Diabetes as a word was borrowed from the Greek word meaning “a siphon”, 2nd century A.D Greek physician called Aretus the Cappadocian was the first to use it to represent a disease condition in a patient to passed urine excessively a medical term called “polyuria”. Diabetes as a disease poses so much life threats to human, it has gained so much attention by the world, it has created awareness world wide. It spans through continents, gender and different ages. International health organization ahs made this area of special interest because of the dangers and threats this disease has risen to the world; this disease has also raised a lot of questions and tension. Scientists and researchers have put in their best but the fact still remains that this disease is “treatable” but not “curable” yet. The American Diabetes Association reported in 2009 that there are 23.6 million children and adults in the United States-7.8% of the population, who have diabetes. Many people suffer from the disease but they are unaware.
This disease had existed several years ago but the world was in darkness and ignorance about it and even when it was known the treatment unknown until 1921 when insulin became medically available but before this time many had died. Researchers first gave an active extract of the pancreas containing insulin to a young diabetic patient in 1922, and the food and drug administration (FDA) first approved first approved insulin in 1939. Insulin used for treatment of diabetes is usually derived from beef and pork pancreas and also from human recombinant technology; the FDA approved the first human recombinant insulin for diabetes in 1982. Until recent times diabetes was thought to affect basically the elderly but researches has made it clear that if affects both the old and the young.
Basically there are two categories of diabetes: diabetes mellitus and diabetes insipidus and the both of them are characterized by “polyuria”, excessive excretion of large amount of urine with the distinction been that the urine in diabetes insipidus is not sweet as it does not contain sugar like in diabetes mellitus and there is no hyperglycemia (elevated blood level glucose) and both of them are to some extent genetically inherited. Often times when the word diabetes is used it means DIABETES MELLITUS which is a disease condition when the body does not produce or properly use INSULIN, a hormone produce by the pancreatic islets of langerhans which causes cells in the liver, muscle and fat cells to take up glucose from the blood storing it as glycogen in the liver, muscles and preventing the usage of fat as energy. In diabetes the body either does not produce enough insulin or can’t use it own insulin well or both.
DIABETES INSIPIDUS is a condition characterized by excessive thirst and excretion of large amount of diluted urine on a regular basis. The most common types of diabetes insipidus is neurogenic diabetes insipidus caused by deficiency of arginine vasopressin (AVP) also called antidiuretic hormaone (ADH) and the other nephrogenic diabetes insipidus caused by an insensitivity of the kidneys to ADH, it can also be an iatrogenic artifact (adverse effect or complication) of drug use. Other kinds of diabetes insipidus are dispogenic and gestational diadetes insipidus.
TYPES OF DIABETES
There are 4 types of diabetes namely:
1. diabetes type 1
2. diabetes type 2
3. gestational diabetes
TYPE 1: This type of diabetes is characterized by the loss of the insulin-producing pancreatic islets of langerhans which results in deficiency of the hormone insulin; it is furthermore classified as immune-mediated or idiopathic diabetes. There is currently no preventive measure against diabetes type 1 and many people with this disease are often healthy and possess normal weight at the onset of the disease. Type diabetes is traditionally called juvenile diabetes because of its high occurrence in children.
Treatment for type 1: The principal treatment of diabetes type 1 is the administration of artificial insulin via injection subcutaneously and a constant monitoring of the blood glucose level. Lifestyle precautions are also very helpful in type 1 diabetes. Treatment for diabetes must be continued uninterruptedly for prevention of diabetes ketoacidosis which may result in coma and possible death . The average glucose level for the type 1 patient should be as close to normal (80-120 mg/dl, 4-6 mmol/l) as is safely possible. Some physicians suggest up to 140-150 mg/dl (7-7.5 mmol/l) for those having trouble with lower values, such as frequent hypoglycemic events. Values above 400 mg/dl (20 mmol/l) are sometimes accompanied by discomfort and frequent urination leading to dehydration.
TYPE 2: This type of diabetes is characterized by insulin resistance, reduced secretion of insulin and sensitivity to insulin. Type 2 diabetes is the more common type of diabetes. In the early stage of type 2 diabetes, the predominant abnormality is reduced insulin sensitivity, characterized by elevated levels of insulin in the blood. At this stage hyperglycemia can be reversed by a variety of measures and medications that improve insulin sensitivity or reduce glucose production by the liver. As the disease progresses, the impairment of insulin secretion worsens, and therapeutic replacement of insulin often becomes necessary. Central fat which is fat concentrated around the waist in relation to abdominal organs and not subcutaneously is consider a predisposing factor to insulin resistance because this central fat produces a group of hormones called adipokines that have the possibility of impairing glucose tolerance. Obesity is found in about 55% of individuals diagnosed with diabetes. Aging and family history also contribute to development of type 2 diabetes. This type of diabetes may go unnoticed for several years because it has mild early symptom and there is usually no ketoacidotic episodes but the long term complications associated with this type of diabetes when unnoticed could be disastrous. Complications of diabetes type 2 include renal failure, vascular disease, vision damage and heart failure.
Type 2 diabetes is usually first treated by increasing physical activity, decreasing carbohydrate intake, and losing weight. These can restore insulin sensitivity even when the weight loss is modest, for example around 5 kg (10 to 15 lb), most especially when it is in abdominal fat deposits. It is sometimes possible to achieve long-term, satisfactory glucose control with these measures alone. However, the underlying tendency to insulin resistance is not lost, and so attention to diet, exercise, and weight loss must continue. The usual next step, if necessary, is treatment with oral antidiabetic drugs. Insulin production is initially only moderately impaired in type 2 diabetes, so oral medication (often used in various combinations) can be used to improve insulin production (e.g., sulfonylureas), to regulate inappropriate release of glucose by the liver and attenuate insulin resistance to some extent (e.g., metformin), and to substantially attenuate insulin resistance (e.g., thiazolidinediones). According to one study, overweight patients treated with metformin compared with diet alone, had relative risk reductions of 32% for any diabetes endpoint, 42% for diabetes related death and 36% for all cause mortality and stroke.
This kind of diabetes only occurs in pregnancy, it possesses several characteristics similar to type 2 diabetes but this type of diabetes is completely treatable and it disappears after delivery but require proper medical supervision because if not properly handled would damage the health of the mother or fetus. It poses risks to the baby such as high birth way, congenital heart disease and central nervous abnormality, it also reduces fetal surfactant leading to respiratory stress syndrome.
Termed “America’s largest healthcare epidemic”, pre-diabetes is a condition that occurs when a person’s blood glucose levels are higher than normal but not high enough for a diagnosis of type 2 diabetes. As of 2009 there are 57 million Americans who have pre-diabetes.
SIGN AND SYMPTOMS:
The classical symptoms are polyuria and polydipsia which are, respectively, frequent urination and increased thirst and consequent increased fluid intake. Symptoms may develop quite rapidly (weeks or months) in type 1 diabetes, particularly in children. However, in type 2 diabetes symptoms usually develop much more slowly and may be subtle or completely absent. Type 1 diabetes may also cause a rapid yet significant weight loss (despite normal or even increased eating) and irreducible mental fatigue. All of these symptoms except weight loss can also manifest in type 2 diabetes in patients whose diabetes is poorly controlled, although unexplained weight loss may be experienced at the onset of the disease. Final diagnosis is made by measuring the blood glucose concentration.