Diabetes Mellitus Essay, Research Paper

Diabetes Mellitus

Diabetes education is an important part of a treatment plan. Diabetes educators and health care providers are available in many areas to teach essential skills needed after initial diagnosis of the disease. Appropriate education teaches people with diabetes how to incorporate the management principles of the disease into their daily lives and minimize dependence upon the health care provider. An education program is helpful to learn more about the disease process, how to control and live with diabetes, and intermediate and long-term complications of the disease.

Diabetes Mellitus is a metabolic disorder, due to improper utilization of glucose. The diabetic is less efficient in his metabolism and sugar accumulates in the blood and is eliminated in the urine. Diabetes is near the number 5 or 6 in death rate. Symptoms experienced by a diabetic are increased thirst, frequent urination, and weight loss despite an unusual intake of food. Itching of the skin, especially near the genitals is quite common. In addition to these long recognized symptoms, there are other evidences such as persistent skin infections, slow healing of wounds, and yeast infections of the genitalia.

The reason why a diabetic may feel hungry most of the time is that not enough glucose can enter the cell. Because the cells need sugar, the diabetic feels hungry. Severe diabetics have such disturbed body functioning that acids accumulate from the burning of fat, and may eventually cause coma. Today the greater proportion of diabetics must take one form of insulin, or other which also lower the blood sugar, but these are taken by mouth. Of the two million diabetics in the U.S., there are several hundred thousand which are oral hypoglycemic agents.

There are two types in the classification of diabetes. There is the primary disorder, which 90% of diabetics have, and the secondary disorder which only 10% of diabetics possess. Diabetics with the primary disorder are NIDDM (Non Insulin Dependent Diabetes Mellitus). Diabetics with the secondary disorder are Insulin Dependent and usually acquire diabetes before forty years of age.

Not all individuals at genetic risk for IDDM ultimately develop it. Genetics are not sufficient for the development of the disease. Environmental triggers for the development of IDDM have long been suspected. Epidemiological studies have suggested that the incidence of IDDM is increased in both the spring and fall and is coincidental with epidemics of various viral disorders. It is quite evident that several viruses appear to trigger the subsequent immunologic response in genetically predisposed individuals who develop diabetes. Early IDDM is first identified by the appearance of active auto-immunity directed against the beta cells of the pancreas and their products. The combination of auto-immune attack on the beta cell and insulin by insulin auto antibodies progressively diminishes the effective circulating insulin level.

NIDDM diabetes is a very distinct disorder as compared with IDDM. NIDDM classically develops in an older patient population and may or may not require the use of therapeutic insulin. NIDDM is a heterogeneous disorder, characterized by variable plasma insulin levels associated with hyperglycemia and peripheral insulin resistance. Limitation in beta cell response to hyperglycemia appears to be a cornerstone of the pathophysiology of NIDDM. Regardless of the degree of peripheral insulin resistance, if the islets cells have an unlimited capacity to secrete insulin, then sufficient insulin should be available to overcome any degree of resistance.

Moderately elevated blood sugar levels for many years can eventually cause kidney disease, impairment of sight due to the rupture of blood vessels in the eyes, reduction of blood flow to the limbs which can cause numbness and sometimes require amputation, and some changes in nervous sensation. Diabetics also have an increased risk of heart attack and stroke. However, proper treatment can minimize these complications.

With proper treatment most diabetics maintain blood sugar levels within a normal or nearly normal range. This makes possible for Diabetics to live normal lives and prevents some long term consequences of the disease. For the Type I or Type II diabetic with little or no insulin production, therapy involves insulin injections and changes in diet. The diet requires distributing meals and snacks throughout the day so that the insulin supply is not overwhelmed. In addition to eating food that contains polysaccharides rather than simple sugars. Polysaccharides are first broken down in the stomach, consequently producing a much slower rise in blood sugar. For Type II diabetics, the basics of therapy are diet control, weight loss, and exercise. Weight loss appears to partially reverse the condition of insulin resistance in the tissues. The physician may add insulin injections, if a patient s blood sugar level is still high.

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Establishing diabetes education and a health care team directed towards patient involvement in self care and prevention of complications is a model for a revolution in health care delivery and financing within the United States. At all levels –research, education, and clinical care- diabetes intervention is progressing rapidly and is at the cutting edge of its particular practice.