Diabetes Mellitus

I. Introduction

A. Diabetes Mellitus includes a number of metabolic diseases which are the result of problems in insulin production and effectiveness.

II. Medical Definition and Classification

A. Type 1 Diabetes Mellitus

1. Appears in childhood or early adulthood, often following childhood obesity.

2. Caused by the lack of insulin production (Diagnosis and Classification of Diabetes Mellitus 2008, S55).

B. Type 2 Diabetes Mellitus

1. Appears in late adulthood

2. Caused by a combination of low insulin production and reduced insulin sensitivity (Diagnosis and Classification of Diabetes Mellitus 2008, S56 ).

C. Gestational Diabetes and other miscellaneous diseases.

1. Gestational Diabetes Mellitus occurs during pregnancy and seems to be most similar to Type 2 diabetes (Definition Diagnosis and Classification...1999, 19).

III. Causes

A. Type 1 Diabetes Mellitus

1. Often caused by autoimmune attack on beta cells in pancreatic islets leading to the total disruption of insulin production.

2. Some genetic factors

B. Type 2 Diabetes Mellitus

1. Proximally caused by lower insulin sensitivity in target tissues as well as lower insulin production.

2. Lifestyle and diet factors into the prevalence of type 2 diabetes (also has genetic factors) (Diagnosis and Classification of Diabetes Mellitus 2008, S56).

IV. Disease Mechanism

A. Healthy Individuals

1. Insulin controls the uptake of glucose by body cells from the blood stream

2. Without insulin (as in type 1 diabetes) glucose increases in concentration on the blood stream and cells do not take in needed glucose (hyperglycemia).

3. Carbohydrates, fats and proteins are thus not metabolized/stored properly (Milnar et al. 2007, 20).

4. High glucose concentrations in the blood stream can acidify blood stream leading to coma or death (Definition Diagnosis and Classification...1999, 2).

V. Complications

A. Hyperglycemia can lead to several conditions including:

1. Keto-acidosis and Non-Ketotic Hypersmolar syndrome.

2. Retinopathy.

3.Nephropathy (Definition Diagnosis and Classification...1999, 220).

VI. Treatment

A. Treatment varies depending on the progress and disease pathway of the disease.

1. Type 1 diabetics require insulin because they no longer produce insulin.

2. Type 2 diabetics often see improvement with exercise and diet regulation, but depending on severity may also need insulin and medications (Metformin) (Diagnosis and Classification of Diabetes Mellitus 2008, S55-56).

VII. Demography

A. 285 million people have diabetes mellitus, with 90% having type 2 diabetes.

B. Cases found throughout the world, but is most common in urbanized areas, perhaps due to changes in diet and lifestyle (Melmed et al. 2011, 1371).

VIII. Conclusion

A. There are variations in the causes and symptoms of diabetes (Diagnosis and Classification of Diabetes Mellitus 2008, S55).

B. While Type 1 diabetes is at least somewhat genetic, the current global epidemic in diabetes is probably due to changes in lifestyle and diet associated with urbanization (Kleinfield 2006).

C. More research is needed in order to mediate the health effects of diet and lifestyle changes on the global population.

References

(1999). Definition, Diagnosis and Classification of Diabetes Mellitus and its Complications. Diabetic Medicine, 17. Retrieved February 25, 2014, from http://www.staff.ncl.ac.uk/philip.home/who_dmg.pdf

(2008). Diagnosis and Classification of Diabetes Mellitus. Diabetes Care, 31(Supplement_1), S55-S60.

Kleinfield, N. R. (2006, September 13). Modern Ways Open India’s Doors to Diabetes. New York Times. Retrieved February 25, 2014, from http://www.nytimes.com/2006/09/13/world/asia/13diabetes.html?pagewanted=all

Melmed, S., Polonsky, K., Larson, P. R., & Kronenberg, H. M. (2011). Type 2 Diabetes Mellitus. Williams textbook of Endocrinology (12th ed., pp. 1371-1435). Philadelphia: Saunders.

Mlinar, B., Marc, J., Janež, A., & Pfeifer, M. (2007). Molecular mechanisms of insulin resistance and associated diseases. Clinica Chimica Acta, 375(1-2), 20-35.