Term Paper on "Diabetes Type II in Adults"

Term Paper 12 pages (3731 words) Sources: 9 Style: APA

[EXCERPT] . . . .

Diabetes Type II in Adults

CONFRONTING a DREAD DISEASE

Insulin is a hormone released by the pancreas to bring glucose to the cells so the body can use it for energy (University of Maryland Medical Center 2008). If this does not happen, the body has nothing to use for its functions. Diabetes develops. There are many types of diabetes. The most common are type 1 insulin-dependent, type 2 non-insulin-dependent and gestational diabetes. Type 2 is lifelong and characterized by high sugar levels trapped in the blood instead of flowing into the cells. This type develops when the body does not respond correctly to insulin. It is often accompanied by obesity and insulin resistance. Because the cells are not getting the needed insulin, the pancreas produces more and more until sugar levels build up abnormally in the blood. This condition is called hyperglycemia. It often occurs with insulin resistance, because fat impedes the body's ability to take up insulin. Type 2 develops gradually. While it often does in overweight persons at the time of diagnosis, it can also develop in underweight or lean persons, especially the elderly (University of Maryland Medical Center).

Major risk factors in Type 2 diabetes are family history and genetics, low activity, poor diet and excess body weight, particularly around the wait (University of Maryland Medical Center 2008). It has been observed to occur more among African-Americans and Native Americans. Those who are 45 years old and older and suffer from glucose intolerance, high blood pressure, with HDL cholesterol less than 35 mg/dL or triglyceride higher than 250 mg/dL and a history of gestational diabetes (University of Maryland Medical Center).

The American Diabetes Association recommended that adults 45 years and older should be tested for diabetes as age is a major risk factor (National Diabetes Information Clearinghouse 2000). If they the glucose reading turns out normal, the test should be repeated at three-year intervals. Those less than 45 years old should be tested if they are high-risk. Other risk groups are those whose weight is 20% more than the ideal or with a body mass index of 27 more; who have a parent or sibling with diabetes; American-Indians, Asian-Americans; Hispanic-American and Pacific Islander Americans; women who give birth to a baby weighing more than 9 pounds or have diabetes while pregnant; blood pressure of 140/90 or more; abnormal blood lipid levels; and glucose intolerance (National Diabetes Information Clearinghouse).

Statistics showed the importance of promoting knowledge and awareness about Type 2 Diabetes (Nathan 2004). It is the leading cause of blindness, end-stage kidney disease and lower-limb amputations in the U.S. alone. Records bared that 30 to 70% of those with the disease also suffer from nerve damage, which is often severe. Approximately 14 million Americans are afflicted with this Type and around half of them are not aware of it. In addition, more than 600 new cases are diagnosed with the disease every year. Cases have increased three times since 1960. Experts said that Type 2 diabetes is likely to develop in those who are over 40 years old, obese, with a family history, live a sedentary lifestyle and from specific racial strains. The increase in the incidence of Type 2 diabetes also increases the risk for a stroke or heart disease two times. These are among the justifications for a sustained health promotion program on the disease (Nathan).

Further statistics said that roughly 2,000 new cases of Type 2 diabetes are diagnosed on a daily basis (Simmons 2001). This figure meant an increase in incidence in the past 40 years. One in every five persons over 65 has the disease. An increasing number of children and adolescents have been diagnosed with this disease in addition to adults. Obesity appeared to be the leading cause. Afflicted women stand at an increased risk of heart disease, stroke, kidney failure, blindness, neuropathy, amputation, periodontal disease and even dementia. Inadequately controlled blood sugar levels raise their risk of developing one or more of these conditions. And the longer they have been ailing, the greater the risk. Contend with statistics on overweight and the American lifestyle and eating habits. Roughly 33% of Americans are overweight and 23% are obese. Popular American meals are processed, packaged and full of fats and sugar. Americans rely or choose fatty and high-caloric fast foods for their meals on account of a busy lifestyle without the needed time to prepare nutritious foods. In addition, there is less time for physical activity to counteract the unnecessary calories (Simmons).

Diabetes specialists estimated that metformin and acarbose would be more effective in combating Type 2 diabetes and with fewer complications (Nathan 2004). Previous treatments reduce blood sugar by injecting or taking insulin into the system. This is to increase the rate of the tissues taking in glucose from the blood and converting it into energy. The drug is sulfonylurea. Metformin, a biguanide, has been around for more than a decade in Europe and Canada. A large multi-center study conducted on August 31, 1995 showed that the drug could lower blood glucose as effectively as sulfonylurea. It also showed that the drug could increase HDL and significantly reduce overall cholesterol levels, triglycerides and LDL. It reduces the liver's capacity to produce glucose. It is better than insulin and sulfonylureas, which can cause hypoglycemia and metformin almost never does. Sulfonylureas can cause weight gain, but metformin induces weight loss in some cases. The sulfonylureas stimulate the pancreas to produce insulin but the pancreas stops functioning after a few years. Metforming tends to remain effective longer. Metformin's side effects include transient nausea and diarrhea. It is the preferred drug by those who are unable to control their blood glucose levels through diet and exercise. Diet and exercise are the first measures for Type 2. If this would not work, Metformin should be used with a sulfonylurea or insulin. Metformin is, however, prescribed with caution to those with impaired kidney function as it might cause lactic acidosis. It is likewise not recommended for heavy drinkers and those who have kidney and liver diseases or congestive heart failure (Nathan).

Acarbose is a boon to Type 2 patients with postprandial hyperglycemia (Nathan 2004). This condition is a steep rise in glucose after eating, common among those in the early stages and those who have harbored the disease for years. The pancreas has turned sluggish in secreting insulin in reaction to a meal. The drug is an alpha-glucosidase inhibitor, which inhibits an enzyme, so that less glucose enters the bloodstream. This allows more time for the pancreas to secrete enough insulin. But the undigested carbohydrate ferments in the large intestines. Flatulence can result. Comparing effects, acarbose may not be as powerful as Metformin and the sulfonylureas. But it is preferred by those whose blood sugar rises steeply despite other treatments (Nathan).

These new drugs are found better than the sulfonylureas (Nathan 2004). They may not reduce blood glucose levels in 10-20% of patients even at the highest recommended doses. Some patients obtain good results at first, but the results cease in 5-10% of them in the succeeding years. When this happens, patients can only move back to insulin. Insulin therapy in itself does not sufficiently control blood glucose levels. Doctors and patients choose not to use high doses. Yet body tissues in Type 2 diabetes respond only to large doses (Nathan).

An increase in the incidence of type 2 diabetes has been observed (Rynk 2002). Lifestyle appears to be strongly linked to it. Statistics said that approximately 95% of diabetes cases in the U.S. are Type 2 or adult-onset diabetes. A study conducted at the Normal J. Arnold School of Public Health in Columbia, South Carolina, found that exercise and weight loss matched the action of medications at almost twice as much. The respondents from the region included 45% non-Whites, who had higher risk of Type II diabetes. These were African-Americans, Hispanics, Native Americans and Asian-Pacific Islanders. Many of them had a family history of diabetes who wanted to find benefit from the study for themselves and their families. It aimed at losing weight, reducing dietary fat to 25% of calories and raise activity level to 30 minutes at most days of the week. The results were so favorable that the study ended a year earlier. The first step taken during the investigation was to treat the diabetes through medications, including insulin directly. Copies of the vegan diet were distributed. The second step was a 30-minute walk each day whether outdoor or indoor. The researchers found that those who followed the simple advice experienced a dramatic change in their diabetes. Medications were reduced or discontinued. Some of them had weight loss, a reduction in cholesterol and sugar levels and in some, weight loss even made the diabetes disappear. They assured the respondents that weight loss did not have to be large to recognize the benefit of the diet and exercise regimen (Rynk, Rooney 2007).

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