Diabetes

Diabetes - What is diabetes?

Overview

Diabetes mellitus is a multifactorial, systemic disease characterized by hyperglycemia (increase in blood sugar) and frequent hyperlipidemia. The symptoms are caused by a decrease in the secretion of insulin or a decrease in the effectiveness of the insulin. Diabetes mellitus is frequently associated with problems of the microvascular and macrovascular systems, neuropathic disorders, and dermopathic lesions.

The most common disturbance of carbohydrates metabolism is diabetes mellitus. It is characterized by a disorder in the metabolism of insulin and of carbohydrates, fat, and protein. It also involves a defect in the structure and function of blood vessels. The disease usually occurs when there is insufficient supply of insulin may be due to failure in body’s production, blockage of insulin supply, and autoimmune response wherein the insulin may bind to an immune serum globulin fraction, preventing utilization.

The cause of each type of diabetes mellitus is still unfolding, In relation to IDDM (insulin dependent diabetes mellitus), it seems that genetics have a permissive role that allow environmental factors to trigger an onset of diabetes by stimulating an autoimmune process. The increased awareness and understanding of the role of genetics, heredity, autoimmunity, and environmental factors in the cause of IDDM has allowed fore research, which is in progress, directed at halting the onset of IDDM in susceptible persons.

Other contributing factors to the cause of diabetes mellitus include deposits of amylin in the Beta cells. Amyloid deposits eventually result in destruction of all cells of the islets. Glucose toxicity may be another causal factor in Non Insulin Dependent Diabetes Mellitus (NIDDM). Several studies have indicated hyperglycemia to be toxic to Beta cells. Insulin resistance acts like a block in the uptake of glucose in the muscle and fat cells, increasing the glucose in the bloodstream, which increases the resistance to insulin and worsens hyperglycemia. Insulin resistance increases with obesity. However, weight loss is not the simple solution. There appear to be two separate defects or blocks in glucose uptake by the muscle and fat cells. One defect is inherited, and then if obesity occurs, resistance is acquired.

When skeletal muscle and fat muscle start to develop resistance to insulin, a vicious cycle begins. Compensation for this resistance begins, with the pancreas secreting more and more insulin to keep blood glucose levels within a normal range. Finally, the pancreas becomes exhausted and slows down or stops production of insulin. Other factors that increase insulin resistance include natural aging (there is a loss of muscle mass and increased fat), counter regulatory hormones (glucagons, epinephrine, cortisol, growth hormone), and certain medications such as glucocorticoids.

By its very nature, diabetes mellitus can be significantly influenced by the treatment components. These treatment components can be delivered only by self- care. No other disease demands so much of the patient’s own self-knowledge and skills. Thus, the professional nurse has the challenge and responsibility to help patients gain the knowledge, skills, and attitude necessary for self-management.

Epidemiology:

• It is the fourth leading cause of death by disease in the United States.

• It is a chronic disease that has no cure.

• More than half of patients with diabetes are unaware that they have the disease.

• Prevalence rate increase with age, with about half the cases in people older than 55.

• Incidence indicates the new cases of diabetes about 750,000 are diagnosed annually.

• Epidemiologic studies not only define the prevalence and incidence of diabetes, but also the incidence of complications and who is at risk for development of complications.