Diabetes and the Endocrine System An Assessment

DIABETES AND THE ENDOCRINE SYSTEM

Diabetes and the Endocrine System

The endocrine system, in basic terms, comprises of the various glands making or producing hormones. The relevance of the said hormones cannot be overstated when it comes to the regulation of various body processes including, but not limited to, growth, breathing, appetite, etc. Apart from diabetes, some of the other disorders associated with the endocrine system are inclusive of; Hashimoto’s thyroiditis, Graves’ disease, Cushing’s syndrome, and Addison’s disease.

Diabetes has been identified as a leading cause of death in the country, as well as in other parts of the world. As a matter of fact, according to the Centers for Disease Control and Prevention – CDC (2021), data available for the years 2015-2018 indicates that 11.3% of U.S. adults (of age 20 and above) had been diagnosed with diabetes. At present, as the CDC (2021) further points out, the disease happens to be the 7th leading death cause within the country. To a large extent, this is a clear indication that there is a lot that needs to be done to reign in this particular condition. However, it should be noted that efforts to decrease the number of persons diagnosed with diabetes each year, as well as bring down the death rate attributed to diabetes ought to start with proper understanding of the disease and how it impacts various bodily systems, assessment of the most effective medical interventions and assistive technology interventions, as well as evaluation of the various concerns (i.e. cultural issues) that could get in the way of, or promote, rehabilitation.

It is important to note that in essence, diabetes impacts the body’s blood glucose levels regulation. Amongst those who have not been diagnosed with diabetes (and do not have pre-diabetes), blood glucose levels are kept in check by glucagon and insulin. While the latter plays the role of reducing blood glucose levels, the former’s role happens to be that of increasing the levels of glucose in the blood. Thus, to a large extent, the two function ‘hand in hand’ to ensure balanced blood glucose levels. It therefore follows that amongst those diagnosed with diabetes, there happens to be an imbalance of sorts between glucagon and insulin effects. In this case, the body either fails to manufacture insulin in sufficient amounts, or it fails to respond in a proper manner to insulin. According to Wu, Ding, Tanaka, and Zhang (2014), amongst those with type 2 diabetes, the body’s response to insulin happens to be ineffective. In this case, the body is unable to make proper use of insulin – due to its resistance to the action of the same. As a consequence, a person having type 2 diabetes happens to have blood glucose levels that are higher than normal. To a large extent, this is the most common type of diabetes. On the other hand, when it comes to type 1 diabetes, it is important to note that the body in this case happens to be incapable of producing insulin in sufficient levels. Thus, failure to inject insulin results in high blood glucose levels. There are other categories of diabetes which also deserve a mention in this write-up. These are inclusive of monogenetic diabetes, gestational diabetes, and pre-diabetes.

Before highlighting the medical interventions as well as treatment options for diabetes, it would be prudent to briefly assess the roles of the pancreas in blood sugar level control. To begin with, past studies have clearly confirmed that there indeed exists a correlation between diabetes and the pancreas (Marshall, 2020). Essentially, the pancreas is charged with the production of hormones and enzymes that come in handy in the digestion of food. Insulin happens to be one of the hormones produced by this particular organ. The said peptide hormone is of great relevance in glucose regulation. This is more so the case given that it comes in handy in the transportation of glucose into cells (from the blood). Therefore, it is failure by the pancreas to manufacture sufficient insulin (due to the killing of beta cells by the body’s immune system) that results in build-up of glucose in a person’s bloodstream (i.e. hyperglycemia). This results in type 1 diabetes. Some of the more common symptoms of type 1 diabetes are inclusive of, but they are not limited to; blurred vision, weakness and fatigue, significant changes in mood (i.e. occasioned by irritability), unexplained loss of weight, hunger, frequent urination, as well as increased thirst (American Diabetic Association, 2020). It should be noted that as the American Diabetic Association (2020) further points out, this particular type of diabetes mainly affects adolescents and children.

When it comes to type 2 diabetes, it should be noted that as it has been pointed out elsewhere in this text, the body becomes resistant to the produced insulin – effectively meaning that to reign in the high blood glucose levels, the pancreas is required to produce additional insulin. When this cannot be achieved, a person could gradually begin to experience type 2 diabetes symptoms. Many of the symptoms of type 2 diabetes are similar to those of type 1 diabetes. However, in addition to the symptoms of type 1 diabetes that have been highlighted above, persons with type 2 diabetes could also experience darkening of certain skin areas such as neck and armpits, tingling feelings or numbness of feet and/or arms (American Diabetic Association, 2020). Sometimes, the said symptoms could take a long time to appear, i.e. a couple of years. Other organs that play an active role in blood sugar control are the liver as well as the kidneys.

In as far as type 2 diabetes is concerned, there are a number of risk factors that have been highlighted, or identified, by previous studies. Some of the more common risk factors are inclusive of; overweight and obesity, age, as well as ethnicity/race, and family history (Wu, Ding, Tanaka, and Zhang, 2014). When it comes to weight, Al-Goblan, Al-Afifi, and Khan (2014) point out that “in obese individuals, the amount of non-esterified fatty acids, glycerol, hormones, cytokines, pro-inflammatory markers, and other substances that are involved in the development of insulin resistance, is increased” (p. 590). On the other hand, with regard to age, the older a person is, the higher his or her chances of being diagnosed with this kind of diabetes. When it comes to family history, past research has indicated that person whose siblings or parents have been diagnosed with diabetes type 2 in the past have a higher risk of developing this particular kind of diabetes (Al-Goblan, Al-Afifi, and Khan, 2014). Lastly, in relation to ethnicity and race, Cheng, Kanaya, Roario, and Araneta (2019) are categorical that in comparison to African and European populations, higher prevalence rate of type 2 diabetes have been observed in Asian and Hispanic populations. The authors are of the opinion that the differences observed on this front could be as a consequence of a wide range of factors. The said factors, according to the authors, could be inclusive of; the environment, lifestyles, epigenetics, as well as genetic factors. In the absence of the appropriate treatments and interventions, diabetes could trigger a number of complications. Some of the more serious complications relate to; dementia, eye damage, kidney disease, nerve damage (i.e. digestive system nerve damage and other nerve damage), stroke, heart disease, etc.

On the other hand, when it comes to diabetes type 1, some of the risk factors that ought to be highlighted in this context are inclusive of; exposure to certain environmental elements/factors and genetics (Al-Goblan, Al-Afifi, and Khan, 2014). Like is the case with type 2 diabetes, failure to manage and/or treat type 1 diabetes could result in a number of complications. The said complications, which are largely similar to those of type 2 diabetes, could be inclusive of, but they are not limited to; nerve damage (specifically in the feet), eye damage, kidney damage, and a host of cardiovascular complications. It would also be prudent to note that failure to properly control diabetes could result in complications for women during pregnancy.

Interventions and treatment options for diabetes have improved over the last few decades. It should be noted that both type 1 and type 2 diabetes require different treatment/management approaches. To begin with, type 2 diabetes requires effective management as well as medications. Exercises and diet are particularly instrumental in the management of the condition. In some instances, it is possible for a person to ensure that target blood sugar levels are maintained with exercises and diet alone. However, in some other scenarios, medications may have to be prescribed. According to Nasri and Rafieian-Kopaei (2014), one specific drug that is often prescribed at the onset of treatment is Metformin. As the authors further point out, this particular drug comes in handy in efforts to ensure that the body makes more effective use of insulin, i.e. via the enhancement of the sensitivity that a patient’s body has to insulin. The other drugs which could be prescribed or considered on this front are; sulfonylureas, glinides, thiazolidinediones, DPP-4 inhibitors, as well as GLP-1 receptor agonists. In those scenarios whereby the medications highlighted above are unable to meet the targeted blood sugar levels, the patient could be put on insulin therapy. Following an assessment of the patient, the physician is capable of making a determination as to the best type of insulin the patient should be put on, i.e. long-acting insulin or short-acting insulin.

With regard to type 1 diabetes, it is important to note that as DiMeglio, Evans-Molina, and Oram (2018) point out, lifelong insulin happens to be the standard treatment or course of action. In the recent past, advances in medical technology have resulted in the development of an artificial kidney – which essentially happens to be an implanted device that monitors glucose on a continuous basis and takes corrective measure when deviations are noted or detected. Exercises and diet are also part and parcel of type 1 diabetes management. In all instances of diabetes, the health practitioner could prescribe a variety of other medications depending on the specific circumstances of the patient. Thus, the other medications which are likely to be prescribed in both scenarios are; drugs to lower cholesterol levels, hypertension medications, etc. Further, in both scenarios, patients are advised to actively monitor their blood sugar levels.

Continued advances in technology have also made it easier for persons living with diabetes to cope with the condition. This is to say that at present, there are diverse technological solutions designed to make it easier to manage blood sugar levels and ensure that complications are kept at bay. To a large extent, technology has made it possible to embrace a personalized approach in the management as well as treatment of diabetes. For instance, in the words of Alcantara-Aragon (2019), “smart technology exists as wearables, implants, and mobile applications to track glucose levels, share data, access relevant information, communicate with both health-care providers and others with diabetes, and, ultimately, guide you in making better decisions” (p. 77). It is hoped that going forward, even greater advances will be made to not only ease the management of diabetes, but also improve outcomes for patients.

Still on the management and treatment of diabetes, it would be prudent to note that there are a number of cultural concerns that ought to be taken into consideration. One such concern relates to the utilization of insulin. For instance, according to Rebolledo and Arellano (2016), there are some cultures that reject inulin owing to certain social factors as well as specific cultural beliefs about the drug, etc. For this reason, the authors are categorical that there is need to ensure that the treatment plan developed is cognizant of concerns of this nature. It is only after being aware of such factors that measures can be taken to address certain aspects of the cultural issues raised. This is a particularly important factor owing to the fact that insulin happens to be “the mainstay of therapy for type 1 diabetes and is also recommended in newly diagnosed type 2 diabetes” (Rebolledo and Arellano, 2016, p. 187).