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ARRoGANT CoURiERS WiTH ESSaYS
Grade Level: Type of Work Subject/Topic is on:
[ ]6-8 [ ]Class Notes [Information about Insuln]
[ ]9-10 [ ]Cliff Notes [-dependent Diabetes ]
[ ]11-12 [ ]Essay/Report [ ]
[x]College [x]Misc [ ]
Date: 06/94 # of Words:1791 School: Database State: ?
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******REMINDER******
The information contained in the Rare Disease Database is provided
for educational purposes only. It should not be used for diagnostic or
treatment purposes. If you wish to obtain more information about this
disorder, please contact your personal physician and/or the agencies
listed in the "Resources" section of this report.
Insulin-dependent Diabetes is a disorder in which the body does not
produce enough insulin and is, therefore, unable to convert nutrients
into the energy necessary for daily activity. The disorder affects
females and males approximately equally. Although the causes of
insulin-dependent diabetes are not known, genetic factors seem to play a
role.
Symptomatology
--------------------------------
Normally, sugars and starches (carbohydrates) in the foods we eat are
processed by digestive juices into glucose. Glucose circulates in
the blood as a major energy source for body functions. Its use is
regulated primarily by insulin, a hormone produced by the pancreas gland
(located behind the stomach). In the person with diabetes, there is
a malfunction in the production of insulin. There are two main types
of diabetes: Type I or Insulin-Dependent and Type II or
Noninsulin-Dependent.
The insulin-dependent type of diabetes generally has onset during
childhood or adolescence, though it can occur at any age. Because
the pancreas supplies little or no insulin in this disease, daily
injections of the hormone and a controlled diet are necessary to
regulate blood sugar levels. Insulin is generally effective in
preventing glucose buildup, but it is a treatment and not a cure for
diabetes.
The onset of Insulin-Dependent Diabetes begins with frequent
urination, extreme thirst, constant hunger, and unexplained weight
loss. Because people with Type I Diabetes lack sufficient
insulin, glucose accumulates in the blood to levels too high for the
kidneys to excrete. In an effort to remove the excess sugar, the kidneys
excrete large amounts of water as well as essential body elements
resulting in frequent urination, thirst, and weakness. Hunger and
fatigue are caused by the body's inability to utilize foods properly
for nourishment and energy. To find alternate sources of energy, the
body turns to its stores of fat and protein, causing weight loss and
the accumulation of fat breakdown products (acetone and related
acids) in the blood. These metabolites of fat produce increased acidity
of the blood, and a potentially fatal condition (ketoacidosis) can
result if treatment is not prompt.
A child with Type I Diabetes may also fail to grow and develop
normally. Diabetics of all ages may experience itching of the skin,
changes in vision, and slow healing of cuts and bruises. Medical
attention should be sought if any of these symptoms occur.
The diabetic condition can result in certain long-term
complications which may involve many organs of the body. The blood
vessels, nervous system, kidneys and eyes are particularly affected.
While successful control of blood glucose levels may reduce the risk of
complications, the exact relationship between these factors is not
fully understood. Studies are being conducted to determine whether
strict blood glucose control plays a significant role in preventing or
delaying the onset of complications resulting from diabetes.
1. Cardiovascular Complications.
Heart and blood vessel diseases such as heart attack, hardening of
the arteries (arteriosclerosis), and stroke are the leading causes of
illness, disability and death among diabetics. Persons with
diabetes are twice as likely to suffer from coronary heart disease
and stroke and five times as likely to suffer from arterial disease of
the limbs than the non-diabetic population. Exactly how diabetes
damages the cardiovascular system is not yet clear.
2. Diabetic Nephropathy (Kidney Disease).
Kidney (renal) disease, or diabetic nephropathy, can be a serious
complication of diabetes. Normally, the kidneys cleanse
impurities from the blood, but diabetes can cause damage to the blood
vessels in the kidney and interfere with this vital process. A
procedure called hemodialysis is frequently used to remove waste
products from the blood when the kidneys can no longer perform this
function adequately. Diabetics with serious renal disease may also be
candidates for a kidney transplant if a suitable donor organ is
available.
3. Diabetic Neuropathy (damage to the nerves).
Diabetes can also cause a complication called Diabetic Neuropathy which
is damage to the peripheral nerves. These nerves run throughout the
body, connecting the spinal cord to muscles, skin, blood vessels, and all
other organs. Most importantly, they serve as the primary link between
the central nervous system and the entire body. Diabetes is a common
cause of peripheral neuropathy; however, this condition can also result
from injury, alcoholism, or other factors. Almost all people with
diabetes eventually develop some peripheral nerve involvement, but for
many, it is slight and produces no symptoms. For the 10 to 25 percent
who suffer from serious neuropathy, it can produce problems such as
tingling and numbness in the feet, dizziness, impotence, leg pain and
double vision.
4. Diabetic Retinopathy (damaged retina).
Diabetes is the leading cause of partial loss of vision and new
blindness in the United States today. Generally, diabetes affects
the retina of the eye and produces a variety of changes referred to as
diabetic retinopathy. Less frequent, but no less serious, are several
other eye problems caused by diabetes including cataracts, glaucoma,
and optic nerve disease. While many persons with diabetes undergo some
changes in the retina, only about 3 percent are seriously threatened
with blindness. Today, there are approximately 150,000 Americans who
suffer significant visual impairment due to diabetic retinopathy. (For
more information on this disorder, choose "Diabetic Retinopathy" as your
search term in the Rare Disease Database.)
Although the way in which diabetes damages eye tissue is not
known, two important treatments have been developed in recent years.
The first, laser photocoagulation, uses finely focused beams of laser
light to seal off and destroy abnormal retinal vessels and diseased
tissues. While this treatment does not prevent diabetic changes from
taking place, it has proven beneficial in reducing the risk of severe
vision loss in many cases.
The second technique, vitrectomy, involves surgical removal of
cloudy eye fluids that result from blood vessel hemorrhage. This
procedure offers hope to people with severely impaired vision
resulting from this form of diabetic retinopathy. Scientists
continue to explore better use of these techniques as well as the basic
causes of eye damage resulting from diabetes.
5. Complications of Pregnancy.
Diabetic women run a greater risk of having babies who are
stillborn, die in infancy, and suffer from congenital defects than do
non-diabetics. It is not uncommon for infants of diabetic mothers
to be larger than normal at birth if maternal blood glucose level is
elevated. In fact, this is sometimes a warning sign of diabetes in a
woman who has not yet been diagnosed with the disorder. Strict
attention to control of diabetes is essential during pregnancy to help
reduce risks to both mother and baby.
Diabetic emergencies which require prompt medical attention
include hypoglycemia and ketoacidosis. Hypoglycemia, also called "insulin
reaction" or "insulin shock" can occur if the blood sugar level of the
person with diabetes falls too low. This results from too much insulin
in the system caused by too large a dose of insulin, overly strenuous
exercise, or failure to eat shortly after insulin is taken. Although
each person may react differently, common symptoms of insulin
reaction include trembling, sweating and nervousness. Some persons with
diabetes may experience hunger, headache, nausea, drowsiness, or symptoms
similar to inebriation. In severe cases of insulin shock, the person
with diabetes may even become unconscious. A careful blend of
correct amounts of insulin, exercise and food can usually prevent
insulin reaction. When hypoglycemia does occur, however, most people
with diabetes sense early warning signals and eat or drink something
sweet to raise the amount of sugar in the blood. If a person is
unconscious, an injection of glucose solution or the hormone
glucagon (which stimulates the production of glucose), should be
administered.
Ketoacidosis, or Diabetic Coma, results from too little insulin
in the system.
When the body is unable to use glucose for fuel, it draws on its own
stores of protein and fat for energy. Acids, or ketones, produced by
the excessive breakdown of fat then accumulate in the blood stream
quicker than the kidneys can excrete them. Unlike hypoglycemia, the
symptoms of ketoacidosis develop slowly over a period of days. The
person with diabetes may begin to experience abdominal pain, nausea,
vomiting, rapid breathing and drowsiness. If left untreated, ketoacidosis
can progress to coma and death.
Ketoacidosis can be prevented by careful daily evaluation of
insulin needs. Particularly stressful situations such as illness
or surgery may require increased amounts of insulin. Most importantly,
a person with diabetes should never skip or delay an insulin injection
and should pay careful attention to his/her diet.
A survey by the U.S. Department of Health, Education and Welfare
during 1960 to 1962 on forty-four million adults showed that men and
women with diabetes ran a higher than average risk of periodontal
disease.
Related Disorders
--------------------------------
Type II Diabetes (Non-Insulin Dependent Diabetes Mellitus) is the more
common form of the disorder. Also known as Adult Onset Diabetes, it
usually occurs after the age of 40 years. This type of diabetes is
not secondary to other diseases or conditions. In many cases,
the disorder can be controlled through diet, regular exercise, and
sometimes, with oral medications (e.g., chlorpropamide, glypizide, or
glyburide).
Therapies: Standard
--------------------------------
A daily routine of insulin-injection, controlled diet, exercise to
burn off glucose, and testing for blood sugar level is vital in achieving
and maintaining good blood sugar control in patients with
Insulin-Dependent Diabetes. Urine testing for glucose spillage had
been a standard recommendation in past years, but has now been replaced
with self blood glucose testing. Self monitoring of blood glucose
levels uses a single drop of blood which is obtained with a finger stick,
and placed on a chemically treated pad on a plastic strip; the color
change of the chemically treated pad is compared to a color chart or
"read" by a battery operated portable meter.
Insulin must be given by injection, usually two or more times each
day. Recently portable "insulin pumps" have been developed, which permit
continuous administration of insulin, as well as additional amounts of
insulin when needed to control the changes in blood sugar level that occurs
after meals.
Etiology
--------------------------------
The exact causes of Insulin-Dependent Diabetes are not known
although most types of diabetes are known to have hereditary factors.
Scientists believe that both heredity and environment may play important
roles in the development of diabetes.
Research suggests that certain viruses, in combination with
genetic susceptibility and other unknown environmental factors, may
trigger the onset of some types of this disorder. High levels of
growth hormone in adolescents and adults under stress may also stimulate
the production of glucose by the liver.