Essay on "Diabetes Mellitus (Dm) Is a Family"

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Glucose is the energy "currency" that the body uses (Winter & Signorino 2002). Just like a river shouldn't dry up or flood, the same is true with glucose in the body. For example, drought would be represented by low blood glucose concentrations (hypoglycemia), which can be life threatening or fatal if the case is severe because the brain cannot function properly unless it is constantly getting glucose (2002). Flood, on the other hand, would be represented by high blood glucose concentrations (hyperglycemia). When hyperglycemia is persistent, this is when DM is diagnosed (2002). In general, the body must keep its blood glucose concentrations in a narrow range [60-209 mg/dL (3.3-6.1 mmol/L) during fasting] to avoid hypoglycemia and hyperglycemia (2002). Hormones control blood glucose concentrations that regulate the rates of glucose production and glucose consumption (2002).

If someone is diagnosed with diabetes, the amount of blood glucose is too high, which creates a condition called hyperglycemia. This happens for one of two reasons: 1) the body is producing no insulin -- Diabetes Type 1; and, 2) the cells do not respond correctly to the insulin -- Diabetes Type 2 (Medical News Today 2009).

In Type 1 Diabetes, the individual's own body has destroyed the insulin-producing beta cells in the pancreas (Medical News Today 2009). This is known as an autoimmune disease. Any time one's own body destroys something good in the body is the sign of an autoimmune disease. Because a person with Type 1 Diabetes has a body that is destroying something good, it is considered an autoimmune disease (2009). Therefore, people who have Type 1 Diabetes have to take insulin every single day in order to stay alive. Diabetes Type 1 is not the result of a person's lifestyle either. It is not preventable, in other words.

Diabetes Type 2 is characterized by one of two main problems -- and sometimes both problems together: 1) Not enough insulin is being produced in the body; and, 2) the insulin is not working properly, which is known as insulin resistance (Medical News Today 2009). Unlike Diabetes Type 1, Diabetes Type 2 can be prevented as it is almost always caused by an unhealthy, overweight and unfit lifestyle. It usually occurs in people who have been overweight for quite some period of time and it tends to show up later in a person's life. However, there have been more and more cases in recent history where people in their 20s are developing Type 2, yet it is still relatively uncommon (2009). Approximately 85% of all diabetes patients have Type 2 Diabetes (2009).

Prognosis.

Diabetes has intrigued medical professionals for ages. A condition that produces excessive thirst, constant urination, and severe weight loss, diabetes mellitus was almost always fatal until the early part of the twentieth century (Poretsky 2010). The most important feature in preventing the complications of DM is early diagnosis, according to Lebovitz (2003). This is especially important in type 2 or late-onset autoimmune type 1 diabetes because these types of disorders start with a relatively asymptomatic period that can last anywhere between 5 and 10 years (2003).

Diabetes is a chronic disease, however, the symptoms can be helped and people can have a long, healthy life with DM if they take the proper steps in caring for themselves (Venes 2009). The isolation and the subsequent production of insulin in 1922 by F.G. Banting and C.H. Best, Canadian physicians, made it possible for people with DM to lead a normal life (2009).

Treatment methods.

There are several different types of medicines that are used for treating diabetes. Each group of medicines work in different ways and more than one may be taken at a time. For example, sulfonylureas help a person's pancreas make insulin. They can be taken once or more a day (Milchovich & Dunn-Long 2007). Meglitinides are another type of medication that helps the cells in the pancreas increase the production of insulin (2007). DPP-4 Inhibitors have a few different actions: 1) they lower blood sugar, especially right after meals and between meals; 2) they improve the amount of insulin produced by the pancreas; and, 3) they decrease the amount of sugar made by the liver, especially at meal time. DPP-4s are used to treat Type 2 diabetes and there are several side effects of using them (e.g., stuffy or runny nose; sore throat, cold; headache; stomachache; and, diarrhea) (2007). Byetta/Exenatide is in the category of Incretin Mimetic medication and it has several actions as well: 1) it helps produce insulin in the pancreas right after a meal; 2) it stops the liver from producing too much sugar when it is not needed; 3) it slows the rate in which food leaves the stomach; and, 4) it helps with weight loss (2007).

Another way for a patient to get insulin is through an insulin pump (Milchovich & Dunn-Long 2007). These pumps are battery operated and about the size of a pager, only weighing a few ounces (2007). Insulin is quickly delivered to the body through a thin plastic tubing into a needle that is inserted under the skin in the abdomen. This needle is changed every 2 days. A steady amount of insulin (basal insulin) is given constantly and additional doses of insulin (boluses) are given at mealtimes (2007). The blood sugar must be tests frequently throughout the day and the pump must be adjusted to deliver the right amount of insulin that the body needs (2007).

Insulin pumps are great for patients because they actually provide better blood sugar control because of the constant infusion of insulin into the body, as well as the constant monitoring of blood sugar and the frequent adjustment of insulin doses (2007).

A person with DM must not only take medication, but he or she must also do other consistent practices such as following a meal plan, exercising, and testing blood sugar (Milchovich & Dunn-Long 2007).

For a patient with DM, the best thing he or she can do is to learn to recognize symptoms of low blood sugar -- for example, confusions, sweating, and heart palpitations -- as well as those symptoms of high blood sugar -- for example, polyuria and polydipsia (Venes 2009).

In order to prevent complications related to DM, patients should avoid smoking, manage their serum lipid levels on a regular basis, and keep hypertension under control (failure to do so could result in a risk of atherosclerosis) (Venes 2009). Receiving regular vaccinations to prevent influences and pneumococcal pneumonia is also another vital step that patients with DM must take in order to stay as healthy as possible and avoid complications of DM (2009).

Cost.

According to the American Diabetes Association (2007), the national cost of diabetes (as of 2007) exceeds $174 billion. This estimate includes $116 billion in excess medical expenditures related to diabetes, as well as $58 billion in reduced national productivity (2007). People who are diagnosed with diabetes have, on average, medical expenditures that are estimated to be 2.3 times higher than the expenditures would be for a person who did not have diabetes (2007). An estimated $1 in $10 health care dollars is ascribed to diabetes (2007). Indirect costs of diabetes include increased factors like absenteeism, reduced productivity, and lost productive capacity because of early mortality (2007).

Current research.

Lebovitz (2011) notes that patients with Type 2 DM, the most common form of diabetes, are normally treated with pharmacologic agents in combination with lifestyle… READ MORE