The Truth About Diabetes Essay

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The Truth About Diabetes

The Truth About Diabetes
Diabetes is a killer; in fact, it is among the top ten killers of adults in the United
States. "It can lead to, or contribute to, a number of other serious diseases" (Sizer and
Whitney 112). Diabetes means "syphon" or "to run through" (Sizer and Whitney 112)
therefore denoting the increase in urinary volume excreted by people suffering from this
disease. Mellitus means "sweet". Diabetes mellitus means increased excretion of sugars
being released with the urine, creating a sweet smell at the time of elimination. The
patient with this type of disease has a problem with his insulin production or usage.
Insulin is a hormone produced in the pituitary gland, that helps to digest the sugars and
use them for energy, and must be given through an injection into the arms or legs; if this
is not done the gastointestinal enzymes in a person's stomach will digest the hormone. A
diabetic does not produce adequate insulin or cannot use his own. Diabetes mellitus is not
a single disease. This is a heterogeneous syndrome for which several theories of etiology
(explanation of the cause of the disease) have been proposed (WebMd Health). Diabetes is a
life-threatening disease, but it is not a death sentence. With proper maintenance of
insulin, exercise, and diet, diabetes can be controlled. Advances in medicine will create
a larger variety of treatment options and help remove the stigma, as well as fears,
associated with diabetes.

The signs and symptoms of diabetes are divided into early, secondary, and late signs. Some
of the early signs include polyuria (excessive urination) and thirst; another sign can
also be a sweet smell from urine. This odor is due to the loss of water through promoting
cellular dehydration. Polyuria is the result of large amounts of glucose, ketone bodies,
and protein being excreted by the kidney; an osmotic effect of sugar attracts water and
promotes diuresis. The secondary signs include nausea and vomiting, dry mucous membranes
with cracked lips, hot flushed skin, abdominal pain and or rigidity, acetone odor of the
breath, soft eyeballs because of dehydration, and kidney disease. Other signs include
impaired vision or blindness resulting from cataracts and damaged retinas, nerve damage,
skin damage, and strokes and heart attacks. The root cause of all of these symptoms is
probably the same (Sizer and Whitney 113). Late symptoms include hypotension, oliguria
(secretion of a diminished amount of urine in relation to fluids intake) or anuria (the
complete suppression of urinary secretion by the kidneys) (American Diabetes Association).
Later, decreased circulating fluid volume lessens blood flow to the kidney, thus resulting
in renal shutdown with oliguria or anuria. The late are more severe and present more of a
problem. Coma and stupor are the final and most extreme symptoms. Electrolyte imbalances,
profound shock, and rapidly lowering pH all contribute to the loss of consciousness
(Luckmann and Soerensen 1544).

Diabetics can develop a myriad of chronic complications. The health problems relating to
diabetes are in the eyes, skin, urinary system, and heart. Glaucoma occurs when pressure
builds up in the eye. In most cases this pressure causes drainage of the aqueous humor to
slow down to the point that it builds up in the anterior chamber. This pressure pinches
the blood vessels that carry blood to the retina and optic nerve, causing less oxygen and
nutrients to be delivered to the needed areas in the eye. Vision is gradually lost because
the retina and nerve are damaged (American Diabetes Association). "Treatment is usually
medications. People with diabetes are sixty percent more likely to develop cataracts,
defined as the clear lens of the eye clouding, and blocking light" (American Diabetes
Association). A person may need to wear sunglasses more than usual, and use glare control
lenses in his glasses. Retinopathy and glaucoma may also develop in people with diabetes.
Retinopathy is the general term used for all of the retinal disorders caused by diabetes.
In ketoacidosis a condition called metabolic acidosis arises in untreated diabetes and in
the patient whose condition remains uncontrolled by insulin. This is one of the most
severe acute complications of diabetes (Luckmann and Sorensen 1567).

Skin changes and infections can occur in a diabetic patient. The different types of skin
changes that occur are known as diabetic dermopathy and necrobiosis lipoidica
diabeticorum, both attributed to microangiopathy (a disease of the small blood vessels),
in which a membrane of capillaries thickens (diabetic microangiopathy), or in which clots
form in the arterioles and the capillaries. Shin spots are brown spots located on the
anterior surfaces of the lower extremities. These are painless and harmless, and initially
measure less than one centimeter in diameter. Necrobiosis lipoidica diabeticorum is
believed to be the result of trauma and consists of lesions that are similar to those that
occur in diabetic dermopathy, but is more likely to be associated with ulcerations and
necrosis. These lesions are reddish yellow and atrophic. Skin grafts (skin planting or
placement of skin from another part of the body onto the damaged skin) are possible
solutions to alter the damage caused by this problem. Necrobiosis lipoisica diabetic orum,
a degenerative disease of the dermal connective tissue characterized by the development of
erythematous papules or nodules in the pretibial are, is present most often in
insulin-dependent women, which may later precede the onset of overt diabetes (American
Diabetes Association). Infections like these mentioned do occur more in patients with
diabetes than in other clients. The mechanisms of the onset of more frequent infections
include a defect in the mobilization of inflammatory cells and impairment in the white
blood cells. Recurring infections, such as boils and furuncles, in the undiagnosed client
often lead the health care provider to suspect diabetes. The loss of sensation or nerve
damage may delay the detection of infection. The persistence of glycosuria (sugars in the
urine) may encourage bladder infections especially in a neurogenic bladder (a bladder that
can not be controlled by the patient) (Brunner). Patients with diabetes are usually more
susceptible to some microorganisms and fungi, in part because of the high sugar content in
their blood and urine. Two out of three people with diabetes die from heart disease and
stroke associated with blood vessel disease (Luckmann and Sorensen 1565-1569). Chronic
hyperlipemia is excessive fats in the blood. Vascular degeneration may, in turn, affect
the kidneys causing diabetic nephropathy, and the eyes causing diabetic retinopathy and
eventually blindness. In addition to this, diabetes can eventually cause nephropathy
(Luckmann and Sorensen 1565-1569). A diabetic coma is the result of ketoacidosis.
Hyperglycemia is the result of glucose not being transported to the cells because of a
lack of insulin. Without available carbohydrates for cellular fuel, the liver begins to
convert its glycogen stores back to glucose (glycogenolysis, and then biosynthesis of
glucose, called gluconeogenisis); both of these are being produced more than needed. This
unfortunately aggravates the situation by raising the blood sugar to an even higher point
(Luckmann and Sorensen 1565).

Not only elderly people acquire diabetes, but also any person of any age and origin can
develop diabetes, possibly caused by genetic or environmental factors. Ninety to
ninety-five percent of people with diabetes have Type 2 diabetes (International Diabetes
Federation). This type usually occurs in people over the age of forty, yet it is now
affecting children and adolescents to a greater extent. However, the older one is, the
greater the chances are for developing diabetes. Family history and ethnicity are
important in predicting the possible onset of diabetes. There has been little research
done outside of the United States, but within the United States population of African
Americans, Hispanic Americans, Native Americans, Asian Americans, and Pacific Islanders
are more likely to develop or have diabetes. Some women develop a temporary type of
diabetes called "gestational diabetes" when they are pregnant. Gestational diabetes
develops in two to five percent of all pregnancies, yet usually disappears after the
pregnancy is over (WebMd Health). Women that had gestational diabetes or have given birth
to a baby of four kilograms (two pounds) or greater are at a greater risk of developing
Type 2 diabetes at a later stage in life. Obesity, too, encourages the onset of diabetes,
for the fact that over eighty percent of people with Type 2 diabetes are overweight. The
more overweight a person is, the greater their risk for developing diabetes. A family
history of diabetes increases the risk for the onset of diabetes for closely related
family members. Also physical inactivity increases the risk for developing Type 2
diabetes. Type 2 diabetes has been known as adult diabetes because of its gradual
development throughout the life of a person, beginning at middle age. Childhood diabetes
is Type 1; it occurs when the pancreas completely stops manufacturing insulin. Both types
of diabetes have strong genetic component, tending to run in families. These individuals
usually have high blood pressure, abnormal levels of blood fats, and have difficulty with
blood clotting (WebMd Health).

The majority of diabetics must learn to give themselves injections of insulin. Insulin may
be injected into the stomach or thigh. Another treatment is the insulin pump. This is an
alternative to release insulin into a diabetics system. Insulin therapy may be complicated
by one or more of six possible complications. These complications include hypoglycemia,
tissue hypertrophy or atrophy or both, erratic insulin action, insulin allergy, and
insulin resistance. Symptoms of hypoglycemia are altered consciousness, tachycardia, or
increased perspiration. Symptoms of hyperglycemia are polyuria or nocturia; the patient
may also develop symptoms of ketoacidosis or hyperosmolar coma, tissue hypertrophy or
atrophy, and possibly insulin allergies (Luckmann and Sorensen 1565-1575). Sugars in foods
that are eaten may cause insulin instability.

The diabetic diet is broken down into two different types; these types are the qualitive
diet and the quantitive diet. A qualitive diet is prescribed for persons with mild
diabetes. In a qualitive diet, the patient must refrain from adding sugar to his coffee,
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