Diabetes can be referred to as a metabolic disorder that occurs when a person has high blood glucose level either due to the insufficient production of the insulin or if the cell are not being able to use up the insulin properly. This paper would describe about how the normal physiology is affected by this condition, the etiology, the causes and the symptoms of the diseases followed by a care plan for the management of the disease.
Normal anatomy and physiology of the major systems
The blood sugar level in the body is sustained in a very fine range and the two hormones; the insulin and the glucagon help in maintaining this narrow range. Both the hormones gets secreted from the pancreas and hence are called the pancreatic endocrine hormones(Chen, et al., 2012). It is the secretion of the glucagon and the insulin from the pancreas that helps in determining whether a patient has diabetes or hypoglycemia.
The insulin is produce beta cells of the pancreas and its amount of secretion increases with the increase in the blood glucose level. Similarly when the blood sugar level falls, the amount of the secreted insulin drops down. Glucose controls the blood sugar level by attaching and signaling the cells to for absorbing glucose from the blood stream. Insulin allows the storing of th4e excessive glucose in the liver (Chen, et al., 2012).
The alpha cells of the pancreatic islet of Langerhans, on the other hand secretes the Glucagon. In this case glucagon is not secreted when the glucose level is the blood high. It is secreted when the blood glucose level is low such as during the exercise or between the meals(Chen, et al., 2012). Glucagon plays the role of making the liver to secrete the glucose for increasing the glucose level. This is how the blood sugar is controlled in the body.
Causes (etiology) and risk factors of the condition
Diabetes is caused due to the several factors depending upon the lifestyle, the genetic setup, the ethnicity, family history and of course environmental conditions. The cause of the diabetes varies with the type and the individual.
Type 1 diabetes– T1D is an autoimmune disorder where the immune system of the body attacks the insulin producing pancreatic cells of the body. According to some scientific studies this type of diabetes is caused by genes and the environmental factors like the viruses, which might trigger this clinical condition. Hence the body is incapable of producing insulin(Johnson, et al., 2013).
Type 2 diabetes- T2D is caused by lifestyle and genetic factors. In this condition the body becomes the resistant to the general effects of insulin or when the body generally loses the capacity to produce enough insulin the pancreas(Johnson, et al., 2013). T2D begins with the insulin resistance in the body, which is a condition in which the liver, muscles and the fat cells are incapable of using the insulin. Hence the body requires insulin in excess than what is being produced in the body to cope up with the added demand(East, et al., 2012). Extra belly fat and higher body mass is related to T2D. The variants of the HLA-DQA1, HLA-DQB1, and HLA-DRB1 genes enhance the risk of development of type 1 diabetes (Dean et al., 2014). The mentioned genes provide directives for creating proteins that possess a grave role in the immune system.
Gestational diabetes- This type of diabetes occurs during pregnancy but gradually disappears after the baby is being born. Hormones secreted by the placenta can contribute to insulin resistance that occurs in all women at the time of late pregnancy. Gaining too much weight at the time of pregnancy may develop gestational diabetes.
Risk factors
Obesity is one of the major risk factors of diabetes, lack of exercise and sedentary ways of living increases the insulin resistance. Unhealthy eating such as the consumption of the processed food, sweetened beverages, high sugar candies and low quality of the carbohydrates can cause a dramatic surge in the blood sugar level. Diabetes is also more common in some of the ethnic groups such as the Hispanic/latino American, Asian American, the specific Islanders and the Alaska natives. Family history plays an crucial role in the development of diabetes(Stankov, et al., 2013). Those having pre-diabetes or gestational diabetes are likely to develop diabetes in future.
Body system affected by diabetes
Many clinical conditions stem from the diabetes. Extreme thirst is one of the noticeable symptoms in diabetes. Diabetic patients may have sweet smelling breaths due to the high levels of ketones. Frequent urination can be an early sign of diabetes. Diabetes affects the blood vessels and contribute to high blood pressure and is linked to high levels of cholesterol that enhance the risk of heart attacks and the cardiovascular diseases(Chen, et al., 2012). Apart from the heart, eyes are also affected by high blood sugar level causing diabetic retinopathy which causes swelling and leaking of the blood vessels in the back of the eye.
The effect of diabetes can be dangerous as it can cause neuropathy that is commonly noticed by tingling sensation and numbness in hands and feet, lack of arousal in the sex organ(Chen, et al., 2012). Apart from this factors diabetic patients may have reduced skin integrity as high blood sugar level causes the body to lose the fluids at a much faster rate, which can lead to dry and cracked skin. Life threatening conditions can also be caused due to diabetes as the body uses hormones to turn the fat into energy giving rise to high level of toxic acids called the ketones leading to life threatening condition.
Management
The management of diabetes should initiate with a proper monitoring of the blood sugar levels at a regular intervals. Periodic measurement of the blood sugar level can be done by a blood test called the hemoglobin A1c or glycohemoglobin (or glycosylated hemoglobin).Type 1 diabetes has to be treated with insulin, which involves the injection of the insulin in the fat (American Diabetes Association. ,2014).
Healthy eating is a cornerstone of healthy lifestyle. It is essential to pan the meal with a good mix of carbohydrates other than simple carbohydrates. Sweetened beverages should be avoided and more fibrous food should be consumed to keep the blood sugar level balanced(Shrivastava, et al., 2013)Staying hydrated is an important way to manage with the diabetic symptoms (American diabetes association. 2016). Strenuous workout increases the demand of the glucose by the muscles and hence the blood sugar remains in control(Nather, et al., 2013). It is the liver that neutralize with the falling effects of glucose and consumption of alcohol may slow down the release of glucose, when the body needs it(Nather, et al., 2013).
Diabetes is a chronic disease that can have a long term affect in different body organs leading to additional clinical condition other than diabetes. Although diabetes cannot be cleared from the root, but the blood sugar levels can be managed by adopting suitable food habits, active life style and adherence to proper medications.
American Diabetic Association, A. D. (2014). Diagnosis and classification of diabetes mellitus. Diabetes care, 37(Supplement 1). S81-S90.
Chen, L., Magliano, J., D., Zimmet, & Z., P. (2012). The worldwide epidemiology of type 2 diabetes mellitus—present and future perspectives. Nature reviews endocrinology, 228.
(2014). Diagnosis and classification of diabetes mellitus. Diabetes care, 37(Supplement 1). USA: American Diabetes Association.
East, E., H., Subauste, S., J., Gandhi, A., . . . A., C. (2012). About secondary causes of diabetes mellitus. Journal of the Mississippi State Medical Association, 380.
Johnson, J., R., Nakagawa, T., Sanchez-Lozada, G., L., . . . Lanaspa, M. A. (2013). Sugar, uric acid, and the etiology of diabetes and obesity. Diabetes, 3307-3315.
L, D., & J, M. (2014). Genetic Factors in Type 2 Diabetes. The Genetic Landscape of Diabetes [Internet]. Bethesda (MD): National Center for Biotechnology Information (US).
L, D., & J., M. (2014). Genetic Factors in Type 2 Diabetes. The Genetic Landscape of Diabetes [Internet]. Bethesda (MD): National Center for Biotechnology Information.
Nather, A., Ho, S., Quah, & L., Y. (2013). Management of Diabetes Mellitus. In The Diabetic Foot, 33-42.
Shrivastava, R., S., Shrivastava, S., P., Ramasamy, & J. (2013). Role of self-care in management of diabetes mellitus. Journal of Diabetes & Metabolic Disorders, 14.
Stankov, K., Benc, D., Draskovic, & D. (2013). Genetic and epigenetic factors in etiology of diabetes mellitus type 1. Pediatrics, peds-2013.
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