Diabetes is a disease affecting the manner in which the body
handles digested carbohydrates. If neglected, diabetes can cause
extremely severe health complications, ranging from blindness to kidney
failure.
Around eight percent of the population in the United States has
diabetes. This means that around sixteen million people have been
diagnosed with the disease, based only on national statistics. The
American Diabetes Association estimates that diabetes accounts for
178,000 deaths, as well as 54,000 amputees, and 12,000-24,000 cases of
blindness annually. Blindness is twenty-five times even more common
among diabetic patients in comparison with nondiabetics. If current
trends continue, by the year 2010 complications of diabetes will exceed
both heart disease and cancer as the leading cause of death in America.
Diabetics have a high level of blood glucose. Blood sugar level is
regulated by insulin, a hormone secreted by the pancreas, which releases
it in response to carbohydrate consumption. Insulin causes the cells of
the body to absorb glucose from the blood. The glucose then serves as
fuel for cellular functions.
Traditional diagnostic standards for diabetes have been fasting
plasma glucose levels greater than 140 mg/dL on 2 occasions and plasma
glucose greater than 200 mg/dL following a 75-gram glucose load.
However, even more recently, the American Diabetes Association lowered
the criteria for a diabetes diagnosis to fasting plasma glucose levels
equal to or higher than 126 mg/dL. Fasting plasma levels outside the
normal limit demand further testing, usually by repeating the fasting
plasma glucose check and (if indicated) initiating an oral glucose
tolerance test.
The many symptoms of diabetes include excessive urination, excessive
thirst and hunger, sudden weight loss, blurred vision, delay in healing
of wounds, dry and itchy skin, repeated infections, fatigue and
headache. While suggestive of diabetes, these symptoms can also be
caused by other factors, and therefore anyone with symptoms suspicious
of the disease should be tested.
There are 2 different varieties of diabetes.
Type I Diabetes (juvenile diabetes, also known as insulin-dependent
diabetes): The cause of type I diabetes starts with pancreatic inability
to make insulin. This causes 5-10% of cases of diabetes. The pancreatic
Islet of Langerhans cells, which secrete the hormone, are destroyed by
the patient's own immune system, probably because it mistakes them for a
virus. Viral infections are believed to be the trigger that sets off
this auto-immune disease. Type I diabetes is most prevelant in the
caucasian population and has a hereditary component.
If untreated, Type I or juvenile diabetes can lead to death within
two to three months of the onset, as the cells of the body starve
because they no longer receive the hormonal prompt to absorb glucose.
While a great majority of Type I diabetics are young (hence the term
Juvenile Diabetes), the condition can develop at any age. Autoimmune
diabetes is diagnosed by an immunological assay which shows the presence
of anti-insulin/anti-islet-cell antibodies.
Type II Diabetes (non insulin dependent diabetes, also known as
adult onset diabetes): This diabetes is a consequence of body tissues
becoming resistant to the effects of insulin. It accounts for 90-95% of
cases. In many cases the pancreas is producing a plentiful amount of
insulin, however the cells of the body have become unresponsive to its
effect due to the chronically high level of the hormone. Finally the
pancreas will exhaust its over-active secretion of the hormone, and
insulin levels fall to beneath normal.
A tendency towards Type II diabetes is hereditary, although it is
unlikely to develop in normal-weight individuals eating a low- or even
moderate-carbohydrate diet. Obese, sedentary individuals who eat
poor-quality diets built around refined starch, which constantly
activates pancreatic insulin secretion, are prone to develop insulin
resistance. Native peoples like North American Aboriginals, whose
traditional diets never included refined starch and sugar until these
items were introduced by Europeans, have very high rates of diabetes,
five times the rate of caucasians. Blacks and hispanics are also at
higher risk of the disease. Though Type II diabetes isn't as immediately
disastrous as Type I, it can lead to health complications after many
years and cause serious disability and shortened lifespan. As with Type I
diabetes, the condition develops primarily in a certain age group, in
this case patients over forty (which is why it's typically termed Adult
Onset Diabetes); however, with the rise in childhood and teenage
obesity, this condition is being seen for the first time in school
children as well.
If treatment is neglected, both Type I and Type II diabetes can lead
to life-threatening complications like kidney damage (nephropathy),
heart disease, nerve damage (neuropathy), retinal damage and
blindness(retinopathy), and hypoglycemia (drastic reduction in glucose
levels). Diabetes damages blood vessels, especially smaller
end-arteries, leading to very severe and premature atherosclerosis.
Diabetics are prone to foot problems because neuropathy, which afflicts
about ten percent of patients, causes their feet to lose sensation. Foot
injuries, common in day-to-day living, go unnoticed, and these injuries
cannot heal because of atherosclerotic blockage of the microscopic
arteries in the foot. Gangrene and subsequent amputation of toes, feet
or even legs is the result for many elderly patients with
poorly-controlled diabetes. Usually these sequelae are seen sooner in
Type I than Type II diabetes, because Type II patients have a small
amount of their own insulin production left to buffer changes in blood
sugar levels.
Type I diabetes is a severe disease and there is no known permanent
cure for it. Nonetheless, the symptoms can be controlled by strict
dietary monitering and insulin injections. Implanted pumps which release
insulin immediately in response to changes in blood glucose are in the
testing stages.
In theory, since it induced by diet, Type II diabetes should be
preventable and manageable by dietary changes alone. However, as so
often happens, clinical theory is defeated by human nature in this case,
as many diabetics (and many obese people without diabetes) find it
personally impossible to lose weight or even stick to a diet free of
starchy, sugary junk food. So Type II diabetes is frequently treated
with drugs which restore the body's response to its own insulin, and in a
few cases injections of insulin.
Please note that this article isn't a subsitute for medical advice.
If you suspect you have diabetes or even are in a high risk demographic
group, please see your doctor.
