Diabetes an individual with Type 2 diabetes

 

Diabetes is a disease where the
body becomes unable to either produce or respond human insulin, causing
elevated blood glucose levels and difficulty in metabolising carbohydrates
(Oxford Dictionaries, English, 2018).

Diabetes Mellitus includes two
different versions of the disease, these are known as Type 1 and Type 2 diabetes.
Any individual will only ever have one of the two versions, however an individual
with Type 2 diabetes may develop Type 1 diabetes at another stage. Diabetes is
a disease which allows the predisposition to the disease to be passed hereditarily,
however the genes alone will not cause the disease an environmental factor is
requited to trigger it (American Diabetes Association, 2018).  This is relevant for both Type 1 and Type 2 diabetes,
with Type 2 having a stronger link to heritage. However, the development of Type
2 diabetes also has a link to obesity which is another trait that can be passed
on hereditarily. There is about a 6% chance of an individual obtaining the
disease if they have a direct blood linked family member who has Type 1 Diabetes,
if not then there is only a risk of just under 0.5% for the individual (NHS choices, 2014).

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Type 1 Diabetes is where the
pancreas stops producing insulin in high enough quantities to regulate blood
glucose levels. Due to this blood glucose can drop to dangerous levels causing hypoglycaemia,
blood glucose levels may also get too high if the disease is not treated
correctly causing hyperglycaemia. Whereas Type 2 Diabetes is where the body
does not respond to the insulin produces in an effective way, resulting in the uptake
of glucose from the blood to the body being reduced. If left untreated the body
will initially attempt to treat itself by increasing the amount of insulin
produced. (Diabetes co UK, Insulin, 2018).

Type 1 Diabetes is viewed as an
autoimmune condition due to the body’s immune system targeting and attacking
the insulin producing pancreatic cells due to mistaking them as harmful; this
will completely stop the production of insulin from the cells, if they had not been
destroyed completely (NHS choices, 2014). Type 2 Diabetes is caused due to
insulin resistance, where the body becomes unable to either produce a high
enough volume of insulin or use the insulin that is produced effectively. An individual
may be more susceptible to getting Type 2 diabetes if they are overweight or obese
(NHS choices, Causes, 2016).

Type 1 Diabetes

Type 2 Diabetes

Symptoms

Feeling thirsty

Feeling thirsty

Urinating more frequently – especially at night

Urinating more frequently – especially at night

Feeling very tired

Feeling very tired

Weight loss and loss of muscle bulk

Unexplained weight loss

Regular bouts of thrush, or itchiness around genital area

Regular bouts of thrush, or itchiness around genital area

Blurred vision

Blurred vision

Slow healing cuts/grazes

Slow healing cuts/grazes

Figure 1: Symptoms of Diabetes (NHS choices, Symptoms,
2016)

The symptoms of both Type 1 and
Type 2 diabetes are very similar to each other, as seen in Figure 1. At later
stages of Type 1 being undiagnosed there may also be symptoms which are more
severe such as vomiting or deep heavy breathing. If symptoms for Type 1 Diabetes
get to this stage, then the individual should be admitted to hospital. For Type
1 Diabetes the symptoms can be detected quite obviously and are able to be
detected over a short period of time, possibly a couple of weeks. Whereas with
Type 2 Diabetes the symptoms are less obvious and gradually develop; therefore,
may not be able to be detected by the individual, therefore an individual may have
Type 2 Diabetes as an underlying disease for years without knowing (NHS choices,
Symptoms, 2016).

The two different types of Diabetes
are treated in different ways, Type 1 requires insulin injections, whereas Type
2 generally does not and is managed with diet control and sometimes tablet
medication. Due to the severity of type 1 Diabetes blood glucose levels are
required to be tested before every meal to identify the amount of insulin that
needs to be injected in relation to both the blood glucose level indicated and
the quantity of carbohydrate and sugars to be consumed at the meal.

Insulin is a hormone produced by the
?-cells
of the islets of Langerhans in the pancreas of the human body (Anon, Insulin, 2018). It is a hormone that has a main
role in the regulation of blood glucose levels, without the presence of insulin
an individual will develop Diabetes. Insulin is important as it allows the
passage of glucose from the blood into the body’s cells where it is used as
fuel, also allowing the storage of glucose in the form of glycogen within
muscle and liver cells for use later (Diabetes co UK, Metabolism,
2018). For an individual suffering from either form of Diabetes Mellitus the
cells within their body’s will have problems taking up glucose, due to either lack
of insulin availability (Type 1) or insulin resistance (Type 2). Insulin resistance
is when the cells within the body stop responding to the signals given off by
the insulin being produced, causing blood glucose levels to rise as the glucose
in the blood will not be able to cross the membranes into the cells (Endocrineweb, 2018). The body will try to cope with
the problem of insulin resistance by producing larger amounts of insulin than what
is considered normal in healthy individuals; this is known as Hyperinsulinemia (Diabetes co UK, Hyperinsulinemia, 2018). Hyperinsulinemia
and insulin resistance of this type will most likely lead to Type 2 diabetes,
however in rare cases it may occur due to a tumour at the ?-cells
in the pancreas.

If the body is unable to absorb
and store glucose from the blood then the blood glucose levels will rise, this
is known as Hyperglycaemia. Once blood glucose levels get above 7.0 mmol/L
(when fasting) or 11.0 mmol/L (2 hours after meals) (World Health Organisation,
2006). If blood sugar levels exceed 7.0 mmol/L for an extended period, then
organs may begin to become damaged by the excess glucose levels; however, until
blood glucose levels reach >11.0 mmol/L symptoms of hyperglycaemia may not become
noticeable. Increased thirst, hunger, and urination are 3 main symptoms of Hyperglycaemia,
along with fatigue, weight loss, and blurred vision (Diabetes
co UK, Hyperglycaemia, 2018). High blood glucose levels can result in short
term complications such as Ketoacidosis; this can affect individuals with either
Type 1 or Type 2 Diabetes, most cases are however in those individuals with
Type 1 Diabetes. If blood glucose levels rise above 15.0 mmol/L then the
individual involved becomes at a higher risk of Ketoacidosis (Diabetes co UK, Ketoacidosis, 2018). Ketoacidosis is
a result of the body not having enough insulin to allow glucose to pass from
the blood into the cells it is required in, due to this lack of energy the
cells are forced to burn fatty acids, this produces acidic ketone bodies within
the cells, these are toxic and cause harm to the cells. Ketoacidosis generally starts
to produce symptoms once blood glucose levels have remained high for over 24
hours; symptoms that may occur are, vomiting, dehydration, unusual/sweet smelling
breath, hyperventilation, high pulse, dizziness/disorientation, and the most
serious of all being the individual passing out and going into a coma (Diabetes
co UK, Ketoacidosis, 2018).

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