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Diabetes-Human Disease

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Diabetes is a disease that occurs because blood sugar levels in the body are higher or lower than normal levels. According to the International Diabetes Foundation, "Diabetes affects 246 million people worldwide," and the Center for Disease Control states that, "roughly 21 million Americans have the disease" (Economist 2007). Diabetes is a chronic disease with may causes, signs, and symptoms, diagnosis, treatments, and outcomes.

Diabetes is a chronic life-long disease. Diabetes has many different causes that involve many different systems and organs throughout the body. There are two main types and some less common types of diabetes. Although the signs and symptoms are similar, the causes are not.

Type I is called Juvenile-onset diabetes or insulin dependent which is also known as genetic disease. With type I diabetes there is little or no insulin transported from the pancreas to the liver because there are little to no insulin producing beta cells. It is usually diagnosed in children and young adults. Type I diabetes is also an autoimmune disease in which the immune system identifies the pancreas as being foreign. The immune system begins to destroy the pancreatic cells that produce insulin.

Type II Diabetes is commonly known as adult maturity on-set diabetes, non-insulin-dependent diabetes mellitus (NIDDM), or old age diabetes because it is usually diagnosed in older people. Younger people are being diagnosed with Type II diabetes due to lack of exercise, obesity, and failure to maintain a proper diet. Type II diabetes is not known as an autoimmune disease because the body produces too much insulin which is referred to as insulin-resistance (IR) (G.Becker pg4-5).

Some other types of diabetes are diabetic gastroparesis, gestational, secondary, and impaired glucose tolerance diabetes (IGT). Diabetic gastroparesis result from delayed emptying of the stomach. Gestational diabetes occurs during pregnancy and causes a higher glucose reading level than normal. Secondary diabetes is caused due to damage to the pancreas due to other health problems. Impaired glucose tolerance (IGT) is a condition when a person's glucose levels are higher than normal.

Signs and Symptoms are similar in all types of diabetes. A person with diabetes may experience frequent urination, increased thirst, weakness, and experience blurred or double vision. Most people will experience more bladder and urinary tract infections than usual due to sugar being in the urine, which make it more susceptible for infections. Women may experience more than normal growth of fungus, bacteria, and yeast which may result in vaginal infections. Women may also experience discomfort during intercourse due to not being able to produce vaginal secretions. Men may experience impotence which appears to be a problem related function of the nerves that control blood flow in the penis, which results in the inability to achieve an erection (C. Kilo, J. Williamson p71-73).

Persons with diabetes can be diagnosed using a complete history and physical examination along with many laboratory tests. The laboratory tests may include urine, blood, glucose tolerance, fasting blood sugar, and the glycohemoglobin (HbAIC) tests. Urine is tested for glucose and ketones (acids that collect in the blood and urine when the body uses fat instead of glucose for energy source). Blood tests are used to measure the amount of glucose that is in the bloodstream. Glucose tolerance test checks the body's ability to process glucose. During the test, sugar levels in the blood and urine are monitored for three hours after drinking a large dose of sugar solution. The fasting blood test involves fasting overnight and blood is drawn the next morning to check glucose levels. The glycohemoglobin tests take an average of all blood sugar levels for two months and compares levels (

Diabetes can be treated by maintaining a proper diet, practicing good eating habits, and taking prescribed medications. Medication may be taken orally or through injections. Insulin pumps are also used to control diabetes. Educating patients teaches them how to choose healthier foods and the importance of controlling the disease. Support groups have also been an effective treatment. Support groups allow patients to support and encourage each other with the disease.

Failure to control diabetes can result in many complications or death. Complications may include amputation of limbs due to impaired circulation. Kidney disease may result to using dialysis or complete kidney failure resulting in needing a transplant. Impaired vision and blindness due to cataracts and damage to the retinas can result in uncontrolled diabetes. Other complications include nerve and skin damage, gum disease, tooth loss, stroke, and heart attack (F. Sizer, E. Whitney p.123).

Diabetes is a disease that affects people of all ages worldwide. Depending on your genetic factor, it may not be preventable. Many people are able to live normal lives through diet, taking prescribed medications, exercise, and maintaining a healthy body weight.

Case Study

Angie Fuller is a 50 year old woman who was diagnosed with type I diabetes (an autoimmune disease) 25 years ago. She was diagnosed with retinopathy 3 years ago. It has been stable with microalbuminuria , which is controlled on an angiotensin-converting enzyme (ACE) inhibitor. Angie was also diagnosed with neuropathy and hypercholesterolemia last year. The hypercholesterolemia is controlled with simvastatin (Zocor). She is currently taking ultralente insulin and a rapid-acting insulin in boluses before each meal. Angie has good control determined by her HbA1c levels averaging 7% within the past 3 years. Within the past 2 months her HbA1c has increased to 9%. A week ago she was found to be disoriented and hypoglycemic after she ran her car into a curb while driving home from work. Her glucose level was 26mg/dl when checked by the paramedics called to the scene. After treatment, she



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