DIABETES MELLITIS: TYPE 1 AND TYPE 2

Diabetes mellitus is a group of metabolic diseases characterized by elevated blood glucose levels (hyperglycemia) resulting from defects in insulin secretion, insulin action or both. Insulin is a hormone manufactured by the beta cells of the pancreas, which is required to utilize glucose from digested food as an energy source. Chronic hyperglycemia is associated with microvascular and macrovascular complications that can lead to visual impairment, blindness, kidney disease, nerve damage, amputations, heart disease, and stroke. In 1997 an estimated 4.5% of the US population had diabetes.

Direct and indirect health care expenses were estimated at $98 billion.1

The type of diabetes is based on the presumed etiology. This chapter provides information about the two most common types of diabetes: type 1 and type 2 diabetes (see Table 1).

TABLE 1

Characteristics of the Common Types of Diabetes

		Type 1	Type 2
	Age	Childhood	Pubertal
	Onset	Acute; severe	Mild-severe; often insidious
	Insulin secretion	Very low	Variable
	Insulin sensitivity	Normal	Decreased
	Insulin dependence	Permanent	Temporary; may occur later
	Racial/ethnic groups at increased risk	All (low in Asians)	African Americans, Hispanics, Native Americans, Asian/Pacific Islanders
	Genetics	Polygenic	Polygenic
	Proportion of those with diabetes	80%	10%-20%
	Association: obesity	No	Strong
	Acanthosis nigricans	No	Yes
	Autoimmune etiology	Yes	No

Source: Adapted from Orr, DP. Contemporary management of adolescents with diabetes mellitus. Part 1: Type 1 diabetes. Adolescent Health Update 2000;12(2), Table 2, p 3.

In type 1 diabetes, the body does not produce insulin, and daily insulin injections are required. Over 700,000 people in the United States have type 1 diabetes; this is 5-10% of all cases of diabetes mellitus. Type 1 diabetes is usually diagnosed during childhood or early adolescence and it affects about 1 in every 600 children.

Type 2 diabetes is the result of failure to produce sufficient insulin and insulin resistance. Elevated blood glucose levels are managed with reduced food intake, increased physical activity, and eventually oral medications or insulin. Type 2 diabetes is believed to affect more than 15 million adult Americans, 50% of whom are undiagnosed. It is typically diagnosed during adulthood. However with the increasing incidence of childhood obesity and concurrent insulin resistance, the number of children diagnosed with type 2 diabetes has also increased worldwide.2

For example, from 1982 to 1994 in one mid-western city, the proportion of children with type 2 diabetes increased from approximately 4% to 16%.3 This increase is greatest among individuals from certain ethnic/racial groups (African Americans, Native Americans, Hispanics and Asians/Pacific Islanders) and for those with a family history of type 2 diabetes.

Type 1 Diabetes

ETIOLOGY/CONTRIBUTING FACTORS

•         Caused by the immune destruction of the beta cells of the pancreas.

•         Antibodies to islet cells and insulin are present at diagnosis.

•         Insulin secretion gradually diminishes.

•         May present at any age, but most common in childhood and adolescence.

•         Insulin by injection is necessary for survival.

•         Contributing factors:

–        Genetic predisposition

–        Environmental triggers (infection or other stress)

Type 2 Diabetes

•         Caused by insulin resistance in the liver and skeletal muscle, increased glucose production in the liver, over production of free fatty acids by fat cells and relative insulin deficiency.

•         Insulin secretion decreases with gradual beta cell failure.

•         Reductions in blood glucose levels often can be achieved with changes in food intake and physical activity patterns. Oral medication and/or insulin injections are eventually required.

•         Contributing factors:

–        Obesity

–        Age (onset of puberty is associated with increased insulin resistance)

–        Lack of physical activity

–        Genetic predisposition

–        Racial/ethnic background (African American, Native American, Hispanic and Asian/Pacific Islander)

–        Conditions associated with insulin resistance, (e.g., polycystic ovary syndrome).

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Know About Diabetes and Secure Your Loved one

Diabetes is a chronic syndrome that happens either when the pancreas does not create enough insulin or when the body can't viably utilize the insulin it delivers. Insulin is a hormone that manages glucose. Hyperglycemia, or raised glucose, is a typical impact of uncontrolled diabetes and about whether prompts genuine harm to a hefty portion of the body's frameworks, particularly the nerves and veins.

347 million individuals worldwide have diabetes. In 2004, an expected 3.4 million individuals died on from outcomes of fasting high blood sugar. A comparable number of deaths have been evaluated for 2010. More than 80% of diabetes deaths happen in low- and center salary nations.

Type 1 diabetes

Type 1 diabetes (beforehand known as insulin-indigent, adolescent or youth onset) is portrayed by insufficient insulin creation and obliges every day organization of insulin. The reason for sort 1 diabetes is not known and it is not preventable with current learning.

Manifestations incorporate unnecessary discharge of pee (polyuria), thirst (polydipsia), steady appetite, weight reduction, vision changes and weakness. These side effects may happen all of a sudden.

Type 2 diabetes

Type 2 diabetes (some time ago called non-insulin-reliant or grown-up onset) results from the body's insufficient utilization of insulin. Sort 2 diabetes involves 90% of individuals with diabetes far and wide , and is to a great extent the consequence of overabundance body weight and physical idleness.

Indications may be like those of Type 1 diabetes, yet are regularly less checked. Accordingly, the illness may be diagnosed a few years after onset, once muddling’s have as of now emerged.

Up to this point, this sort of diabetes was seen just in grown-ups yet it is presently likewise happening in kids.

Gestational diabetes

Gestational diabetes is hyperglycemia with onset or first recognitionthroughout pregnancy.

Side effects of gestational diabetes are like Type 2 diabetes. Gestational diabetes is frequently diagnosed through pre-birth screening, instead of reported side effects.

How can the burden of diabetes be reduced?

Prevention

Simple lifestyle measures have been shown to be effective in preventing or delaying the onset of type 2 diabetes. To help prevent type 2 diabetes and its complications, people should:

·         achieve and maintain healthy body weight;

·         Be physically active – at least 30 minutes of regular, moderate-intensity activity on most days. More activity is required for weight control;

·         eat a healthy diet of between three and five servings of fruit and vegetables a day and reduce sugar and saturated fats intake;

·         Avoid tobacco use – smoking increases the risk of cardiovascular diseases.

Diagnosis andtreatment of Diabetes

How Reverse Your Diabetes Today

Diabetes can strike any person any time of life.

Almost everybody knew the name Blood Sugar. If someone’s glucose level increasing dramatically medical science call that Diabetes or blood sugar patent.

What happened if someone’s glucose label increased?

To answer that, you first need to understand the role of insulin in your body.

Insulin serves as a “key” to open your cells

When you eat, your body turns food into sugars, or glucose. At that point, your pancreas is supposed to release insulin.

Insulin serves as a “key” to open your cells, to allow the glucose to enter -- and allow you to use the glucose for energy.

But with diabetes or blood sugar, this system does not work.

Type of diabetes::

There commonly two type of diabetes we see diabetes type 1 and diabetes type 2. But it has also other types. These are such as gestational diabetes, which occurs during pregnancy, as well as other forms.

Description of diabetes type 1

With type 1 diabetes, the body’s immune system attacks part of its own pancreas. Scientists are not sure why. But the immune system mistakenly sees the insulin-producing cells in the pancreas as foreign, and destroys them. This attack is known as "autoimmune" disease.

These cells – called “islets” (pronounced EYE-lets) – are the ones that sense glucose in the blood and, in response, produce the necessary amount of insulin to normalize blood sugars.

Insulin serves as a “key” to open your cells, to allow the glucose to enter -- and allow you to use the glucose for energy.

Without insulin, there is no “key.”   So, the sugar stays -- and builds up-- in the blood. The result: the body’s cells starve from the lack of glucose.

And, if left untreated, the high level of “blood sugar” can damage eyes, kidneys, nerves, and the heart, and can also lead to coma and death.

Insulin Therapy

So, a person with type 1 treats the disease by taking insulin injections.

This outside source of insulin now serves as the “key” -- bringing glucose to the body’s cells.

The challenge with this treatment is that it’s often not possible to know precisely how much insulin to take. The amount is based on many factors, including:

• Food

• Exercise

• Stress

• Emotions and general health

Description of diabetes type 1

The most common form of diabetes is called type 2, or non-insulin dependent diabetes.

This is also called “adult onset” diabetes, since it typically develops after age 35. However, a growing number of younger people are now developing type 2 diabetes.

People with type 2 are able to produce some of their own insulin. Often, it’s not enough. And sometimes, the insulin will try to serve as the “key” to open the body’s cells, to allow the glucose to enter. But the key won’t work. The cells won’t open. This is called insulin resistance.

Often, type 2 is tied to people who are overweight, with a sedentary lifestyle.

Treatment focuses on diet and exercise. If blood sugar levels are still high, oral medications are used to help the body use its own insulin more efficiently. In some cases, insulin injections are necessary.

Taking insulin regularly is big problem for every person who suffers by blood sugar and their family members. If we take care of food, exercise etc. then we can reverse our blood sugar  label.

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