Diabetes Mellitus Is One of

Diabetes Mellitus is one of the most important and common chronic diseases found in humans. The disease has foundational consequences for the body and the mind and seriously affects society in general in both direct and indirect ways. Millions of people have diabetes mellitus and many more are likely to develop it as the years go by, risk factors increase in prevalence and as more people manage the disease and successfully have children.

Another reason why diabetes is important is because the majority of medical care that is provided for the disease is self administered and therefore at high risk of patient noncompliance. Diabetes is one of the most common of the chronic medical disorders and is expected to present one of the twenty-first century's biggest medical challenges. The number of people with diabetes is escalating both in the UK and world wide and type 2 diabetes in particular is increasing at an alarming rate.

& #8230;in diabetes, patients deliver over 95 per cent of their own care. (Clark, 2004, p. ix) Diabetes like many other chronic diseases will increasingly demand the attention of the medical community and the community at large as the disease grows in prevalence and incidence, in many ways due almost entirely too so called lifestyle choices that high risk individuals make that increase the odds of occurrence (the most important being overeating and obesity). (Silink, Kida & Rosenbloom, 2003, p.

2) Definition and Prevalence Diabetes Mellitus is a profound medical disorder that involves the reduction of or absence of the ability of specialized cells in the pancreas (islets of Langerhans) to produce insulin. Insulin is the main hormone responsible for the body's cellular ability to utilize and break down glucose, the sugar that fuels nearly all cells of the body. Lack of effective or available insulin then disallows glucose, the end result of nearly all the foods we eat to be taken from the blood stream and used as cellular fuel.

(Clark, 2004, p. ix) the limited cellular fuel use as well as the buildup of excess glucose in the blood stream both result in profound functional impairment and over a long-term can result in permanent physical degradation. In cases of profound absence of insulin even over the short-term, such as is the case when the pancreas simply stops producing insulin death can result, relatively rapidly.

The prevalence of Diabetes of three particular types type 1 (complete lack of insulin production) type 2 (lowered and ineffective use of insulin) and gestational diabetes (a form of type 2 diabetes that effects pregnant women) is significant and in fact the American Diabetes Association (ADA) estimates that nearly 8% (23.6. million diagnosed and an est. 57 million undiagnosed) of the U.S. population has one of these three forms.

(ADA Website, 2009, "Total Prevalence" http://www.diabetes.org/diabetes-statistics/prevalence.jsp) the ADA also estimates that the annual financial cost of diabetes to be an estimated $174 billion.

(ADA Website, 2009, "Diabetes Statistics" http://www.diabetes.org/diabetes-statistics.jsp) Signs and Symptoms Signs and symptoms of diabetes vary between types, while type 1 diabetes often appears in early to late childhood, sometimes rather suddenly, creating dizziness, vision disturbances, abnormal thinking, sluggishness, irritability, seizures, general weakness, extreme hunger or lack of appetite, reduced growth or rapid weight loss or gain, and even exhibit as a ketoacidotic coma, when the byproducts of glucose breakdown called ketones build up in the body and create a deadly catatonic state.

The rapid manner in which the glucose control is lost as the pancreas completely stops making insulin, is dangerous and can be deadly if untreated. While in type 2 diabetes the symptoms can occur on a more gradual basis as the pancreas slows down production of insulin and the cells become resistant to insulin uptake, therefore the process rarely results in ketone overload. The symptoms are similar but type 2 can be more insidious as it is more commonly undiagnosed and could possibly have been prevented with early intervention lifestyle changes.

Pain and reduced circulation in the extremities and/or long-term vision loss can also occur in type 2 as does permanent nerve damage in the eyes and extremities. Dependency on insulin is present in type 1 while in type 2 other pharmacological options and even simple lifestyle and diet changes can often suffice in the early stages of the disease, though many type 2 diabetics eventually become insulin dependant. (Clark, 2004, p.

4) Risk Factors Ethnic minorities such as black, Asian, Pacific Islanders and Hispanic populations are more commonly effected by type 2 diabetes and type 1 diabetes but there is an increase in the Caucasian population. People who get type 2 diabetes are frequently overweight or obese, sedentary and can have other chronic diseases and disorders (such as high blood pressure of cardiovascular disease) as a result of or in conjunction with diabetes. (Orth-Gomer, Chesney & Wenger, 1998, p. 4) Type 1 diabetes has a genetic connection that is not completely understood.

Health Assessment Strategies Health assessment strategies to identify diabetes include testing an individual for all of the risk factors, either through self report of medical data and taking single blood glucose tests. If blood glucose levels are above 100 and the individual has not recently eaten anything sweet it would then be recommended that a fasting blood glucose level be completed, where the individual goes without eating for 12 hours and then takes a glucose test.

Again if this test is above 100 a glucose tolerance test is done where an individual drinks a dose of glucose and is then tested every hour until a normal functioning individual would have processed the glucose (4 hours). Anyone at risk for diabetes should be screened at least once a year to make sure the disease has not become present in the individual.

Primary and Tertiary Non-Pharmacological Prevention Strategies Diabetes prevention often revolves around teaching young people about the importance of eating right and staying active as a means of primary prevention, though type 1.