Individual lifestyles have been getting much attention from the popular press and the public health sector. Men and women are encouraged to follow a healthy lifestyle by engaging in habitual exercise, eating nutritious food, and avoiding vices like smoking. There are different economic and social factors that affect one’s health.
Diabetes mellitus or simply diabetes is one of the leading causes of death in several countries including the United States. Problems or failure in insulin excretion or action leads to a high blood glucose level (sugar) which is an indication of diabetes. Even though diabetes can be controlled, it is still a chronic medical illness which means it lasts one’s lifespan. As time goes by, a person with diabetes might possibly experience nerve damage, blindness, and kidney failure.
Insulin, which is secreted by the pancreas, is the hormone that regulates the level of glucose in the blood stream (Folkman 21). Glucose is the simple sugar that comes from the foods that people eat and provides the energy needed throughout the body. The body requires a steady stream of glucose all throughout the day. Since people understandably do not spend the entire day eating food to maintain the needed steady stream of glucose in the body, it serves as the time when insulin comes into action.
Whenever blood glucose levels are peaking, insulin stimulates cells in the fat, muscles and liver. Muscle and liver transform glucose into a compound called glycogen which serves as energy storage for future use. Another function of insulin is to remove other by-products of food that can damage several organs over time.
Insulin is closely associated with another hormone named glucagon which also is produced by the pancreas. Glucagon comes into action when blood-sugar levels are low. It stimulates the muscles and liver that will cause them to breakdown the glycogen created by insulin. The two hormones complete the system of blood-glucose control.
In the United States alone about 8% of the population or around 17 million people suffer from diabetes and about 12 million people who have the disease but are not aware of it. Worldwide, cases of diabetes have also been surprising affecting millions and millions of people.
II.Brief History of Diabetes
Diabetes is amongst the oldest identified diseases in the world. It dates back to 1550 BCE as it was mentioned in an Egyptian script pertaining to as passing of too much urine. Sushruta, a distinguished Indian physician categorized this disease and cited it as Medhumeha (Folkman 57). He extended its association with an inactive lifestyle and obesity, recommending exercise as its cure. The Indians’ observation for this disease was based on the use of ants, whether they found a person’s urine appealing or enticing (depending on the blood sugar level).
Aretaeus of Cappadocia, an Ancient Greek physician during the first century was the first one to conclude the clinical explanation of diabetes. It was Aretaeus who coined the term diabetes as he observed an extreme amount of urine that passed through one’s kidneys. During the 980-1037, diabetes was characterized with an unusual appetite and downfall of one’s sexual functions (Folkman 79). Avicenna, during the medieval times in Persia, authenticated that the urine of a diabetic person tasted sweet. He also acclaimed two classifications of diabetes, a primary and secondary. Even though diabetes has been longed recognized, it was only during the 1900 that the treatments of several efficiency have been accepted (Eckman 55).
There are three main types of diabetes mellitus namely, Type 1 diabetes, Type 2 diabetes, and Gestational diabetes (Folkman 66). Each has of the type varying signs, symptoms and effects. Type 1 diabetes, previously referred to as insulin-dependent diabetes mellitus or IDDM, is constituted by a person’s inability to produce insulin thus requiring intervention by injecting insulin. Type 2 diabetes, also known as non-insulin dependent diabetes mellitus or NIDDM, is a condition in which the cells fail to use insulin appropriately which can ultimately contribute to an absolute insulin deficiency (Becker 33). Gestational diabetes on the other hand occurs when a pregnant woman who has no prior case of diabetes experience a high blood glucose level during pregnancy which can lead development of type 2 diabetes.
Type 1 diabetes mellitus results from the autoimmune destruction of the beta cells of the pancreas which produce insulin. An increase in the blood and urine glucose level can be expected as the body lacks insulin. The condition can be eventually fatal if the person is not treated with insulin. Insulin can be administered through several methods such as insulin pumps, inhaled insulin, pancreatic transplant, and through injection which is the most common among the techniques.
Treatment, however, must be continued indefinitely as there is still no cure to be found today. Although the treatment will not extensively affect normal activities if coupled with sufficient knowledge, training and awareness of patients, many still consider it a burdensome affair. Both low and high blood glucose levels can prove to be dangerous for patients with the disease. High blood sugar level may lead to increased fatigue which can result to long-term damage to organs. On the other hand, low blood sugar can result to episodes of unconsciousness or seizures which require immediate emergency treatment. Type 1 diabetes can lead to a complication known as diabetic ketoacidosis (DKA) which results from insulin shortage. DKA results from the body burning fatty acids which then produce ketone bodies which then can be lethal (Eckman 98).
Type 2 diabetes, a metabolic disease, is characterized by high blood glucose levels caused by insulin resistance and a relative insulin deficiency. Type 2 diabetes has extremely minute tendencies to develop DKA compared to type 1 diabetes (Becker 40). One effect of this type of diabetes is to develop a non-ketonic hyperglycemia (high blood glucose level without developing ketoacidosis). Some long-term effects of high-blood sugar include increased risk of diabetic retinopathy which affects the eye, heart attacks, strokes and kidney failure. Worse effects comprise of amputation due to affected circulation in the limbs, loss of hearing, eyesight and cognitive ability. Using a C-peptide assay, type 1 can be distinguished from type 2 diabetes. It works by measuring the endogenous insulin production of the body.
Gestational diabetes is exhibited by a high blood glucose levels during pregnancy especially during the third trimester of pregnancy. It is caused by the female body’s inability to secrete extra insulin needed during pregnancy which therefore results to increased blood sugar levels. Gestational diabetes is treatable while women who have sufficient control of glucose level significantly decrease its risk. However, women with this type of diabetes have an increased risk of developing type 2 diabetes or in a small percentage even type 1 diabetes after pregnancy (Lombardi 90). Women afflicted with gestational diabetes generally have babies with smaller birth weight which leads to problems in lesser survival rate of premature and early births. Also, babies born to mothers with gestational diabetes also have increased risk of delivery complications, low blood sugar and jaundice. Most patients are treated by using diet modifications and moderate exercise while others need to take anti-diabetic drugs such as insulin.
IV.Signs and Symptoms
Some signs and symptoms of type 1 diabetes mellitus include increased thirst or polydipsia, frequent urination or polyuria, extreme hunger or polyphagia, weight loss without trying, fatigue and blurred vision.
On the other hand, type 2 diabetes features similar signs and symptoms with type 1 diabetes but with the addition of slow-healing sores and frequent infections and patches of darkened skin.
Unlike the type 1 and 2, gestational diabetes rarely shows signs and symptoms. If signs do show, it is most likely similar to those shown by type 1 and type 2 diabetes. Screening has the best chance of diagnosis (Lombardi 64).
Causes of Type 1 diabetes and Type 2 diabetes are different. Genetic factors are said to be the main causes of diabetes type 1 and viral illness may also play a part. Hormonal problems may also lead to this type of diabetes. On the other hand, type 2 diabetes is caused by genetic and environmental factors. There is no clear explanation as to what really causes diabetes. It’s a scientific mystery that scientists and physicians are unable to give a rationalization to. There are however certain aspects or factors that may lead to this illness. These elements are regarded as risk factors a person must try to conquer.
Questions about diabetes being inherited are often asked. In studies, people with a family history of diabetes have a 25% more chance of developing the illness. For twins having such family background, a 50% chance of acquiring diabetes is present (American Diabetes Association 88) Expectant mothers of twins can somehow control the likeliness of her twins or one of her twins having diabetes by sustaining a normal blood sugar level so as not to pass the illness to any of her children (Bernstein 23). About 5.5% to 11.6% people that are diagnosed with diabetes are said to have a family account of the sickness.
Too much protein, carbohydrates, and fats are harmful to one’s body and may lead to a person having diabetes. Diet is a key factor in order for the body to do its fundamental functions. Too much food can obstruct one’s pancreas from executing its purpose of secreting insulin. With inadequate insulin, one’s blood glucose level increases, leading to diabetes (Lombardi 54). People who are sweet lovers have more chances of getting this illness since these food such as cakes, bread, ice cream, chocolates, pudding, etc are full in carbohydrates.
Diabetic people may also attribute their illness to emotional stress. An unbalanced and disorganized lifestyle due to an extremely busy and stressed life/routine severely influences one’s metabolism. Anxiety, sorrow, worry, depression, and misfortune are some emotions that may alter or change one’s blood glucose level, hence leading to diabetes (Ruhl 46). Stressed people also resort to smoking which makes them more vulnerable to develop the illness.
Use of drugs such as Dilantin and steroids may lead to diabetes as it can raise one’s blood sugar level. Other drugs like streptozocin, thiazide diuretics, and alloxan are lethal to the beta cells of a person’s pancreas thus causing him diabetes.
Another major reason of diabetes is obesity. Unbalanced height and body weight of an individual acts as an inclining factor for diabetes. It can be commonly observed with people suffering from diabetes type 2 who are in the age of 40 years (Seidell 26). The extra fat in one’s body make the insulin to improperly function. This increased fat leads to the tissue cells and muscle of an individual to become impervious to insulin hence causing a high blood glucose level that will in turn lead to diabetes.
Several viruses or infections may also lead to diabetes. Coxsackie B virus can poison one’s pancreas that will impair the release of insulin henceforth leading to an escalated sugar level causing diabetes. Age is also a factor as studies have shown that as an individual age specifically those above 45 years old tend to have a drastic change in their lifestyle hence having a greater chance of acquiring diabetes (Ruhl 93). An inactive lifestyle often leads to weight gain that will then lead to diabetes.
VI.Diabetes in Women
Women particularly in the US have been having more health issues nowadays. According to studies, a big part of the women population in the US are becoming more obese as they age and physically inactive (American Diabetes Association 101). These factors raise the probability for diabetes type 2 to occur. Generally women have challenging and complex lives. More than half of the population in the US alone suffers from diabetes. Women who have diabetes have an added difficulty in their lives by battling such chronic disease alongside all the other personal and social challenges they go through every day. Pregnant women with diabetes are more at risk since the effect of diabetes can occur on both the mother and the unborn kid. In the United States, about 2%-5% pregnant women have gestational diabetes. Asian, Hispanic, Black, American Indian women have 2 to 4 times higher occurrence of diabetes than white women (Beckles & Thompson 45). The risk of having cardiovascular problems which are the most known complication ascribed to diabetes is more present in women than men. Blindness caused by diabetes also often occur more in women than men. A lot of risk elements of diabetes are more widespread in women than in men such as physical inactivity, obesity or weight gain (Seidell 88).
Women, during their menstrual cycle have fluctuations in their hormone levels which can have an effect on their blood glucose level. A lot of women have their blood sugar levels higher 3 to 5 days prior to their cycle (Beckles & Thompson 16). Food cravings which are usually chocolates or any other sweet food before and during a woman’s period make it harder to control one’s glucose level. Women also feel a bit sluggish during their period.
Women, during their adolescent years, experience psychological and psychosocial changes as part of their transition to adulthood. Adolescent diabetic women encounter different lifestyle choices that have an effect on their capabilities to fight and control the illness. Policies or the lack thereof in the society influence adolescent women’s abilities to make healthy and sound lifestyle options.
During their reproductive years, women have more growth to responsibly control their disease. Pregnant women have the hardest times if they become diabetic as it will affect her health and the baby’s as well. It will also place a high risk for the future health of the baby and will lead to costly standard of living as well. During the middle years of a woman, major physiologic incidents take place like menopause. This is a crucial stage for a woman as many chronic illnesses and complications of diabetes most often initially happen together with other psychological and social changes like retirement and divorce. Diabetic women in their older years are more susceptible to other chronic disabilities and illnesses.
The occurrence of diabetic ketoacidosis is 50% higher among women (Beckles & Thompson 65). Often known as diabetic coma, diabetic ketoacidosis or DKA is an illness caused by poorly regulated diabetes and manifested by high blood sugar levels as well as ketones. Lack of insulin causes this condition. During those times that insulin therapy was yet to be available, DKA was the principal cause or reason of death coming from diabetes.
Diabetic women are 7 times more likely to have peripheral vascular disease than those that are not suffering from diabetes. Peripheral vascular disease is a condition that results from decreased flow of oxygen as well as blood to one’s tissues in the legs and feet. The main indications of this illness are sporadic claudication such as pain in one’s calf, buttocks, and thighs during physical activities (Beckles & Thompson 79).
Women who suffer from diabetes also have more sexual health difficulties than men. Low levels of hormones in women can cause weak vaginal lubrication. Stress and pregnancy also reduce such lubrications that affect a woman’s sexual activities. A study has also shown that diabetic women have a harder time reaching orgasm and that they have lesser sexual desires than those without the illness (American Diabetes Association 122).
Diabetes is a chronic illness that can only be cured in particular situations. Management of disease focuses on maintaining blood glucose levels as close to the normal rate as possible without triggering hypoglycemia (Bernstein 32). This is possible through proper exercise, diet, and use of suitable medications.
There is a discussion as to what proper diet is commended to diabetic people. Most often the recommended diet is the one which is high in nutritional fiber particularly soluble fiber. This diet should also be low in fat specifically saturated fat. Diabetics are also encouraged to take less carbohydrate. For diabetic people it’s not a matter of what an individual eats, but also the time or when he/she eats. The period between the injection of insulin and taking meal for a diabetic person depends on the kind of insulin he/she took. If before sleeping a patient finds their sugar level to be low, it is recommended for him/her to take long-acting carbs before hitting the sack to avoid night period hypoglycemia (Ruhl 120). Moderate to none consumption of some drugs and alcohol is advised. Alcohol prevents glycogenesis in one’s liver while some drugs constrain hunger indications. Contemporary methods to treat diabetes are dependent on lifestyle changes as well. Regular exercise and other physical activities should be done by diabetic patients (Dawson 44).
There are also anti-diabetic medications present to manage this illness. These medicines lower the sugar levels in one’s blood. These medications are administered orally except pramlintide, exenatide, and insulin. These remedies are known as oral antihyperglycemic or oral hypoglycemic agents. Numerous drugs that are taken by mouth are effective in the diabetes type II (Dawson 27).
Insulin therapy is another treatment available for diabetic people. This is done through giving out of exogenous insulin to the patient. Those with type I diabetes rely on injected insulin because the hormone can no longer be produced within. Those with diabetes type II have comparatively low production of insulin and may need insulin therapy once other medications fail to work.
Diabetes is one if not the world’s most expensive widespread disease. By and large it is evident that diabetes poses such great risks and problems for all specially women. The high possibilities of disease are fast growing and it’s important to take this issue seriously. Diabetes is a severe illness and a slow killer. It doesn’t have a solid recognized curable medication. Keeping the sugar level of diabetic people is vital to avoid major complications such as cardiovascular attack, damage to the kidneys, and blindness.
Health sectors must give more focus to diabetes in order to find new and alternative treatments. Those people who are knowledgeable when it comes to this disease must also become educators and motivators as well. It’s important to spread the word about this illness to avoid further occurrence of it at a higher rate and pace. Physicians must let people know the true and difficult complications that diabetes may cause. More people should be able to acquire and get access to medical tools such as blood sugar testing devices and insulin pumps. Researchers have also started working on improved methods and drugs for transplantation of beta cells to one’s body for insulin (American Diabetes Association 198).
Diabetes management should be widely taught and be readily available to those who are in need of it. Diabetic people especially women should have a regular exercise routine that would be incredibly beneficial to them. It will help control their sugar level without any added medicines. Having such chronic disease is definitely not easy. Diabetes poses great challenges to those people who have it. But living with it positively and effectively is possible. Diabetic people must simply maintain discipline in keeping their blood sugar level at a normal rate.