Diabetes is a life-long chronic disease affecting more than 25.8 million people in the USA (8.3% of the population), and 7 million have undiagnosed diabetes. In 2010, approximately 1.9 new cases of diabetes were diagnosed among people between 20 years of age and older. In 2007, the direct and indirect medical cost for diabetes was $174 billion (CDC. n.d). By 2050, 1 in 3 adults in the USA will have diabetes. Diabetes is the leading cause of blindness, kidney failure, and amputations not related to accidents. Diabetics have shorter life expectancy and twice the risk of dying any day compared to a person of similar age-group without diabetes (CDC, n.d).
Worldwide diabetic population increased by 133% in 30 years from 150 million to 350 million people, and by 2030, 552 million people could have the disease worldwide (MNT, 2011). There are 3 types of diabetes, Type1, Type2 and Gestational Diabetes. Syndrome X is not specifically classified type of diabetes, but it is a grouped factor, which increases risk factors, for Type 2 diabetes. Coronary artery disease and stroke are risk factors for most diabetes; however, genes, environmental factors and inherited lifestyles are some of the major risk factors for developing any type of diabetes (Adams, 2012).
The risk of developing any type of diabetes is an overlapping factor that may apply to any other sub-type of the disease. The genetic risk for developing diabetes is not limited to family history, immune system genes (human Leukocytes antigen-DR (HLA-DR)) and Beta3 Adrenergic receptor gene (Adams, 2012). Scientists have suggested that most people that are susceptible to diabetes have different gene mutations. For instance, researchers have shown that mutation in Beta3-adrenergic receptor gene, that cause mutation in a protein called TRP64ARG, is not present in all type 2 diabetic patients. However, the mutation in this gene is common in Pima, African and Mexican descendant of diabetic patients (Adams, 2012). TRP64ARG mutation causes a slower metabolism, thus, causing obese in people that had the mutation. On the other hand, HLA-DR had an interesting role in diabetes, and it has been shown that HLA-DR3 or HLA-DR4 mutations can cause diabetes. Nonetheless, HLA-DR7 allele play a role on diabetes among blacks and HLA-DR9 plays a key role among Japanese population (USN. 2012).
Environmental factors and lifestyle such as obesity, inactivity, unhealthy diet to mention but a few may enhance the risk of developing the disease in a predisposed individual or even individuals who do not have a family history of the disease. Hence, multifactorial variables, may lead to diabetes.
Inactivity is one of the key leading cause of type 2 diabetes. To minimize the onset of the disease, the American diabetes association (ADA) recommended a body mass index (BMI) of at less than 25 units. In addition, the ADA recommended that men should keep their lower waist size below 40 inches and less than 35 inches for women (NIH, 2012). In a bigger body fat or obese individual with type 2 diabetes, body fat inhibits or block the uptake of insulin into the cells and muscles, and thus forcing or signaling the pancreas to make more insulin. Consequently, by causing the pancreas to over produce insulin, leads to the breakdown of the beta cell producing insulin because it cannot keep up with the demand to make such amount of insulin that the body demands (NIH, 2012).
Type1 diabetes is usually found among children, teens and young adult. In type 1 diabetes, the beta cells, which makes insulin in the pancreas, is either destroyed by its immune system or infection. Hence, the pancreas makes little or no insulin and thus creates hyperglycemic condition (NIH, 2012).
Gestation diabetes involves pregnant women between the age of 25 and up. In this situation, the hormones produced by the placenta blocks the uptake of insulin, thus creating a hypoglycemic condition in pregnant women.
More importantly, people with diabetes of any kind should watch their skin, vision, teeth, feet and hands and avoid infection; they should also maintain their blood pressure, blood glucose level, eat a healthy diet and watch their body size. It is very important that people that have a history of diabetes and obesity should have yearly checkups.
If this disease is not treated, it will lead to complications such as coronary heart disease, blindness, kidney failure, nerve damage, blood vascular damage, erectile dysfunction, frequent urination, fatigue, stroke and even brain damage and death. Diabetes is the 6th leading cause of death in the US.
Type1 and Type 2 diabetes have different mechanisms or mode of actions; hence treatment applications for the disease is different, but, both have common preventative or maintenance measures. For type 1 diabetes, it is important that the patients maintain a healthy diet, regular exercise; insulin intake and normal blood glucose level. Type 2 diabetic patients can be treated with alpha glucosidase inhibitor, meglitinides etc., and gestation diabetic treatment involves insulin intake or maintaining a healthy lifestyle, exercise and regular checkup starting from 24 weeks into pregnancy (NIH, 2012).
In general, all diabetic patients must maintain a regular checkup, healthy diets as recommended by the American diabetes association, daily exercise at least 30 minutes a day and losing weight if the patient is overweight or obese.
References
Adams, A. (2012). Genes Can Cause Type 2 Diabetes. Genetichealthe.com. Retrieved from http://www.genetichealth.com/DBTS_Diabetes_Controlling_Type_2_Diabetes.shtml#topCeneter for disease contron and prevention (CDC). (n.d). Diabetes Retrieved from http:// www.cdc.gov/chronicdisease/resources/publications/AAG/ddt.htm.
EMEDTV. (2012). Diabetes. Emedtv.com.Retrieved from http://diabetes.emedtv.com/diabetes/ diabetes.html.
Lega, L., Ross, N., et. al (2011). Lega, L., Ross, N.,et. al. (2011). Gestational Diabetes History May Signal Deprivation in Women with Type 2 Diabetes. JWH. Retrieved from http://web.ebscohost.com.ezp.waldenulibrary.org/ehost/pdfviewer/pdfviewer?sid=bbce43 51-4aef-4981-8c7c-9929420b7589%40sessionmgr114&vid=4&hid=125.
Medical News Today (2011). Global Diabetes Population Rises From 150 To 350 Million In 30 Years. Retrieved from http://www.medicalnewstoday.com/articles/229642.php.
National Institute of Health. (2012). Diabetes. NCBI.COM. Retrieved from http://www.ncbi.nlm.nih.gov/pubme dhealth/PMH0002194/.
US News.(2012).Type 1 Diabetes. Retrieved from http://health.usnews.com/health- conditions/diabetes/type-1-diabetes.
Chronic hyperglycemic condition induces the production of “free radicals” (charged oxygen molecules). Charged oxygen molecules cause serious damage to the blood vessels including atherosclerosis.Moreover, chronic hyperglycemia initiates irreversible binding of glucose to various proteins including collagen, in red blood cells. Consequently, by-products or glycosylation end-products causes the release of cytokines, an inflammatory response and growth factors, for thickening of the blood vessels.
Furthermore, these reactions and product formation, inactivate nitric oxide. Nitric oxide is very important factor for vasodilation. Thus, inactivating this compound, blood vessels are hardened and eventually lead to increased blood pressure. In addition, blood clothing cells (platelets) becomes sticky and leads to blood clots in the blood vessels. As a result of all the damage caused by chronic hyperglycemic condition, diabetics are prone to develop cardiovascular disease (McCance, 2010).
Reference
McCance, K. L., Huether, S. E., Brashers, V. L., & Rote, N. S. (2010). Pathophysiology: The biologic basis for disease in adults and children (6th ed.). Maryland Heights, MO: Mosby Elsevier, pp.745-754.