Formal academic writing with introduction, conclusion, and structured responses

Diabetes Management

Diabetes mellitus is one of the non-communicable diseases that have continued to be in the forefront of public health challenges. Diabetes occurs when the body system is unable to produce sufficient insulin. Typically, insulin is a hormone secreted from the beta cell within the pancreases that regulates the blood sugar as well as assisting in conversion of glucose into energy. Diabetes occurs when there is high level of glucose in the blood, and when the body pancreas in unable to produce enough insulin.

Type 2 diabetes known as non- insulin-dependent diabetes mellitus (NIDDM) accounts for more than 90% of diabetes globally. The type 2 diabetes occurs when a body is unable to produce sufficient insulin to overcome abnormality. There are three types of diabetes:

Type 1 diabetes,

Type 2 diabetes and Gestational diabetes.

Type 1 diabetes or insulin dependent diabetes is an autoimmune system where the diseases in the body attack the insulin producing pancreases cell. People with type 1 diabetes do not have ability to produce insulin and they require lifelong insulin injection to survive. Typically, type 1 diabetes could occur at any age, however, type 1 diabetes are generally frequent among children and young adults. (Valentine, Alhawassi, Roberts, et at 2011).

On the other hand, type 2 diabetes is associated with hereditary factor or lifestyle risk factors. The life style factor leading to type 2 diabetes include insufficient physical activity, poor diet, obesity and overweight. Similar to Type 1 Diabetes, the use of insulin injection could control sugar level in the blood. However, type 2 diabetes is common among people 40 years and above, and the disease is becoming prevalent among younger age group.

Objective of this paper is to discuss the prevalence and the main cause of diabetes in Australia.

1. Outlinig the incidence / prevalence and main causes of Diabetes in Australia.

Diabetes Mellitus has been identified as one of the high prevalent of disease in Australia, and its impact could lead to morbidity and death. An estimated of 280 Australians develops diabetes per day, and the total number of 3.6 million Australia has been diagnosed of diabetes. By 2031, it is estimated that approximately 3.3 million Australian will develop diabetes. Between 2008 and 2009, the National Diabetes Register recorded approximately 9,308 new cases of type 1 diabetes among people aged between 0 and 14 and 13,756 among people aged 15 and above revealing that there is an incident of 6 new cases of diabetes per day. It is also estimated that more than 100,000 people are being diagnose of diabetes yearly. (Whiting, Guariguata, Weil, et al. 2011).

In South Australia alone, more than 600 people are diagnosed of diabetes each month. Typically, diabetes is one of the fastest growing chronic diseases in Australia, and its complication could lead to stroke, heart attack, kidney damage, and foot ulcer. However, type 2 diabetes is the most prevalent type of diabetes in Australia, and between 85 and 90% of people suffering from diabetes are with type 2 diabetes.( Minges, Zimmet, Magliano, et al. 2011).

The data presented by National Diabetes Services Scheme (2012) reveals that around 85% of registrants have type 2 diabetes while 12% have type 1 diabetes.

Diabetes Classification

Number of Registrants

Type 1

128,986

12.01%

Type 2 (insulin)

204,188

19.01%

Type 2 (non-insulin )

714,207

66.48%

GDM (Gestational Diabetes) (insulin)

6,541

0.61%

GDM (Gestational Diabetes) (non-insulin)

15,014

1.40%

Other Diabetes (insulin)

2,404

0.22%

Other Diabetes (non-insulin)

3,028

0.28%

Source: National Diabetes Services Scheme (2012)

Typically, there is no single cause of diabetes, while some cause could be changed, other could not be changed. Hereditary through family history is one the causes of diabetes in Australia. People who are over 45 years of age and one or two of the family member has diabetes have 2 or 6 times risk of developing type 2 diabetes. The risk of diabetes increases with age. People who are over 45 years of age and overweight also face the risk of developing diabetes. However, obesity is one of the major causes of diabetes and if it is possible to eliminate obesity from the Australian population, the Australia will reduce the incidence of type 2 diabetes by 38% in men and 47.4% in women. Obesity is the major risk factor associated with type 2 diabetes. Typically, people with obese body posses the three times risk factor of developing type 2 diabetes. Increase in waist-hip ratio, and waist circumference are the powerful factors leading to the prevalence of type 2 diabetes in Australia.

Typically, the rising in the number of people with type 2 diabetes in Australia is being driven by increase in the ageing population. Reduction in physical activity, and poor diet consumed are another major causes of type 2 diabetes in Australia. People who focus on eating food with energy dense and highly saturated fatty acid could face the risk of developing type 2 diabetes.

While the number of people with type 2 diabetes is higher than people with type 1 diabetes, there are still important similarities and differences in the disease process.

Similarities and Differences between Type 1 and Type 2 Diabetes

This section discusses the similarities and differences of type 1 and type 2 diabetes. One of the similarities of type 1 and type 2 diabetes is that both are characterized by a progressive ?-cell failure. Type 1 and type 2 diabetes are similar in the sense that both are genetic disease. There are genes in human body that could pass diabetes from parent to offspring. However, in type 2 diabetes, the environmental factors such as caloric intake and obesity could interact with genetic factor to increase the risk of type 2 diabetes. More importantly, both type 1 diabetes and type 2 diabetes depend on a certain amount of insulin produced by pancreas.

Moreover, both type 1 and type 2 diabetes could be compared based on their symptoms. Type 1 diabetes is caused by high blood glucose or sugar, whereas symptom of type 2 diabetes is the response of the body to high blood sugar. Patients of type 1 and type 2 diabetes may experience similar symptoms such as weight loss, increased urination, and thirst. More importantly, both type 1 and type 2 diabetes have similar complications. Both diseases could deliver a kidney disease, which may result in kidney abnormalities, and poorly managed kidney diseases could lead to the kidney failure in type 1 and type 2 diabetes. Both type 1 and type 2 diabetes may also lead to eye complication as well as disorder in the blood vessels.

Both type 1 and type 2 diabetes also have similar treatment. The treatment of both diseases is to control amount of glucose in the body by taking an exercise and balanced diet. Typically, the patients should follow a balanced diet, which include eating more vegetable and fruits. The patients should also eat food that contains low fat and calories.

Despite the similarities between type 1 and type 2, there are still differences between the two diseases. Patients with type 1 diabetes are insulin dependent. They need to take some dose of insulin daily to survive. On the other hand, patients with type 2 diabetes are not insulin dependent. Typically, the type 1 diabetes occurs when pancreases are not able to produce the insulin needed. Type 2 diabetes occurs when pancreases are unable to produce enough insulin or insulin is not working properly. Moreover, type 1 diabetes represent 15% of the all cases of diabetes while type 2 diabetes represent 85% of all cases of diabetes in Australia. Other important differences between type 1 and type 2 diabetes lie on the diagnosis, symptoms, and management. Table 1 presents overall differences between Type 1 and Type 2 Diabetes.

Table 1: Differences between Type 1 and Type 2 Diabetes

Type 1 diabetes are insulin dependent

Type 2 diabetes are non-insulin dependent

Occurs when the pancreas are unable to produces the insulin needed,

Represents between 10 and 15% of all cases of diabetes

Type 1 diabetes is one of the most common chronic childhood diseases in Australia;

Type 1 diabetes is not caused through lifestyle factors,

It is increasing at about 3% yearly.

Type 2 diabetes occurs when the patient's pancreas is not producing enough insulin or the insulin is not working properly,

Type 2 diabetes represents between 85 and 90% of all cases of diabetes,

Risk factors include ethnic background, family history and overweight -- especially around the waist,

Lifestyle factors such as unhealthy food. Insufficient or lack of physical activity can contribute to type 2 diabetes development.

Diagnosis

Diagnosis

The disease can occur at any age; however, it usually occurs among younger age group.

The disease usually occur in adults who are over the age of 45, however, it is increasingly common among younger age.

Symptoms

Symptoms

The symptoms of type 1 diabetes include excessive thirst, fatigue constant, urination, weakness unexplained weight loss, and, irritability.

In type 2 diabetes, symptoms may sometimes go unnoticed as the disease develops gradually. Symptoms may include skin infections, blurred vision, slow healing, numbness and tingling in the feet.

Management

Management

Management includes use of an insulin pump or lifelong daily insulin injections. There is also a need for regular blood glucose level tests, regular physical exercise and healthy eating.

Management includes healthy eating and regular physical activity. The lifestyle modification is critical to lower the level of glucose in the body. Management may also include regular taking of blood glucose-lowering tablets.

(Maple-Brown. Sinha. & Davis 2010).

Case Study

The case study below reveals the method the type 1 diabetes could alter pathophysiological condition of an individual, which consequently leads to the development of the chronic condition. Josh is a 9-year-old Australian-Aboriginal boy living with his parents, his grandmother (who is NIDDM) and two siblings. Over the last few months, Josh mother has noticed that Josh increasingly becoming unwell, and the boy has been constantly thirsty and often hungry. Moreover, Josh frequently passes urine as well as getting up to the toilet 2 or 3 times per night. Josh has also had episodes of abdominal pain. Josh's mother reports that the boy seems tire every time in the day.

"A BGL and urinalysis indicate BGL-20mmol/L and the U/A shows large glucose and 6 trace ketones+h8b. Insulin was administered in the ED and an IV cannula inserted. Josh has been admitted to hospital for stabilization and management of Diabetes." (Case Study, 2012).

Analysis of complication of the disease reveals that Josh has type 1 diabetes. Typically, all the symptoms manifested on Josh reveal that the boy has type 1 diabetes. The underling pathophysiological defect of type 1 diabetes is the destruction of pancreatic beta cells leading to the inability of body to produce insulin. Since the body is no longer able to produce insulin, a type 1 diabetic patient will depend on exogenously administered insulin to survive. The chronic condition associated with diabetes is that people with type 1 diabetes are susceptible to diabetic ketoacidosis because of inability of the body to produce insulin, which leads to accumulation of "ketones in body fluids, decreased pH, electrolyte loss and dehydration from excessive urination, and alterations in the bicarbonate buffer system result in diabetic ketoacidosis (DKA). Untreated DKA can result in coma or death." (Mealey, 2010 P. 5).

3. Type 2 diabetes is a chronic disease that develops complications in patients such as damage of kidneys, nerves, eye, blood vessels and heart. Type 2 diabetes could lead to pathophysiological changes with development of the chronic condition. Pathophysiological changes are the concept used to describe the functional changes that occur along the chronic disease. Typically, the body always needs to maintain internal equilibrium called homeostasis. However, a disease such as type 2 diabetes may disrupt normal physiology and anatomy of the body and a cellular damage could change normal functioning of the whole body. The underlying pathophysiological defect associated with type 2 diabetes involves:

resistance to insulin; increased of the production of glucose by the liver and, altered pancreatic secretion of insulin.

The chronic condition generally leads to the tissue resistance to insulin, which eventually lead to impaired insulin secretion. Insulin resistance prevents the proper use of insulin at the cellular level. Thus, an individual suffering from type 2 diabetes often produces excessive insulin resulting to (hyperinsulinemia), and over the year, there would be a decline in the insulin produced by pancreas below normal level leading to the disorder called syndrome X or "insulin resistance syndrome." Typically, severe physiologic stress may lead to ketoacidosis (DKA) in individual suffering from type 2 diabetes. Long period of severe hyperglycemia may lead to hyperosmolar nonketotic acidosis with excretion of urine that contain large amount of glucose leading to dehydration, acidosis and electrolyte imbalance. (Mealey, 2010).