Causes of Diabetes Mellitus – Diabetes Mellitus Example

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"Causes of Diabetes Mellitus" is a delightful example of a paper on diabetes mellitus. Diabetes Mellitus, or simply diabetes, refers to a group of metabolic diseases that are characterized by hyperglycemia caused by the defects in the secretion of insulin or defects in insulin action or a combination of the two (Oputa & Chinenye, 2012). There are three main types of diabetes mellitus. Type 1 diabetes mellitus is caused by the failure of the body to generate enough insulin. Type 2 diabetes on the other hand is caused by the resistance of the body to insulin.

Most patients suffering from type 2 diabetes are obese. Finally, there is gestational diabetes which is associated with pregnant mothers who have high levels of glucose during the pregnancy. In terms of prevalence, diabetes mellitus affects all countries. As of 2011, diabetes prevalence globally was estimated to be at 8.5% of the entire global adult population, translating to more than 360 million people (Oputa & Chinenye, 2012). Type 2 diabetes accounts for most of these cases with more than 90% of those affected suffering from this type of diabetes.

Type 1 affects just over one million people while 4% of all pregnant women suffer from gestational diabetes. Etiology This disease is caused by a number of factors. First, genetics has been found to play a role in the prevalence of both type 1 and type 2 diabetes. For type 1 diabetes, research has shown that a combination of the genes that possess the instructions of the formation of human leukocyte antigens (HLAs) may put one at risk of type 1 diabetes (National Diabetes Information Clearinghouse (NDIC), 2011).

Similarly, certain gene variants are responsible for type 2 diabetes, although this is still a subject of investigation. Secondly, environmental factors such as the types of foods, presence of viruses, and exposure to toxins may lead to diabetes (NDIC, 2011). Viruses such as rubella and cytomegalovirus destroy beta cells, and this may lead to type1 diabetes. Dietary factors may also contribute to the diseases. For example, an infant exposed to cereal proteins and raw milk has an increased chance of getting type1 diabetes. Thirdly, one’ s lifestyle also plays a role.

Specifically, studies have shown that lack of physical activity and obesity are linked to the development of type 2 diabetes. An increase in the intake of calories and lack of physical exercises causes the body to become insulin resistant. In terms of gender, type 1 and type 2 diabetes affects both sexes (NDIC, 2011). Gestational diabetes only affects pregnant women and associated with the family history of the individual. Type 1 diabetes is prevalent in children and young adults, although older persons have been found to have the diseases. Tube 2 mainly affected people aged 45 years and older (NDIC, 2011). Pathophysiological processes The pathophysiology of diabetes mellitus can be well understood by focusing on type 1 and type 2 separately.

For type 1 diabetes, the pathophysiologic defect is the autoimmune destruction of beta cells. This causes a deficiency in the secretion of insulin (Ozougwu, et al, 2013). The destruction of the beta cells is caused by an environmental event like a virus infection. Since the pancreas is not able to produce insulin, the glucose does not enter the cells and therefore remains in the blood.   The body responds to this by breaking down fats through lipolysis in order to meet the energy needs of the cells.

This process leads to the production of glycerol and fatty acids. The body converts glycerol into glucose while the fatty acids are converted to ketones (Ozougwu, et al, 2013). The increased levels of ketones in the body fluids leading to a reduced pH and dehydration. This leads to diabetic ketoacidosis (DKA), which may lead to a coma or even death. Type 2 diabetes is characterized by three main disorders: peripheral resistance to insulin, high production of glucose, and impaired insulin secretion by the pancreas.

The resistance to insulin by the tissues occurs first, and this is followed by the impaired insulin secretion. Since the insulin does not enter the cells, glucose accumulates in the blood, and this leads to hyperglycemia (Ozougwu, et al, 2013). The body responds to this by increasing the production of insulin by the pancreas. After several years, the level of pancreatic insulin production reduces drastically. Clinical Manifestations & Complications The common symptoms of the disease are those related to hyperglycemia.

Symptoms will include frequent urinating, hypotension, and dehydration (The Merck Manual, 2013). Due to the dehydration, patients will start feeling weak, fatigued and their mental status changes from time to time. Hyperglycemia may also lead to loss of weight, vomiting, and poor vision and may lead to increased fungal and bacterial infections. There are three major manifestations/complications of the disease. The first is diabetic retinopathy which causes blindness (The Merck Manual, 2013). Unfortunately, there are no early symptoms of this complication.

Secondly, there is diabetic nephropathy which causes chronic renal failure. This leads to kidney failure. Finally, there is diabetic neuropathy which refers to a reduction in the blood supply to tissues (The Merck Manual, 2013). Patients might start to lose temperature sensation, weakness of the muscles, finger numbness, failing vital body parts such as legs and hands, and stroke. Diagnostics There are three main blood glucose measurements that can be used to diagnose this disease. The first is the fasting plasma glucose (FPG) levels. Diabetes is diagnosed if the patient has fasting blood glucose of 126 mg per dL or more on two different occasions (Patel & Macerollo, 2010).

Secondly, a random blood glucose level of 200 mg per dL or more can also be used to diagnose the disease. This diagnosis must be accompanied by symptoms of diabetes. Finally, an oral glucose tolerance test (OGTT) can be done eight hours of fasting and a 75-g glucose load (Patel & Macerollo, 2010). This is followed by a blood draw after two hours. If a serum blood glucose level of at least 199 mg per dL is tested, then the patient is said to be diabetic.

In addition to the three tests, other tests can be performed to identify the type of diabetes. For example, c peptide can be linked to insulin to form proinsulin which reflects the total amount of endogenous insulin. Type 2 diabetes patients have normal to very high levels of c peptide, and this reflects higher insulin concentrations with little sensitivity to it. The screening of type 1 diabetes is not usually recommended (Patel & Macerollo, 2010). For type 2, it is generally recommended that screening should be done for all persons at risk of the disease.

The diabetes risk calculator is used for screening, and it incorporates measures such as weight, height, and blood pressure. For the diagnosis of diabetes, this calculator has a positive predictive value (PPV) of 14% and a negative predictive value (NPV) of 99.3% (Patel & Macerollo, 2010). The screening of gestational diabetes is unclear. Affected Health Patterns with Specific Impact Diabetes mellitus affects a number of health patterns, but three main ones are discussed.

First, diabetes affects activity and exercise where an individual may find it difficult to carry out activities requiring energy use. Specifically, this disease may result in chronic complications such as coronary artery disease (MedicineNet, Inc. , 2014). This makes it difficult for an individual to use many of the body systems for mobility and mortality. Secondly, it affects the elimination of health patterns. In particular, diabetes has been linked with urinary complications. For example, diabetes may lead to infections in the balder that may cause the obstruction of the urinary tract (MedicineNet, Inc. , 2014).

This may lead to urinary retention. Finally, diabetes mellitus affects sleep and rest. Patients suffering from diabetes complain of fatigue where the body generally lacks energy. This is usually accompanied by shortness of breath and general weakness of the muscles (MedicineNet, Inc. , 2014).

References

MedicineNet, Inc (2014). Diabetes Mellitus Related Diseases & Conditions. Retrieved from http://www.medicinenet.com/diabetes_mellitus/related-conditions/index.htm

National Diabetes Information Clearinghouse (2011). Causes of Diabetes. National Institutes of Health (NIH). Pp. 1-16.

Oputa, R.N & Chinenye, S (2012). Diabetes mellitus: a global epidemic with potential solutions. African Journal of Diabetes Medicine, 20(2): pp. 33-35.

Ozougwu, J C et al (2013). The pathogenesis and pathophysiology of type 1 and type 2 diabetes mellitus. Journal of Physiology and Pathophysiology, Vol. 4(4). Pp. 46-57

Patel, P & Macerollo, A (2010). Diabetes Mellitus: Diagnosis and Screening. American Family Physician, Vol. (81)7: pp. 863-870.

The Merck Manual (2013). Diabetes Mellitus (DM). Retrieved from http://www.merckmanuals.com/professional/endocrine_and_metabolic_disorders/diabete s_mellitus_and_disorders_of_carbohydrate_metabolism/diabetes_mellitus_dm.html#v98 8221

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