Many people feel uncomfortable when it comes to the thought of needles. Imagine having to inject insulin up to four times a day. For people living with Type 1 Diabetes, this is a common way of life and does not prevent a normal lifestyle. This is also the reality of many living around the world today. Diabetes is increasingly becoming a common condition in the world with 125 million children and adults living with Type 1 Diabetes, and a total of 30 million people who live with any other forms of diabetes (“Type 1 Diabetes Facts”).
This paper seeks to explain the symptoms, treatments, and the long-term outlook for diabetic patients.Diabetes is a lifelong condition related to high levels of sugar-glucose in the blood. Insulin, a hormone which is formed by the pancreas helps in decreasing these levels in the blood. An inadequate amount of insulin or a failure of the human body to correctly use insulin causes diabetes. Primarily, there are two types of diabetes Type One Diabetes also called insulin-dependent or Juvenile Diabetes, and Type Two Diabetes (“Diabetes Type 1 and Type 2 definition and facts”).
In autoimmune diseases, like Type 1 Diabetes, the immune system falsely assembles antibodies and cells that are guided against and make damage to the patient’s tissues. In people with Type 1 Diabetes, the beta cells of the pancreas, are involved in insulin production and are attacked by the misled immune system (“Diabetes Type 1 and Type 2 definition and facts”).In Type 2 diabetes, the pancreas has the ability to produce insulin in adequate amount but the body cells have lost sensitivity to the insulin being produced. In a feedback mechanism, the pancreatic cells are triggered to produce increasingly more insulin as a response to the increasing blood sugar levels and at the end of the cycle, there is overwork and hence failure of the pancreatic cells with no positive response by the body cells. This type of diabetes was previously referred to as non-insulin-dependent diabetes as the patients do not have to inject themselves with insulin as is the case with type 1 diabetes (“American Diabetes Association”). It is also referred to as adult-onset diabetes as it is uncommon among people aged below 40 years. Muscle cells and the and cells in the adipose tissue are the most unresponsive to insulin and therefore overweight and obesity becomes a major risk factor for Type 2 diabetes Mellitus (“Diabetes Type 1 and Type 2 definition and facts”).
There are different symptoms that indicate the presence of Diabetes. Three of the most notable symptoms that are common for both types of diabetes are increased frequency of urination, increased feeling of hunger and thirst, weight loss, lethargy and feeling of generalized body weakness and slow deterioration of the hearing and sight. It is also common to witness decreased wound healing rate (“Diabetes Type 1”). There are also several long-term effects of uncontrolled diabetes including ketoacidosis, retinopathy and loss of kidney functions.Diabetic Ketoacidosis is a complication that mostly occurs in Type 1 Diabetes, and is rarely found in Type 2 Diabetes. Glucose is one of the body’s standard fuels. For glucose to act as a fuel, it must be transferred directly from the bloodstream into the cells where respiration takes place.
Insulin is a hormone that originates in the pancreas and helps in this transfer which then means that with no insulin or the cells failed response to the available insulin, the blood glucose levels will be significantly increased. Therefore, when there is not enough insulin most cells cannot use the glucose which is in the bloodstream. Because cells require energy to exist, they switch to a backup structure in order to acquire the energy needed. Fat cells start separating, developing compounds called ketones. Ketones maintain little energy in cells but also make the blood too acidic.
Diabetic Ketoacidosis is generally the first sign that people see when they have diabetes, which can happen for two central reasons- people stop taking their insulin and an illness happens and stresses the body. An illness usually increases the body’s requirement of vitality. However, when people become ill, they need more insulin to move the extra glucose produced into their cells. If people don’t take extra insulin when they are ill they might develop Ketoacidosis (“Diabetic Ketoacidosis”).Diabetic Neuropathy happens with patients with Type 1 and 2 Diabetes.
High glucose levels is toxic to the nerve endings. This means, therefore, that when there is increased level of sugars in the blood, there is damage to the nervous system around which blood passes during circulation (“Diabetes Complications”). The first common symptoms people experience is the feeling tingling especially in the extremities and sometimes adverse numbness. However, there are a couple of names associated with this complication. There is Peripheral Neuropathy- which affects the feet and legs and sometime the arms and hands.
Autonomic Neuropathy which is the Autonomic nervous system, and the least is Proximal Neuropathy with affects most patients with Type 2 Diabetes and complicates the hips, thighs and legs. Lastly, Focal Neuropathy affects certain Groups of Nerves (“Healthline”).The most significant diagnostic and screening test for diabetes Type 1 and Type 2 is the blood sugar test.
In normal healthy human beings, the blood sugar levels vary depending on the time of testing based on the duration between the test-time and the last meal. For the non-diabetic children and adults, the fasting blood sugars should range between 4.0 to 5.9 mmol/L. These levels can increase to up to 7.8 mmol/L when tested about 90 minutes after a meal.
For people with diabetes Type 1, and Type 2 the blood sugar levels during fasting is between 4.0 and 7.0 mmol/L and after a meal, the level can shoot to between 5 and 9 mmol/L for the Type 1 Diabetes and below 8.5mmol/L in Type 2 Diabetes (“Type 1 Diabetes Facts”).
Random blood sugar is the commonly applied test in clinical practice as it does not require any recall of the last meal take, random test results of below 11.1mmol/L (<200mg/dl) is within normal range and any reading above is indicative of probable diabetes mellitus ("Diabetes Type 1 and Type 2 definition and facts").One of the most common testing modalities for type 1 diabetes entails a Hemoglobin A1 test. In this test, the doctors test sugar sticks and how long they are around. In the body, sugar sticks too to the proteins.
The red blood cells circulate in the body or three months before they die off, and that when u have to visit your endocrinologist. When sugar sticks to these hemoglobin proteins in these cells, it is known as glycosylated hemoglobin or hemoglobin A1c. Measurement of HBA1c gives us an idea of how much sugar is present in the bloodstream for the preceding three months. In most doctors’ offices the normal range is 4%-5.
9. In poorly controlled diabetes, it’s 8% or above, and in well-controlled patients it is less than 7.0% (optional <6.5%).
The perks of measuring the A1C is that it gives a stable view on what’s happening over the course of time, and the value does not vary as much a finger stick blood sugar measurements . There is a direct correlation between A1c levels and average blood sugar levels (“Diabetes Type 1 and Type 2 Definition and facts”).Insulin injections are generally the first-line treatment for patients living with, patients with Type 1 and Type 2 diabetes. All types of insulin produce the same effect. However, the makeup of different types of insulin affects how fast or long they work to help mimic the natural increases and decreases in insulin throughout the body during the day. Rapid-acting insulin- this type of insulin begins work appropriately 15 minutes after injection. Its effects can last two to four hours.
It’s often used before a meal. Short-acting insulin you inject this insulin before a meal. It starts working 30 to 60 minutes after you inject it and last five to eight hours.
Also, intermediate-acting insulin starts working 30 minutes to an hour after injection and its effects last up to eight hours. Lastly, long-acting insulin which may not start working until two hours after you inject it.However, it can last up to twenty-four hours after you inject it.
“Nondiabetics do not have to worry about if they are producing insulin and their body is receiving the right amount of insulin throughout the day, however, if you are diabetic Continuous Glucose monitoring is a great track to take. A continuous Glucose monitor is a way to be able to monitor Blood sugar levels throughout the day and the nighttime, without having to do a finger-pricking as much. The machine works but having a small electrode which is called a glucose sensor inserted into the skin to measure the blood sugar levels. (“Medtronic Diabetes”)Insulin Pump treatment one of the most advanced ways to receive insulin works by having a small electronic device about the size of a smartphone that can be easily carried on a belt, inside a pocket, or attached to a bra so it is virtually not visible to others. This device is attached to your body via a thin tube called an infusion set. This makes insulin pump therapy very discreet. This therapy replaces the need for frequent injecting by rapid-acting insulin continuously 24 hours a day.
The Basal rate- this is a small amount of insulin that your insulin pump continuously gives you. Your pre-programmed rate is determined by your own body’s needs and programmed by a healthcare professional (Coghlan).Because the quantity provided by the pump can be more precise and the rates can be customized. An insulin pump can mimic a pancreas more closely. There is also a dose called a bolus dose also goes with pump therapy and additional insulin can be delivered on demand to match that food people are going to eat and delivers the insulin to correct a high blood sugar.
The insulin goes from the pump to your body. The pump has a compartment that has a reservoir that is filled with insulin. From the pump’s reservoir insulin travels along a thin tube and infused into your body through an infusion set which is inserted into the skin. The infusion set contains a small cannula which sits under the skin. The pump and tube can easily connect and disconnect to people’s bodies and can be useful in everyday life (“Insulin Pump Therapy”). The future outlook for diabetic patients is advancing and medical professionals are looking for a cure soon.Diabetes is currently ranked among the terminal illnesses that reduces the lifespan of most people and also increases the social and economic burden. However, it is also one of the conditions that can not only be prevented but also easily controlled.
Controlling the sugar levels and ensuring that the body cells have adequate glucose to perform the normal metabolism ensures that the diabetic patient does not develop complications and that they are able to live a normal life. One of the most significant observations related to diabetes is the easiness with which anyone can identify the indicator signs and symptoms (“International Journal of Pediatric Endocrinology”). However, adequate public health education should be provided to ensure that the public is aware of these signs, the predisposing factors and other details regarding the condition. This will help the patients to get adequate help in good time and hence assure effective control of the disease. The future of the management of diabetes has to focus directly on the patients with a motive to make their lives easier and more manageable. The insulin pump is one of the most recent developments towards this, and more strategic efforts should be made towards achieving a more comfortable life for the diabetic patients.