01-14-2016, 06:55 PM
Our body is designed to regulate the blood sugar levels. When the blood sugar regulation is not what it is supposed to be, it gives rise to the metabolic disease known as “Diabetes”. Diabetes affects people on the long run. This particular condition has to be controlled for a lifetime as there is no cure for it.
Diabetes has many causes. It was classified into two major types at one point of time. Now, it has been identified that there is more to the type and the cause as well. The two major types of diabetes are discussed in detail below.
TYPE 1 DIABETES
This type is also known as diabetes mellitus type 1. The insulin cells are produced in the pancreas. Insulin is secreted by these cells. The hormone insulin plays a vital role in monitoring the blood sugar in the body. Type 1 diabetes is where the insulin cells are targeted and destroyed by the immune system. This auto-immune disorder makes it impossible for the patient to survive without a regular dose of insulin as there is a massive increase in the blood and urine sugar due to the body lacking insulin. Globally type 1 diabetes accounts for 5-10% of the population.
Increased thirst (polydipsia) and increased urination (polyuria) and also increased hunger (polyphagia) are the common symptoms seen. Due to increased thirst, dry mouth is also commonly observed in people. Diabetic ketoacidosis is very common and this also leads to dry skin, abdominal pains and vomiting. People also exhibit rapid breathing. About 12% of the people with type 1 diabetes have also been diagnosed with clinical depression.
The genetic makeup of an individual determines whether this condition is dominant or recessive. A total of 50 genes is responsible. The gene IDDM1 is a strong factor for one to develop type 1 diabetes. The presence of IDDM1 is on the chromosome 6 and this locus is associated with increased risk of type 1 diabetes. Apart from these genes, heredity also plays a key role. If the father has diabetes, the child has a 10% higher chance of developing the disease in a later stage. Identical twins have more similar genetic makeup. This gives them a higher probability of developing the disease. If one twin is diagnosed with diabetes, the other twin has a 30-50% chance of being diagnosed with the same.
Apart from genetic factors, the environment has a role to play. People living in certain parts of the world have been seen to have a higher risk than the others. For example, Caucasians in different parts of Europe show a 10-fold difference in the risk of developing the disease.
Certain drugs used in the treatment of pancreatic cancer are known to affect the insulin production. Streptozotocin is one such drug which is used during chemotherapy for pancreatic cancer.
( Source: Diabetes Education Online)
Persistent hyperglycemia is seen in people with type 1 diabetes. And the new cases of this type show diabetic ketoacidosis. The plasma sugar level is more than 11 mmol/L two hours after a 75g oral dose of sugar. Autoantibodies like islet cells autoantibodies and insulin antibodies are present in the serum. Glutamic acid decarboxylase is also targeted by autoantibodies. Looking for such autoantibodies is also a part of the diagnosis. Immunofluorescence and radiobinding assays are performed for the antibody detection.
People with type 1 diabetes can continue to have a normal life as long as they undergo insulin therapy. Immunosuppressive drugs are to be taken to keep the autoimmune reactions in check. Vitamin D is administered and this is known to decrease the risk factor. Managing the lifestyle of the individual and controlling the dietary habits are the ways to prevent this condition from becoming adverse. Islet cell transplantation and pancreas transplantation are tedious. Though the islet transplant is successful, the compatibility between the donor and the recipient and the survival of the islet cells in the body require monitoring. Pancreas transplantation is possible if the type 1 diabetes is very mild. Above all, physical activity is very much advised and this helps in reducing blood sugar levels.
TYPE 2 DIABETES
Diabetes mellitus type 2 is the non-insulin dependent type of diabetes. When compared to type 1 diabetes, type 2 diabetes is more common amongst people. The life expectancy is reduced by 10 years. Though the condition itself is non- fatal, there are secondary factors which cause complications. Heart diseases are often associated with diabetes type 2.
Like type 1, polydipsia, polyuria, and polyphagia are seen. Weight loss is also one of the most common symptoms. Blurred vision and peripheral neuropathy also accompany this condition. In people lacking proper care, blindness and kidney failure are two of the many complications that arise. Cognitive neuropathy and dementia are also seen in some people. Alzheimer’s disease and vascular neuropathy follow in severe cases.
Like type 1 diabetes, type 2 diabetes is affected by the genetic makeup of the individual. Apart from genetics, lifestyle is considered to be the major factor in developing this condition. In rare cases, diabetes is caused by an abnormality in a single gene. Obese individuals are more prone to diabetes type 2. Consuming sweetened beverages and products increase the blood sugar levels and when the accumulation is more than the regulation, the risk factor increases. Fatty food having a higher concentration of polyunsaturated fatty acids also are considered as risk factors.
Certain predisposed medical conditions also lead to diabetes type 2. Hyperthyroidism and Cushing’s syndrome are two such health conditions. Medications like beta blockers, glucocorticoids, thiazides and atypical antipsychotics. Testosterone deficiency is also associated with diabetes.
The diagnosis is similar to that of type 1 diabetes where the level of plasma glucose is the basis of determining whether the person is positive for diabetes or not. Oral glucose tolerance test and plasma glucose test is performed.
Hemoglobin A1C or the HbA1c measures the percentage of hemoglobin cells with glucose molecules attached to them. This test is of importance in detecting and managing diabetes. Lipid profiling also helps in identifying diabetes.
Proper diet and regular exercise prevent the onset of this condition. Diabetes has no cure as such. The onset or the prevention takes effect based on the individual’s lifestyle choices. Once diagnosed with diabetes, one has to follow healthy lifestyle practices, consume more green leafy vegetables and reduce intake of sugar based products. High blood pressure and high cholesterol also affect diabetes. Decreasing blood pressure can help in increasing life expectancy.
Medicines are available for helping in the regulation of the blood sugar. Some of these medicines belong to the flowing classes: sulfonylureas, thiazolidinediones, dipeptidyl peptidase-4 inhibitors, SGLT2 inhibitors, and glucagon-like peptide-1 analog. Apart from medicines, oral and injectable doses of insulin also help in the management of diabetes. Angiotensin-converting enzyme inhibitors are prescribed to prevent kidney disease.