Category: Diabetes

Dispelling Assumptions Understanding and Raising Awareness about Type 1 Diabetes

Navigating the Impact of Type 1 Diabetes

I was ten years old, sitting in a math class with all of my friends, when I got a devastating phone call. A call from my mother explaining with fear in her voice that my sister perhaps had got diabetes type 1. My grandmother picked me up and drove me to Karolinska Hospital, where I met up with the rest of my family. I still remember the doctor arriving in the waiting area and telling us that my little sister had type 1 diabetes. What was our family supposed to do now? None of us knew anything about the disease. However, we knew that we needed to adapt to a new routine in our everyday life, though how? Then I had assumptions that I necessarily not should have needed. Diabetes type 1 is a severe disease that must be taken more seriously and, above all, be informed about more in society to get rid of unintentional assumptions.

Words Describing Diabetes, Pixabay, 2016

The prominent assumptions about diabetes type 1 are that people get it because they are overweight and consume too much sugar. This assumption is far off from the truth and not correctly right. The reason behind the assumption is that people associate diabetes type 1 with diabetes type 2. Diabetes isn’t only one disease, but several different diseases.

Diabetes type 1 is a chronic, autoimmune, and incurable disease caused by insulin deficiency. Having type 1 implies that the body’s immune system attacks and destroys the insulin-producing beta cells in the pancreas. The hormone insulin is required to regulate blood sugar. Imagine hormones like keys. The insulin formed in the pancreas, produced in the Pancreatic islets of Langerhans, is used as an insulin key to open the cell, which causes the blood glucose to be transferred away from the blood to the cells where it’s converted into energy. Without insulin, the glucose flows past the locked cell causing high blood sugar levels. The information above is explained in Hjälpredan (2017), written by Karolina Janson and Lotta Skoglund. Therefore, insulin treatment is essential for people with type 1 diabetes to control their blood sugar.

However, type 2 diabetes is an insulin-resistance disease where the resistance to insulin is increasing; the keys are too few. Type 2 isn’t autoimmune and is caused mainly by obesity and the lack of physical activity. Compared to diabetes, type 1, people with type 2 still produce insulin and could get rid of the disease by changing their lifestyle. Eva Örtqvist, a senior doctor at Astrid Lindgren’s Children’s Hospital, showed, in a recent conversation, statistics that there are approximately 40 000 people total in Sweden who has type 1, whence 8 000 of these are under 18, and 400 000 people in total that have type 2. Explaining that it’s more common for people to have type 2 diabetes today in Sweden’s society, and therefore obesity and sugar are underlying reasons for the assumption that the same factors are causing type 1. Try to remember that diabetes type 1 and 2 have similar characteristics, though ultimately two separate diseases.

Graph showing the number of insulin pumps in different age groups, Swediabkids, Annual Report 2017

When I tell people that my sister has diabetes, the reaction I often face is, “I could never survive diabetes because I’m afraid of needles.” This is the view from one perspective of diabetes type 1 the only tool you have is a hammer, and thereby, you treat everything as if it was a nail. This is not an accurate assumption any longer. Even though there hasn’t been a fortunate discovery where scientists have found out what causes diabetes, more and more technology has advanced and improved. Comparing diabetes treatments today and ten years ago, there is a striking development. “Present-day,

65 % with diabetes type 1 under the age of 18 uses an insulin pump,” stated Eva Örtqvist. An insulin pump is an alternative treatment for insulin pens which can facilitate everyday life for the reason that fewer syringes are required. Instead of taking a syringe for each meal, only one every third day is needed. You may be wondering, how far has the development advanced today? Minimed670g, the first self-adjusting insulin pump system that both gasses and breaks down the intake of insulin, was recently launched. Freestyle Libre is a blood glucose meter that does not require lancets, test strips, and blood; instead, blood glucose is monitored using Bluetooth with remote control. This shows that diabetes is not a challenging disease to live with anymore; everything is about one’s own attitude.

A video produced by Barndiabetesfonden shows that a large percentage of adults have the assumption that people with type 1 diabetes live a normal life compared to healthy people. An assumption that a relative of someone with diabetes hoping was accurate, however, isn’t. Having diabetes means more responsibility and learning the symptoms when both low and high blood sugar decrease complications. Low blood sugar, or hypoglycemia, is when the blood sugar is under 3.0-3.5 mmol/l, which could lead to insulin coma. If left untreated, insulin coma could be fatal and, at worst, lead to death and permanent brain damage.

Hyperglycemia, the opposite of hypoglycemia, is when the blood sugar is too high. Too high blood sugar for too long can lead to both short-term and long-term complications. Kidney diseases, cardiovascular diseases, eye diseases, amputation of feet, and diabetic ketoacidosis are just a few examples of effects when you don’t treat the disease right. As a diabetic, you need to regularly keep control of the blood glucose levels to prevent the effects stated earlier. You can never turn a blind eye to the disease.

To conclude, it’s easy to have an assumption about a disease without knowing the whole truth about it. Therefore, we need to fight and combat assumptions with information and facts. Diabetes type 1 is a disease that is not similar to any other. It’s not possible to compare type 1 diabetes with type 2 diabetes any longer, the same as it’s not possible to compare different dementia diseases.

References:

1. Janson, K., & Skoglund, L. (2017). Hjälpredan: Diabetes typ 1. Familjeliv Media AB.
2. Örtqvist, E. (Personal Communication). Senior Doctor, Astrid Lindgren’s Children’s Hospital.
3. Swediabkids. (2017). Annual Report.

Managing Diabetes: A Collaborative Multidisciplinary Approach

Rising Diabetes: Insulin, Glucose, and Global Concerns

Diabetes is a severe illness where there is an insufficient amount of insulin. The body can find it difficult to utilize insulin adequately. The pancreas is the body structure that produces insulin. Islets of Langerhans are cells found in the pancreas, whereas beta cells are cells that are found in islets, which make insulin present. Food that is high in starch and carbohydrates, amongst other nutrients, is later broken down into glucose. This process happens in the stomach, which then glucose is transmitted into the bloodstream. In order for the cells to function well, they need energy. This is exhibited by glucose. The role of insulin is to prompt liver and muscle cells (among other cells) to absorb glucose to be transferred to energy. If the body has a considerable amount of energy, insulin prompts the liver to store glucose as glycogen.

Diabetes is a serious condition if not treated well. According to the World Health Organisation, in April 2016, diabetes was going to be the seventh most consequential cause of death around the world. Nowadays, diabetes is becoming more common. Worldwide, around 347 million of the population are known cases of diabetes. A rise in deaths in the coming future is not surprising. This is because 1.5 million cases were noted in 2012, and according to research, the probability of increasing by 50% is existing. (World Health Organisation, 2016).

There are three types of diabetes:

Type 1 (also known as insulin-dependent diabetes): This is often found in adolescents and youth. When food is absorbed and reached in the stomach, glucose is present and liberated in the bloodstream. Type 1 diabetes experiences a problem. They lack insulin production, and as a result of this, glucose can not get into the cells, and they experience an increment in blood glucose levels (Diabetes UK, 2017).

Type 2: This tends to be developed during the 40’s or older. Similarly, for type 1 diabetes mellitus, the same scenario is repeated where insulin somehow lacks and cannot penetrate the cells. Despite the fact that they are similar, there are cases which differentiate. Fatty deposits cling to the cells, forbidding the glucose from getting in. This is caused by the fact that fat disallows the process to exhibit in its normal manner and not because of a shortage of insulin in the body. Type 2 diabetes is experienced in 85% of the known cases worldwide. Some factors that make this condition more severe are smoking and being obese. This is because, as previously specified, the fat disallows insulin from functioning well.

Type 2 diabetes can be found in anyone who has a good Body Mass Index. If diabetes is mistreated, chronic health issues will be faced, such as blindness- retinopathy, and neuropathy, which can end up with amputations and kidney failure (Diabetes UK,2017). Folks who experience diabetes are more exposed to Cardiovascular diseases such as CVA. The nervous system may also be damaged due to diabetes, and neuropathy can arise. Numbness and lack of feeling in the extremities of our body are the result of diabetes, and ulceration may take place. One should give importance to any cuts that may appear during daily activities, such as nail cutting or walking on bare feet. Cuts and ulcers in diabetics may take longer to heel, which might result in wounds, and if not treated well, amputations may take place.

Gestational diabetes resembles that of type one and type 2, but it is often found during pregnancy. If diabetes is shown at the initial stage of the pregnancy, it might indicate that the mother suffered from diabetes before. This can be medicated with the use of insulin, amongst other treatments. In this type of diabetes, if treatment is given with immediate effect, the condition can be eliminated. Promoting a healthy lifestyle and a good Body Mass Index before, during, and after pregnancy is of utmost importance to eliminate as much as possible diabetes (Nice.org.uk,2016).

Nursing’s Vital Role in Diabetes Care and Education

Health care staff shows compassion and care towards the patients regardless of gender, ethnic race, and religion. The nursing role consists of looking after ill patients, dying patients, and patients with special needs and advocating health advice. (“WHO|Nursing”). The role of a nurse is essential when taking care of diabetes. When the nurse faces people who lack knowledge about healthy lifestyles, the nurse must emphasize the good practices. This has to be linked with the relatives, to work hand in hand with the nurse and cooperate by not giving sugar-based food or junk food, which may not help with his/her condition.

The professionals must not use as many as possible so that the patient can absorb all the said information. If this is not abided by, goals set by the multidisciplinary team will not be achieved (Nursingworld.org.org,2017). The nurse has to undertake BGM. Following this, the nurse has to observe any differences noticed in the patient and document them in order to administer the adequate dose of medication. Prevention of sores is prudent; therefore, information is provided to the patient and relatives. Cushions and adequate padding under the legs is a good prevention.

A particular nursing role is the Tissue Viability Nurse, who has a crucial role in monitoring wounds for fast-paced healing. Foot ulcers are very trivial in patients who are experiencing diabetes. 6% out of the 15% who developed a foot ulcer ended up in the hospital to treat infection and other complications (Apma, 2016). Patients who have stage I ulcers should be treated immediately to eliminate escalating tissue damage and promote healing. Stage I foot ulcer is classified as a superficial ulcer, where wadding and cushioning are used to ease pressure and off-load the leg (Doupis & Veves, 2008).

Poor circulation, irritation, diabetic neuropathy, trauma, and pressure on the foot for long hours cause diabetic foot ulcers to form. A podiatrist’s advice is vital to recommend footwear. Footsteps are monitored by the podiatrist during follow-ups to see the patient’s process and not developing new ulcers (Nice.org.uk, 2015).

Collaborative Care: Diet, Exercise, and Physiotherapy in Diabetes Management

Promoting a healthy and accustomed diet for the patient is the role of the dietitian. The reason behind this is to keep blood glucose levels in the blood under control, together with cholesterol levels and blood pressure. A dietician is a paramount source because he aids patients with customized diet plans to minimize the risk of stroke and heart disease. The recommended food has reduced fats, salts, and sugars (Diabetes: Healthy Eating with Diabetes, 2009).

As much as possible, the nurse collaborates with the dietician to support the patient to keep his intake of biscuits and sweets as low as possible. These can be altered with fat-free and sugar-free biscuits. This way, the patient is balanced; he is pleased with biscuits, but at least fats and sugar are minimized. Sugary drinks such as soft drinks should be eliminated as blood glucose levels would increase. Two liters of water are recommended to eliminate dehydration (Bda.uk.com, 2013).

PhysiotherapyPhysiotherapy is part and parcel of the multidisciplinary team as they have to work hand in hand to achieve the goals set. Physios aid patients in enhancing their conditions by suggesting and recommending different exercises according to the condition of the patient. They analyze the improvements and appraise every little advancement to encourage independence and give hope. Physiotherapists and Pedologists are to work hand in hand for recommendations of best care, especially when mentioning foot care. A case in point is when analyzing the mobility of an individual to prevent any bed sores from forming and assessing the patient for the right posture of walking (Nhs. uk, 2017).

Nurturing Patient Awareness: Education and Challenges in Diabetes Care

Having a look at the journey of care, one can see a variety of cases. People who are not residing in long-term facility care and are diagnosed with diabetes may not be aware that they are not eating the right food with adequate amounts, which may include fat, sugar, and salt intake. They may also miss the treatment as they forget or see it as a cost, and they don’t even dare to buy it or take it when they feel up to it. Part of the role of the multidisciplinary team is to educate the patient and enhance his knowledge for better self-care. The main focus in all these scenarios is always the patient; therefore, promoting a healthy lifestyle is necessary for the good of the patient.

Education is the key to patient awareness; therefore, without it, the patient lacks self-care, healthy nutrition intake, and treatment and may mislead the planned goal. With knowledge, the patient can also be more independent, excluding that Dementia or similar conditions are not present in this case. With all of this, the nurse can promote a better way of living, and the patient looks at life in a more interesting manner. An obstacle that a nurse may face is when patients are not willing to cooperate and neglect instructions that are made clear.

These patients need watching constantly and also need a lot of support from their relatives (Nice.org.uk, 2015). When meeting the patient, it is of utmost importance that the nurse conduct eye contact with the patient. If this is not abided by, the patient may lack concentration, and the nurse will show a lack of interest. Speaking rapidly may also make the patient feel lost. When reaching a certain old age, the senses may start to deteriorate, such as poor eyesight and poor hearing; therefore, speaking adequately, calmly, and repeating when necessary is prudent to ensure that the message is conveyed.

Fostering Trust and Education: Effective Communication in Diabetes Care

Empathizing with the patient and treating him/her with dignity may make the patient acquire trust in the nurse, rather than unnecessary shouting and being hard. Explaining to the patient without using a lot of jargon makes the patient comfortable to understand his case. For example, Notifying the patient that he/she is suffering from hyperglycemia is useless if the patient does not know what the term hyperglycemia means. Rather than that, the nurse could say the patient is suffering from high blood sugar in the blood. In this way, the nurse is speaking in a way that she is assuring herself/himself that the patient is getting the message. Keeping distractions to the minimum is another advantage to help the patient get the message (Fischbach, 2010).

Informative leaflets can be given to the patients and their family members to help them gain more knowledge about the condition. When patients are in long-term care or residential homes, the nurses and healthcare team are responsible for taking blood glucose frequently. Also, giving out treatment and delivering good care will show up by stabilizing the blood glucose, for instance, by administering treatment regularly at the proper time and proper dosage and eating food to enhance the situation. This stability will show progress and minimize the risk of developing other health conditions.

Groups and organizations associated with diabetes are available. These contribute to awareness and conduct programs to help people overcome diabetes. These entities also provide a good source of education, where anyone concerned may utilize this knowledge to handle his/her condition better. The World Health Organization organizes an agenda for the scope of increasing information about minimizing the risk of diabetes and supplying people with information on how to adhere to healthy habits. Who also publish statistics about anyone experiencing diabetes. WHO also remarks a lot on healthy eating to make people more aware of how to live healthily and achieve a good Body Mass Index. This also includes exercising daily because being in a healthy state may be key to keeping chronic illnesses away, such as diabetes and being overweight (Who. int, 2009).

Collaborative groups like the Malta Diabetes Association give their helping hand by visiting patients, educating them and their family members, and clearing any uncertainties that they might have. The Pursuit helps by giving out concrete and practical advice. During educational sessions, leaflets are distributed to make it easy for the patient to remember and understand what it is all about. Newsletters and magazines are issued often in order to keep patients informed regarding diabetes. (Maltese Diabetes Association,2017) A good informative program about diabetes is X-PERT. These include changes in food intake, healthy snacks, and daily fitness sessions. The meetings are two and a half hours over a period of six weeks. (X-PERT Diabetes 2016).

Conclusion

When treating patients with diabetes, the multidisciplinary team is essential for the care of the patients to enhance their way of living. The multidisciplinary team does not focus on oneself or independently, but on the contrary, they work as a team to achieve the desired goal for the good sake of the patient. The focus of the multidisciplinary team is always on the patient; therefore, they must work hand in hand because if not, the patient is the one who will have a bad experience. The multidisciplinary team must make use of continual professional development in order to keep updated with new procedures, techniques, and new evolutions because medical health evolves rapidly, and with the education acquired, one can help the patient fruitfully.

In this assignment, the significance of including patient education as part of the care was emphasized. This can be achieved with the help of groups, which we specified earlier, and with the involvement of the multidisciplinary team. It is imperative that the education provided should be well elucidated and implicated by the family members. As data is showing, which is quoted earlier on, diabetes is getting more common nowadays, but longevity is getting longer, too. To be able to reduce the number of diabetes sufferers, one must understand and get educated, and that’s where the role of health promotion kicks in.

Leaflets, magazines, billboards, and health promotion advertisements on television are crucial. This will contribute to making society more intelligent and reduce the number of new cases of diabetes. We, as a society, have to contribute in order to reduce the risk of ill suffering and obviously cure. Diabetic patients may be more susceptible to experiencing depression. When this happens, the multidisciplinary team must target to tackle it as well, with care and empathy, and above all, with lots of support. If the mentioned measures are adhered to, people with diabetes will face an easier life, which involves support, a healthy lifestyle, exercising, reading of BGM on a regular basis, and treatment as required.

Appendix:

Mr. X’s condition was identified six years ago and resulted in type 2 diabetes. He is a 70-year-old gentleman who has been residing in the elderly residence for four years. He used to live with his child, who was unable to handle his bad tendencies of food, and despite healthy food being provided, he still entertains himself with food that is rich in fats and sugars. An episode of dehydration occurred, and his daughter brought him to casualty while she was alerted that her father was urinating often and haematuria was present. Mr.X was disoriented. A urinalysis and CBC, amongst other tests, were taken on admission, and it resulted that he was suffering from diabetes.

While he was in hospital, BGM was recorded regularly and resulted in type 2 diabetes. Gliclazide was administered at the dose of 80mg daily, Metformin was administered at 500 mg twice daily, and fixed doses of Insulatard. These were the treatments required to treat his condition, that is, diabetes type 2. Both patient and relative agreed that Mr.X should be sent to a long-term care facility for more professional care. On discharge, the patient was sent to St. Vincent De Paul because his daughter could not take care of him, where he could be provided with the necessary treatment and care daily. This was to safeguard Mr. X because he also had traces of Dementia and could risk an overdose leading to hypoglycemia or miss his treatment if left independently.

Mr.X is now living in Saint Vincent De Paul and is a semi-dependent patient. BGM tests are still being monitored daily. He is still being treated with metformin gliclazide and insulin, according to his BGM. Lately, he was diagnosed with a pressure sore stage 1 in his left heel. As advised by TVN, he is to be ambulated regularly, avoid long stays in bed, and observe the sore to heal to prevent further complications.

References:

1. World Health Organisation. (2016). Global Report on Diabetes. Retrieved from https://www.who.int/diabetes/global-report/en/
2. Diabetes UK. (2017). Diabetes – The Basics. Retrieved from https://www.diabetes.org.uk/resources-s3/2017-11/diabetes_the_basics_2017.pdf
3. Nice.org.uk. (2016). Diabetes in Pregnancy: Management from Preconception to the Postnatal Period. Retrieved from https://www.nice.org.uk/guidance/ng3
4. WHO. (n.d.). Nursing and Midwifery. Retrieved from https://www.who.int/news-room/q-a-detail/nursing-and-midwifery
5. Nursingworld.org.org. (2017). The Role of Nurses in Diabetes Care. Retrieved from https://www.nursingworld.org/practice-policy/workforce/what-is-nursing/the-role-of-nurses-in-diabetes-care/
6. Apma. (2016). Foot Complications. Retrieved from https://www.apma.org/Patients/FootHealth.cfm?ItemNumber=981
7. Doupis, J., & Veves, A. (2008). Classification, Diagnosis, and Treatment of Diabetic Foot Ulcers. Wounds, 20(5), 117-126.
8. X-PERT Diabetes. (2016). About X-PERT. Retrieved from http://www.xpertdiabetes.com/about-x-pert
9. Diabetes: Healthy Eating with Diabetes. (2009). British Dietetic Association. Retrieved from https://www.bda.uk.com/resource/diabetes-healthy-eating.html
10. Bda.uk.com. (2013). Diabetes. Retrieved from https://www.bda.uk.com/resource/diabetes.html
11. Nhs. uk. (2017). Physiotherapy. Retrieved from https://www.nhs.uk/conditions/physiotherapy/
12. Fischbach, F. T. (2010). A Manual of Laboratory and Diagnostic Tests (8th ed.). Lippincott Williams & Wilkins.
13. Who.int. (2009). Promoting a Healthy Diet for the WHO European Region. Retrieved from https://www.euro.who.int/__data/assets/pdf_file/0017/146721/E93736.pdf
14. Maltese Diabetes Association. (2017). About Us. Retrieved from http://www.diabetesmalta.org/about-us/

The Silent Epidemic: Unveiling the Impact and Management of Diabetes

Glucose, Insulin, and Complex Health Implications

Imagine a disease that is spread throughout one-tenth of all Americans and one-fourth of them do not even realize that they are infected; a disease that is ranked in the top ten in death causation in the United States; and a disease that places most noninfected people at risk. This disease is alive and well and goes by the name of diabetes. Diabetes is defined as a disease in which one’s blood glucose (blood sugar) levels are too high to be considered healthy. Glucose is an imperative element of everyone’s internal, organic makeup. For this reason, the term “diabetes” has been around for ages, yet the disease has been present for all of human history.

Furthermore, as technology has developed and research has become more abundant, the disease has grown more complex. Various types and stages of the disease that have been established cause treatments to diversify on a patient-to-patient basis. Even with the improvement of treatment options, diabetes is still taking lives at a high rate; some would even say that it is an epidemic. As previously stated, one in ten people (Americans) are diagnosed with diabetes; however, many more are affected by the disease in some way or fashion.

Glucose, derived from the Greek word for “to pass through,” is the most familiar type of sugar to humans, attributed to the fact that it originates from the food that humans eat. This sugar, once in the bloodstream, is used for energy throughout the day. In terms, glucose is positive in every way for human function, yet not having the right amount of glucose in the bloodstream can be detrimental. If one’s glucose levels are too low, he/she will be lethargic and will lack the energy needed to perform daily tasks, but if his/her glucose levels are too high, potentially fatal, internal issues will begin to occur. When one has high glucose levels, nerve, kidney, and even eye damage are all possibilities.

High glucose levels (over time) can also lead to other serious bodily malfunctions such as heart disease and stroke. Those who have not been diagnosed with diabetes should worry not because of a natural hormone called insulin. Insulin is a natural mode of transportation that moves glucose from the bloodstream into cells. There, glucose will either be used for energy (ATP) or sent into cell storage. This is precisely where those with diabetes are lacking. Diabetes is an indicator that someone is lacking an appropriate amount of insulin to transport the amount of glucose that he/she is taking, or he/she could have insulin that does not respond as it should when in the bloodstream. This is an issue that has been around as long as glucose itself.

Historical Origins, Evolving Treatments, and Personal Struggles

The full name for diabetes is diabetes mellitus. The term originates from a combination of the Greek word “diabetes” (to pass through) and the Latin word “mellitus” (which means honey). This is important because it was first used by Apollonius of Memphis around 2269 years ago (250 BC) – it was not used in English text until 1425. This disease has been speculated to have been around since humans had originated. However, it was not fully discovered until the findings of Liverpoolian physician Matthew Dobson. In 1776, Dobson confirmed that the urine of people with diabetes had a sweet taste because of remnants of excess sugar. He learned of this phenomenon when he noticed a brown sugar-like substance in their urine. Dobson’s discoveries led to the ability to diagnose and treat diabetes.

Treating diabetes is a very difficult task. If the diagnostics show that the disease is not very serious, some can treat diabetes by making healthier life decisions. This points to lighter and more nutritious food options and being more physically active than previously before. For many, that is a tough transition to make. When one makes the same constant decisions to eat unproductively or has a job that does not require physical activity by an individual (including unemployment), it can be tough to change his/her ways if there is no positive reinforcement backing his/her decisions.

However, those people are lucky because if the disease worsens, treatment becomes a little more difficult. Most people need better dieting and exercise, but they also need medication along with it. These medicines may come in the form of pills to control the disease itself or can come in the form of injection needles (which are used to inject insulin into a diabetic bloodstream. Even if a patient does not need the insulin shots regularly, they are still necessary during occasional checkups.

Living with type 1 diabetes is very difficult for the family of the patient, and especially the one with the disease him/herself. The routine is rigorous: check one’s blood sugar and diet, take medication, have a plethora of doctor checkups and appointments, and do it all over again. I’ve learned this by watching the struggle of my grandfather. He is the most stubborn but prideful man I know on this planet. He is sixty-six years old and has been diabetic for over 20 years. In July 2013, because of damage done to his nervous system, he had a stroke (nearly paralyzing him on his entire left side).

Coping with the Consequences of Diabetes

My family was distraught, seeing that he was the matriarch of my family. Consequently, he has never been the same since before his stroke. He used to be a hard-working man (physically). He was active in every way: whenever things needed to be fixed, he was there, and whenever his grandkids (including myself) wanted to play, he was available. Now, he can no longer participate in those activities, and as a matter of fact, he cannot complete much simpler activities. His driving, eating, and even walking were all heavily impaired by the event of 2013. He often explains that the constant pain in his body due to his stroke is enough to make him shed tears every single day.

Also, he rarely has the pleasure of enjoying the time that he is relaxed because of the half dozen pills he takes three times throughout the day, the burden of having to check his blood sugar four times a day, and the (what I would call) God-awful sugar-free diet that he has been placed on. Furthermore, due to my grandfather’s stubbornness, my mother, aunt, uncle, and grandmother all feel as though they must act as caregivers. They always make sure that he is eating right and taking his medicine. They police his activity and are constantly declining his everyday wants and want-to-dos. None of my family truly enjoys having to be so authoritative towards him, and he especially does not take fondly to it. Nevertheless, he is just one person, out of millions, with the disease. He even has the most common type of the disease. Many Americans are in a much smaller boat than himself.

There are three main types of diabetes, along with another minor form. The first type of diabetes is type 1 diabetes. Type 1 diabetes, formally known as juvenile-onset diabetes, is usually the result of the human body’s defense system attacking and breaking down cells that produce insulin. Doctors are not yet clear as to why this attack occurs. Unfortunately, this disease usually occurs in infants and young children because it is more of a defect than an acquired disease. Those with type 1 diabetes need insulin injections every day, or the disease becomes fatal. The next type of diabetes is type 2. Type 2 diabetes sounds a bit more pleasant, but that is simply an illusion.

Type 2 diabetes, formally known as adult-onset diabetes, is the most common type of diabetes (accounting for at least ninety percent of all cases of the disease). The disease often has to do with a body’s resistance to insulin. Oftentimes, obesity is the cause of this disease, thus unpredictable, and can be diagnosed at any point in someone’s lifetime. This type of diabetes can often be managed by a change of diet and exercise. The third type of this disease is often referred to as Gestational diabetes. Many would think that not a large sum of individuals acquire this type of diabetes because it is specific to women in pregnancy; however, one in every four pregnant women worldwide contract the disease.

Confronting Diabetes through Personal Experiences

Complications to both the mother and the child will most likely occur. The positive in this form of diabetes is that it disappears after pregnancy ends, but both the mother and the child are more likely to attain type 2 diabetes over their lifetimes. There also exists an early stage of diabetes called prediabetes. Prediabetes is not a disease, yet it is an indication that you are on the path. To have prediabetes, your blood glucose level must be much higher than what it should be but not yet in the diabetes range. With all of these types of diabetes in mind, the average person should consider getting their blood tested more often than usual. It cannot hurt, but it would be nice to know where you are on the diabetes spectrum.

Seeing my story about my grandfather should be enough to deter anyone from an unhealthy lifestyle; however, maybe it would be more effective to see the stories of other real people. The first story highlights the battle of sixty-five-year-old Florence “Flori” Schikker. She had ten grandchildren and, for that reason, denied that she might have had diabetes for over twenty-seven years. She did not take the disease seriously until her toe was amputated. Here is a real quote along with further explanation of the situation as a whole: “Doctors told me the only way to survive this fight was to amputate my leg,” Schikker says.

She acknowledges that she has lived an unhealthy lifestyle for many years. Working in a bank, she did very little exercise, ate fast food, and drank Coke on a regular basis.

“If the doctor tells you you’re a diabetic, don’t ignore it. Don’t get to where I am. The sooner you accept things, the better it is for your health.”

Only after her toe was amputated did she realize the seriousness of diabetes and how her lifestyle was a major contributing factor to her situation. She knew very well that both her mother and brother had type 2 diabetes. And four years earlier, Peralta’s doctor had already told her that she had prediabetes. That meant that her blood sugar levels were higher than they should have been but not yet high enough to constitute diabetes.

Overcoming Diabetes Challenges through Determination

Another story highlights a woman by the name of Elizabeth Peralta from the Bronx. She was diagnosed with type 2 diabetes in July 2014 at the age of 53. She was knowledgeable that diabetes ran in her family, including her mother and brother (not to mention that four years before her incident, she was diagnosed with prediabetes).

At her annual checkups, Peralta’s doctor warned her about her growing risk given her family history of diabetes — a significant risk factor for developing the condition, according — and the fact that she gained considerable weight over the years. Peralta’s weight kept rising, which peaked at 240 pounds. Then, one day in July 2014, she lost sensation in her feet. She went on to say, “My legs were killing me, and I was feeling funny, so I went to see my doctor,” she says. Her doctor did a test to see her three-month blood sugar average and was alarmed when it was over ten.

“My doctor told me it was a miracle I was walking around because my sugar was so high,” Peralta recalls.

Soon afterward, Peralta made a vow to change her ways and become healthy once again. She worked with Maria E. Rodriguez, who is a program manager at The Diabetes Alliance at Mount Sinai. With Rodriguez’s aid, Peralta was able to make a complete one-eighty in her life. She dieted for years, along with an exponential growth in workout routines. Because she stayed disciplined, Peralta is no longer in need of medication to keep her blood sugar within a normal range.

Diabetes is a disease that everyone has heard of, yet nobody truly knows the significance of what it actually is or its effects on those diagnosed and family members.

A Hypothetical Journey into the Reality of Diabetes

For that reason, here is something that will make it a bit more relatable: a hypothetical. Imagine if you were living the life of an average American. You worked a nine-to-five, had children and a wife, and ate as you pleased. You feel as though you are having internal bodily issues; however, you think nothing of it. On an annual checkup at the doctor’s office, you learn that your blood sugar level is far too high and you have been diagnosed with diabetes. You think very little of it until your life completely changes. Every morning, when you wake up, your routine is altered. Before showering, brushing your teeth, and eating breakfast, you must take your blood sugar and take three to four pills.

Then, when you finally do sit down for breakfast, you must eat very specific meals that do not involve an excess of sugar. As you go about your day, you will have to repeat the routine of blood sugar checks and medication twice more. Also, snacks are no longer an option. At some point in your day (tired from the mental stress of work), you must find time to exercise. When your kids ask to play, the activity must be limited due to your body’s inability to produce ATP at a high rate. One day after following this diabetic routine, you feel an ache in your chest. You fall to the floor, unknowledgeable about the near future. You are rushed to the hospital and have been informed that you had a heart attack; luckily, you pull through. Nevertheless, your routine is now altered once again.

Along with the pills you have been taking, you now need to incorporate insulin shots into your day. You need to visit your doctor on a weekly basis and have been limited to little or no physical activity during the day. This means that you will never be able to be taken off of medication and can no longer do fun activities with your family. To top it all off, a couple of mistakes in your diet can now prove fatal. This is a life that no one wants to live, but it is a harsh reality for many. This should show those who are healthy how important a healthy lifestyle is. And if one is diagnosed with diabetes, it should be taken seriously immediately.

Recognizing Signs, Seeking Testing, and Preventing Loss

Diabetes is a disease in which one’s blood glucose (blood sugar) levels are too high to be considered healthy. Millions of Americans and others worldwide are affected. I myself have witnessed it, and it is certainly life-altering. Although there is no cure, living an exemplary physical lifestyle can reverse some effects. If one knows that he/she has been underperforming in the category, then searching for the signs is imperative. The symptoms are mild yet still noticeable. Hunger and fatigue is the number one indicator that one has diabetes. If constant tiredness and an unhealthy urge of hunger is always present, the disease could be present.

Urinating too frequently and a sudden sense of thirst are also noticeable differences those with diabetes can pose. Dry mouth, itchy skin, and blurred vision are also strong indicators of diabetes. If one experiences these symptoms, he/she should get tested immediately. The test either consists of Hemoglobin A1c testing or Oral Glucose Tolerance testing. The Hemoglobin A1c test is simple: one gets his/her blood drawn, and professionals check for the average level of blood sugar over an extended amount of time by looking at the hemoglobin (the protein found in red blood cells).

The Oral Glucose Tolerance test is less common, but it involves getting blood drawn once (then the patient will drink a mixture of glucose dissolved in water) and getting blood drawn again two hours later. The doctors try to analyze how effectively insulin works within a patient’s bloodstream throughout the test. These tests are very simple and take very little time. Advocation for these tests should sharply rise as more information is released about the disease itself; it also should be stated how important it is for those who receive positive results to consult with his/her doctor on what changes can and should be made. This way, fewer people, year in and year out are taken from their families and loved ones.

References:

1. Centers for Disease Control and Prevention (CDC). (2021). Diabetes. Retrieved from https://www.cdc.gov/diabetes/basics/index.html
2. American Diabetes Association. (2021). Types of Diabetes. Retrieved from https://www.diabetes.org/diabetes/type-1
3. American Diabetes Association. (2021). Type 2 Diabetes. Retrieved from https://www.diabetes.org/diabetes/type-2
4. American Diabetes Association. (2021). Gestational Diabetes. Retrieved from https://www.diabetes.org/diabetes/gestational-diabetes
5. American Diabetes Association. (2021). Complications. Retrieved from https://www.diabetes.org/diabetes/complications
6. Bailey, E. (2015). After toe amputation, a wake-up call about diabetes. CNN. Retrieved from https://www.cnn.com/2015/05/06/health/diabetes-toe-amputation/index.html
7. Landau, E. (2015). How one woman’s diabetes turned into a message of hope. CNN. Retrieved from https://www.cnn.com/2015/04/16/health/diabetes-weight-loss-es/index.html
8. Mayo Clinic. (2021). Diabetes. Retrieved from https://www.mayoclinic.org/diseases-conditions/diabetes/diagnosis-treatment/drc-20371451

Genetic and Lifestyle Factors in Diabetes: Unraveling the Connection

Unraveling the Glucose Absorption Puzzle

How much is a diabetes diagnosis subject to genetics, and how much is it on account of lifestyle? In order to figure this out, it has to be established how much of it truly is genetic. This is also efficient because people’s lifestyles are difficult to monitor in comparison to their genetics. Diabetes is a genetically passed down condition that becomes apparent in different stages of a carrier’s life depending on the variation or type. It is a very serious condition, and without knowing its genetic properties, it may be harder for an individual to assess their probability of having it. Diabetes, when studied as a genetic condition, therefore, is much more informative than an alternative.

Diabetes is a hereditary condition, which can be implied by its strong dependence on varying genetics. Diabetes is essentially a condition that turns the human body’s blood into a built-up central for sugars that have entered the body. See, how a normal body takes in energy is fairly straightforward. When someone consumes a food source with glucose in it, which is just about everything, it is dissolved and digested. During the digestion process, the pancreas sends the glucose and insulin outward into the body through the bloodstream. Cells in the body are signaled to open their membrane and allow glucose to be absorbed by the insulin in the blood. The insulin flows into receptors on a cell’s membrane that will open up paths for the glucose.

The variations of diabetes, type one or type two, are based on the irregularities in this process. Type one diabetes is when the insulin being produced is either very minute in quantity or not functioning, meaning when it falls into receptor sites, the cell does not recognize it and does not open up its wall. Type two diabetes is when there are no receptors for the insulin being made in particular. Both types essentially result in a lack of absorption of glucose in the body and a build-up in their bloodstream. This is because carbohydrates rely on insulin and have no other way of being processed out of the bloodstream. The result is not only an unhealthy bloodstream but also a malnourished body that will take it out on itself if not treated correctly (Gerstein, 2013).

Exploring Diabetes Inheritance and CTLA-4 Relevance

There are many effects of the condition. The sugary bloodstream will eventually begin to slowly kill proteins in the body, which several organs and even tissues need to function correctly. Other parts of the body, like the cornea of a person’s eye, kidney, heart, or nerves, can be threatened by the body’s complications (Gerstein, 2013).

Type 1 diabetes is the most commonly associated with hereditary passage. Speculations of this stem from the fact that most type one diagnoses begin in children or a young age population group when type two, in comparison, usually shows up after the age of thirty, suggesting more of a lifestyle factor being at hand (Gerstein, 2013).

It is believed that diabetes is largely passed on by an autosomal chromosome 2q33 with a deficient strain of CTLA-4. CTLA-4 is a type of protein receptor that is usually associated with conditions that have dominant autosomal characteristics, but diabetes, on the other hand, is not necessarily dominant or recessive (Nistico, 1996). Type one diabetes is considered almost mysterious because its association with CTLA-4, or 2q33, isn’t quite a consistent phenomenon because type one is polygenic.

This essentially means that there are a variety of genes that can contribute to the conclusive overall condition of diabetes. Having so many genes involved means that it can be recessive, dominant, or a combination (Nistico, 1996) (Nieuwenhuijze, Liston, 2015). CTLA-4 was initially thought to be associated with a type of diabetes because it is one encoder for t-cell receptors, and being that diabetes is an autoimmune disease, t-cells are essential to its effects (Nistico, 1996).

Genetic Factors, Transmission Patterns, and Diversity in Diabetes Diagnosis

Definitive research does not exist to show certain likelihoods as to whether a father or a mother is more genetically responsible. This is difficult to prove, of course, because of the variating recessive and dominant genes that make up a diabetes diagnosis. However, there are more cases of diabetes in young children whose fathers are carriers of the condition, but the exact reasoning is not proven (Osborn, 2013). Transmission may not be realized in the case of type two, being that it is normally dormant until brought to fruition from lifestyle (Gerstein, 2013).

Linkage is one of the concepts developed after Mendel developed his initial basis of genetics. Given that diabetes is an example of linkage, this would make it post-mendelian. Approximately 73% percent of type one diabetes is shown to be subject to allele transferring or sharing of ASP pairs shown in a study with siblings (Risch, 2000).

It is often misunderstood among the populace that someone necessarily must be overweight to be diagnosed with diabetes. Diabetes can be an apparent condition in anyone with a hereditary pool. According to the American Diabetes Association, as of 2015, over 9.4% of the population in the U.S. alone was diagnosed with diabetes of one form or another, and 1.5 million every year. They say that the top four ethnicities that make up the diagnosed population are currently Asian Americans (8%), Hispanics (12.1%), African Americans (12.7%), and the combined group of American Indians as well as Alaskan natives (15.1%). Since diabetes is polygenic, it’s difficult to say exactly what the cause of these concentrations is.

Adaptive Nature of Diabetes Types and Management Challenges

The more adaptive type of diabetes is type two diabetes because it tends to stay dormant until someone develops obesity or a generally unhealthy lifestyle. This means that it tends to arise or be more likely to arise if the body is taking in and storing an overwhelming amount of carbohydrates or glucose, to begin with. Both types can prove the body somewhat adaptive because the side effects are just the body trying to accommodate it. For example, when the body isn’t getting enough from its intake, it begins to feed off of what’s stored in the body, resulting in weight loss (Gerstein, 2013).

Unfortunately, the condition’s unpredictability caused by its polygenetic causes and multi-effect results make it not only difficult to diagnose but incurable as well. However, an individual can combat many of the symptoms by self-injecting insulin shots on a daily basis (Gerstein, 2013).For these reasons, it can be concluded that, yes, diabetes is largely on account of genetics, but in a lot of cases, mainly type two, lifestyle has to be taken into account.

References:

1. Gerstein, H. C. (2013). Diabetes: Chronic Complications (3rd ed.). John Wiley & Sons.
2. Nistico, L. (1996). CTLA-4 in autoimmune diseases. Annals of the New York Academy of Sciences, 778, 325-332.
3. Nieuwenhuijze, A., & Liston, A. (2015). The multifaceted role of the thymus in tolerance. Immunology and Cell Biology, 93(9), 787-793.
4. Osborn, C. Y. (2013). Inherited diabetes: Betrayal of the pancreas. Journal of Diabetes & Metabolism, 4(6), 279.
5. Risch, N. (2000). Linkage strategies for genetically complex traits: I. Multilocus models. American Journal of Human Genetics, 66(6), 1773-1784.
6. American Diabetes Association. (2015). National Diabetes Statistics Report, 2014. Diabetes Care, 38(Supplement 1), S1-S93.

Managing Diabetes Complications: Strategies for Prevention

Diverse Risks: Diabetes and its Complications

People with diabetes are more prone to develop a wide variety of serious health problems. Consistently high blood pressure levels lead to serious diseases that mainly affect the heart and blood vessels, eyes, kidneys, nerves, and teeth. In addition, people with diabetes may also have a higher chance of developing infections.

Nowadays, diabetes is a leading cause of cardiovascular diseases, blindness, kidney failure, and lower limb computation. So, by maintaining blood glucose levels, blood pressure, and cholesterol, diabetes complications can be prevented or delayed. Therefore, people with diabetes need regular monitoring.

Major complications of diabetes are as follows:

I. Cardiovascular diseases- They affect both the heart and blood vessels and usually cause fatal complications such as coronary artery disease and heart stroke. Cardiovascular is the most common disease that leads to death in people with diabetes. High blood pressure, high blood glucose levels, high cholesterol, and other risk factors lead to an increase in cardiovascular complications.

II. Kidney disease- It occurs by damaging the blood vessels in the kidneys, which leads to kidney failure. Kidney disease is very common in people with diabetes. So, maintaining normal levels of blood glucose and blood pressure can reduce the risk of kidney disease.

III. Nerve disease- When blood pressure and blood glucose levels are too high, diabetes causes damage to the nerves throughout the body. This leads to indigestion, erectile dysfunction, and other problems. The most commonly affected areas are the extremities, especially in the feet. Nerve damage in these areas is known as peripheral neuropathy, which causes pain, tingling, and loss of feeling. So, people with diabetes should regularly examine their feet.

IV. Eye disease- People with diabetes mostly develop eye diseases like a reduction in vision and blindness. It develops because of high blood pressure, high blood glucose levels, and high cholesterol. It can be managed by regularly checking the eyes and by not taking high levels of glucose and lipids.

V. Pregnancy complication- Women who develop diabetes during pregnancy have a high risk of complications if they don’t carefully monitor and manage their conditions. Women with type 1 and type 2 diabetes should achieve targeted glucose levels before conceiving to prevent possible organ damage to the fetus.

High blood glucose during pregnancy can lead to excess weight put on the fetus. This causes problems during delivery, trauma to the child and mother, and a sudden decrease in blood glucose for the infant after birth. Children who are exposed for a longer time to high blood glucose in the womb may develop diabetes in the future.

VI. Oral complication- If blood glucose is not properly managed by people having diabetes, then they may cause inflammation of the gums (periodontitis). Periodontitis is a major cause of tooth loss, and it also has a high risk of cardiovascular disease. Regular oral check-ups should be done to ensure early diagnosis.

References:

1. American Diabetes Association. (2021). Cardiovascular Disease and Risk Management: Standards of Medical Care in Diabetes—2021. Diabetes Care, 44(Supplement 1), S125-S150.
2. Thomas, M. C., & Cooper, M. E. (2006). Zinman B. Cardiovascular disease in diabetes: how does diabetes management change with cardiovascular disease?. Diabetes, Obesity and Metabolism, 8(3), 161-170.
3. Tuttle, K. R., Bakris, G. L., Bilous, R. W., Chiang, J. L., de Boer, I. H., Goldstein-Fuchs, J., … & Molitch, M. E. (2014). Diabetic kidney disease: a report from an ADA Consensus Conference. American Journal of Kidney Diseases, 64(4), 510-533.
4. Vinik, A. I., & Ziegler, D. (2007). Diabetic cardiovascular autonomic neuropathy. Circulation, 115(3), 387-397.
5. Scanlon, P. H. (2003). The English national screening programme for sight-threatening diabetic retinopathy. Journal of Medical Screening, 10(1), 16-18.
6. American Diabetes Association. (2020). Management of Diabetes in Pregnancy: Standards of Medical Care in Diabetes—2020. Diabetes Care, 43(Supplement 1), S183-S192.
7. Dabelea, D., Mayer-Davis, E. J., Saydah, S., Imperatore, G., Linder, B., Divers, J., … & Hamman, R. F. (2014). Prevalence of type 1 and type 2 diabetes among children and adolescents from 2001 to 2009. JAMA, 311(17), 1778-1786.
8. Löe, H., Theilade, E., & Jensen, S. B. (1965). Experimental Gingivitis in Man. Journal of Periodontology, 36(3), 177-187.