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Understanding Diabetes and Its Complications

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Understanding Diabetes and Its Complications

An estimated 16 million people in the United States have diabetes-more than one third are not aware that they have the disease. This year alone, more than 798,000 cases will be diagnosed. Diabetes is the seventh leading cause of death by disease in the United States; this year alone, more than 187,000 Americans will die from this disease and its complications (CDC). Education about diabetes is essential to understanding the disease and preventing its complications.

Diabetes mellitus is a chronic, systemic disturbance in the metabolism of carbohydrates, protein, and fat (ADA, Medical Management 3). The term diabetes derives from the Greek word which means "to go through a siphon." Thus diabetes refers to the overproduction of urine known as polyuria. Mellitus comes from the Latin word mel (honey) and describes the sweet odor of the urine. Diabetes occurs when the beta cells of the pancreas fail to produce or secrete an adequate amount of insulin. Diabetes also effects the vascular and nervous system.

In order to understand diabetes, it is important to understand how we normally metabolize food. Our bodies are composed of millions of cells, and in order to function, these cells must create energy. This energy comes from glucose. Glucose is mainly obtained from food.

When we eat, food enters the digestive system and is broken down into glucose. The three components from which glucose is made are carbohydrates, proteins, and fats. Carbohydrates convert 100% into glucose; protein converts 50-60%; and fat converts 10%. Once food is broken down into glucose, it can be absorbed in the blood and carried to the cells of the body. However, for glucose to enter the cells, insulin must be present.

Insulin is a hormone that regulates the entire absorption process. It acts like a key that can unlock the doors of the cell. Cells have receptor sites, like keyholes, that receive insulin. When insulin attaches to a receptor site, a passageway is created that enables glucose to enter the cell. Once glucose is absorbed in this manner, it can be immediately used for the use of energy or it can be stored as glycogen in the liver and muscle cells for future use. Excess glucose is converted into fat. The normal fasting glucose level is 70-100 mg/dl; after meals is 70-140 mg/dl.

There are two classifications of diabetes. These are Type 1 and Type 2. In Type 1 diabetes, individuals have no insulin secretion, therefore they are prone to breaking down fat and having high ketone levels, which requires insulin injections to maintain life. The body's immune system destroys the insulin-producing beta cells of the pancreas. Symptoms develop when most of the beta cells are destroyed. It is believed that there is a genetic link to Type 1 diabetes, but there is also some debate as to viruses and environment playing a significant role in this type of diabetes.

Type 2 diabetes occurs when insufficient amounts of insulin are produced. Type 2 diabetics secrete some insulin, but not enough to maintain normal blood glucose levels. Typically, this type of diabetes occurs after the age of 45, and there is a family history of diabetes; also, 85% of these diabetics are overweight. It is treated by diet, exercise, weight loss, and oral medications to lower blood glucose levels. There has been debate as to how Type 2 diabetes begins. It seems unclear whether decreased tissue sensitivity to insulin or impaired beta cells function occurs first. Regardless of which actually comes



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