after the insulin treatment fall into remission of the disease (the “diabetic honeymoon”). Its length depends on the severity and degree of B cell damage, their ability to regenerate, and the level of residual insulin secretion, as well as the severity and frequency of related viral infections.
Sixth stage – the complete destruction of b-cells, and a complete lack of insulin secretion and C-peptide. Clinical signs of diabetes form and insulin treatment becomes necessary again.

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